420 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



time it is to be admitted that fanatical enthusiasts, who devoutly be- 

 lieve in their own wonderful gifts, and who are sustained in such be- 

 lief by their experiments with hysterical persons, are capable of much 

 more than mere impostors, who speculate in animal magnetism. The 

 power of reason usually remains unimpaired in hysteria. Like other 

 people, they are able to connect one idea with another, and to form 

 correct conclusions, although they are so preoccupied with a sense of 

 their own sufferings as to be unwilling to think of other matters. A 

 very prominent peculiarity in hysteria consists in the loss of power of 

 the will to control the movements of the body. This peculiarity is also 

 attributable to the almost absolute control which the mental excite- 

 ment has obtained. Even persons in good health, when agitated in 

 mind, pay less attention to the motions of their limbs, and do not, by 

 any action of their will, restrain their reflex movements which arise 

 during the agitation. In spite of the authority of Momberg, I cannot 

 agree with those who believe the enfeeblement of will of the hyster- 

 ical to be the result of a reflex action of such intensity as to overcome 

 the action of volition. The real state of the case I believe to be ex- 

 actly the reverse. At my clinic, I have nearly always succeeded in 

 producing a fit of hysterics in suitable cases, or in exciting a slight 

 attack into one of great violence, by expressing great sympathy with 

 the patient, and by assuring her that the fit was going to be a bad 

 one, thereby so agitating her as to hinder her from bringing her will 

 to act upon her motions. On the other hand, by treating the patient 

 roughly during the paroxysm, by throwing glass after glass of water 

 in her face, and by threatening to keep it up to the end of the attack, 

 I have nearly always been able to stimulate the patient to a vigorous 

 exertion of her will, and thereby have put an end to the involuntary 

 movements. Uneducated bystanders, and superficial observers, when 

 they see how manifestly the fits depend upon psychical influences, are 

 very apt unjustly to suspect the patient of an imposture. Besides, the 

 course of the attack, as described above, corresponds exactly with the 

 well-established facts of physiology regarding reflex action and the 

 effect of the will upon it. 



There is much variety as to the course, duration, and results of 

 hysteria. In most instances the disease comes on gradually. At 

 first, the cnly symptoms are those of bodily and mental hyper- 

 aesthesia and their consequences ; and it is not until afterward that 

 the convulsions and other symptoms of greater or less violence show 

 themselves. Sometimes they never appear. In rare instances the 

 complaint begins with an attack of hysterics running an acute course, 

 the other symptoms not making their appearance until afterward. At 

 the menstrual period, and immediately prior to it, the disease is almost 



