Idiosyncrasy

By idiosyncrasy we understand a peculiarity of constitution by which an individual is affected by external agents in a manner different from mankind in general. Thus, some persons cannot eat strawberries without a kind of urticaria appearing over the body; others are similarly affected by eating the striped bass; others, again, faint at the odor of certain flowers, or at the sight of blood; and some are attacked with cholera-morbus after eating shellfish--as crabs, lobsters, clams, or mussels. Many other instances might be advanced, some of them of a very curious character. These several conditions are called idiosyncrasies.

Bégin,[1] who defines idiosyncrasy as the predominance of an organ, a viscus, or a system of organs, has hardly, I think, fairly grasped the subject, though his definition has influenced many French writers on the question. It is something more than this--something inherent in the organization of the individual, of which we only see the manifestation when the proper cause is set in action. We cannot attempt to explain why one person should be severely mercurialized by one grain of blue mass, and another take daily ten times that quantity for a week without the least sign of the peculiar action of mercury being produced. We only know that such is the fact; and were we to search for the reason, with all the appliances which modern science could bring to our aid, we should be entirely unsuccessful. According to Bégin's idea, we should expect to see some remarkable development of the absorbent system in the one case, with slight development in the other; but, even were such the case, it would not explain the phenomena, for, when ten grains of the preparation in question are taken daily, scarcely a day elapses before mercury can be detected in the secretions, and yet hydrargyriasis is not produced; while when one grain is taken, and this condition follows, the most delicate chemical examination fails to discover mercury in any of the fluids or tissues of the body.

[Footnote 1: "Physiologic Pathologique," Paris, 1828, t.i., p. 44.]

Bégin's definition scarcely separates idiosyncrasy from temperament, whereas, according to what would appear to be sound reasoning, based upon an enlarged idea of the physiology of the subject, a very material difference exists.

Idiosyncrasies are often hereditary and often acquired. Two or more may exist in one person. Thus, there may be an idiosyncrasy connected with the digestive system, another with the circulatory system, another with the nervous system, and so on.

An idiosyncrasy may be of such a character as altogether to prevent an individual following a particular occupation. Thus, a person who faints at the sight of blood cannot be a surgeon; another, who is seized with nausea and vomiting when in the presence of insane persons, cannot be a superintendent of a lunatic asylum--not, at least, if he ever expects to see his patients. Idiosyncrasies may, however, be overcome, especially those of a mental character.

Millingen[1] cites the case of a man who fell into convulsions whenever he saw a spider. A waxen one was made, which equally terrified him. When he recovered, his error was pointed out to him. The wax figure was put into his hand without causing dread, and shortly the living insect no longer disturbed him.

[Footnote 1: "Curiosities of Medical Experience," London, 1837, vol. ii., p. 246.]

I knew a gentleman who could not eat soft crabs without experiencing an attack of diarrhea. As he was exceedingly fond of them, he persevered in eating them, and finally, after a long struggle, succeeded in conquering the trouble.

Individuals with idiosyncrasies soon find out their peculiarities, and are enabled to guard against any injurious result to which they would be subjected but for the teachings of experience.

Idiosyncrasies may be temporary only--that is, due to an existing condition of the organism, which, whether natural or morbid, is of a transitory character. Such, for instance, are those due to dentition, the commencement or the cessation of the menstrual function, pregnancy, etc. These are frequently of a serious character, and require careful watching, especially as they may lead to derangement of the mind. Thus, a lady, Mrs. X, was at one time under my professional care, who, at the beginning of her first pregnancy, acquired an overpowering aversion to a half-breed Indian woman who was employed in the house as a servant. Whenever this woman came near her she was at once seized with violent trembling, which ended in a few minutes with vomiting and great mental and physical prostration, lasting several hours. Her husband would have sent the woman away, but Mrs. X insisted on her remaining, as she was a good servant, in order that she might overcome what she regarded as an unreasonable prejudice. The effort was, however, too much for her, for upon one occasion when the woman entered Mrs. X's apartment rather unexpectedly, the latter became greatly excited, and, jumping from an open window in her fright, broke her arm, and otherwise injured herself so severely that she was for several weeks confined to her bed. During this period, and for some time afterward, she was almost constantly subject to hallucinations, in which the Indian woman played a prominent part. Even after her recovery the mere thought of the woman would sometimes bring on a paroxysm of trembling, and it was not till after her confinement that the antipathy disappeared.

Millingen[1] remarks that certain antipathies, which in reality are idiosyncrasies, appear to depend upon peculiarities of the senses. Rather, however, they are due to peculiarities of the ideational and emotional centers. The organ of sense, in any one case, shows no evidence of disorder; neither does the perceptive ganglion, which simply takes cognizance of the image brought to it. It is higher up that the idiosyncrasy has its seat. In this way we are to explain the following cases collected by Millingen:

[Footnote 1: Op cit., p. 246.]

"Amatus Lusitanus relates the case of a monk who fainted when he beheld a rose, and never quitted his cell when that flower was blooming. Scaliger mentions one of his relatives who experienced a similar horror when seeing a lily. Zimmermann tells us of a lady who could not endure the feeling of silk and satin, and shuddered when touching the velvety skin of a peach. Boyle records the case of a man who felt a natural abhorrence to honey; without his knowledge some honey was introduced in a plaster applied to his foot, and the accidents that resulted compelled his attendants to withdraw it. A young man was known to faint whenever he heard the servant sweeping. Hippocrates mentions one Nicanor, who swooned whenever he heard a flute; even Shakespeare has alluded to the effects of the bagpipes. Julia, daughter of Frederick, King of Naples, could not taste I meat without serious accidents. Boyle fainted when he heard the splashing of water; Scaliger turned pale at the sight of water-cresses; Erasmus experienced febrile symptoms when smelling fish; the Duke d'Epernon swooned on beholding a leveret, although a hare did not produce the same effect; Tycho Brahe fainted at the sight of a fox; Henry III. of France at that of a cat; and Marshal d'Albret at a pig. The horror that whole families entertain of cheese is generally known."

He also cites the case of a clergyman who fainted whenever a certain verse in Jeremiah was read, and of another who experienced an alarming vertigo and dizziness whenever a great height or dizzy precipice was described. In such instances the power of association of ideas is probably the most influential agent in bringing about the climax. There is an obvious relation between the warnings given by the prophet in the one case, and the well-known sensation produced by looking down from a great height in the other, and the effects which followed.

Our dislikes to certain individuals are often of the nature of idiosyncrasies, which we can not explain. Martial says:

 "Non amo te, Sabidi, nec possum dicere quare;

Hoc tantum possum dicere, non amo te;" 

or, in our English version:

 "I do not like you, Doctor Fell,

The reason why I can not tell;

But this I know, and that full

I do not like you, Doctor Fell." 

Some conditions often called idiosyncrasies appear to be, and doubtless are, due to disordered intellect. But they should not be confounded with those which are inherent in the individual and real in character. Thus, they are frequently merely imaginary, there being no foundation for them except in the perverted mind of the subject; at other times they are induced by a morbid attention being directed continually to some one or more organs or functions. The protean forms under which hypochondria appears, and the still more varied manifestations of hysteria, are rather due to the reaction ensuing between mental disorder on the one part, and functional disorder on the other, than to that quasi normal peculiarity of organization recognized as idiosyncrasy.

Thus, upon one occasion I was consulted in the case of a lady who it was said had an idiosyncrasy that prevented her drinking water. Every time she took the smallest quantity of this liquid into her stomach it was at once rejected, with many evident signs of nausea and pain. The patient was strongly hysterical, and I soon made up my mind that either the case was one of simple hysterical vomiting, or that the alleged inability was assumed. The latter turned out to be the truth. I found that she drank in private all the water she wanted, and that what she drank publicly she threw up by tickling the fauces with her finger-nail when no one was looking.

The idiosyncrasies of individuals are not matters for ridicule, however absurd they may appear to be. On the contrary, they deserve, and should receive, the careful consideration of the physician, for much is to be learned from them, both in preventing and in treating diseases. In psychiatrical medicine they are especially to be inquired for. It is not safe to disregard them, as they may influence materially the character of mental derangement, and may be brought in as efficient agents in the treatment.--N.Y. Medical Journal.