The diversity of the theories of aetiology is also reflected in the treatments of neurasthenia, which have included the following.

• Somatic: surgery, hydrotherapy, application of electric currents, tonics.

• Drugs: arsenic, ergot, phosphorus, strychnine, calomel, digitalis, narcotics.

• General measures: rest, exercise, diet, change in climate.

• Psychological: 'heart-to-heart' talk, autosuggestion, emotional re-education, hypnosis, faith healing, exhortation, psychoanalysis. Spread to other countries

One of the most fascinating aspects of the history of neurasthenia is its ready acceptance by countries other than the United States where it was originally conceived as a peculiarly American phenomenon. The diagnostic entity took firmer root in some countries than in others. In many countries the concept was indiginized and took on local cultural colours.

The reasons for its spread can be summarized as follows.

• The all-embracing nature of the entity provided a foothold for almost everyone involved.

• The concept provided a blend of scientific theory, thus lending legitimacy to a cluster of symptoms which are mostly subjective.

• It is considered to be a disease resulting from overwork which affects the upper social class.

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