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Category: Diseases of The Nervous System

A state in which ideas control the body and produce morbid
changes in its functions.

Causes. It occurs mostly in women, and usually appears first about the
time of puberty, but the manifestations may continue until the menopause
or even until old age. It occurs in all races. Children under twelve years
are not very often affected. A physician writes: One of the saddest
chapters in the history of human deception, that of the Salem witches,
might be headed, "Hysteria in Children," since the tragedy resulted
directly from the hysterical pranks of girls under twelve years of age.
During late years it has been quite frequent among men and boys. It seems
to occur oftener in the warm and mild climates than in the cold. There are
two predisposing causes that are very important--heredity and education.
Heredity acts by endowing the child with a movable (mobile) abnormally
sensitive nervous organization. Cases are seen most frequently in families
with marked nervous disease tendencies, whose members have suffered from
various sorts of nervous diseases.

Education. The proper home education is neglected. Some parents allow
their girls to grow up accustomed to have every whim gratified, abundant
sympathy lavished on every woe, however trifling, and the girl reaches
womanhood with a moral organization unfitted to withstand the cares and
worries of every-day life. And between the ages of twelve and sixteen, the
most important in her life, when the vital energies are absorbed in the
rapid development of the body, the girl is often "cramming" for
examinations and cooped in close schoolrooms for six or eight hours daily;
not only that, but at home she is often practicing and taking lessons on
the piano in connection with the full school work. The result too often is
an active bright mind in an enfeebled body, ill-adapted to subserve the
functions for which it was framed, easily disordered, and prone to act
abnormally to the ordinary stimuli of life.

Direct Influences. Those influences that directly bring on the attack are
fright, anxiety, grief, love affairs, and domestic worries, especially in
those of a nervous nature. Diseases of the generative organs and organic
diseases in general, and of the nervous system especially, may be causes
of hysteria.

Symptoms. These may be divided into two classes: 1. Interparoxysmal or
time between the paroxysms (spells). 2. Paroxysmal. During the time of the
attack. First variety--The will power seems defective. In bad cases
self-control is lost. The patient is irritable, and easily annoyed by the
slightest trifle; is very excitable and easily moved to laughter or tears
without any apparent cause for either. Easily discouraged and despondent.
She wants lots of sympathy. Second--Loss of sensation is frequently
present, and it is most commonly one-sided; it may involve certain parts,
as one or two limbs, the trunk escaping, or part of one limb. Various
spots of want of sensation (feeling) may exist. The skin of the affected
side is frequently pale and cool and a pin prick may not cause bleeding.
In some cases they feel the touch of the hand, but there is no feeling
from heat. There may also be oversensitiveness to pain and of the skin. It
may be one-sided or both, or only in spots. The left ovarian region is a
common sensitive point; also over the breasts, lower positions of the
ribs, on top of the head and over many portions of the backbone. Pain in
the head is a very common and distressing symptom, and is usually on the
top. Pain in the back is common. Abdominal pains may be very severe and
the abdomen may be so tender as to be mistaken for peritonitis. Various
parts of the body may have neuralgic pains. There may be intense pain
around the heart. There may be complete blindness, the taste and smell may
be disturbed or complete loss of hearing. Third--Paralysis is frequently
present. It may be one-sided or only of the lower extremities, or only one
limb. The face is usually not involved when it is on one side. The leg is
more affected than the arm. Sensation is lessened or lost on the affected
side. Paralysis of the lower extremities is more frequent than one-sided
paralysis. The power in the limbs hardly ever is entirely lost; the legs
may usually be moved, but the legs give way if the patient tries to stand.
The affected muscles do not waste. The feet are usually extended and turn
inward. Sudden loss of voice occurs in many cases. The paralysis is
generally paroxysmal, and is frequently associated with contractures,
shortening of the muscle. The contractures may come on suddenly or slowly,
and may last minutes, hours, or months, and some cases even years.
Movements of the hands, arms, etc., like the motions in chorea are often
seen in the young. A trembling (tremor) is sometimes seen in these
patients. It most commonly involves the hands and arms, more rarely the
head and legs. These movements are small and quick. Fourth--Swallowing may
be difficult on account of spasms of the muscles of the pharynx. The
larynx may be involved and interfere with respiration. Indigestion in some
form is often present. The stomach and bowels may be very much bloated
with gas. There may be a "phantom tumor" in the intestine (bowel).
Constipation may be very obstinate, vomiting may be present and persistent
and hiccough present. The action of the heart may be irregular, and rapid
heart action is common. The least motion may cause difficult breathing and
false Angina Pectoris (heart pang); the urine is retained not infrequently
in female patients.

Next: Symptoms of the Paroxysms


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