the foundations of personality-第22章

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It　was　a　group　of　French　neurologists；　headed　by　Charcotand　including　very　illustrious　men；　such　as　Janet　and　Marie；　who　paid　the　first　scientific　attention　to　the　disease。　Under　their　analyses　hysteria　was　defined　as　a　mental　disease　in　which　certain　symptoms　appeared　prominently。　1。　Charcot　especially　paid　attention　to　what　are　known　as　the　attacks。　The　hysteric　patient　（usually　a　woman；　and　so　we　shall　speak　of　the　patient　as　〃she〃）　under　emotional　stress　and　strain；　following　a　quarrel　or　a　disagreement　or　perhaps　some　disagreeable；　humiliating　situation；　shows　alarming　symptoms。　Perhaps　she　falls　（never　in　a　way　to　injure　herself）　to　the　floor　and　apparently　loses　consciousness；　closes　her　eyes；　rolls　her　head　from　side　to　side；　moans；　clenches　her　fists；　lifts　her　body　from　the　floor　so　that　it　rests　on　head　and　heels　（opisthotonic　hysteria）；　shrieks　now　and　then　and　altogether　presents　a　terrifying　spectacle。　Or　else　she　twitches　all　over；　weeps；　moans；　laughs　and　shouts；　and　rushes　around　the　room；　beating　her　head　on　the　walls；　or　she　may　lie　or　stand　in　a　very　dramatic　pose；　perhaps　indicating　passion　or　fear　or　anger。　The　attacks　are　characterized　by　a　few　main　peculiarities；　which　are　that　the　patient　usually　has　had　an　emotional　upset　or　is　in　some　disagreeable　situation；　that　she　does　not　hurt　herself　by　her　falls；　that　consciousness　is　never　completely　abolished　and　fluctuates　so　that　now　she　seems　almost　〃awake〃　and　then　she　seems　almost　in　a　complete　stupor；　and　that　the　expression　of　emotion　in　the　attack　is　often　very　prominent。　These　symptoms　are　readily　differentiated　from　what　is　seen　in　epilepsy。＇1＇　＇1＇　The　French　writers　of　the　school　of　Babinski　deny　that　the　above　symptom　and　even　the　majority　of　the　following　have　a　real　existence　in　hysteria。　The　English；　American　and　German　neurologists　and　the　rest　of　the　French　school　describe　hysteria　substantially　as　I　am　here　describing　it。

2。　The　hysteric　paralyses　which　are　featured　in　all　the　literatures　of　the　world　are　curious　manifestations　and　often　very　stubborn。　Following　an　accident　（especially　in　industry　and　in　war）　and　after　some　emotional　difficulty　there　is　a　paralysis　of　some　part　of　the　body。　The　arm　or　some　particular　part　of　the　arm　cannot　be　moved　by　the　will；　is　paralyzed；　or　else　the　difficulty　involves　one　or　both　legs。　Sometimes　speech　is　gone；　or　the　power　of　moving　the　head；　occasionally　the　difficulty　is　with　one　side　of　the　face；　etc。　Usually　the　paralysis　comes　on　suddenly；　but　often　it　comes　on　gradually。　Modern　neurology　soon　discovered　that　these　paralyses　were　quite　unlike　those　seen　when　there　is　〃real〃　injury　to　the　brain；　spinal　cord　or　the　peripheral　nerves。　They　corresponded　to　the　layman's　idea　of　a　part。　Thus　a　paralysis　of　the　arm　ends　at　the　shoulder；　a　paralysis　of　the　feet　at　the　ankle；　and　in　ways　not　necessary　to　detail　here　differ　from　what　occurs　when　the　organic　structure　of　the　nervous　system　is　involved。　For　example；　the　reflexes　in　hysteria　are　unaltered；　and　stiffness　when　it　occurs　is　not　the　stiffness　of　organic　disease。　If　a　neurologist　were　to　have　a　hysteric　paralysis　a　very　interesting　problem　in　diagnosis　would　be　presented。　Further；　the　paralysis　yields　in　spectacular　fashion　to　various　procedures　or　else　disappears　spontaneously　in　remarkable　fashion　overnight。　Paralyses　of　this　type　have　disappeared　under　hypnosis；　violent　electric　shocks；　〃magical〃　liniments；　threats；　prayers；　the　healer's；　the　fakir's；　the　doctor's　personal　influence；　under　circumstances　of　danger　（a　fire；　a　row；　etc。）；　by　pilgrimages　to　Lourdes；　St。　Anne　de　Beaupre；　the　Temple　of　Diana；　the　relic　of　a　saint；　by　the　influence　of　sudden　joy；　fear；　anger；　by　the　work　of　the　psychoanalyst　and　by　that　of　the　osteopath！　Every　great　religious　leader　and　every　savage　medicine　man　beating　a　tom…tom　has　had　to；　prove　his　pretensions　to　greatness　by　healing　the　sickso　intensely　practical　is　manand　he　has　proved　his　divinity　by　curing　the　hysterics；　so　that　they　threw　away　their　crutches；　or　jumped　blithely　out　of　bed；　or　used　their　arms；　perhaps　for　the　first　time　in　years。　Hysteria　has　caused　more　talk　of　the　influence　of　mind　over　body　than　all　other　manifestations　of　mental　peculiarity　put　together。　Wherever　there　is　anything　to　be　gained　by　hysteric　paralyses；　these　appear　in　much　greater　frequency　than　under　ordinary　circumstances。　Thus　the　possibility　of　recovering　damages　seems　to　play　a　role　in　bringing　about　a　paralysis　that　defies　treatment　until　the　litigation　is　settled；　similarly　the　possibility　of　being　removed　from　the　fighting　line　played　a　large　part　in　the　causation　of　war　hysteric　paralysis。　3。　A　group　of　sensory　phenomena　is　conspicuous　in　hysteria；　sometimes　combined　with　the　paralyses　and　attacks　but　often　existing　alone。　A　part　of　the　body　will　become　curiously　insensitive　to　stimulation。　Thus　one　may　thrust　a　pin　into　any　part　without　evoking　any　pain　and　APPARENTLY　without　being　felt；　one　may　rub　the　cornea　of　the　eye；　that　exquisitely　sensitive　part；　without　arousing　a　reaction；　one　may　push　a　throat　stick　against　the　uvula　as　it　hangs　from　the　palate　without　arousing　the　normal　and　very　lively　reflex　of　〃gagging。〃　These　insensitive　areas；　known　as　stigmata；　played　a　very　important　role　in　the　epidemic　of　witchcraft　hunting　of　the　sixteenth　and　seventeenth　centuries；　when　the　witch　was　so　diagnosed　if　she　felt　no　pain　when　a　needle　was　thrust　into　her。　Mankind　has　often　enough　worshiped　the　insane　and　mentally　aberrant　and　has　as　often　been　diabolically　cruel　to　them。　What　has　been　stated　of　the　paralyses　is　true　of　the　insensitive　areas；　they　correspond　to　an　idea　of　a　part　and　not　to　an　anatomical　unit。　Thus　a　loss　of　sensation　will　reach　up　to　the　wrist　（glove　type）　all　around；　front　and　back；　or　to　the　elbow　or　the　shoulder；　etc。　No　organically　caused　anaesthetic　area　ever　does　this；　and　so　the　neurologist　is　able；　usually；　to　separate　the　two　conditions。　And　the　anaesthesias　yield　as　do　the　hysteric　paralyses　to　a　variety　of　agents；　from　prayer　and　persuasion　to　a　bitter　tonic　or　a　blow。　I　confess　to　a　weird　feeling　in　the　presence　of　a　hysteric　whose　arm　can　be　thrust　through　and　through　with　a　needle　without　apparently　suffering　any　pain；　and　it　seems　to　me　that　this　may　be　the　explanation　of　the　fortitude　of　those　martyrs　who　have　astonished　and　sometimes　converted　their　persecutors　by　their　sublime　resistance　to　torture。　There　has　been　described　as　part　of　hysteria　the　hysteric　temperament。　The　characteristics　of　this　temperament　are　the　emotional　instability；　the　strong　desire　for　sympathy；　the　effort　to　obtain　one's　desire　through　weakness；　through　the　appeal　to　the　sympathy　of　others；　an　irritable　egoism　never　satisfied　and　without　firm　purpose。　It　is　true　that　the　majority　of　peace…time　hysterics　show　this　peculiar　temperament；　but　it　is　also　true　that　the　war…time　hysterics　often　enough　were　of　〃normal〃　character；　without　prior　evidence　of　weakness。　As　I　before　mentioned；　Freud　became　greatly　interested　in　this　group　of　patients　and　especially　in　the　female　patients；　since　in　ordinary　neurological　practice　the　male　hysteric　is　not　common。　Out　of　his　experience　and　effort　he　built　up　a　system　of　belief