HYSTERIA

Categories: 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.