_Sexual Neurasthenia._――Another and more general aspect of the results of the sexual mismanagement will be studied under the above heading. The general weakness, nervousness, general debility, general nervous exhaustion, proceeding from sexual excesses, will be considered from another stand-point than those, subsequently, which are considered and named, more from the more attractive phenomena, than from an understanding of their pathological anatomy. A generalization of signs, symptoms, and conditions of sexual weakness, covers a multitude of manifestations found under other names, but calculated more especially to assist in the study of a weakness not depending upon observable organic disease. Sexual neurasthenia differs from neurasthenia of other origin, in that the former is always coupled with weakness of the genital organs, which is not necessarily the case in neurasthenia of mental origin. Again, the genital weakness is always traceable to sexual excesses or juvenile pollution. The most troublesome form of neurasthenia is the sexual. There are but few symptoms in common with neurasthenia from any cause that do not appear in this variety. The diagnosis, or line of demarkation between sexual neurasthenia and the variety of actual organic diseases, is not always well defined. It undoubtedly forms a stage beyond which is structural disease of sexual excess, or the cause is perpetuated. I cannot admit that true impotence and spermatorrhœa are concomitants of neurasthenia, as they are phenomena of structural changes; but a threatened condition may exist. In this, I believe, I am at variance with some modern writers high in authority. For the most satisfactory description of this disease, and the application of the term, neurasthenia, the profession is indebted to Geo. M. Beard, who has given the subject a most thorough review in periodicals and in Beard and Rockwell’s _Medical and Surgical Electricity_. In 1869, Beard published an article in the _Boston Medical and Surgical Journal_, giving illustrations of thirty cases treated principally by electricity; and again, with a better understanding of the cerebral and spinal forms, he presented a paper before the _New York Neurological Society_, in 1877, which was published in the _New York Medical Journal_. Other papers, by the same author, have appeared, which evince a careful study of nervous weakness. Erb has given also a very excellent treatise in vol. XIII of Ziemssen’s “Cyclopœdia.” Authors have not, thus far, given due credit to the sexual organs as a cause of neurasthenia. Erb treats of the disease in a confused manner, in portions of his treatise, compared to his clearness on other subjects, evincing more book theories than facts from clinical observation. In generalizing he is clear, but in classifying, he is not particular enough in pointing out the different signs of neurasthenia originating from the brain, from that form belonging to the spinal cord.