The proper treatment of cases of hysteria, according to Harris, is strong faradism, applied by a small electrode or wire brush to the moistened skin. The stimulus is made powerful enough to force the patient to admit that he feels. The theory is that the powerful stimulation “breaks down the psychical auto-inhibition which produces the hysterical anesthesia.”
Faradism is only the first phase of the treatment. Verbal suggestion follows. Building on the basis of the feeling produced by the faradism or on the basis of the ocular evidence of motion in the hitherto paralyzed muscles, the patient is informed that the electricity will now be more and more strongly felt and that he will be cured in a few minutes.
The two elements in the therapy, then, are: encouraging verbal suggestion and the suggestion afforded by the paraphernalia of a complex looking, noisy machine. The knowledge on the part of the patient that a powerful and mysterious stimulus, namely, electricity, is being employed is a third element of suggestion.
Persistent hysterical sciatica, such as that of the present case, may require prolonged treatment. In this instance, the man was completely cured in five minutes, so that he was made able to run across the room. He said he would now be able to go back to the front, and wondered why he could not have been cured before.
Prognosis of intensive reëducation in reflex (physiopathic) disorder—complete recovery (except for the hysterical fraction of the disease) not expected.
Case 566. (Vincent, 1916.)
A young soldier was superficially wounded in the left knee, in August, 1914. A year later, he showed amyotrophy of the left calf, which measured 2.5 cm. less than the right, a weak slow Achilles reflex on the left side, cyanosis and hypothermia of the left foot, weakness and limitation of movements in the left foot, with slight contracture in flexion of leg upon thigh.
Thenceforward and for eight months, this soldier was submitted at the Tours Centre to intensive reëducation. For two hours every day upon prescription he walked, ran, and hopped upon the left leg. In September, 1916, after twelve month’s training, there was a certain improvement in his disorder. The leg was now completely extended upon the thigh, and the amplitude in the movement of the foot was almost normal; but the amyotrophy, vasomotor disorder and certain electrical disturbances remained quite unchanged. The man himself recognized that his status was greatly improved, but he could not walk more than four or five kilometers without great fatigue.
In view of the inferior results of reëducation in some of these cases, should any attempt at all be made to reëducate? Vincent thinks that that should be; but that it should be borne in mind that sometimes no results may be obtained. If the reflex disorder (in the Babinski sense) is minimal and the chief difficulty is hysterical, then sometimes the man may go back to service after reëducation; but in intense examples of reflex (physiopathic) disorder, invaliding has often proved necessary.