HYSTERIA. 



terical symptoms, while, in cases of malignant growth and in destruc- 

 tive affections, hysteria is much less common. Of the ovarian diseases, 

 the dermoid cysts of moderate size cause hysteria much oftener than 

 do the very large sacs resulting from cystoid growth. In some cases 

 irritation of the genitals arising from excessive coitus, or imperfectly 

 effected coitus, from onanism, or from simple sexual excitement, has 

 an influence upon the nervous system, similar to that of the textural 

 lesions of the sexual apparatus above mentioned. But it would be 

 both narrow-minded and frivolous, and indicative of a most imperfect 

 comprehension of the nature of woman, to ascribe all cases of hysteria, 

 whose source could not be traced to structural change of the genitals, 

 to over-excited sexual appetite, or to its unnatural gratification. I 

 certainly am no optimist, and indeed rather incline in the other direc- 

 tion, but I cannot believe that all the hysterical widows and old maids 

 who are hysterical, without exhibiting any structural disease of their 

 genital apparatus, suffer from suppressed sexual passion, or gratify it 

 in an illegitimate manner. 



Where there is much predisposition to hysteria, it may proceed 

 from any other organ of the body which may happen to be diseased 

 I have seen a strongly-pronounced case of it in a young girl with a 

 tedious affection of the stomach, but whose sexual function was per- 

 fectly normal. 



We must entirely agree with JETasse, in his delicate and excellent 

 description of hysteria, that the frequence with which hysteria occurs 

 in childless women, in widows, and in old maids of the upper class of 

 society, is attributable rather to psychical than to physical influences. 

 The effect of strong psychical impressions upon the nervous system at 

 large is often quite evident even in perfectly-healthy subjects. Per- 

 sons under the influence of great terror stand as if thunderstruck, un- 

 able to move from the spot ; an angry man clinches his fists, bites his 

 lips, and moves restlessly to and fro without act of his will. More- 

 over, we not unfrequently find that the influence of extreme terror or 

 anguish of mind produces complete anaesthesia, and excessive intel- 

 lectual exertion often gives rise to hypergesthesia. Indeed, every day 

 we have the opportunity of observing that mental emotion has an in- 

 fluence upon the excitability of the vaso-motor and nutritive nerves ; 

 that it causes the cheeks to redden or to grow pale, the muscles or 

 the skin to contract or to relax, the tears or saliva to flow. If all 

 these various disturbances of innervation can arise from transitory 

 psychical impressions, it is easy to imagine that permanent nervous 

 derangement, with disease of texture of the nervous system, may de- 

 velop under the influence of the permanent mental emotions, which 

 beset a woman who finds all the expectations and hopes of her life dis- 



