Spermatorrhea furnishes many examples of the local form of neurasthenia, or exhaustion, the sexual centres being primarily affected. In these cases, however, sooner or later, the whole nervous system becomes Involved. So in other forms of the disorder, the exhaustion at first local, finally, if neglected, implicates the whole organism. Often, in brain exhaustion, the symptoms are at first purely local. Almost always the cause of a local neurasthenia, or exhaustion, is excessive use of the part. Thus, cerebral or brain exhaustion, or debility, is usually the result of mental overwork, while sexual asthenia, or weakness is generally due to abuse of the sexual organs or to sexual excesses. When to the brain fatigue, or exhaustion, are added the depressing effects of excessive anxiety, or allied emotions, the symptoms from the first are more general, and the exhaustion may effect chiefly a single function of the brain. In pure brain exhaustion, the loss of a disposition to work, is usually the first symptom, the sufferer finding that it constantly requires a more and more painful effort of the will to perform the allotted task. At first, there is loss of the power of fixing the attention, and this, by and by, is accompanied by a weakness of the memory; disturbances of sleep are frequent; various abnormal sensations in the head are complained of. In most cases there is not absolute headache, but a feeling of weight or fullness, or an indescribable distress, usually aggravated by mental effort. It is true that in some cases of very dangerous brain tire, mental labor is performed with extraordinary vigor and ease; the power of work, is, for the time, markedly increased, and even the quality of the product may be raised. The patient may glory in a wild intellectual exaltation, a sense of mental power, with an almost uncontrollable brain activity. It is probable, however, that these cases are not instances of pure neurasthenia, or brain exhaustion, but that there is active congestion of the gray matter of the brain. In these cases the disease is very prone to end in serious organic affection of the brain.
Severe brain exhaustion may be associated with good spirits, but usually there is marked depression, and this perversion of function generally goes on, if the disease be not checked, to decided melancholy. The will power, like all the other functional activities of the brain, is prone to be weakened, morbid fears may finally develop, and at last, that which was at the beginning a single brain exhaustion, may end in persistent hypochondria, followed by insanity.
Peculiar sensations are common in neurasthenia, such as chilliness, unnatural itching, a feeling as though ants or other insects were crawling on the skin. Eruptions are common. Attacks of neuralgia are often frequent and sometimes severe, being usually worse in those persons of nervous ancestry. In some cases there is a lack of proper sensation, in others an unnatural sensitiveness. There is also in many cases a peculiar tenderness over some portion of the spinal column, especially in women.
In women, with nervous disturbance of the sexual organs, there is frequently great pain felt during menstruation; in others, ovarian irritation and a so-called "irritable," or sensitive uterus, giving rise to manifold nervous and hysterical symptoms, sometimes culminating in convulsions or "fits." In not a small proportion of the uterine diseases which are generally only locally treated by physicians, the local disease is largely and sometimes solely the expression of a general weakness of nervous origin.
SELF-ABUSE AND EXCESSES.
It is well known that Onanism, or masturbation, as well as sexual excesses, produce an exhaustion of the nerve centres presiding over the sexual functions. This is the common history of spermatorrhea or loss of the virile fluid by nightly emissions, accompanied by lascivious dreams.
General Neurasthenia, or nervous exhaustion, may also produce a local weakness of the sexual centres of the brain and spinal cord, with symptoms at least resembling those of partial impotency and great irritability of the sexual organs, or a complete impotence, with premature seminal discharge whenever coition is attempted. Many times this condition results from excessive intellectual labor, even with no sexual excesses or abuses. Nocturnal, or nightly emissions, are not always experienced in these cases. When they do occur, the debilitating losses of vital fluid react upon the brain, robbing the victim of courage and manliness and exciting various phases of morbid fear and sensitiveness.
Many cases of nervous debility, or exhaustion, are the result of long continued malarial poisoning, diarrhea, Bright's disease, exhausting fevers or other debilitating affections. Numerous are the cases in which the patient is able to trace the origin of the malady back to an attack of influenza, or grip. An epidemic of the latter disease is sure to be followed by numerous cases of nervous prostration, or exhaustion.