410 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



tic of hysteria are ascribable. For instance, although most patients are 

 extremely susceptible to external influences, yet this may be due quite 

 as well to exalted irritability of the peripheral nerves as to an over- 

 excitability of those portions of the brain whence consciousness of the 

 impression is derived. The former supposition is contradicted by the 

 wide-spread character of the hypersesthesia, as well as by the simul- 

 taneous derangement of the psychical function ; the latter by the in- 

 tensity of the reflex action by which the hyperaesthesia is accompanied. 

 The latter condition is only ascribable to increased irritability of the 

 peripheral nerves, or to coexistent increase of irritability in the spinal 

 ganglia. Hence the most plausible theory of the origin of hysteria 

 is that to which Hasse adheres, namely, that the affection springs from 

 a nutritive derangement of the general nervous system, both central 

 and peripheral. 



The facts that hysteria is observed almost exclusively in females, 

 and principally in females between the age of puberty and that of the 

 extinction of the sexual function, and that in a great number of cases 

 hysteria is accompanied by a morbid condition of the sexual organs, 

 have given rise to the supposition that hysteria is a disorder of the 

 general nervous system originating in the nerves of the organs of gen- 

 eration. This theory, although somewhat too narrow, is true in a 

 iarge number of cases. We have come to the conclusion, from the 

 various phenomena described in previous chapters, that disease not 

 unfrequently is transmitted from the nerves which it immediately af- 

 fects to other nerves, and to central organs ; and by analogy we may 

 infer that a morbid state of the nerves of the sexual apparatus may ex- 

 l end to those of the rest of the body, as well as to the central organs. 

 The mild derangements of innervation, the hyperaesthesia, the aug- 

 mented reflex irritability, and the psychical disorder which shows itself 

 in some women during the period of menstruation, would seem to de- 

 pend upon a process of this nature, and, as it were, form a physiolo- 

 gical analogue to the pathological state of the sexual organs which 

 exists in hysteria. There cannot be any doubt that some cases of 

 hysteria arise in this manner. If a uterine infarction should develop 

 after an abortion or a severe labor in a woman who has previously 

 been healthy, and should this be accompanied by a well-marked hys- 

 teria ; should the hysteria continue as long as the uterine disease lasts, 

 and should it disappear as soon as we succeed in discussing the infarc- 

 tion, it would be manifest that to the uterus alone were due the mani- 

 fold nervous derangements which we call hysteria. All diseases of 

 the womb and ovaries do not exert an equal influence in producing 

 this disease. Besides the infarctions, it is more especially the ulcera- 

 tions of the os uteri and the flexions of the womb which induce hvs- 



