The complexus of morbid phenomena designated by this misnomer, would require volumes to adequately describe. The state exists in the intellectual and in the ignorant alike. Its victims have played a large part in the world's history. It occurs in all gradations and varieties. It may be, and frequently is, hereditary. Sometimes in different generations it alternates with epilepsy, insanity, alcohol, and consumption.

The only thing in common between the widely different conditions termed hysteria, is the fact that in these cases, after death, we have no means of discovering definite organic disease of the nervous system.

For the sake of the lay reader only a brief description of hysteria will be given, and for further information, I shall refer those who wish it to medical works upon the diseases of the nervous system, particularly those of Charcot and his pupils.

Most of the works in the English language upon diseases of the nervous system also describe it, and there are some excellent monographs upon it as well. 12

Clinical History Of Hysteria

Minor degrees of this condition are evinced by an instability of the emotional system. It occurs more frequently in women than in men.

The attack of laughing and crying which may come upon them as the result of mental excitement, grief, etc., is well known to all. It is probably not so well understood by the public that, in the graver forms of this disease, persons may be temporarily paralyzed in one limb, or in one side of the body, in the upper or lower extremities, or in all at the same time. There are attacks of blindness, deafness, perversion of the senses of taste and smell, or, again, all of these senses may be wonderfully acute. Sometimes, but not always, there exists intense vanity, a great desire for notoriety, and this desire may lead the patient to simulate many organic diseases, or to pretend in various ways that he is afflicted with conditions which are only imaginary. Hence, to say that a patient is hysterical may imply perhaps more than would be desired.

The profoundly hysterical persons sometimes have what Charcot terms hystero epileptic fits. These persons also take very strong likes and dislikes without reason. Again, they are very intuitive. There is not an organ or a system of the body exempt from these symptoms.

There may be areas of numbness (anesthesia), or hyperesthesia (great sensitiveness) may be present. There may be zones of the body so sensitive that they cannot bear even the weight of the slightest clothing. The skin may become pale or the reverse. Bloody sweats have been described; in fact, it would be impossible to imagine a symptom which does not exist in some of these cases. Hence it follows that a layman should never make a diagnosis of hysteria in himself or in any one else, for, indeed, it will puzzle at times the skill of the most expert neurologists. The point which should be understood clearly by all is this, that the disease is susceptible of relief through widely different agencies.

Cases of hysterical paralysis may yield to the application of magnets, metals, prayer, dings, electricity, aye, anything in which the patient can he made to believe. Again, these same patients may prove refractory for years, and be cured by some trifling circumstance, or never cured.

Many of the miracles and wonders worked by charlatans are upon this class of patients. I have no objection to the patient being cured, no matter how it is done, if the cure is not more injurious than the disease. The thing which is objectionable is that this is sometimes not the case.

Mrs. A. is cured of an hysterical affection by J.'s magnetized medicine, or other means. Mrs. B. may be afflicted with some disease which, if not properly treated, will end fatally.

Now Mrs. B., led by the marvellous experience of Mrs. A., may lose precious time while experimenting with the remedy which was given Mrs. A. by J. This has more than once occurred in my experience.

Notably, a lady suffering with uterine cancer, but ignorant of the nature of the disease, instead of consulting a physician, was led to try a patent medicine because it had cured one of her friends of hysterical vomiting. Now cancer in this region, if it is recognized early enough, may be so thoroughly removed that a useful life may be prolonged for a number of years.

In the case related the lady continued to take the medicine for four months, consuming in that time about thirty-six bottles of it. When a correct diagnosis was made, alas, the rapidly growing cancer had invaded the tissues to such an extent that medicine and surgery could do little or nothing for her. It is this fear which should send every man and woman to a reliable physician, at least for a diagnosis. The question of treatment can be then decided. I do not claim that all of the cures which have been made by irregular practitioners were upon those who were simply hysterical. I do not believe that is the caae. I am too well aware of the fallibility of even the best physician, and while confessing that our methods are as yet imperfect, I still maintain that it is better to consult a man with experience and training, than one who is without these. I think that it is better that a man should see his physician a thousand times when it is not necessary, than to fail to see him once when he is in need of his assistance.

Persona afflicted with any form of hysteria are entitled to the utmost consideration. In these cases, particularly, the physician should use the greatest amount of care, for he may overlook some existing organic disease.

Some types of hysteria are made better and some worse by hypnotism. All are benefited if some form of suggestion, with or without hypnosis, is skilfully used.

Mental therapeutics promises more in this field than in any other. Whenever the imagination is strong, when the patient shows fanatical tendencies; whenever the disposition is essentially contradictory, as is often the case; whenever the patient pretends a great many conditions that do not exist, and when, accompanying all these, the intellect is' enfeebled, hypnotism should be used with the greatest care, if at all, and only when other methods fail.