Neurasthenic Nation: America’s Search for Health, Happiness, and Comfort, 1869–1920 by David G. Schuster (review)

Neurasthenia was once thought to be America’s “most precious pathological possession,” a disease so singularly indicative and productive of national character that at least one observer labeled it “Americanitis.” Over the course of the late- nineteenth and early-twentieth centuries, this unassuming nervous illness approached the improbable proportions of a vogue, and, as Tom Lutz has argued, it became one of that era’s richest nodes of intersecting discourses. The last several decades have seen researchers from a variety of disciplines working to more thoroughly illuminate those intersections, and Schuster’s Neurasthenic Nation is a welcome addition to this growing body of scholarship.

Between the covers of a compact and eminently readable volume, Schuster neatly distills much of his predecessors’ work while seeking to locate neurasthenia within the context of “America’s search for health, happiness and comfort”—a struggle which he sees as part of a broader effort to understand “how Americans developed a sense of what it means to be a ‘normal’ person” (xi). As Schuster’s quotation marks here would seem to suggest, notions of normality require careful qualification, and some readers may initially quibble with the author’s failure to more fully follow through on this mandate. This omission does, admittedly, make it harder to accept some of the book’s foundational premises, such as the claim that, before the advent of neurasthenia, things like “depression” and “pain” had been considered “unfortunate but entirely normal aspects of life” (1), or the suggestion that neurasthenia “establish[ed] happiness and comfort as the norm of good health” (2). While there is no doubt that the symptoms of depression and pain have long been regular features of human existence, it is not clear in what sense they were ever considered “normal” (humoral theory, for instance, which dominated medical thought for most of the last two millennia, considered such things to be entirely abnormal, the product of what was imagined to be a literal “imbalance” of elemental bodily substances). It similarly remains unclear how neurasthenia might be responsible for establishing happiness and comfort as the hygienic norm, especially for Americans, whose nation’s founding documents enshrine happiness—or at least the pursuit of it—as the healthy aim of all democratic individuals.

These reservations certainly complicate but may not ultimately compromise what seems, after all, to be this study’s signal virtue: its commitment to investigating the shadows of neurasthenic history and finding in the unlikeliest corners evidence of the disease’s astonishing reach and pervasiveness. For Schuster, neurasthenia was never an isolated or narrowly medical issue, but, almost from the moment it emerged, a phenomenon deeply imbricated in matters of national importance. In his opening chapter, Schuster rehearses the circumstances of neurasthenia’s advent with brief biographies of the medical figures most responsible for shepherding the disease into national consciousness: E.H. Van Deusen, George Beard, and S. Weir Mitchell. Following the work of scholars like Bonnie Ellen Blustein, Schuster wishes to understand neurasthenia as central to the disciplinary skirmishes between established alienists (like Van Deusen) and up-and-coming neurologists (like Beard and Mitchell). At stake in this contest was the very future of American psychiatry, and Schuster shows how neurasthenia effectively presided over the shift from asylum-based theories and therapies, to those which were more firmly rooted in scientific research (and which would ultimately usher in the reign of psyche over soma in the twentieth century).

At the center of the book lie three chapters which further illuminate neurasthenia’s complicity in phenomena which range from debates over Christian Science to the genesis of the Arts and Crafts Movement in America. Chapter 3, for example, suggests that neurasthenia played a pivotal role in helping Americans negotiate tensions between faith and science that, in the late nineteenth and early twentieth centuries, often saw physicians pitted against advocates of spiritual therapies, with neurasthenics “caught in the...