It is necessary first of all to rule out physical disease.  To do this means a thorough physical study.  By doing this a considerable number of women will be immensely helped.  Flat feet, varicose veins, injuries to the organs of generation, eye strain, relaxed gastro-intestinal tract, and the major diseases,—­these must be remembered as factors that may determine nervousness.

With this question settled, let us assume that there is no such difficulty or it has been remedied, and we have next to consider the life situation of the patient.  Here we enter into a difficult place, where knowledge of life and understanding of men and women, as well as tact, are the essentials.

It is necessary to remedy whatever bad hygienic habits exist.  A rich woman may have settled down to a deenergizing life, with too much time in bed, too many matinees, too many late nights, too many bonbons, etc.  Aside from the psychical injuries that such a life produces, it is bad for “the nerves” in its effects upon digestion, bodily tone, and the sources of mood.  On some simple detail of life, some unfortunate habit, the whole structure of misery may rest.

I always keep in mind an incident of some years ago when I lived in a small town in Massachusetts.  For some reason our furnace threw coal gas into the house in such a way as nearly to poison us.  The landlord sent several plumbers down, and one after the other suggested drastic remedies,—­a new chimney, a new furnace, etc.  Finally the landlord and I investigated for ourselves.  At the bottom of the chimney we found an inconspicuous loose brick which allowed air to enter the chimney beneath the entrance of the pipe from the stove.  We got ten cents’ worth of lime and fastened the brick in firmly.  A complete cure, where the specialists had failed.

So there often exists some drain on the energy and strength of the woman which may be simple and easily changed, and yet is critical in its significance and importance.

An overdomestic woman may stick too closely to the house; an underdomestic one may go too often to movies and suffer the fatigue of mind and body that comes from over-indulgence in this most popular indoor sport.  Carelessness about the eating and the care of the bowel functions may have started a vicious chain of things leading through irritability and fatigue into neurasthenia.  We say human beings are all the same, but the range of individual susceptibility to trouble is such that a difficulty not important to most people will raise havoc with others who are in most ways perfectly normal.

Look then for the bad hygiene!  Look for the evils of the sedentary life Look for the root of the trouble in lack of exercise, poor habits of eating, insufficient air, disturbed sleep!  Search for physical difficulties before inquiring into the psychical life.