ABSTRACT
The muscular weakness observed in neurasthenics is evidently a primary symptom—one that is characteristic of fatigue—while the tremor and muscular twitching and then observed are to be regarded as adventitious or secondary symptoms; i.e., they are indirect outgrowths of the fatigue. In addition to the muscular and tendon phenomena presented, the patient complains of various abnormal sensations. These range from vague generalized feelings, often incapable of description, to others which are definite in character and localized in certain portions of the body. Usually the complaint will be merely of a general feeling of fatigue or of a sense of more or less marked exhaustion. The generalized sense of fatigue is to be regarded as a primary or essential symptom, while the lightness of the head, the various constricting sensations, and the giddiness, are to be looked upon as secondary or adventitious phenomena—not in themselves essential constituents of neurasthenia, and not always present.
