416 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



all hysterical patients complain of a sense of pressure and fulness ic 

 the region of the stomach, or else of cardialgia, and, independently of 

 the colic which sometimes troubles them, give most extraordinary ac- 

 counts of the sensations which they feel in their abdomens. Under this 

 head also come the thirst, often observed in hysterical persons, and 

 the frequently-recurring desire to empty the bladder, although it 

 is not full. Perverted sensation in the sexual organs is much more 

 rare than might be supposed, more so, indeed, than has been rep- 

 resented by many authorities. Husbands of hysterical women often 

 declare that their wives evince a disinclination to sexual intercourse, 

 and do not often exhibit much excitability. They seldom give an ac- 

 count of an opposite condition. Even in hysterical prostitutes it is 

 exceptional to see symptoms of nymphomania. In other cases, again, 

 coitus is very painful to the patient, although there may be no palpable 

 lesion of the genital organs. 



The derangements of the motor function observed in hysteria are 

 scarcely less numerous and varied than those of sensation. Their 

 most common form is that of hysterical convulsions. There is no 

 doubt but that the morbid excitement of the motor nerves, which gives 

 rise to hysterical spasms, proceeds from the spinal marrow and me- 

 dulla oblongata. One of their characteristic signs is, that they never 

 cause loss of consciousness. It is usually supposed that hysterical 

 convulsions are of reflex origin, so that the spinal cord can only trans- 

 mit the impressions conveyed to it from the sensory nerves to the 

 motor nerves. As the convulsions frequently spring from impressions 

 produced upon the sensory nerves, or the nerves of special sense, it 

 seems probable that this theory is the correct one ; hence, in cases 

 where the convulsions seem to occur spontaneously, we must suppose 

 that the cause has eluded our observation. In some cases, hysterical 

 fits consist in a mere twitching of one or more of the limbs, especially 

 of the arms; They often recur, at short intervals, for a while, when- 

 ever the temper of the patient is excited, and whenever stimuli, even 

 of moderate strength, act upon the nerves of sensation or those of 

 special sense. In other cases the spasms extend more or less over the 

 entire body. They occur in violent paroxysms, and may almost assume 

 the appearance of tetanic spasms, and still oftener of epileptic convul- 

 sions. Opisthotonos, pleurosthotonos, and orthotonos, are seen often 

 enough in hysteria, as are also clonic convulsions, which set the face, 

 trunk, and extremities into spasmodic motion. The patient often 

 foams at the mouth, his thumbs are clinched in the palms of thr. 

 hands the only sign, by which the attack may be distinguished from 

 an epileptic one, being loss of consciousness. Very often spasm in- 

 volves the group of muscles which operate in producing some complex 



