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. ”
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.
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.
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 fruits 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 applicatin 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 o to 100 o 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.