HYSTERIA may be confounded with neurasthenia, but both affections may exist simultaneously in some cases. The absence of crises, contractures, among other hysterical stigmata serves to elim inate the disease as the primary one.
Attention called to the various motor disturbances in neurasthenia that may be confounded with hysteria. Tremor, the most important, exists in two-thirds of al] cases, and is identical with that of exoplithalmie goitre. Other motor troubles exist, though less frequently: cramps, without apparent cause; muscu lar weakness; rhythmical spasms of the neck, tongue, and diaphragm, and con striction of the (esophagus Abasia may also be a symptom of neurasthenia, without any lrysterical signs. Pitres (La Sem. 111(2d., Oct. 5, '92).
Severe (grave) hysteria without stig mata is very conunon; again, hysterical neurasthenia is one of the commonest varieties of this disease, and includes a very large part of the cases that ordi narily go under the name of neuras thenia. The recognition of this is very
important because of the bearing which it has upon prognosis and treatment.
While hysterical neurasthenia may be called a pseudoneurasthenia-, it would be very wrong to view as hysteria all pseu doneurasthenie cases. As classification the following are suggested as different types of pseudoneurasthenia; 1. Habit neuroses, in which the symptoms mostly represent the persistence of manifesta tion of previous disease long since sub sided. 2. Neuroses from the pure auto suggestion; this would include certain types of phoboneuroses. 3. Intoxications, as from gout, urtnia, improper metab olism, etc. 4. Hysterical neurasthenia. Morton Prince (Boston Med. and Surg. Jour., Dec. 29, '9S).