Hysteria was known to the ancients and in fact is as old as the written history of mankind. Considered essentially a disease of women, it was given its present name which is derived from "hysteron," the Greek name for the womb. We know to-day that men also are victims of this malady, though it arises under somewhat different circumstances than is the case with the other sex. Men and women, living in the same world and side by side, are placed in greatly different positions in that world, are governed by different traditions and are placed under the influences of differing ambitions, expectations, hopes and fears. Hysteria arises largely out of the emotional and volitional reactions of life, and these reactions differ in the sexes.
It was a group of French neurologists, headed by Charcot--and including very illustrious men, such as Janet and Marie, who paid the first scientific attention to the disease. Under their analyses hysteria was defined as a mental disease in which certain symptoms appeared prominently.
1. Charcot especially paid attention to what are known as the attacks. The hysteric patient (usually a woman, and so we shall speak of the patient as "she") under emotional stress and strain, following a quarrel or a disagreement or perhaps some disagreeable, humiliating situation, shows alarming symptoms.
Perhaps she falls (never in a way to injure herself) to the floor and apparently loses consciousness, closes her eyes, rolls her head from side to side, moans, clenches her fists, lifts her body from the floor so that it rests on head and heels (opisthotonic hysteria), shrieks now and then and altogether presents a terrifying spectacle. Or else she twitches all over, weeps, moans, laughs and shouts, and rushes around the room, beating her head on the walls; or she may lie or stand in a very dramatic pose, perhaps indicating passion or fear or anger. The attacks are characterized by a few main peculiarities, which are that the patient usually has had an emotional upset or is in some disagreeable situation, that she does not hurt herself by her falls, that consciousness is never completely abolished and fluctuates so that now she seems almost "awake" and then she seems almost in a complete stupor, and that the expression of emotion in the attack is often very prominent. These symptoms are readily differentiated from what is seen in epilepsy.[1]
[1] The French writers of the school of Babinski deny that the above symptom and even the majority of the following have a real existence in hysteria. The English, American and German neurologists and the rest of the French school describe hysteria substantially as I am here describing it.
2. The hysteric paralyses which are featured in all the literatures of the world are curious manifestations and often very stubborn. Following an accident (especially in industry and in war) and after some emotional difficulty there is a paralysis of some part of the body. The arm or some particular part of the arm cannot be moved by the will, is paralyzed; or else the difficulty involves one or both legs. Sometimes speech is gone, or the power of moving the head; occasionally the difficulty is with one side of the face, etc. Usually the paralysis comes on suddenly, but often it comes on gradually. Modern neurology soon discovered that these paralyses were quite unlike those seen when there is "real" injury to the brain, spinal cord or the peripheral nerves. They corresponded to the layman's idea of a part. Thus a paralysis of the arm ends at the shoulder, a paralysis of the feet at the ankle, and in ways not necessary to detail here differ from what occurs when the organic structure of the nervous system is involved. For example, the reflexes in hysteria are unaltered, and stiffness when it occurs is not the stiffness of organic disease. If a neurologist were to have a hysteric paralysis a very interesting problem in diagnosis would be presented.
Further, the paralysis yields in spectacular fashion to various procedures or else disappears spontaneously in remarkable fashion overnight. Paralyses of this type have disappeared under hypnosis, violent electric shocks, "magical" liniments, threats, prayers, the healer's, the fakir's, the doctor's personal influence; under circumstances of danger (a fire, a row, etc.); by pilgrimages to Lourdes, St. Anne de Beaupre, the Temple of Diana, the relic of a saint; by the influence of sudden joy, fear, anger; by the work of the psychoanalyst and by that of the osteopath! Every great religious leader and every savage medicine man beating a tom-tom has had to, prove his pretensions to greatness by healing the sick--so intensely practical is man--and he has proved his divinity by curing the hysterics, so that they threw away their crutches, or jumped blithely out of bed, or used their arms, perhaps for the first time in years. Hysteria has caused more talk of the influence of mind over body than all other manifestations of mental peculiarity put together. Wherever there is anything to be gained by hysteric paralyses, these appear in much greater frequency than under ordinary circumstances. Thus the possibility of recovering damages seems to play a role in bringing about a paralysis that defies treatment until the litigation is settled; similarly the possibility of being removed from the fighting line played a large part in the causation of war hysteric paralysis.
