532 



HYSTERIA. 



applicable by those whom experience has taught, to 

 adapt general principles to individual examples. 

 Whatever medicines are given, it will generally be 

 found serviceable to combine with them some form 

 of bathing. Early hours of going to bed and rising ; 

 a careful avoidance of great irregularities in living, 

 which are of all things the most surely paid for by 

 fits of despondency ; an agreeable course of read- 

 ing ; much exercise in the open air ; cheerful so- 

 ciety whenever society is not more irksome than 

 silence and retirement ; a moderate pursuit of field- 

 sports; but, above all things, when it is practic- 

 able, a frequent change of residence ; all these 

 things may be looked upon as important parts of 

 the treatment. 



The proper regulation of the diet is very mate- 

 rial ; and it will be happy for the hypochondriac 

 if, amidst the fancies and the follies of medical 

 authorities on this particular point, he can elicit 

 from his adviser some rules which are not utterly 

 irrational. In general, we apprehend that the 

 quantity of food taken, and the times at which it 

 is taken, demand more attention than the quality 

 or nature of the food. Particular cases will sug- 

 gest particular precautions ; but what is commonly 

 called living by rule is certainly not the rule of 

 health. With a few exceptions, we would rather 

 recommend the invalid to peruse lord Bacon's short 

 Essay on the Regimen of Health than all the books 

 on diet that were ever compiled. 



Of the importance of a proper regimen of the 

 mind in this unfortunate malady, too much cannot 

 be said. In some unhappy cases the mind is from 

 the first too much diseased to permit the establish- 

 ment of such regimen, and, as in the case of Cow- 

 per, the prospect is truly cheerless. But in many 

 cases the efforts of the patient may be successfully 

 roused. A journey, a new study or pursuit, fre- 

 quent rides on horseback, or any thing which ef- 

 fects a complete diversion of the thoughts, is most 

 expedient ; and contrivances apparently slight are 

 sometimes rewarded by great results. The patient 

 has, in favourable cases, sufficient power left to 

 abstract his attention from the subject of his own 

 health, and from medical reading, if strongly im- 

 pressed with the danger of pursuing such trains of 

 thought : and when exhorted to change his diet or 

 regimen, to take exercise, or make any other effort, 

 he may truly be encouraged with the assurance that 

 if he 



" Throw but a stone, the giant dies." 



Such are some of the principal circumstances 

 worthy of observation in hypochondriasis, a disease 

 which, although it sometimes attacks women, is 

 much more common, as a consideration of its causes 

 might lead us to expect, in men ; and one of the 

 worst of woes of that period of life when the ac- 

 tivity of youth is gone and the characteristic ser- 

 enity of age is not yet attained. There is no time 

 in a man's life in which the management of the 

 mind is more important than in this ; as, without 

 care and due precaution, it may prove to be a period 

 of discontent, of unhappiness, and even of impru- 

 dencies and rashness, for which there is no longer 

 the excuse of youth and inexperience. 



Hysteria, or hysterical disorder, is, as we have 

 already remarked, not the disorder of middle aged 

 gentlemen, but of young women, for the most part 

 of delicate frame, highly susceptible nerves, indo- 

 lent habits, and minds less carefully regulated than 

 would be desirable. It is, however, sometimes the 

 affliction of older females, females of middle age, 



and occasioned by derangements of the health 

 which especially disorder the nervous system. In 

 most of its forms it is a very troublesome malady, 

 and difficult of cure. Yet so much may be done, 

 by a careful attention to the general regimen of 

 young women, to lessen the extreme susceptibility 

 of the nervous system, that hysteria deserves quite 

 as much attention as hypocbondriasis. 



The slighter indications of the hysteric tempera- 

 ment generally become observable in young women 

 after they have attained the age of fourteen or 

 fifteen, and consist of an increased sensibility to all 

 causes, however trifling, of a nature to produce 

 pleasure or chagrin. After a few years, if the 

 habit of giving way to every emotion is not 

 checked, and if any circumstances happen which are 

 of a nature to disturb the affections, the more 

 marked features of the disorder called hysterical 

 are wont to appear; such as immoderate fits of 

 crying or of laughing, easily induced, and very ir- 

 regular spirits. At length, on the occurrence of 

 something which causes either great disappointment 

 or unusual sensations of pleasure, or after the ex- 

 citement of animated society, or after dissipation 

 and fatigue, the young lady has what is known to 

 be an hysteric fit. She bursts into tears, and sobs 

 violently, and for a long time, and as if she would 

 inevitably be choked ; or, being moved to laughter, 

 she continues laughing so loudly and so long as to 

 alarm the bystanders. Perhaps she falls down, or 

 sinks into a chair, quite exhausted. Her face is 

 red, her eyes are closed, and the eyelids are tremu- 

 lous; the mouth is often firmly shut. It is per- 

 ceived that the heart palpitates violently, and the 

 arteries in the neck pulsate strongly. The breath- 

 ing is variously affected ; very often there is an 

 evident constriction of the throat, and the patient 

 forcibly applies her hands as if to remove it; some- 

 times the respiration is profound and tranquil, some- 

 times short and hurried. In some cases the hyste- 

 ric person lies composed and quiet, but very often 

 the hands and arms are violently thrown about, or 

 the hands are strongly pressed upon the stomach, 

 as if for the relief of violent pain ; in some in- 

 stances the trunk of the body is contorted, and 

 occasionally the convulsive movements are more 

 general and not easily controlled. Such an attack 

 may last a quarter of an hour, or an hour, or even 

 many hours, and may leave the patient uncomfort- 

 able, affected with headach, and feeling pain in the 

 throat, and in those muscles which have been in 

 strong action during the fit. Her own account of 

 the fit commonly is, that she perceived a sensation 

 as of a round ball in some part of the bowels, which 

 seemed gradually to ascend until it reached the 

 upper part of the throat, and then to remain, press- 

 ing upon the windpipe until she thought she should 

 be suffocated. Although there has been such loss 

 of control over the voluntary muscles during the 

 fit, and such irregularity in their action, it will not 

 be found that the patient has always been deprived 

 of consciousness of what was taking place around 

 her ; she has perhaps heard all that was said, and 

 known all that was done, although quite without 

 the power to speak, or to give any indication of 

 her own feelings or wishes. 



One of the most singular characteristics of the 

 hysterical disorder is, that in individuals liable to 

 attacks of the above description, or any modifica- 

 tion of them, (for the forms of the paroxysm it- 

 self are very variable), there is often a resemblance 

 or simulation of various other maladies. There 



