[2] This is especially true of the menopause in women, and often enough of each menstrual period. That there is a climacteric in men is not so clear, but something corresponding to it occurs, at least in the case of some men.
In addition, these activities, which are so all-important, determine the basic conduct by arousing the basic appetites and desires of the individual. It is the change in the gastro-intestinal tract and in the tissues of the body that starts up the hunger feeling and the impulses which prompt men to seek food; in other words, this type of coenaesthesia has set going all the physical and mental activities relating to food; it is the basic impulse behind agriculture and stock raising, as well as energizing work activities of all kinds. It is the tension in the seminal vessels of the male that wakes up his passion, if it is not the sole source of that passion. Sex desire in the adult male has many elements in it, not pertinent at present, but the coenaesthetic influence of the physical structures is its starting point. In men as well as women there is a cycle of desire, with height due to physical tension and abyss following the discharge or disappearance of tension, that profoundly influences life and conduct. Here the sympathetic nervous system and the internal secretion of the genital glands awaken into sexual activity brain, spinal cord and muscles, so that the individual seeks a mate, plunges into marriage and directs his conduct, conscious of taste and desire, but largely unconscious of the physical condition that is impelling him on. In this sense the subconscious activities dominate in life, because the functions of nutrition and reproduction are largely unconscious in their origin, but there is no organized, plotting subconsciousness at work.
Once a thing is experienced, it is stored in memory. What is the basis and position of a memory when we are not conscious of it, when our conscious minds are busy with other matters? What happens when a desire is repressed, inhibited into inaction; when consciousness revolts against part of its own content? Is a "forgotten" memory ever really lost, or a desire that is squelched and thrust out of "mind" really made inactive? Do our inhibitions really inhibit, or do we build up another self or set of selves that rise to the surface under strange forms, under the guise of disease manifestations?
Sigmund Freud and his followers have made definite answers to the foregoing, answers that are incorporated in a doctrine called Freudianism. Freud is an Austrian Jew, a physician, and one that soon specialized in nervous and mental diseases. Early in his career he did some excellent work in the study of the paralysis of childhood (infantile hemiplegia), but his attention and that of an older colleague, Breuer, were soon drawn (as has occurred to almost every neurologist) to the manifestations of that extraordinary disease, hysteria. Hysteria has played so important a role in human history, and Freud's ideas are permeating so deeply into modern thought that I deem it advisable to devote a chapter to them.
CHAPTER V. HYSTERIA, SUBCONSCIOUSNESS AND FREUDIANISM
Hysteria was known to the ancients and in fact is as old as the written history of mankind. Considered essentially a disease of women, it was given its present name which is derived from "hysteron," the Greek name for the womb. We know to-day that men also are victims of this malady, though it arises under somewhat different circumstances than is the case with the other sex. Men and women, living in the same world and side by side, are placed in greatly different positions in that world, are governed by different traditions and are placed under the influences of differing ambitions, expectations, hopes and fears. Hysteria arises largely out of the emotional and volitional reactions of life, and these reactions differ in the sexes.
It was a group of French neurologists, headed by Charcot—and 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.