The Lumleian lectures on some modern theories concerning hysteria : delivered before the Royal College of Physicians of London on March 19, 24, and 26, 1914 / by J. A. Ormerod.

  • Ormerod, J. A. (Joseph Arderne), 1848-1925.
Date:
[1914?]
Catalogue details

Licence: In copyright

Credit: The Lumleian lectures on some modern theories concerning hysteria : delivered before the Royal College of Physicians of London on March 19, 24, and 26, 1914 / by J. A. Ormerod. Source: Wellcome Collection.

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    to observe this for oneself. There was a woman in Queen-square Hospital last year whose hand was fixed in the “ obstetric position.” Dr. Adie, house physician, kindly observed her at my request during her sleep, and found the position the same. Mrs. A, the patient whose fits and anes- thesia I have already described, came to me last year with her right middle finger firmly flexed into the palm. Her lmsband assured me that the con- tracture remained during her sleep. So it did during hypnotic sleep, though in this condition the finger could be easily coaxed to open. The persist- ence of a hysterical contracture during natural sleep is not, perhaps, what we should expect, yet it has long been known. F. C. Skey, the well-known surgeon of St. Bartholomew’s Hospital, notices the fact in his lectures delivered in 1866. After com- menting on the fact that chloroform an£esthesiawill remove hysterical contractions of the fingers or elbow he says: “To bring this morbid state of the muscle within the influence of the mind as its cause is almost of necessity to infer the local evil to be wilful; but if it were so, the state of unconscious- ness during sleep would remove it, which it does not, for the contraction is constant by night and by day.” The second point is that, when such contractures are forcibly overcome, the patient seems to suffer intense pain. The reason is not obvious. Is it due to some purely local condition of the muscles ? Or is it the expression of some more general law ? For some authors have noticed that pain in the head occurs when functions which hysterical patients have lost, such as memory, sensibility, or motility, are being restored in the course of treatment. Now, since permanent hysterical symptoms, such as paralysis, ancesthesia, contractures, and the like, are often ushered in by pain, it may be that in the reverse stage, from symptom to cure, pain is a stage through which the patient must pass. Of course, in these remarks about pain and the persistence of contractures during sleep I exclude cases in which adhesions have formed about the joints—a complication which, according to Weir Mitchell, readily occurs in hysterical cases.