“Nerve strain, or nerve exhaustion, comes largely from the frets, the griefs, the worries, the carks and cares of life. Yet although the imagination undoubtedly affects it, it is not a mere whim or imaginary disease, as all healthy women and physicians think; but it is the veriest of realities. When some flippant talker or some slipshod thinker scoffs at nervousness as a sham disorder, I say to him: ‘Can the bribe of a principality keep you from blushing when you are ashamed, or from blanching when you are afraid?’ Under the flitting sense of shame or of fear these vasomotor disturbances are momentarily beyond your control; and so they are in the nervous woman, whose vital organs are, as it were—not transiently but—perpetually blushing and blanching under deficient brain-control over the lower nerve centers. “Strangely enough, the most common symptoms of nerve disorder in women are the very ones which tradition and dogmatic empiricism attribute to womb disease. “They are, in the order of their frequency, great weariness and more or less of wakefulness and inability to walk any distance, a bearing-down feeling, headache, nape-ache and backache, scant, or _painful_, or delayed, or suppressed menstruation, cold feet, and irritable bladder, general spinal and pelvic soreness, and pain in one ovary, usually the left, or in both ovaries. The sense of exhaustion is a remarkable one; the woman is always tired, she passes the day tired, and she goes to bed tired, and she wakes up tired, often, indeed, more tired than when she fell asleep. She sighs a great deal, she has low spirits, and her arms and legs become numb so frequently that she fears palsy or paralysis. “There are many other symptoms of nerve strain, but since they are not so distinctly uterine, and, therefore, not so misleading, I shall not enumerate them. Now, let a nervous woman with some of the foregoing group of symptoms recount them to a female friend, and she will be told that she has womb disease. Let her consult a physician and ten to one he will think the same thing and diligently hunt for some uterine lesion. If one be found, no matter how trifling, he will attach to it undue importance, and treat it heroically as the offending organ. If no visible disease of the external organs be discoverable, he will lay the blame to the invisible endometrium, or on the unseeable ovaries, and continue the local treatment. In any event, whatever the inlook or the outlook, a local treatment is bound to be the issue.”