SEXUAL PSYCHOSES AND NEUROSES 209 



The neuroses occurring at puberty may be sensory, Neuroses of 

 motor or visceral. These have been fully investigated P ubert y- 

 by physicians, and a clear account is given by Osier 1 , 

 which should be studied by those interested in the 

 subject. Here it will be sufficient to recall the chief 

 manifestations. 



The sensory disturbances are represented by various 

 forms of anaesthesia or hyperaesthesia. There may also 

 be derangement or impairment of the special senses of 

 taste, smell, vision and hearing, giving rise to unpleasant 

 tastes and smells, to photophobia, or to continuous 

 noises. 



Derangement of the motor nerves is seen in chorea. 

 True chorea occurs very much more frequently in girls 

 (70 per cent.) than in boys. At the same time it is not 

 a disease which is more than incidentally connected with 

 puberty. The psychical element in true chorea is very 

 marked, although often overlooked ; and, whatever the 

 usual idea of the etiology may be, there is no doubt fear 

 or fright is frequently a causal factor in the onset. So 

 it comes about that the disease is common during the 

 period of nervous tension which may be found at puberty 

 in girls of a neuropathic temperament. False chorea, or 

 ' habit spasm ', is, likewise, most frequently seen in girls 

 from ten to fourteen years of age. Twitchings of the 

 face or limbs are the commonest movements. These 

 habits tend to disappear as the girl grows up and her 

 nervous system becomes less irritable. Again functional 

 paralyses are sometimes observed at puberty. They 

 may be paraplegic, hemiplegic, or monoplegic; indeed, 

 any known form of organic paralysis may be simulated. 

 Contractures and spasms occur in hysterical patients, 

 but not so frequently at puberty as at the menopause. 



Visceral manifestations are seen in regard to the 

 respiratory mechanism, which may be altered in rhythm, 

 or there may be a ' catching ' during inspiration. 

 Occasionally, there is a spasmodic cough Alimentary 



1 Osier, W., The Principles and Practice of Medicine, 1916. 



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