Abstract
In December 1942 I presented for the opening meeting of the American Psychosomatic Society a preliminary report on A Mechanism of Fatigue in Neuropsychiatric Patients.1Subsequently, Alexander and I2reported a psychosomatic study of hypoglycemic fatigue. This latter communication and the preliminary report were confined to describing a well defined group of psychoneurotic patients with an associated peculiarity of carbohydrate metabolism, manifested by flattening of the intravenous dextrose tolerance curve, as in hypoglycemia. The psychologic condition can be described best as an asthenic syndrome, the outstanding features being apathy, loss of zest, a general let-down feeling of aimlessness and revulsion against the routine of everyday life, be it occupational or household duties. Seldom is this apathy connected with anxiety or a pronounced depression. Another constant feature is fatigue, chronic or appearing in acute attacks. The fatigue has certain fairly constant features. It is present as a rule on
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