Hysteria
Hysteria is a mental and nervous disorder arising
from intense anxiety. It is characterised by a lack of control over acts and
emotions and by sudden conclusive seizures and emotional outbursts. It often
results from repressed mental conflict. This disorder appears in both sexes,
but is far more common in young women of the age group between 14 and 25 years
because of their natural sensitivity. In many cases it tends to occur around
the period of adolescence and becomes less frequent after the age of 25. It is uncommon
after the age of forty-five years. Hysteria is an ancient disorder. The term is
derived from the Greek word hystron, meaning uterus. The diagnosis dates back
to ancient Greek medicine, according to which a variety of symptoms was attributed
to a wandering of the womb through the body.
The recorded history of the diagnosis begin in
ancient Egypt with the Kahnus Papyrus dating from about 1900 BC, which enumerates
a series of morbid states attributable to displacement of the uterus. In the
Middle Ages hysteria was associated with ideas of demoniacal possession,
witchcraft and religious fanaticism. Later it came to be solely related to the
female sex. Osler, an eminent psychiatrist defines hystria as "a disorder
chiefly of young women, in which emotional states control the body, leading to
perversion of mental, sensory, motor and secretory functions."
Symptoms
A wide range of symptoms are regarded as hysterical
The onset of hysterical attacks may be sudden, provoked especially by strong
feelings or may be heralded over a period of several hours by prodromal
features. The main symptoms include inappropriate elation or sadness, crying
without cause, almost conclusive laughter, deep sighing, cramps in the limbs,
mild rumblings in the belly and sense of constriction in the throat.
The symptoms of hysteria are of two degrees. In the
first degree, the patient may feel heaviness in the limbs, more severe cramps,
strong feeling of ascending abdominal constriction, continual sightings,
difficulty in breathing, construction in the chest, palpitations, feeling of a
foreign body lodged in the throat, swelling of the neck and of the jugular
veins, suffocation, headache, clenched teeth, generalized and voluntary tensing
of muscles of locomotion. The patient remains conscious during paroxysms. The
convulsions are usually milder and occur more often during the bending and
extending of limbs.
In the second degree, additional symptoms, besides
the preceding ones, are noticeable and these may include wild and painful
cries, incomplete loss of consciousness, enormously swollen neck, violent and
tumultuous heart-beats, involuntary locomotor muscle contraction, frightening generalised
convulsions, violent movement and frequent spitting. Sometimes the patient
jumps about on his / her bed and at other times adopt almost tetanic postures.
The attack may last several hours. There may be prompt return of consciousness
immediately after the convulsions.
The psychical
symptoms include a weakness of the will, a craving for love and sympathy
and a tendency to emotional instability. Hysterical people tend to react too
readily to suggestion and through this suggestibility they are swayed greatly
by their surroundings. The morbid exaggerated moods led to impulsive conduct
which may often seem irrational. Such people are liable to be much misunderstood
and misjudged. At times there may be much absent-mindedness, and loss of memory
about events or for definite periods. If this mental dissociation is severe,
one may develop hysterical wandering attacks, a state of double consciousness
or dual personality.
Hysterical trances may last for days or weeks. Here
the patient seems to be in a deep sleep, but the muscles are not usually
relaxed. In the most severe instance of this, the heart action and breathing
may be scarcely apparent that death may be suspected and the person buried
alive. Somnambulism or sleep-walking and catalepsy, where limbs remain in any
position in which they are placed, are other hysterical states.
Causes
The most common causes of hysteria are sexual excess,
or sexual repression, perverted habits of thought and idleness. Heredity plays
an important part in its causation. A nervous family, taint and faulty
emotional training, when young, are predisposing causes. The emotional shocks
may have been caused by mental or physical factors such as mental strain,
stress, fear, worry, depression, traumatism, masturbation and prolonged
sickness.
Hysteria is an extremely
mental phenomenon which may take varying forms. In certain types the disorder
may result from some situation to which ne is unable to adapt oneself such as
marriage, engagement, position of responsibility, the death of relations or
loss of love. Factors involving the sexual life in some way are frequently
present. A number of studies have indicated a possible connection between
hysterical symptoms and organic brain disease. A patient with epilepsy has
often been found to get hysterical attacks. Drug intoxication is another
organic brain disease closely associated with hysteria.
Treatment
Hysteria is curable in nearly all cases. Since the
causes of hysteria are both physical and mental, treatment should be directed
toward both the body and the mind. Regard for one’s physical welfare is of
primary importance. A healthy, well-functioning body is best able to keep the
reasoning mind in control of the total organism. The measures on the physical side should include a well- ordered
hygienic mode of living, a nutritious and bland diet, adequate mental and
physical rest, daily exercise , agreeable, occupation, fresh air, regular hours
of eating and sleeping, regulation of the bowels and wholesome companionship
with others.
On the mental plane, the patient should be taught
self-control and educated in positive thinking. Her mind must be, by some means
drawn away from herself. Proper sex education should be given immediately,
especially as regards sublimation of sexual desire or normal sexual indulgence
for the married patient. In most cases
of hysteria, it is desirable for the patient to start treatment by adopting an
all-fruit diet for several days. She should have fresh juicy fruits such as
orange, apple, grapes, grapefruit, papaya and pineapple during this period.
The all-fruit diet should be followed by an exclusive
milk diet for about a month. Most hysteria patients are considerably run down and
the milk diet will help build better blood and nourish the nerves. If the full
milk diet is not convenient, a diet of milk and fruits may be adopted. The
patient, may, therefore, gradually embark upon a well balanced diet of seeds,
nuts and grains. Vegetables and fruits. The patient should avoid alcohol, tea,
coffee, tobacco, white sugar and white flour and products made from them.
Jambul fruit, known as jamun in the vernacular, is
considered an effective home remedy for hysteria. Three kgs of this fruit and a
handful of salt should be put in a jug filled with water. The jug should be
kept in the sun for a week. Women suffering from hysteria should take 300 grams
of this fruit on an empty stomach and also drink a cup of water from the jug.
The day she starts this treatment, three kgs. more of these fruits together
with a handful of salt should be put in
another jug filled with water, so that when the
contents of the first jug are finished, contents of the other may be ready for
use. This treatment should be continued for two weeks.
Honey is regarded as another effective remedy for hysteria. Two of the main causes of hysteria are
irregularity of the menstrual cycle and insanity. Honey is invaluable for both
these conditions. It causes good bleeding during the cycle, cleans the uterus,
tones up the brain and the uterine musculature and keeps the body temperature
at a normal level. It is advisable to use honey regularly and increase the
quantity after the first start. It will bring down body temperature thus preventing further fits.
Exercise and outdoor games are important in the prevention
and cure of hysteria. They take the mind away from one’s self and induce
cheerfulness.
Yogasanas which are useful in hysteria are bhujangasana,
shalbhasana, matsyasana, sarvangasana, dhanurasana, halasana, paschimotanasana,
yogamudra and shavasana. Weak patients, who are not able to take much active
exercise , may be given massage three or four times a week.
Other measures useful in the treatment of hysteria
are air and sun baths. They are calming and at the same time invigorating to
the nerves. Daily cool baths are also an excellent tonic. Suitable physical
activity must be balanced with adequate rest and sleep. In case of hysterical
fit, the clothing of the patient should be loosened and her head lowered by laying
her out flat at once. She should not be allowed to assume an erect position for
sometimes after the fit. She should be slapped gently in the face and mustard
plasers applied to the soles of the feet and the wrists. In ordinary cases no
further treatment is necessary and the symptoms will soon pass off or cease if the
patient is left alone.
In a genuine
hysterical attack, the most effective means of interrupting the paroxym is
the application of cold water in some form to the head and spine. Either the
cold water may be poured or cold pack or ice pack may be applied to the hand
and back of the neck. If this cannot be done, cold water may be splashed on the
face. The patient should be provided with plenty of fresh air and some of her
clothing should be removed to facilitate easy breathing and to expose the skin to
fresh air. In a violent seizure of
hysteria, pressure on the ovaries often checks the attack. The patient should
be made to lie on the back and the first forcibly pressed into the iliac region.
As soon as possible, a neutral immersion bath at 98°
to 100°F. may be given and continued until the excited condition subsides. If
this is not convenient, a hot foot bath , with cold applications to the head,
may be used instead. Following an attack the patient should have rest,
quietness, darkness and if possible, sleep until the lost energy has been
gradually recovered.
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