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Weiss examines some of the recent literature on the subject of neurocirculatory asthenia. He points to Cohen and his associates who stress the inability to differentiate the syndrome from anxiety neurosis and who favor the pathophysiological
designation. He quotes Margolin who also demonstrates that the syndromes are not clearly differentiated, and that the internist calls it neurocirculatory asthenia while the psychiatrist calls it anxiety neurosis. Miles and Cobb see the two designations as opposites in a continuum, and oppose the conceptualization of the disease inherent in the present efforts to list a set of symptoms and give it a label. Weiss argues against Cohen's attempt to make psychological deductions from a study of physiological data, and against Cohen's effort to deny the importance of psychological studies in the disease. The arguments are 1, the symptoms of neurocirculatory asthenia are those of psychoneurosis; 2, family history shows a high incidence of psychopathology; 3, a neurotic personality structure is discovered in longitudinal studies; 4, emotionally disturbing events precipitate the onset of the symptoms and these are specific for the personality structure involved; 5, meaningful behavior follows discussion of material with these patients; 6, dealing with the material has psychotherapeutic value. Weiss feels that the physiological names for the illness imply a disease of a part rather than of the whole; that it makes for an artificial label, closing the door to further investigation and understanding; that it becomes an epithet which condemns the patient and gives the physician an erroneous sense of understanding the illness. He suggests that the proper psychiatric designation be used for the syndrome.