ACQUIRED DISEASE FROM HYSTERICAL EMOTION.
IN the earlier part of this volume, pages s7-s9, we traced out how the arterial blood supply to all parts of the body is under the influence of the sympathetic nervous system, and how readily an impression made through the senses tells through that system upon the body. We have now to consider a class of cases in which certain phenomena of disease are developed, largely, from external causes acting through this nervous organization.
In some persons the excitability of the emotional nervous sys tem is so great, that the merest disturbance of the nervous tension produces some indications or phenomena of disease. Persons so placed are said to be hysterical, and are given to manifest a long and peculiar train of diseases.
There are other persons who, without being hysterical, are easily influenced through the senses, and are rendered liable to be even dangerously affected through what are called the emo tions or passions, especially the passions of anger, fear, and grief.
In the present chapter we have briefly to consider the types or forms of phenomenal disease, called the hysterical.
Under the one term hysteria so many affections simulating diseases of the true organic type have been recognized, it were almost to go over the whole of the list again to enumerate them. Some authors, indeed, would accept many of the affections placed in the last chaptqr as being purely of hysterical nature and would consider them of hysterical origin. The general characteristics of the disease hysteria are given briefly on p. 1s1, and a very few additions here will suffice.
Hysteria is almost entirely a disorder of the female sex, al though it is sometimes met with in the male. It is most fre quently developed in the years of life extending from the com mencement of adolescence up to thirty. Its commonest symptoms are those of emotional excitements, evidenced in paroxysms of laughing, crying, convulsive, starts and movements, and periods of faintness or insensibility. Almost all cases are attended with one or other of these symptoms, but in some examples the purely physical characters of different diseases are presented without these special characteristics of hysteria, and then the diagnosis is rendered exceedingly difficult.
Excessive sensitiveness to external impressions and to pain, hysterical hyperesthesia, is a common symptom in hysteria. Thus the most striking illustrations of hysterical neuralgia, or of toothache, are seen under the condition of pregnancy. On the other hand, we may have hysterical insensibility to pain, i. e. to common sensation, called, technically, hysterical anesthesia, affecting a part of the body, as the hand or foot, or the whole of the body.
The insensibility to pain which has been produced in some susceptible individuals by the process known as mesmerism par takes of the hysterical character. All the strange phemonena that have often been recorded as observable in hypnotic and mesmeric states I should classify under the present head.
Persons afflicted with hysterical tendencies are apt to mani fest various automatic movements, which are distinguishable from mere habits by the sharpness and peculiarity of their oc currence, and by the uncompromising persistency with which the automatic act is carried out.
The illustrious Thomas Willis gives us an illustration of this automatism, amounting to a condition of disease, in the case of a youth who lived near to him. This youth was silly and foolish, yet knew, exactly, without any sign the interspaces of the hours, and as often as the space of a whole hour had elapsed, as if he had been a living clock, he would personate the right number of the hour by so many hoarse sounds, and no business or employ about any other occupation could make him omit this task. He, at the beginning, was wont to imitate aloud by making a noise at every stroke of the sounding clock; and as often as he heard tl:e sounding of the hell of the clock he cried, one, two, three, repeat ing successively the several pulsations. Hence, says Willis, it happened, afterwards, " that the animal spirits, by daily imita tion being accustomed to be stirred up by such a motion, accord ing to the set spaces of time, at length were able to distinguish the same periods of their own accord, nothing directing, as if the sliding spaces of time had been measured out by the wheels of a clock." The above is an extreme case of automatic disease, and is perhaps the most singular on record, as coining from a master who was one of the most faithful observers in the whole world of science. But phenomena approaching to it are not wanting amongst the hysterical and hypochondriacal classes of modern communities. Some so circumstanced are impelled to walk a given distance each day in order to touch some particular object, or perform some particular trivial act. Others repeat in an auto matic manner a series of words, ejaculations, or sentences. Others again, especially amongst the hypochondriacal, give indications, in an automatically recurrent manner, of some particular suffer ing or pain, which they accompany with a special observation re lating to the same, but which on inquiry may turn out to have no real meaning. A further class of the purely hysterical type suffer from automatic recurrent paroxysms of pain like neuralgia, tooth ache, rheumatism; or again, of paroxysms of cough, difficulty of swallowing, blushing, erethema fugax, or palpitation of the heart. In these the singularity of the phenomenon, whichever it may be, is that it is not traceable to any definable organic origin.
The most common rules connected with phenomena of disease are open to exception, and so in the hysterical there may be in ternal irritations which keep up the hysteria. In these instances a true physical is combined with an emotional affection, and the results are of a serious character. I have more than once known symptoms, commonly called hysterical, terminate fatally under these circumstances. I have known, for example, what seemed to be purely an hysterical cough continue so persistently as to produce death from exhaustion. I knew death take place once from the severity of hysterical convulsion. I knew an instance in which what seemed to be hysterical constriction of the gullet, or oesophagus, ended fatally, and in which the after-examination showed that there was no organic constriction.
Persons hysterically disposed are liable to changes in the blood, and particularly to that change which has been described at page 150, anaemia. Under this condition of blood, accom panied as it generally is with loss of vascular tone, the affected suffer from numerous physical perversions, such as flushes, chills, coldness of the extremities, perspirations, irregular actions of the bowels, deficient tone in the stomach and intestines, with flatu lency as a constant and oppressive symptom, and, often, a copious diuresis of a perfectly colorless secretion. In addition to these symptoms, they suffer, at times, from distressing and painfnl sen sations of ringing sounds in the head, which are, iu fact, arterial murmurs caused by the effect of pressure on relaxed vessels in the cranial circulation. The sound produced, when it is sudden and unexpected, is occasionally mistaken as proceeding from with out, and from no obvious cause.
Together with these vascular murmurs and other signs of ir regular and nervous action, intensified now and then to a brisk hysterical paroxysm, there are frequent temporary perturbations of the muscles of the body; sometimes a mere sensation or quiver, "live blood;" at other times a sharp twitch or start in the eyelids or the extremities, or in some of the involuntary muscles, or through the body altogether.
The capriciousness of hysterical persons in relation to taste and appetite has often formed subject of comment by observers of disease, and is indeed one of the most peculiar characteristics of the complaint. The sense of taste may be entirely lost, or it may be so perverted that what are generally considered the most delicate flavors are disliked, while the most objectionable things are relished with avidity. In very severe examples distaste for ordinary foods passes into dislike, and therewith appetite appears altogether to fail. Instances of prolonged fasting, which I and others have recorded, are of this hysterical character, and occa sionally end in death.
It will be seen from the above what a complete range over the whole field of disease is assumed under the title hysteria. It is, in short, all disease developed in an hysterical constitution and modified by it so as to present the symptoms of every disease without, except in the rare occurrences which have been referred to, presenting the danger. I might have noted many other special affections, such as somnambulism, trance, epilepsy, mania, and others which appear under the hysterical disguise; but as, in so doing, I should be repeating their phenomena, the labor is un necessary.
One word more must be added bearing on the hysterical state in relation to what are often called supernatural manifestations and beliefs in them. The hysterically affected are of all persons those who are impressed most strongly with the idea of the super natural. They see, hear, feel, smell, and taste what others, less susceptible, fail to distinguish, and so are led naturally to distort trivial phenomena into startling events and appearances. They make, in simple truth, a world of their own; people it, describe it, and invent thereby a new world which, like their disease, is but a reflection of what is real.