For quite some time now, neurasthenia has been understood as a "nervous" disorder with a well-marked historical career. Introduced in a Boston Medical and Surgical Journal article by George Beard in 1869, within a decade neurasthenia had become a frequently identified and expansively defined American functional neurosis. In the 1880s, after Beard published A Practical Treatise on Nervous Exhaustion (Neurasthenia) and saw it translated quickly into German, the clinical syndrome also became popular in Europe. At first, neurasthenia seemed to be diagnosed most frequently among men of the professional and upper classes but it was soon identified in women and the working classes as well. Understood initially as a definitively physical condition-"neurasthenia" meant literally exhaustion due to depletion of nerve energy-by the turn of the twentieth century it was increasingly regarded as of psychological rather than somatic origin and best treated by varieties of psychotherapeutic intervention.
In the 1900s and 1910s, neurasthenia as a disease entity was widely criticized in medical circles for its diffuseness and imprecision, and by the 1920s, the diagnosis had fallen into disfavor. It survives today in odd ways in China (where it was introduced in the 1920s) and in some pockets of Western medicine, and many believe that it has reappeared in recent years in the form of chronic fatigue syndrome and myalgic encephalomyelitis.
Over the past few decades, several important studies have deepened our understanding of neurasthenia's historical trajectory. Contributions by Sicherman (1977), Gosling (1987), Wessely (1990), andLutz (1991) are particularly noteworthy. But Cultures of Neurasthenia: From Beard to the First World War is the first book to explore comparatively the relationship between neurasthenia and society in England, Germany, and the Netherlands-with attention also to developments in the United States and France-in the last decades of the nineteenth century and the first of the twentieth. The chapters are derived from papers presented by American, Australian, English, German, and Dutch scholars at a workshop held in Amsterdam in 2000. Collectively, they attempt to look systematically at neurasthenia in different national settings and to employ varying perspectives-of contemporary physicians, patients, and the general public. The volume is introduced by two essays, the late Roy Porter's context-setting "Nervousness, Eighteenth and Nineteenth Century Style" and Marijke Gijswijt-Hofstra's overview "Cultures of Neurasthenia from Beard to the First World War." Porter and Gijswijt-Hofstra also served as the volume's editors.
What is the yield? Briefly put, a rich new set of insights. Despite the unevenness and occasional excessive overlap between chapters, as a whole this volume succeeds in considerably deepening our understanding of neurasthenia's complex and nuanced history. We learn, for example, that neurasthenia seemed most popular in Germany, where by the turn of the twentieth century the diagnosis was widely applied to working-class patients and tied to notions of social degeneracy. This was a change connected with German public health and emerging eugenics and in contrast to the 1880s acceptance of Beard's original ideas regarding the social location and physiological etiology of neurasthenia. In France, too,