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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
ones 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 ones 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.
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