E. is a man at present thirty years of age. In person he is of average height, rather slender, with delicate features, somewhat bald, quick in action and speech. He flushes easily and thus often has high color, especially when fatigued or excited. This "vasomotor irritability," as the physicians call it, is quite common in this group of people, and in fact in all neurasthenia, whether acquired or congenital. Though I have described E. as belonging to the slender type of person, it is necessary to say that stout, rugged-looking people are often irritable and hypokinetic. As a child E. "never could stand excitement or strain," as his mother says. What is meant is this: that he became overexcited under almost any circumstances and became profoundly fatigued afterwards. As we have seen, the intense diffusion of excitement throughout the whole body is a sign of the childish and inferior organism; as maturity approaches and throughout childhood excitability decreases and is better localized. When a noise is heard an infant jumps, and so do people like E., but the better controlled merely turn their head and eyes to see what the source of the noise may be. This lack of control of excitement extended in E.'s case to play, entertainment, novelty of any kind, crowds and especially to the disagreeable excitement of quarrels, fights, terrifying experiences, etc. Under anger he trembled, grew pale, and his shouts and screams were beyond control; under fear he became actually sick, vomited and showed a liability to syncope of an alarming kind. E. was not the selfish type of the neurasthenic; he was gentle and kind and ready to share with everybody, a lovable boy of an intensely sociable nature. Nevertheless, his high excitability and his quick fatigue made it necessary to shelter him, for any effort at toughening merely brought about a "breakdown." Here we must reemphasize the fundamental importance of the fatigue reactions. The normal fatigue reaction is to feel weary, to desire rest and to be able to rest and sleep. The abnormal reaction, one directly opposed to the well-being of the individual, is to feel exhausted, to become restless and to find it difficult to sleep. There are children who thrive on excitement and exertion; they sleep sounder for it, they recuperate readily and gain in strength and endurance with every ordinary burden put upon them. There are others to whom anything but the least excitement and exertion acts as a poison, making them restless and exhausted. Not all children who show this perverse fatigue reaction grow up with it. It may be only a temporary phase of their lives, but while it lasts it is very troublesome.