There are many manifestations of neurasthenia, when the cause has been from the sexual; prominent among which is irritability, exhaustion, and sleeplessness following sexual congress; nervous headache with black line under both eyes the next day; creeping sensation and itching of the skin, without any abnormal appearance to cause it; formication, numbness of the hands and feet, flushed face, tenderness and pains that are transitory: all without any detection of organic disease; not but what such symptoms exist in organic disease, but they are more permanent, when they do exist, and can be associated with some assurance. I have had my mind on the point of naming and searching for numerous organic and spinal and cerebral affections, when the patient would multiply antagonistic symptoms so rapidly that I have often concluded that my patient had a new and serious combination of lesions. Organic disease generally has a set of signs and phenomena entirely in accordance with structures involved; but neurasthenic symptoms are most commonly such as are antagonistic to any two forms of neurosis. A greater variety of symptoms exists in neurasthenia than any organic disease. Symptoms of one organic disease are common one day, and of another the next day; and though the two organic manifestations were wholly different, the patient on the third day will perceive them all combined and aggravated. Not all cases of neurasthenia can be attributed to the genital organs. In my experience cases, arising from sexual irritation and other causes, are very evenly divided. I have often been convinced of genital irritation being caused from neurasthenia; but as I have intended the more to discuss sexual neurasthenia, in Neurasthenia from Genital Irritation, I shall be compelled to leave the subject with only having mentioned its bearing on sexual irritation as a cause. Neurasthenia does not differ, when of a genital origin, from the same disease of other origin; only that the genital irritation antedates the neurasthenia. It has been said that neurasthenia usually confines itself to the nervous diathesis. If we only had a definite condition, known as the nervous diathesis, that could be relied on, much would be gained. Some of the most troublesome cases of neurasthenia have appeared in persons whom no one would point out as possessing a nervous diathesis. Beard says, “Among the chief signs of a nervous diathesis are fine, soft skin, fine hair, delicately cut features and tapering extremities.” These are often marked features in nervous women, but neurasthenia has existed in persons coarse, dark, thick-skinned, clump-fingered, and very uncomely in shape; often large and fleshy. In attempting to show the relation of neurasthenia to the genitals in both male and female, it will lend information to relate a few cases: