HYSTERIA. 



409 



the child have been good, and his appearance still be one of robust 

 ness and vigor during the fit, I would advise the administration of a 

 clyster of one part vinegar and three parts water, the application of 

 cold compresses to the head ; and, if the convulsions do not soon sub- 

 side, the application of leeches behind the ears, in numbers correspond- 

 ing to the age of the patient. We cannot give medicine during the 

 fit. After it is over, and should we fear a recurrence, we may give a 

 laxative of calomel and jalap, or one or two doses of calomel with the 

 oxide of zinc. On the other hand, if the child be puny and enfeebled by 

 long sickness, let him have an enema of valerian, or camomile tea, with 

 one or two drops of tincture of castor ; or, if this be ineffectual, a clys- 

 ter of emulsion of assafcetida (3ss j to iv). Sinapisms may also 

 be applied to his calves, and he may be put into a warm bath. Other 

 means are not to be had recourse to until after the fit has subsided. 

 Apart from the cases in which eclampsia is symptomatic of cerebral 

 disease, of uraemia, or the initiatory stage of some acute disorder, it is 

 of importance to determine from which province of the nervous sys- 

 tem the morbid irritation proceeds which is acting upon the medulla 

 oblongata, for it will depend upon such determination whether we 

 give a laxative, an emetic, an antacid, or an anthelmintic, or whether 

 we ought to resort to some other course of treatment. I consider it 

 unjustifiable to dose every child, who has had an eclamptic fit, with 

 calomel and oxide of zinc, " in order to prevent his having another." 

 If the stupor which follows the paroxysm be very profound, cold affu- 

 sion should be prescribed. On the other hand, if there be severe col- 

 lapse, we should order wine, camphor, and musk, and other stimulants. 



CHAPTER V. 



HYSTERIA. 



ETIOLOGY. Hysteria is even still less susceptible of classification 

 in any particular category of nervous diseases than are epilepsy and 

 eclampsia. In this protean malady, derangement of the sensory, mo- 

 tor, and psychical functions is nearly always combined with disorder 

 of the circulatory and nutritive systems. Sometimes one set of symp- 

 toms predominates, sometimes another ; and there often is an exalted 

 excitability in one part of the nervous system, expressed in the form of 

 hyperaesthesia or spasm, and which is complicated with interrupted irri- 

 tability of some other region, evinced by anaesthesia and paralysis. We 

 cannot as yet give a satisfactory answer to the question as to the exist- 

 ence of actual although impalpable material alteration in the nervous 

 elements, to which the various forms of nervous derangement characteris- 



