

352 THE TREATMENT OF DISEASES. 



that these symptoms have existed for a considerable time, without any corre- 

 sponding deterioration of the general health or strength. "When the complaint 

 simulated is some form of inflammation, the thermometer renders good service 

 in enabling us to distinguish between the true and false disease. In real 

 inflammation there is always elevation of temperature, whilst in its counterfeit 

 presentment there is no fever. Hysterical affections have all a strong family 

 likeness, and this often enables us to decide upon the nature of a doubtful case. 

 Moreover, there is a peculiar expression about hysterical women, impossible almost 

 to define, yet readily recognised when once it has been observed. They crave 

 for sympathy, and always endeavour to make out that they are worse than 

 they really are. 



Hysteria, when once established, is a very difficult complaint to cure. The 

 most hopeful cases are those which have been recently established. In young 

 people much may be done to avert a tendency to hysteria by judicious mental 

 and moral training, but when the disease has taken a firm hold of its victim, 

 it often requires a long course of treatment to restore the nervous system to 

 its former degree of stability. It is important to keep the bowels in order by 

 carefully-regulated diet, or, if necessary, by the cautious administration of aperients. 

 The cold sponge-bath, exercise in the open air, either on foot or horseback^ 

 and the avoidance of hot, close rooms, are important elements in treatment. 

 Hysterical girls are often in the habit of sitting up late at night novel-reading, 

 and of lying in bed in the morning ; this should be put a stop to without a moment's 

 hesitation. Systematic study should take the place of light literature, a change 

 which works wonders in improving the general mental and moral condition. 

 There is no one drug that can be trusted to cure hysteria, and each case must 

 be treated on its own merits. The first thing is to endeavour to improve the 

 condition of the general health. When there is anaemia we give iron (Prs. 1 7), 4 

 and when there is want of nervous energy we rely on quinine (Pr. 9), or nux 

 vomica or phosphorus (Pr. 53 or 54). If there be indigestion or flatulence, we resort 

 to one or other of the remedies mentioned when speaking of those complaints. 

 Decided benefit is often derived from a course of bromide of potassium (Pr. 31), 

 and sometimes large doses succeed when smaller have failed. Valerianate of 

 zinc is a valuable remedy in hysteria. The chief indications for its employment are 

 hysterical spasms coming on, chiefly in the evening, a lump in the throat, a profuse 

 discharge of clear watery urine, great sensitiveness and tendency to shed tears, 

 and neuralgia, especially if situated in the neighbourhood of the groin. The dose 

 is five grains three times a day, and it may be given either dissolved in water or in 

 pills. Musk and assafo3tida are often used in hysteria, but they seldom do much 

 good, at all events permanently. 



Now, as regards the " spinal irritation " cases. The application of leeches or a 

 blister to the affected portion of the spine will often do a great deal of good. Cases 

 that have existed for months are sometimes cured in a single day by a good large 

 blister. As regards medicine, benefit is often derived from the use of the ordinary 

 tonics, such as quinine, steel, cod-liver oil, and the different preparations of phos- 

 phorus. It is, no doubt, advisable to avoid standing or walking to the extent of 



