346 THE TREATMENT OF DISEASES. 



understood." She is very apt to think that every one is against her, that she is 

 neglected, and that even her best friends are intentionally unkind to her. She 

 entertains an exaggerated belief in her own importance. She is always thinking of 

 herself, and is apt to forget that she is not an equally agreeable object of contem- 

 plation to others. Often enough she is despondent and depressed, and she sheds 

 tears profusely, but a few minutes after has forgotten her grief and laughs 

 immoderately without any adequate cause. Laughing and crying alternate with 

 almost ludicrous rapidity, and sometimes even they may co-exist. Often the 

 patient is listless and indifferent to everything of ordinary interest, or she may be 

 absorbed in some trivial occupation. She may exhibit great restlessness and 

 impatience, with extreme irritability of temper 011 any attempt being made to control 

 her in any way. It is not uncommon for these patients to display an emotion 

 exactly the reverse of that which would be ordinarily excited. One, for instance, 

 draws the chief prize in a lottery, and begins at once to cry and ring her hands. 

 Another hearing that burglars have broken into the house and stolen the plate and 

 jewellery, sits quietly in her chair, with her hands folded in her lap, and seems rather 

 to enjoy it than otherwise. 



Excited sensibility is another very common accompaniment of the hysterical 

 condition. One patient cannot bear the light ; another is distracted by the slightest 

 sound ; to a third all ordinary odours are intolerable ; whilst to others certain tastes 

 are highly objectionable. Here is an example : " A middle-aged hysterical woman, 

 whom I saw in the hospital a few days ago, had been lying for weeks with her hand 

 before her eyes ' to keep out the light ' of a dull London sky. Bringing a candle 

 before her the room being so dark from an accidental fog that I could not see the 

 pupils she shuddered, knit her brows, and held both hands between her and its 

 feeble light. There was no undue contraction of the pupils, and when her mind was 

 distracted to the condition of her front teeth the light being still close to her eyes 

 the brows were relaxed, the hands removed, and there was no expression whatever 

 of uneasiness." The same author, in describing another case, says : " A lady to 

 whom I was speaking lately, in a tone by no means loud, exclaimed in a voice much 

 noisier than mine, and putting her hands to her ears at the time, * Not so loud, not 

 so loud ! ' but a moment afterwards she stirred the fire so vehemently, and made so 

 much noise in the process, that it was positively annoying to myself, and this 

 without appearing to give herself the least uncomfortable sensation." 



Illusions and hallucinations are by no means uncommon in hysteria, and may be 

 connected with one or more of the senses. In the majority of cases the patient at 

 once recognises the fact that they are illusions, and nothing but illusions. She 

 sees certain things, but she is aware that they are purely ideal and that they have no 

 actual existence. She does not " believe in them," and they exert no influence over 

 her actions. Moreover, they are rarely permanent, and soon take their departure. 



Hysterical people often complain of pain, which is chiefly muscular in origin. It 

 is often experienced in the chest or back, and especially between the shoulders and 

 over the loins. A very common hysterical pain is that occupying some one point in 

 the head ; the patient speaks of it as a sensation like that which might be caused by 

 driving a nail into the part. It is often situated just above one eyebrow, and it 



