19 The Entire Works of Dr. Thomas Sydenham, newly made English from the Originals, etc., by John Swan, M.D., London, 1763, pp. 416, 417.
After a time, the idea that the uterus was the exclusive seat of hysteria was in large measure supplanted by the view that the sexual organs in general were concerned in the production of hysterical phenomena. Romberg defined hysteria as a “reflex neurosis caused by genital irritation.” Woodbury20 concludes as late as 1876 that only where the pathological source of hysterical symptoms resides in the uterus or ovaries, cases may, with some show of propriety, be termed hysterical; and where the uterus and organs associated with it in function are not in a morbid condition no symptoms can be correctly called hysterical.
20 Medical and Surgical Reporter, December 2, 1876.
Bridges,21 another American writer, in a paper on the pathology of hysteria, says that hysteria does not occur most frequently in women with diseased wombs, but in those whose sexual systems, by pampering and other processes, are abnormally developed and sensitive. He makes the same point with reference to the male sex. Sometimes, however, besides the emotional state in the male, there is actual disease of the sexual organs, caused by abuse or over-indulgence. Uterine disease and hysteria are sometimes like results of one cause, and not respectively cause and effect: women are hysterical oftener than men because the uterine function in woman's physiology plays a more important part in the production of emotional diseases than any organ of the male sex.
21 Chicago Medical Examiner, 1872, xiii. 193-199.
The truth would seem simply to be, that, as the uterus and ovaries are the most important female organs, they are therefore a frequent source of reflex irritation in hysterical patients.
Seguin22 adopts with some reservation Brown-Séquard's hypothesis that cerebral lesions produce the symptoms which point out their existence, not by destroying organs of the brain, but by setting up irritations which arrest (inhibit) the functions of other parts of the encephalon. He says that he finds no difficulty in believing that the same symptom may exist as well without as with a brain lesion. “In typical hysteria the functions of parts of the encephalon included in the right hemisphere, or in physiological relation with it, are inhibited by a peripheral irritation starting from a diseased or disordered sexual apparatus or other part; and in case of organic cerebral disease the same inhibitory action is produced. In both kinds of cases we may have loss of rational control over the emotions, loss of voluntary power over one-half of the body, and loss of sensibility in the same part.”
22 “On Hysterical Symptoms in Organic Nervous Affections,” Archives of Electrology and Neurology, for May, 1875.
Simply as a matter of passing interest, the attempt of Dupuy23 to frame a pathology of hysteria is worthy of attention. According to him, every local hysterical phenomenon is dependent upon an abnormal state of either lateral half of the upper part of the pons varolii. The centres of the pons, he holds, are perhaps merely passive in the process, only becoming organically implicated when various forms of permanent contractures and paralyses ensue.
23 Medical Record, New York, 1876, ii. 251.