HYSTERIA HYSTERICS. 349 



contraction was as perfect as it is possible to conceive in fact, it was absolute 

 persisting night and day, during sleeping and waking, even resisting the influence of 

 sleep induced by chloroform. As her physician says, " Better conditions could not 

 be desired to render surveillance easy. I took care, moreover, to place near her two 

 devoted patients, bed-ridden like herself, who were ready to reveal all if they should 

 discover any trickery. I had there the best possible police, that of women over 

 women, for you are a \vaiv that if women enter into any plot among themselves they 

 veiy seldom succeed. This statement will, I believe, be sufficient to convince you 

 that simulation was impossible." 



There is a group of symptoms, known to doctors as " spinal irritation," which if 

 not identical with hysteria, is, at all events, closely allied to it. Its nature may be 

 gathered from the following condensed description of a case : 



The patient, an unmarried lady, aged twenty-three, first came under obser- 

 vation complaining of pains in the head and face, loss of appetite, nausea, 

 flatulence, palpitation, breathlessness, " sinking feelings," weakness, and low spirits. 

 The pain, which was the chief suffering complained of, was sharp and neuralgic in 

 character, and varying in its seat, being sometimes in one part of the head or face, 

 sometimes in another, and generally on the left side only. In the head it 

 confined to a spot which might be covered with the tip of the finger. Headache, in 

 one form or another, was brought on, or exaggerated, by any effort, physical or 

 mental ; it was usually relieved by lying down and keeping perfectly still ; it was 

 scarcely ever absent except when faceache had its turn ; and sometimes it was so 

 continuous and oppressive as to necessitate remaining in bed for days together. 

 Nausea and sickness were its frequent accompaniment, and vomiting and great 

 prostration were its common termination. In the upper part of the spine there were 

 considerable tenderness and a disagreeable feeling of weight, and pressure there 

 brought on or increased the headache, and induced a feeling of nausea and oppression. 

 The feet were always cold ; " chills and flushes " were of frequent occurrence, and so 

 were yawning, sighing, and stretching of the arms. Sleep was often made hideous 

 by nightmare ; fits of lowness of spirits and crying, attended by a sense of choking, 

 as from a ball or knot in the throat, and followed by plentiful gushes of pale, limpid 

 urine, were brought on by the most trivial causes, and the manner and appearance 

 were altogether those of an eminently nervous or hysterical person. 



These symptoms, it appeared, had their starting-point about twelve years before, 

 in the shock and grief caused by witnessing the death of a brother, her last remain- 

 ing near relative, in an epileptic fit. Before that the patient had enjoyed fairly good 

 health. Her family history, however, was bad, for in addition to the brother who 

 died in the fit, it appeared that she had lost her father from consumption, and that 

 her mother was then under confinement in a lunatic asylum. 



Under the use of a more liberal diet, with ammonia and calumba, and with 

 occasional blisters to the nape of the neck, health was re-established in little more 

 than a month. 



A year or so later this young lady again returned to her medical attendant, 

 looking very worn and thin, with all her old symptoms in force, and with 

 cough and difficulty of breathing in addition. The cough was very violent ; barking, 



