II. Between the paroxysms – 1. Occupation – Besides regular out- of-door walking exercise, cheerful society, conversation, and recreation, physical and mental occupation of a useful natural should be strictly enjoined. Healthy, useful employment should become a uniform habit, and the patient be led to feel that life is not a mere holiday to be passed in frivolity and idleness, but a highly important period of existence to be spent in usefulness and enjoyment. Absence of occupation favours that meditative mood into which hysterical patients are liable to fall, and renders cure difficult. See also observations on occupation under “Accessory Measures” in the next Section.* (*Recently the Author met with a striking confirmation of the value of useful occupation as a cure for Hysteria. A patient, a young lady, who a few years ago gave him much trouble, and was an occasion of great anxiety to her friends, happily had her attention and interest excited in a great benevolent scheme for ameliorating the condition of orphan children. The carrying out of this scheme necessitated much thoughtful attention and no inconsiderable physical application. But from the wholesome direction thus given to her thoughts and the new purposes infused, and work given her to do, she has been lifted out of her former self, and has now become to the fullest extent, healthy and happy.
2. Removal from home influences – Nothing, perhaps interposes greater obstacles to recovery than the misplaced tenderness, anxiety, and sympathy of friends, and the constant recurrence of influences which tend to perpetuate the disease; so that sending the patient from home away from her accustomed habits and associations, under the care of kind but judicious friends, offers a favorable chance of recovery. This is easy of accomplishment in the poorest classes, who can be sent into a hospital, and in the richest, who can be placed under the care of a physician or competent friend. But this is often next to impossible for the families of retail shopkeepers, curates, village doctors, and the others, from the union of a light purse with a weighty feeling of independence. One plan can sometimes be adopted – namely, to negotiate an exchange of patients where families of about the same social standing are simultaneously afflicted with a hysterical member (Chambers).
3. Disuse of Stimulants – The daily consumption of alcoholic beverages for the debility and other symptoms of Hysteria is a delusion, and should be strenuously opposed. In Hysteria, wine is a mocker. It yields but the semblance of strength, and instead of benefiting, it tends to confirm and perpetuate the worst symptoms of the complaints. There is, too, real danger lest the patient should soon begin to appreciate the pleasurable sensations yielded by alcohol so highly that she ultimately becomes an inebriate. Faintness from defective nervous supplies is relieved by stimulants, but the exhaustion quickly returns, with the temptation to seek relief by the same remedy. It is most difficult to persuade the patient that the exhaustion is really increased and perpetuated by the stimulant, and that if she will withhold the irritant draught the nerve power will recover, the appetite return, and the functions be restored.
4. The Shower Bath. – The fortitude involved in submitting to the shock of a cold shower bath is splendid discipline, and aids the cure by giving the patient more moral power. Besides, shower- baths improve the circulation by forcing the venous blood to the heart and lungs, and bringing arterial blood to the surface, as seen in the healthy glow of the surface of the body. Patients not accustomed to bathe may commence by taking a few tepid baths. To prevent the inconvenience arising from wetting the long hair of the head, an oiled silk covering may be used to keep it dry.
5. General Cautions – Crowded, badly ventilated, and too brilliantly lighted churches, theatrical exhibitions, exciting sensational novels, tight stays, and late hours in retiring at night and rising in the morning, should be resolutely forbidden. The diet, rest, study, recreation, as well as the various bodily functions, should receive intelligent and uniform attention. When speaking to a sufferer about her disorder, it is well to avoid the term “Hysteria,” and to assure her that it is curable and not dangerous.
HYSTERICAL RETENTION OF URINE – Dr. J.W. Curran recommends a simple and prompt remedy for this distressing symptom – viz., plunging the hands in a wash-hand basin full of coldest water, and moving them about in it, as if in the act of washing. In every instance in which this expedient was tried it was immediately successful; it may, therefore, be recommended for general adoption as more convenient than a warm hip-bath, and infinitely more desirable than the use of the catheter. The latter, as a rule, is both unnecessary and improper in such cases of retention. As confirmatory of this, any person may notice that the plunging of the hands into cold water, when urine has accumulated to any extent in the bladder, is rapidly followed with an irresistible desire to urinate, although the desire to do so had not been previously felt.
23. SPINAL IRRITATION (Neuralgia Spinalis)
DEFINITION – A localized tenderness over the spine, induced or aggravated by pressure on the tender spot, with constitutional weakness, and various reflex symptoms. Spinal irritation is often a combination of the myalgic and hysteric conditions. The affection is essentially nervous in its character, and leaves no discernible post-mortem traces.
VARIETIES – There are several varieties according to the locality of the lesion. 1. Cervical. The tenderness being in the back of the neck. The accompanying symptoms may be headache, faceache, fits of insensibility, affections of the arms, cough, and even pain in the stomach, sickness, or vomiting. 2. Cervico-dorsal. The tenderness being centred at the junction of the neck, and chest, and the pain in the stomach and side, oppression of breathing, heartburn, and palpitation are more decided. 3. Dorsal. In this variety the hyperaesthesis is in the upper parts of the back, with the symptoms of pain in the stomach and side, oppression of breathing, heartburn, and palpitation are more decided. 3. Dorsal. In this variety the hyperaesthesis is in the upper parts of the back, with the symptoms of pain the stomach and side, cough, oppression, fainting, hiccough, and eructations. 4. Dorsolumbar. Here the tenderness is in the waist, and in addition to the symptoms in the previous variety, there are pains in the abdomen, hips and legs, and urinary troubles. 5. Lumbar. The tenderness is below the waist, and there may be a tendency to a kind of paralysis or great weakness of the legs, in addition to the symptoms mentioned under the last variety. 6. Fugitive tenderness in different portions of the spine, with the various symptoms previously mentioned correspondingly modified.
SYMPTOMS – The initiatory are, generally, headache, limited in one spot or in one side, or to the brow or cheek, with sleeplessness, distressing dreams, or nightmare, nausea, or vomiting, cold hands and feet, and alternate chills and flushes. All the symptoms are intensified by exertion, bodily or mental, and the patient evinces an almost constant desire to lie down. The symptoms differ according to the part affected (See Varieties), the most characteristic one being local tenderness.
SPINAL IRRITATION AND OTHER DISEASES – Spinal irritation may stimulate or co-exist with Hysteria; but to the skilled observer there are distinguishing features. In Hysteria the sole of the foot, and the skin generally are commonly insensible to tickling; in spinal irritation, on the contrary, irritability is intensified. Patients do not complain of such extreme depression of strength as in Hysteria, but are chiefly weak when in pain. This affection may be distinguished from actual disease of the spine by observing that the tenderness, though excessive, is Superficial, and the patient complains more when the skin is touched than when the vertebrae are pressed. There is also the absence of impaired nutrition, wasting, and other signs of constitutional disturbance.
Further, in diseases of the spinal cord, as a rule, the spine is not tender to pressure; whereas in Spinal Irritation such tenderness is perhaps the most marked symptom. The personal and family history, and the cause of the derangement, will aid the diagnosis.
CAUSES – The most powerful and frequent predisposing cause is hereditary tendency, especially when Hysteria, Epilepsy, Insanity or other neurosis exists in the family. What is termed a nervous constitution underlies nearly every case of Spinal Irritation. Anaemia, sexual derangement, sterility and absence or non- exercise of the maternal instincts, are also predisposing causes. Neglect of physical exercises, sexual excesses, onanism, are powerful and prominent factors of this affection. In short, everything that tends to exhaust vital power, and consequently produce a nervous condition, must be accounted a cause. The exciting causes are – shock, or grief; injury to the spine, as by railway accidents, blows, falls, etc. To the latter, men are, of course, equally liable; but the nervous system of women is more impressible, so that the immediate shock is more severely felt, and its sequelae are more likely to be deep and lasting. For a like reason, various kinds of rough exercise that keeps the spinal muscles on the stretch – jumping, travelling over rough roads, horseback exercise, etc. – may act as powerful exciting causes.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."