"Surgeons are familiar with the ' hysterical breast.' The breast becomes painful, tender, enlarges somewhat perhaps. The girl fears that a cancer is breeding. She communicates her alarm to her friends, and a medical man is consulted. If he happen to be timid and inexperienced, he makes matters infinitely worse by applying leeches and fomentations; by examining the breast at every visit; and by keeping the patient's attention anxiously fixed upon it. Whereas, the treatment ought to be directed to the state of the general system; and the local uneasiness spoken lightly of or disregarded.

"Among the hysterical affections of the air-passages, is a peculiar kind of cough. It is loud, harsh, dry, more like a bark, or a hoarse bleat, than a cough. Sometimes it is incessant, sometimes it occurs in paroxysms which, I verily believe, are more annoying to hear than to perform. Hysterical affections of the diaphragm, again, are by no means rare. I had a very obstinate case of that sort in one of my hospital patients. She would sit in her bed all day long, uttering every eight or ten seconds a loud and most discordant hiccup. And I remember an out-patient, who presented a picture of perfect health, and who came, week after week, to be cured of what I could consider nothing but a hysterical eructation: it was continual and distressing, and prevented her from obtaining any employment as a servant. Hysterical vomiting is also frequent, simulating cancer of the stomach. Nay, hysterical haematemesis. A romantic girl was for some months under my care in the hospital with that complaint. She vomited such quantities of dark blood (which did not coagulate, however), as I should not have thought possible if I had not seen them. Day after day there were potfuls of this stuff: yet she did not lose flesh, and she menstruated regularly; and, what was very curious, the vomiting was always suspended during the menstrual period, and returned again as soon as the natural discharge ceased. I said she was romantic; but I should rather have said that she had that peculiar mental constitution which belongs to hysterical females. She used to write me long letters of thanks for my attention, though I was heartily tired of her; and these were couched in all the fine language of the Minerva press. At last I sent her away; just as bad as when she came into the hospital. Five or six years afterwards she called at my house with a present of game, and told me she had got married to a hair-dresser, and was quite recovered.

"There is a kind of sanguineous expectoration belonging to young women of this class, and very likely to mislead the unwary. I meet with two or three instances of it every year. The patient spits up daily, at irregular intervals, a thinnish fluid, something like saliva, more or less tinged and streaked with brown or florid blood. A young hand investigates diligently the source of the bleeding, and puzzles himself to determine whether the case be one of hoematemesis or of hoemoptysis. Nine times out of ten it is neither the one nor the other. The blood comes from the mouth or the fauces; and is sometimes the result of self-inflicted scratches.

"Hysterical affections of the joints are common also. A young girl became my patient in the hospital for some trifling ailment, and, after a short time she began to complain of great pain in her knee and hip; she could not stand upon the limb, nor bear to have it moved or touched. I got Sir Charles Bell to see her: he was so satisfied as to the nature of the case-so convinced that it was a genuine example of inflammation and ulceration of the hip-joint-that he gave a little lecture to the pupils who stood round the bed, upon the characteristic position in which the patient lay; and he took her into one of the surgical wards to be under his own care. Some time afterwards I had occasion to go into that ward, and there I found my former patient with her heel drawn tight up against her buttock. It turned out that she had no serious disease of the hip at all; both the pain and the rigid contraction gave way under measures which could have done no good to an ulcerated joint. I think the first clue to the real nature of her malady was the occurrence of a fit of Hysteria. Sir Benjamin Brodie says, that among the higher class of society, at least four-fifths of the female patients who are commonly supposed to labour under diseases of the joints, labour under Hysteria, and nothing else.

"Another prank belonging to Hysteria is that of mimicking disease of the bones of the spine. The patient complains of pain and tenderness at certain points in her back, and weakness probably in her lower limbs; and it is now become notorious that scores of young women have been unnecessarily confined for months or years to a horizontal position, and have had their backs seamed with issues, for supposed disease of the bodies of the vertebrae, who had really nothing the matter with them but Hysteria, and who would probably soon have ceased to complain, if, instead of being restricted to that unnatural imprisonment and posture, they had taken a daily gallop on horseback.

"It is curious enough to notice how the mind is apt to become affected in some of these cases. After the patient has been lying supine for some weeks, she is unable to stand or walk, simply because she thinks she is unable. The instant she makes a fair effort to use her limbs again, she can and does use them. Her condition is at once reversed. A lady told me not very long ago that an acquaintance of hers, a member of a family of distinction, had been lying, I know not how long, on her back; that position having been prescribed for her by some medical man for a presumed disease of the spine. She lost all power of using her legs; but she got quite fat, as indeed well she might, for her appetite was remarkably sharp, and she lived chiefly upon chicken; and the number of fowls she devoured was incredible. She lived at some little distance from town, and at last Sir Benjamin Brodie was sent for to see her. Now, Sir Benjamin, to use a vulgar phrase, is up to these cases; and he wished to see her try to walk; but she declared that the attempt to do so would kill her. He was resolute, however, and had her got out of bed: and in a few days time she was walking about quite well, and very grateful to him for his judgment and decision. A medical man of less name, or less determination would probably have failed. Dr. Bright has a good example of a somewhat similar kind; showing the power of another form of influence. He was asked to see a young lady who had been confined to her bed for nine months. If she attempted to move she was thrown into a paroxysm of agitation, and of excruciating agony, affecting more particularly her abdomen. She had almost lost the use of her lower limbs; and she and her friends seemed to have given up all hope of her restoration. But she presented no appearance of important disease; her countenance bore no marks of visceral mischief; nor was it possible to discover any proof of organic change. Dr. Bright set the case down in his own mind as one of Hysteria. She was thought to have derived relief from some stimulating injection, and from certain pills. As her friends were in moderate circumstances, Dr. Bright talked seriously to the mother, and recommended that simple water should be employed for the injection, and that bread pills should be substituted for those the girl had been taking. The mother soon perceived that these means produced the same tranquillizing effects on her daughter which had hitherto been ascribed to the medicine. 'My visits,' he says, 'became less frequent; I was absent a fortnight: on my renewing my visit, no change had taken place. I attempted to get her shifted gently from the bed to the sofa, but it was impossible; the paroxysm almost overcame her. Once, (after having attended altogether about nine months), I called, after an absence of nearly a month; her sister met me at the street door with a smiling face to tell me that our patient was quite well: and, on enquiry, she related how, three mornings before, under a deep religious impression, she had completely recovered all her powers; and I found her sitting up, working and amusing herself as if she were completely convalescent from some ordinary illness.'