HYSTERIA HYSTERICS. 35 1 



Tenderness over the spine is always a prominent symptom in these cases of 

 so-called spinal irritation. Often enough, however, it is not complained of until 

 specially inquired after, and now and then its existence is not even suspected by the 

 patient until she is made to wince on the application of pressure. Nervous pains, 

 nriu-iilgias of different kinds, often shifting suddenly from one place to another, are 

 a very common, perhaps the most common, symptom of this affliction. They are 

 often brought on by lifting any weight, by twisting or straining the back, or by any 

 effort, mental or physical ; and as often they are relieved, to some extent at least, by 

 lying down. Nausea, retching, and vomiting are also common symptoms, as are 

 spasmodic cough and difficulty of breathing. Palpitation is sometimes met with, 

 often in connection with a feeling of pulsation at the pit of the stomach, throbbings 

 in the temples, heats and flushes, and a tendency to faint. The contraction of the 

 limbs, which formed so conspicuous a symptom in the case we have quoted, is by no 

 means of uncommon occurrence in this form of hysteria. The lower extremities 

 are the parts most frequently affected, but occasionally the arms are also involved. 

 This contraction, which is generally painless, may continue for weeks or months, 

 even during sleep, or there may be occasional intermissions of short and uncertain 

 duration. The onset of the attack is usually very sudden, and the departure is often 

 equally abrupt. In a case occurring in one of the Paris hospitals, there was con- 

 traction of the leg of at least four years' standing. On account of the misconduct of 

 this patient, her physician gave her a stern admonition, and threatened to turn her 

 out. On the next day the contraction had entirely disappeared. In another instance 

 the patient was charged with theft, and the contraction, which had lasted for two 

 years, vanished suddenly from the moral shock caused by this accusation. As a rule, 

 there is no real paralysis of the limbs, and the functions of the bladder and bowel are 

 not interfered with. One of the most remarkable characteristics of this peculiar 

 complaint is the suddenness with which all the symptoms may disappear and be 

 replaced by others. The victims of this disorder are, with few exceptions, of a dis- 

 tinctly hysterical or nervous temperament. They are very prone to pass under or 

 after any strong emotion or excitement large quantities of pale limpid urine. They 

 usually suffer from sudden and distressing flatulent distension of the stomach and 

 bowels, with loud rumblings and explosions, accompanied by the feeling of a ball 

 rolling about, first in the left flank, and then mounting or tending to mount into the 

 throat, where it gives rise to a sense of choking and to repeated acts of swallowing. 

 At times they suffer from bursts of crying, sobbing, or laughing, and they may sigh 

 and yawn, and stretch the arms, and have fits of convulsive agitation and struggling. 

 Other symptoms from which they frequently suffer are breathlessness, nervous 

 cough, palpitation, throbbing in the temples or at the pit of the stomach, flushes and 

 chills, fainting, hiccup, nausea and vomiting, aversion to food or unnatural craving- 

 for it, heartburn, languor and debility, fidgetiness, tremulousness, singing in the ears, 

 and many others of a similar nature. 



Whatever the symptoms complained of may be, we suspect that the affection. 

 is hysterical if the patient is a young unmarried woman, if her menstrual 

 functions are performed irregularly, and especially if, at some former period., 

 she has suffered from fits of hysteria. Our suspicion is confirmed if we find 



