HYSTERIA. 423 



it to my pupils as one of the most effective of nervines, I ascertained that 

 the chloride of gold has been recognized as a special re-agent upon tho 

 nerve-tissues, and that it is much used for this purpose in microscopic 

 investigations. Such a discovery, probably, would never have induced 

 me to make use of it as a remedy, but now this piece of information is 

 of great importance to me, as a confirmation of the fact that the cura- 

 tive action of this remedy had been rightly interpreted. I prescribe 

 the chloride of gold and sodium in the form of a pill (]J auric, chlorat,. 

 natronat. gr. v; gummi tragacanth. 3 j ; sacc. alb. q. s. u. f. pil. No. 40). 

 Of these pills I at first order one to be taken an hour after dinner, and 

 another an hour after supper. Afterward I order two pills to be taken 

 at these hours, and gradually increase the dose up to eight pills daily. 



In some cases of severe hysteria where fulfilling the causal indica- 

 tions does not answer the purpose, or where the origin of extensive hys- 

 terical disturbances of innervation cannot be discovered, either in the 

 sexual apparatus or other organs, I have experienced some excellent 

 results from the use of bromide of potash in increasing doses (fully 

 described in the treatment of epilepsy), while in other cases it failed 

 entirely. An esteemed colleague also, who has a large consultation 

 practice, informs me that, when he is unable to refer severe nervous 

 symptoms to structural changes in the central organs or the peripheral 

 nerves, he often resorts to this effective but empirical remedy. 



Moral treatment is of the utmost importance in all cases of hys- 

 teria, whatever may be the source of the disease. Homberg very 

 properly observes : " Psychical treatment is of such importance that, 

 without it, all other remedies fail." Every thing depends upon our 

 exercising the patient to " oppose the impulse of the will to the reflex 

 impulse." It of course depends upon the peculiarities of the patient 

 as to what measures we shall resort to in special instances. When 

 they have shown themselves to be willing and obedient, and seemed 

 to place reliance upon my directions, I have ordered them to take 

 a cold shower-bath twice a day, and to keep under the shower as 

 long as the utmost exertion of their will would enable them to 

 do so. 



[Electricity is serviceable not only against certain symptoms of 

 hysteria, such as paralysis, anaesthesia, neuralgia, etc., but it is as- 

 serted to be of positive benefit for the general disease. The best 

 application is the induced current in the form of " general electri- 

 zation," as recommended by jBeard and Rockwell, where currents 

 of moderate intensity are passed over the entire surface.] 

 77 



