This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
The persons who suffer Hysteria are commonly young women, in whom the process of menstruation is in some way or other disordered; and who are either naturally of a feeble constitution, or have been debilitated by disease, or by their habits of life. Often they are pale; have cold hands and feet; are subject to chilblains; eat but little, and do not fancy meat, which they sometimes absolutely refuse and dislike; or their taste is depraved and capricious; they will devour wax candles, wafers, chalk, sealing-wax, slate pencil, and similar trash. And, what is very curious and characteristic, although they often abstain almost entirely from animal food for weeks or months together, and take very little nourishment of any kind, they do not, in general, emaciate. You might expect that, under such a mode of life, they would waste away; but they continue, round, and plump, and smooth. Some of them are even ruddy.
And belonging to women of this peculiar constitution there is one other remarkable feature, which it is necessary for us to make ourselves thoroughly acquainted with. Almost any part of the body, in these persons, is liable, under the influence of slight causes,, and even without any obvious cause, to fall into a disordered state of action and suffering more or less resembling that which inflammation or organic disease might excite in the same part.
This is a most important fact; because if we erroneously ascribe symptoms which really result from inflammation to mere nervous or hysterical disorder, we may suffer the patient to perish for want of appropriate measures that might have saved her; and on the other hand, if we apply to these nervous, imitative, hysteric complaints, the treatment proper for inflammation, we shall generally, indeed, relieve our patient for the time; but we shall leave her more liable to the nervous affection than before, and permanently damaged by our. mischievous activity.
One of the diseases which is very often copied by Hysteria is inflammation of the peritoneum. You will find a patient complaining of acute pain in the abdomen, aggravated by the slightest pressure, and she shall have, perhaps, a hot skin, a quick pulse, and a furred tongue. When you meet with such symptoms, says Sir Thomas Watson, in a young female, in whom there is any derangement or irregularity of the uterine functions, you will do well, before you cover her abdomen with leeches, to ask yourselves whether all this suffering may not be simply nervous. Search into her previous history as narrowly as you can. If you find that she has had similar attacks before; if she have been known to suffer hysterical fits; and if the tenderness be excessive, and, as it were, superficial, felt upon the slightest touch as much as when firmer pressure is made, you may generally spare the blood-letting, purge the patient well, and cause an Assafoetida enema to be thrown into the rectum, and in a few hours you will find that the peritonitis has vanished.
"Among the pains which infest females of the hysteric constitution, and which are apt to be erroneously ascribed to inflammation, stitches and pains in the side are probably the most common. They are oftener complained of in the left side than in the right. These things are much more generally understood now than they were even a few years ago. I cannot tell you how many persons I have seen who had been diligently treated with leeches, and blisters, and blue pill, for supposed chronic inflammation of the liver or spleen, or still more actively depleted for presumed pleurisy or pericarditis, when no such inflammation existed, and when the treatment, by reducing the strength, tended to rivet upon the patient that mobility of system which was the chief predisposing cause of the pains."
Pains of this kind are believed by Dr. Inman of Liverpool, to bo muscular pains, and to result, often from over-exercise, or unusual exercise, of particular muscles. Such pains, he observes, are attended by increased sensitiveness of the skin that lies over the affected muscle, and are relieved by steady continuous pressure. He cites many cases in illustration of this sort and source of pain. One is of a lady who, on a wet Sunday, walked along way to church on tiptoes, to save a new dress and petticoats. The walk was followed by acute pain in the back part of both legs. So pains in one side are sometimes due to the novel and active use of the croquet mallet. You will do well, when you hear complaints of similar pains, to search for this possible cause and explanation of their occurrence. They are most apt to present themselves in persons whose general health has been somehow reduced below its general standard.
"You would scarcely suppose that palsy-decided hemiplegia or paraplegia,-could be simulated by Hysteria; yet this certainly is the case; and I have seen iustances of it even among hospital patients. They are difficult and perplexing cases. The sudden occurrence of the paralysis, with no corresponding affection of the face or tongue, and without any of the other symptoms which commonly mark the real disease, its sudden disappearance, and, above all, the supervention of a hysterical paroxysm, will often disclose the true nature of the disorder. Dr. Todd asserts that in hysterical hemiplegia (which is generally incomplete), the patient drags the palsied leg along the floor after her as if it were dead, with a sweeping motion, without endeavouring to lift it, and without that swinging-round movement of the limb observable in those who are paralyzed from organic disease of the brain.
"Hysterical affections referred to the throat are very common. Doss of speech, for instance: the voice being lost on a sudden, and recovered as suddenly. Mock laryngitis. I remember being asked by Sir Charles Bell, some years ago, to see a young woman in the Middlesex Hospital under his care. She had recently arrived, and was breathing with the noise peculiar to inflammation of the larynx. She had twice before, in the country, had tracheotomy performed for similar attacks; and there were the scars of the operations on her neck; but both Sir Charles and myself were satisfied, upon considering all the circumstances of the case, that the difficult inspirations were spasmodic and hysterical; and she recovered under the remedies which do good in Hysteria. Inability to swallow is another of the hysterical vagaries relating to the parts about the throat. Dr. Bright has a very instructive case of that kind. A patient was sent to Guy's Hospital for stricture of the oesophagus. It was stated that the difficulty of swallowing had existed for several weeks, and was increasing. The surgeon under whose care she was admitted was instantly struck by certain circumstances which did not seem to consist very well with the notion that there was organic disease. Her appearance belied it and her age. But he thought it right to examine the throat by means of a probang; and no sooner was the instrument introduced, than the patient went into a hysterical fit, which was followed immediately by Hysteria in several females in the same ward. The complaint turned out to be nothing but a hysteric constriction, and was soon completely removed.