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This summary of a lecture delivered at the Institute of Medical Psychology states that neurasthenia is an obsolete term obscuring the nature of the conditions it is intended to describe. It should be discarded, but if it is not, the word should be used as an equivalent merely of 'abnormal subjective fatigability without obvious organic cause'. So-called neurasthenic symptoms are reducible to the effects of long-continued unconscious fear via the sympathetic system and its physiological connections, if indeed they have other than a subjective existence. These reactions are capable of being unmasked by severe frights such as occur in accidents. (Traumatic neurasthenia.) Cases occur where infective foci have produced a clinical picture of exhaustion similar to that of the psychoneuroses and the physiological mechanism of the symptom production is presumably the same as in purely psychogenic or mixed cases.
The Freudian point of view is criticized as being a curious compromise between Beard's original view and Freud's own psychopathology of the libido. The physioneurosis or actual neurosis has, according to Freud, no psychopathology, and hence is not amenable to psychotherapy. The author thinks that there is nothing in the Freudian view to disturb the psychogenic theory of abnormal fatigability which he advocates.