THE PHYSICAL EXAMINATION 35 



hygienic surroundings, quiet, rest, and much 

 open-air life, as well as entire freedom from 

 excitement. 



True hysteria is so marked in its action that, 

 like epilepsy, there is little likelihood of its exist- 

 ing unnoticed. A child possessing a strong tend- 

 ency toward hysteria will be frequently moody 

 and choleric or irritable. Or he will be sad and 

 melancholy, and will be likely to shun the society 

 of his fellows. The fits themselves generally 

 begin with a suffocating sensation, followed by a 

 rigidity, with consciousness much affected. Then 

 follow spasmodic shocks and a brief repose. This 

 is generally followed by violent shocks, then a 

 delirium filled with sorrows and appeals, then 

 subsidence, and the attack is at an end. This, of 

 course, describes a serious type of attack. Many 

 do not reach such an intensity. 



The causes seem to be heredity, or some excit- 

 ing cause, such as a fright or shock. Hysteria 

 may follow an accident. Exciting or depressing 

 emotions may bring on this affection. Fright is 

 perhaps the most common cause for children who 

 are predisposed to hysteria. Another cause may 

 be "defective education," the effect showing in a 

 child who has never been corrected, controlled, or 

 disciplined, who has been indulged in all his 

 caprices, and who has been allowed to develop 

 exciting emotions by any means he has desired. 



