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 – Homeopathy Treatment & Homeopathic Remedies
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.
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.
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.
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 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 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.
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.
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 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.
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.