The sexual organization itself, in its various conditions and crises, exerts a powerful influence in producing or developing the developing the hysterical affection. As long as the sexual organs remain undeveloped, Hysteria does not appears, except perhaps in persons whose constitutional inclination to this form of disease is so to retard the sexual development. In like manner, after the cessation of the menses, when the sexual organs return to a second-childhood state of abeyance, Hysteria does not appear, excepts as the result of some organic disease of the uterus or ovaries. But after the accession of puberty, the retention of tardy appearance of the menses and all the various derangements of the catamenial, function, the excitements, incident to coition, conception, abortion, miscarriage, uterogestation and parturition may become capable of developing the constitutional predisposition to Hysteria, or perhaps of originating the disease itself where such predisposition did not exist. So sensitive, and delicately organized are some constitutions in respected to the sexual system, that the enforced continence of protracted virginity, the imperfect, incomplete performance of sexual inter course in the married, and the deprivation of such intercourse in those who suddenly become widowed, are alike capable of giving rise to hysterical affection; and even the moral sufferings of disappointed love, unrequited affection and inconsolable grief, have in many instances been known to lead to the same result.
The influence exerted in the production of Hysteria by the uterine life of the females is as unquestionable as it is unlimited. And this included all the organs of the sexual system; but most especially the ovaries, of which mention has already been made in this connection. An irritated condition of the ovaries we regard as being the foundation of and inseparable from the hysterical state. And even as inflammation will extend from one one serous or cellular tissue to another with great rapidity, even where the tissues themselves are not adjacent, so where the ovaries are in this chronic state of irritability, they exert by sympathy such an influence upon other nervous centres that the slightest irritation of their peripheral extremities may induce hysterical paroxysms. Thus in persons subject to Hysteria, which is but another name for laboring under chronic ovarian irritation, the reflex action from irritation of the gastric, the intestinal, or the uterine mucous surfaces, or even of the external cutaneous surface, is often sufficient to throw them into the most violent hysterical convulsions.
The remedies which may be used in cases of Hysteria are very numerous. Indeed there are but few in the Materia Medica, which have not in their pathogenesis some reference to this varied and ever-varying form of disease. Great care should therefore be exercised to prescribe the proper remedy at the commencement of the treatment; then very great caution should be observed in regard to repeating the dose; and still more in changing to another remedy. The habit of changing the remedy to suit the different phases of the disease is a most pernicious one; and this is still more especially true in cases of Hysteria, where a single disorder of the system assumes at different times such an infinite variety of forms. Some one or more of those grand characteristic symptoms, that are nearly always present, and that are observable by the patient herself or by her attendants, should govern the choice of the remedy. And when once thus carefully selected, the medicine must be allowed to act for days or seeks, or perhaps even months, in cases where the improvement continues so long, without repetition of the dose, and still more especially without changing the prescription.
And in cases of Hysteria, as also in epilepsy, or other chronic spasmodic affections, never prescribe for the convulsive stage per se; rather let it pass off by itself without medication. But observe closely all the symptoms; for it may bee that here, in the very last ultimation of the disorder, we may detect the symptom which shall conclusively indicate the remedy for the entire case. The characteristic symptom of a case, that which corresponds to the key-note of the appropriate, homoeopathically indicated remedy, may appear in the course of the convulsive attacks, or at their close; it may be the precursory herald of their approach, like the aura epileptica; it may appear only in the interval of comparative quite;or as, in those cases which have no positive spasms, it may be a more or less constantly attendant symptom; or finally it may even be merely a condition of aggravation or amelioration of time, place or circumstance.
Only a few of the leading and more frequently indicated remedies for hysterical affections can be mentioned here. The entire materia Medica has sometimes to be ransacked to find the true similimum for some of the forms of this disease; a disease whose forms are as numerous as the individual constitutions and temperaments of its subjects, multiplied by the innumerable physical, meral and moral influences which become the means of provoking, exciting or developing the original constitutional delicacy or hereditary predisposition.
Aconite. She has much fear, fear of going into places of business, into crowds, down town for example, or anywhere where many persons are actively passing and repassing. Vertigo on rising from a recumbent position. She dreads too much activity about her; she complains much of her head; she is possessed with a great and distressing fear of death. Predicts her day of death. Aconite, high, will remove all these symptoms; and with them, probably, the whole train of morbid sensations, if allowed to act a long time, with occasional repetitions when the improvement seems to have ceased.
Anacardium. Where great forgetfulness seems to characterize the case. Loss of memory. Uses profane language.
Arsenicum. Where a real hysterical asthma seems to be developed at every little excitement. Worse at night, particularly the latter part of the night. She cannot lie sown for fear of suffocation. She wants a little water every few minutes. Great fate of death. She has many other troubles, but these seem to to predominate.
Asafoetida. There is much trouble about the oesophagus; every excitement that brings on hysterical symptoms, points thither. Dryness and burning in the oesophagus. Sensation of pressure, or as if a body or lump were ascending in the oesophagus, obliging frequent deglutition to kept it down. This feeling in the oesophagus often causes great difficulty in breathing, Soreness in the oesophagus from the chest. When the hysterical symptoms develop themselves in this direction, Asafoetida will cure the case. Globus hystericus.
Aurum. The more her hysterical troubles are developed, the more her thoughts run on the act of committing suicide. This act is more or less constantly and forcibly in all her thoughts. In such cases, under the influence of Aurum, the patient will cease thinking of suicide, and she will get well. This remedy is also indicated by a fine eruption on the lips or face and forehead; and by thoughts of suicide with palpitation of the heart.
Belladonna. There is a general tendency of blood to the head, with redness of the eyes and face, which is still more developed in the spasmodic attacks. She moans very much, even at night, without much sleep. She is very despondent. She will and break pins into pieces, half a day at a time. She is very much troubled with throbbing headache, particularly over the eyes. She has a wild look. Sleepiness but cannot go to sleep.
Calcarea Carb. This important remedy will be particularly indicated in hysterical as in other affections, where the symptoms correspond, in persons of a leucophlegmatic temperament. She swells at the pit of the stomach, like a saucer turned bottom upwards. She has many spasms per day. She is easily chilled. She suffers from cold damp fee. Vertigo on going up stairs. Her menses are too frequent and too abundant. She is often unable to sleep after three o’clock in the morning. Cold feet at night in bed. She cannot go to sleep, her mind turning on the same thought all the time.
Causticum. One of her chief troubles is she cannot keep her upper eyelids up; they are paralyzed or nearly so, and will fall down over they eyes. She is very apt to have piles are made almost intolerable by walking.
Chamomilla. Great tendency to quarrel, to speak in an obstreperous manner. She has to restrain herself much in order to give civil answers to questions.
China, may be useful in cases which are usually worse every other day; and in such as are attended with unusual strong appetite. Sensation of distention in the abdomen.
Cocculus. IOn the fullest development of this disease, this remedy points to a choking constriction in the upper part of the fauces, with difficulty in breathing and an irritable cough or disposition to cough. Retarded menses, which finally appear with great weakness, so much so that she can hardly talk; or she feels nausea, even to faintness. A sensation or roaring in the ears as though there were shells before the ears.
