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HYSTERIA
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HYSTERIA , a See also:term applied to an See also:affection which may See also:manifest itself by a variety of symptoms, and which depends upon a disordered See also:condition of the highest See also:nervous centres. It is characterized by psychical peculiarities, while in addition there is often derangement of the functions subserved by the See also:lower cerebral and See also:spinal centres. Histological examination of the nervous See also:system has failed to disclose associated structural alterations.
By the ancients and by See also:modern physicians down to the See also:time of See also:Sydenham the symptoms of hysteria were supposed to be directly due to disturbances of the uterus (Gr. uorEpa, whence the name). This view is now universally recognized to be erroneous. The term " functional " is often used by See also:English neurologists as synonymous with hysterical, a nomenclature which is tentatively advantageous since it is at least non-committal. P. J. MBbius has defined hysteria as " a See also:state in which ideas See also:control the See also:body and produce morbid changes in its functions." P. See also:Janet, who has done much to popularize the psychical originof the affection, holds that there is " a See also:limitation of the See also: Hence the readiness with which the impulse of the moment is obeyed, the loss of emotional control and the increased susceptibility to See also:external See also:suggestion, which are so characteristic. A secondary subconscious See also:mental state is engendered by the relegation of less prominent impressions to a lower See also:sphere: The dual See also:personality which is typically exemplified in See also:somnambulism and in the hypnotic state is thus induced. The explanation of hysterical symptoms which are See also:independent of the will, and of the existence of which the individual may be unaware, is to be found in a relative preponderance of this secondary subconscious state as compared with the See also:primary conscious personality. An elaboration of this theory affords an explanation of hysterical symptoms dependent upon a " fixed See also:idea." The following See also:definition of hysteria has recently been advanced by J. F. F. Babinski: " Hysteria is a psychical condition manifesting itself principally by signs that may be termed primary, and in an See also:accessory sense others that we may See also:call secondary. The characteristic of the primary signs is that they may be exactly reproduced in certain subjects by suggestion and dispelled by persuasion. The characteristic of the secondary signs is that they are closely related to the primary phenomena." The causes of hysteria may be divided into (a) the predisposing, such as hereditary predisposition to nervous disease, See also:sex, See also:age and See also:national See also:idiosyncrasy; and (b) the immediate, such as mental and See also:physical exhaustion, fright and other emotional influences, pregnancy, the puerperal condition, diseases of the uterus and its appendages, and the depressing See also:influence of injury or See also:general disease. Perhaps, taken over all, hereditary pre-disposition to See also:nerve-instability may be asserted as the most prolific cause. There is frequently See also:direct See also:inheritance, and cases of See also:epilepsy and See also:insanity or other See also:form of nervous disease are rarely wanting when the See also:family See also:history is carefully enquired into. As regards age, the condition is See also:apt. to appear at the See also:evolution periods of See also:life—See also:puberty, pregnancy and the See also:climacteric —without any further assignable cause except that first spoken of. It is rare in See also:young See also:children, but very frequent in girls between the ages of fifteen and twenty-five, while it sometimes manifests itself in See also:women at the menopause. It is much more See also:common in the See also:female than in the male—in the proportion of 20 to 1. Certain races are more liable to the disease than others; thus the Latin races are much more prone to hysteria than are those who come of a See also:Teutonic stock, and in more aggravated and complex forms. In See also:England it has been asserted that an undue proportion of cases occur among See also:Jews. Occupation, or be it rather said want of occupation, ;s a prolific cause. This is noticeable more especially in the higher classes of society. An hysterical attack may occur as an immediate sequel to an epileptic See also:fit. If the patient suffers only from See also:petit mal (see EPILEPSY), unaccompanied by true epileptic fits, the significance of the hysterical seizure, which is really a See also:post-epileptic phenomenon, may remain unrecognized. It is convenient to See also:group the very varied symptoms of hysteria into paroxysmal and chronic. The popular term " hysterics " is applied to an See also:explosion of emotionalism, generally the result of mental excitement, on which convulsive fits may supervene. The characters of these vary, and may closely resemble epilepsy. The hysterical fit is generally preceded by an See also:aura or warning. This sometimes takes the form of a sensation as of a lump in the See also:throat (globus hystericus). The patient may fall, but very rarely is injured in so doing. The eyes are often tightly closed, the body and limbs become rigid, and the back may become so arched that the patient rests on her heels and See also:head (opisthotonos). This See also:stage is usually followed by violent struggling movements. There is no loss of consciousness. The attack may last for See also:half-an-See also:hour or even longer. Hysterical fits in their fully-See also:developed form are rarely seen in England, though common in See also:France. In the chronic condition we find an extraordinary complexity of symptoms, both physical and mental. The physical symptoms are extremely diverse. There may be a See also:paralysis of one or more limbs associated with rigidity, which may persist for See also:weeks, months or years. In some cases, the patient is unable to walk; in others there are peculiarities of the gait quite unlike anything met with in organic disease. Perversions of sensation are usually See also:present; a common instance is the sensation of a See also:nail being driven through the vertex of the head (clavus hystericus). The region of the spine is a very frequent seat of hysterical See also:pain. Loss of sensation (See also:anaesthesia), of which the patient may be unaware, is of common occurrence. Very often this sensory loss is limited exactly to one-half of the body, including the See also:leg, See also:arm and See also:face on that See also:side (hemianaesthesia). Sensation to See also:touch, pain, See also:heat and See also:cold, and See also:electrical stimuli may have completely disappeared in the anaesthetic region. In other cases, the anaesthesia is relative or it may be partial, certain forms of sensation remaining intact. Anaesthesia is almost always accompanied by an inability to recognize the exact position of the affected See also:limb when the eyes are closed. When hemianaesthesia is present, sight, See also:hearing, See also:taste and See also:smell are usually impaired on that side of the body. Often there is loss of See also:voice (hysterical aphonia). It is to such cases of hysterical paralysis and sensory disturbance that the wonderful See also:cures effected by quacks and charlatans may be referred. The mental symptoms have not the same tendency to pass away suddenly. They may be spoken of as inter-paroxysmal and paroxysmal. The See also:chief characteristics of the former are extreme emotionalism combined with obstructiveness, a See also:desire to be an See also:object of See also:interest and a See also:constant craving for sympathy which is often procured at an immense See also:sacrifice of See also:personal comfort. Obstructiveness is the invariable symptom. Hysteria may pass into See also:absolute insanity.
The treatment of hysteria demands See also:great tact and firmness on the See also:part of the physician. The affection is a definite entity and has to be clearly distinguished from malingering, with which it is so often erroneously regarded as synonymous. Drugs are of little value. The moral treatment is all-important. In severe cases, removal from See also:home surroundings, and See also:isolation, either in a See also:hospital See also: Additional information and CommentsThere are no comments yet for this article.
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