A neurotic disorder characterized by a wide variety
of somatic and mental symptoms resulting from dissociation, typically
beginning during adolescence or early adulthood and occurring more
commonly in women than men.
HYSTERICAL NEUROSIS - Symptoms and Signs
Conversion symptoms: Almost any organ disease
symptom can be simulated on an hysterical basis; eg, symptoms mimicking
the illness of a deceased relative. A variety of sensorimotor symptoms
have been considered to be specific to and characteristic of hysterical
neurosis. Weakness and paralysis of muscular groups are common;
spasms and abnormal movements, less frequent. The motor disturbances
are usually accompanied by altered sensibility, especially those
involving touch, pain, temperature, and position sense. Especially
characteristic are the "glove and stocking" distribution
of the motor and sensory disturbances when these affect the limbs;
ie, the distribution is determined by the body-image concept of
a functional arm and leg rather than the dermatome innervation of
the area affected. Another common distribution is complete hemianesthesia,
which extends exactly to the midline of the body fore and aft. Less
frequently, special senses and functions may be affected, such as
in hysterical blindness, deafness, and aphonia; both visual and
auditory hallucinations may occur.
Dissociative phenomena: A variety of altered states
of consciousness may result from the dissociative process. In somnambulism,
the patient appears to be out of contact with his environment, is
seemingly unresponsive to external stimuli, and in many cases appears
to be living out a vivid, hallucinated drama, often the memory of
some past emotionally traumatic event. In amnesia, the most common
form of dissociative hysteria, the patient typically has a complete
loss of memory for all past events covering a period of several
hours to several weeks. Anterograde amnesia may occur, wherein the
amnesia covers the memory of events as they are experienced, the
patient forgetting continuously from moment to moment what he has
just been thinking, feeling, and doing. For a discussion of amnesia
as a functional syndrome in organic cerebral disease.
HYSTERIA - Homeopathic Treatment
& Medicines
#Ignatia. [Ign]
Ignatia is the great homoeopathic remedy for Lagrande nevrose. In
its provings it is a hysterical remedy. Briefly, its symptoms are
great sensitiveness to external impressions. Patients laugh and
cry alternatively; the face flushes on the slightest emotion; spasmodic
laughter which oftentimes ends in screaming; the globus hystericus
is present and so is the clavus hystericus which shows itself as
a sharp pain, as if a nail were being driven into the top of the
head. Thuja has the same pain in the frontal eminence. Both Thuja
and Coffea have the same pain in the occiput. In Ignatia there is
an emission of a profuse, pale urine and this oftentimes relieves
the headache. There are present in the Ignatia patient flatulent
conditions and contortion of the muscles. The globus hystericus
is found under a number of drugs, but Ignatia and Asafoetida have
it the most prominent. The convulsive symptoms of Ignatia are as
varied as the moods of the drug; there may be only a slight convulsive
movement about the throat in drinking , or there may be severe spasms
with clenched hands and blue face greatly resembling those of Cuprum.
The return to consciousness is always accompanied by a sigh and
a deep inspiration. Fear and grief are prominent symptoms of the
hysteria of Ignatia; it is a long suffering grief and the patient
is aggravated by the constant nursing of it. Another interesting
and, one may say, hysterial point about Ignatia is the numerous
contradictory items found in its pathogenesis. Thus we have headache
relieved by stooping, soreness of the teeth better by eating, sore
throat better from swallowing, fever without thirst and chilliness
relieved by uncovering ; the cough is even contradictory, for the
more the patient coughs the more he wants to cough, and it is only
stopped by an effort of the will. In fact, the Ignatia patient is
very much like what Sir James Paget described hysteria to be, namely:
"It says 'I cannot.' 'I will not'; but it really is 'I cannot
will.' " Richet says all mediums are chosen among the "grandes
hysteriques.
#Asafoetida. [Asaf]
One of the characterizing feature of hysteria is the globus hystericus,
or the sensation of a ball in the throat. Asafoetida has this symptom
very prominently. It seems with this drug to be a sort of reversed
peristalsis and it is especially the remedy if the nervous symptoms
be in any way due to the checking of habitual discharges. Another
important symptom of Asafoetida is the accumulation of flatus in
the abdomen; it passes upwards and causes oppressed breathing. Owing
to this the symptom is found that this ball-like sensation above
referred to, starts from the stomach and rises to the throat , and
it is naturally made worse by overeating and by motion. It is a
bursting feeling, as if everything would come out of the mouth.
Hysterical colic is, therefore, well met by Asafoetida. Magnesia
muriatica has some of these symptoms; flatus collects and rises
like a ball in the throat, almost preventing breathing ; relieved
by eructations. With Asafoetida the patient swallows continually
to keep the lump down, and this gulping adds to the difficulty in
breathing. There is a great deal of restlessness and anxiety with
Asafoetida and a changeable mental condition. The muscles jerk and
twitch. The entire system is over-sensitive. Hysterical convulsions
due to suppression of discharges will often indicate Asafoetida.
Predominance of the throat symptoms should lead one to think always
of Asafoetida.
#Moschus. [Mosch]
Fainting is the great keynote of Moschus. When hysterical attacks
are found with fainting, other drugs may be indicated. Asafoetida
may be indicated , Cocculus, Ignatia or Nux moschata, but in most
cases Moschus will be the simillimum. It is especially the remedy
for the paroxysm. The stimulation of tetanic spasms, the unconsciousness
or frequent swooning will point to Moschus. Hughes says no remedy
is as good as Moschus for this condition, and Dr. J. Heber Smith
termed it an indispensable remedy in hysteria. Muscular twitchings
are present and violent spasm or constriction of the chest. She
may even turn blue in the face, foam at the mouth and be chilly.
Moschus, too, has a profuse discharge of pale urine, the globus
hystericus, headache and flatulent symptoms. Oftentimes the fainting
and loss of consciousness will apparently be due to the pressure
of gas on the solar plexus of the sympathetic; violent eructations
of gas occur in these cases and relieve. Uncontrollable laughter
is also a symptom of Moschus, also the alternate moods of joyfulness
and sadness. Sexual desire is increased and symptoms of Nymphomania
or Satyriasis may be present. Hysterical attacks or hiccough may
be met by Moschus, and in the loud eructations in nervous hysterical
people it is said to be our best remedy. A mental condition of Moschus
is a tendency to scold and the patient scolds himself into a fit.
Palladium is another remedy for strong language and scolding. To
sum up, Moschus is indicated by the fainting, by the suffocative
attacks by the crying and laughing, globus hystericus, profuse pale
urine, and by the sudden attacks of unconsciousness. Another remedy
of an animal origin similar to Moschus is Castoreum, and this remedy
also presents a long line of nervous symptoms. It suits in many
instances the symptoms which precede hysteria such as an irritable
weakness. Those who are on the borderland of hysteria may be benefited
by Castoreum.
#Tarentula. [Tarent]
Among the animal remedies -- and they are all great produces of
nervous symptoms -- the spider poisons stand first in the production
of symptoms simulating hysteria. Perhaps the most marked of these
is the Tarentula Hispana, not the Tarentual Cubensis, which is the
carbuncle remedy, but the Spanish spider. This remedy is useful
in hysteria; the paroxysms are apt to be feigned, and the patient
has immoderate attacks of uncontrollable laughter. The most prominent
symptom of the drug, however, is restlessness and trembling of the
limbs; the patient is compelled to keep continually on the move.
There is excessive hyperaesthesia, the spine is sensitive, the ovaries
are sensitive, and there is apt to be nymphomania. It has been found
useful in hystero-epilepsy, which, by the way, is quite a rare affection.
Theridion and Mygale are two of the spider poisons which may be
found useful in hysterical conditions; the great predominating sensitiveness
to noise will call Theridion to mind, and the chorea-like twitchings
will suggest Mygale. Tarentula will be easily recognized by the
constant motion of the extremities, perhaps by the fact that music
soothes, by a constrictive headache, and by the feigned fits of
uncontrollable laughter. For great fidgetiness of the feet, thinks
always of Zincum valerianate; it is our best remedy for this condition.
It is a common symptom in hysterical condition where chronic uterine
disease is present.
#Platinum. [Plat]
Platinum has an altogether different form of hysteria than of the
animal poisons, and it is quickly and easily characterized by its
haughty mental codition. One might say, as an English girl put it:
" She walks about with the h'air of h'an h'empress." Self-esteem
is prominent, and she looks down on every one. No other drug in
the Materia Medica has this symptom as prominent as Platinum. There
are also paroxysms of laughter, which are very loud and boisterous;
in fact, oftentimes the condition borders on the maniacal. The genital
organs are very sensitive; there is apt to be titillation, even
nymphomania. It is in these genital cases that it finds its best
use. Hysterical spasms will call for Platinum when caused by nervous
excitement; there is present constriction of the oesophagus and
a suffocative feeling. Platinum may be easily distinguished from
Ignatia by the mental condition above referred to. Ignatia is decidedly
undemonstrative, while Platinum is absurdly supercilious. Melancholic
conditions are also found under Platinum; the patient is morose
and discontented, and has a disposition to weep. The extreme nervous
condition makes her sleepless. Hyoscyamus must be compared with
Platinum. It has nymphomania, but with more desire to uncover one's
self. The proud mental condition of the drug will always distinguish
it. Palladium is very similar to Platinum; in many respects it may
be distinguished by lacking the haughtiness of Platinum and having
a tendency to be continually "slighted."
#Valeriana. [Valer]
Valeriana is a remedy largely used in the allopathic school for
hysteria, and forms one of the main props of their treatment. As
a remedy for hysteria in the homoeopathic sense it has some useful
symptoms. As under Tarentula,the patient must keep continually on
the move; but exertion causes headache, and the slightest pain causes
fainting. There is a sensation as if something warm were rising
from the stomach; this causes a difficulty of breathing; there is
also present fear, tremulousness, and palpitation. With Valeriana
there is a general state of nervous excitement; the patient is apt
to be joyous, lively, and talkative. A tendency to flushes of heat
is often present. It has also the globus hystericus, and there are
many pains simulating rheumatism. Nervous agitation is its most
marked symptom, and this together with warm sensation rising from
the stomach should distinguish. The alternations of mood which are
prominent with the remedy should not be overlooked. It seems to
be the remedy for the hysterical habit.
#Nux moschata. [Nux-m]
This is also one of our good remedies in hysteria. It is especially
adapted to nervous hysterical people who change rapidly from grave
to gay, but its great distinguishing features are its sleepiness,
its bloating, and its dryness of the mouth. It has also attacks
of fainting, the patient is exhausted from the least effort. There
is a continued constant nervous tension differing from Ignatia in
that the latter is paroxysmal. The symptoms of bloating, which usually
occur after eating, will call to mind Lycopodium and Carbo vegetabilis,
but both these remedies lack the hysterical element of the Nux moschata
bloat. Nux moschata also has a dry,nervous, hysterical cough, oppression
of the chest and fainting fits. Inclination to faint is quite common
with the drug. Bayes say: " In hysteria, particularly the globus
hystericus, few medicines act more promptly." He recommends
the 3 to 6 decimal dilutions. He also says: " In violent hysteric
attacks a drop of Rubini's Camphor on a little lump of sugar every
five or ten minutes is invaluable." This is probably palliative,
as Camphor has no special hysterical symptoms.
#Gelsemium. [Gels]
This remedy has a few marked symptoms which indicate its usefulness
in hysteria. It is especially the remedy in hysterical convulsions
with spasms of the glottis. There is excessive irritability of the
mind and body with vascular excitement, semi-stupor with langour
and prostration. There is a feeling of a lump in the throat which
cannot be swallowed, and there is a copious flow of pale nervous
urine . Gelsemium is adapted to both male and female onanists, and
corresponds especially to the hysteria of the later class. The rigid
os so characteristic of Gelsemium is usually found in hysterical
women who suffer from great nervous excitement, hence the usefulness
of that remedy in this condition. Great numbness of the extremities,
also fear and apprehension ; however , langour and malaise are nearly
always present. Sulphur has copious discharge of watery urine at
the termination of her spasms. This, however, is a common hysterical
symptom, and little reliance can be placed on it as a guide to the
remedy. Vesical irritability with constant desire to urinate in
hysterical patients is well met by Gelsemium.
#Pulsatilla. [Puls]
The hysterical symptoms of Pulsatilla are quite prominent. It has
a constriction in the throat, something there seems to impede speech.
There is a constant change in the feelings and symptoms of the patient,
and here we have again the profuse watery urine. Like Ignatia, there
is a melancholia, sadness, and weeping;but the Ignatia patient weeps
in solitude, while the Pulsatilla patient gushes out her grief anywhere,
and seeks sympathy and consolation and seems to be made better by
it. The open air, of course, relieves the Pulsatilla patient. Menses
are scanty, and the patient complains of constant chilliness. Hysterical
attacks at puberty may indicate Pulsatilla. Fainting fits are common,
and there is apt to be suppression of menses as leading up to the
nervous attacks. Sepia, too, is a prominent remedy for hysteria
associated with uterine symptoms but it is easily distinguished
by the general symptoms. Apis has hysteria at puberty, with amenorrhoea
and awkwardness; patient drops things, is clumsy.
#Belladonna. [Bell]
Belladonna may be a remedy in hysteria when there is much boisterous
excitement, red flushed face, dilated pupils, and the general symptoms
of the drug. There is a rush of blood to the head during the spasmodic
attacks and a wild look. Hyoscyamus has the desire to uncover and
go naked, due perhaps to hyperaesthesia of the skin, the silly laughter
and the muscular jerkings; and Stramonium may have its turn when
the patient is full of absurd fancies, loquacity, etc., but these
remedies are among the infrequent ones in the treatment of hysteria.
#Kali phosphoricum. [Kali-p]
This remedy, one of the tissue remedies, has been found clinically
to be one of our good remedies in hysteria. It is called for in
attacks from sudden or intense emotions, or passions in highly nervous
and excitable patients; the globus hystericus is present; there
are fits of crying and laughter and yawning. There may be spasms,with
unconsciouness. Abdomen tympanitic and sensitive to slightest pressure.
Kali phosphoricum may be borne in mind for these symptoms: Nervous
dread without any cause, looks on the dark side of everything, sighs
and is despondent; fidgetiness and trembling.
#Other remedies.
Agnus castus may come in where there is lasciviousness. Anacardium,
where two wills, one contradicting the other , are present. Cactus
has a few hysterical symptoms, as sadness, crying without reason,
consolation aggravates, love of solitude, fear of death , whole
body feels caged in wires. Cocculus, hyperaesthesia and faintness.
Arsenicum, hysteria and dysmenorrhoea. Sticta, hysteria after loss
of blood, and Cannabis Indica. " This remedy , " says
Hale, " is more closely allied to the hysterical malady than
any drug in our Materia Medica." Isolated symptoms may call
for isolated remedies , and more can be done by treating hysteria
and its manifold phases homoeopathically than by all the nervines
known. |
