Diseases of the nervous system / edited by Archibald Church.

Date:
1908
Catalogue details

Licence: In copyright

Credit: Diseases of the nervous system / edited by Archibald Church. Source: Wellcome Collection.

    1119/1256 (page 1077)
    times paralytic. Here, in addition to hysterical vomiting, which may be independent of cardialgia and hyperalgesia of the mucous membrane of the stomach, hysterical eructations, hysterical meteorism, hysterical borborygmi, etc., have been reported. While the corporeal symptoms of hysteria are exceedingly variable the PSYCHICAL PERMANENT SYMPTOMS on the whole are much more uniform. We include these psychical permanent symptoms under the term “hysterical psychopathic constitution.” I may limit myself, in the description of this condition, to pointing out the connection with the corporeal symptoms and its influence upon the latter. The psychopathic constitution is characterized by the following factors: the variation in sensation and emotional conditions and especially the tendency to extremes, the pathologic absent-mindedness, the pathologic increase of phantasy, the inclination to paramnesia, the faculty of translating emotional impressions into hallucinations and even into “fixed ideas,” the entire ab- sence of objectivity and finally the abnormal suggestibility. It is obvious that these psychical symptoms are in intimate relation and are all subject to the general principle which dominates the entire symp- tomatology of hysteria 1: they may all be referred to the abnormally increased activity of emotional impressions. That the corporeal symptoms, in many cases, are also due to this is plain from our preceding description. It is self evident from this condition of affairs that the bodily symptoms of hysteria are in close relation to the psychical ones. I shall only indicate a few prac- tical and important examples. The intensity of the corporeal symptoms, in many cases, depends upon pathologic variations of the emotions; we have indicated this dependence several times. Many symptoms are first produced by this variation in the perceptions, many are increased by any emotional irritation. On the other hand a marked swaying of the emotional condition, in the sense of a diver- sion, may cause a tenacious hysterical symptom suddenly to disappear. Al- most quite as significant is the role of the pathologic absent-mindedness for the corporeal symptoms. The hysteric is confused, i. e., inattentive in the sense of a defect of tenacity or concentration of attention, in so far as these emotional impressions are concerned. It must, therefore, not excite surprise if, in taking the field of vision, in dynamometric and ergographic investi- gations, etc., often very dissimilar results are obtained. Even the personality of the investigator may play a part. Janet and other authors have even attempted to refer the hysterical anesthesias and paralyses to pathologic in- attention. Although an analogy exists between the hysterical symptoms of absence of function and physiologic inattention, Janet’s view is entirely too one-sided. The active causative factor which also dominates the hysterical symptoms of absence of function, namely the importance of the conception of not being able to move, or to feel, etc., is overlooked. The tendency to abnormal imagination and to the transformation of memory impressions is i Thus it happens that in the history of the teachings of hysteria almost every one of the psychical symptoms that haye been mentioned has been regarded by some author as the underlying principle of all of the others.