37 Axenfeld et Huchard, Traité des Neuroses, 2d ed., 1883, pp. 958-971.
As to sex, it is almost unnecessary to say that hysteria occurs with greater frequency among females than males; and yet it is all important to emphasize the fact that it is not exclusively a disease of the former sex. Some statistics on this subject have been collected. In Briquet's often-quoted 1000 cases of hysteria, 50 only occurred in men. I believe, however, that the proportion of hysterical men to hysterical women is greater than this. Instead of a ratio of 1 to 20, as these statistics would indicate, 1 to 15 would probably be nearer the truth. Statistics upon this subject are deceptive.
The occurrence of hysteria in the male was little discussed before the publication of Briquet's great work, but since that time it has received great attention from the medical profession. Charcot38 in some recent lectures at Salpêtrière has called attention to this subject. From 1875 to 1885 he says that five doctoral theses have been written on hysteria in men. Batault has collected 218 and Klein 80 cases. The Index Catalogue contains 102 references to hysteria in the male.
38 Le Progrès médical, 1885.
Hysteria in men may take on almost any form that it shows in women. It may occur in the strong, although more likely to be seen among the weak and effeminate. Even strong, vigorous workmen are susceptible, at times, to hysteria. According to Charcot, the duration of the affection differs somewhat in the two sexes. In male patients it lasts a long time and the symptoms are troublesome; in females the contrary is usually although not always the case. The occurrence of hysteria in the male sex has probably been overlooked through the tendency to class symptoms which would be regarded as hysterical in women as hypochondriacal in men.
One of the most typical half-purposive hysterical attacks that has ever come under my observation was in a literary man of some prominence. Hysterical syncope, contracture, hysterical breathing, hysterical hydrophobia, coccygodynia, hemiparesis, hemianæsthesia, and blindness are some other forms of hysteria in the male of which there are clinical records the result of personal observation. A remarkable case of hysterical motor ataxy was seen in a boy who was for some time a patient at the Philadelphia Polyclinic. Wilks39 records several interesting cases of hysteria in boys. One simulated laryngismus stridulus, with paroxysmal suffocative attacks and barking. Another was a case of hysterical maniacal excitement; another was an example of malleation, or constant movement as in hammering; still others were instances of extreme hyperæsthesia, of anorexia, and of nervous dyspnœa. The same author also dwells on the hysterical perversion of the moral sense found in boys as in girls. He gives some instances clipped from English newspapers—attempts to poison, murder or attempts to murder, confessions false and true. Many instances could be added from our own sensational American sheets.
39 Op. cit.
No age is free from a liability to hysteria. Its occurrence, however, at certain periods of life with great frequency is well known. The following table has been arranged from tables given by Briquet and Jolly, and shows that it is of most frequent occurrence between the ages of fifteen and thirty:
| Age. | Landouzy. | Georget. | Beau. | Briquet. | Scanzoni. | Total. |
| 0-10 | 4 | 1 | — | 66 | — | 71 |
| 10-15 | 48 | 5 | 6 | 98 | 4 | 161 |
| 15-20 | 105 | 7 | 7 | 140 | 13 | 272 |
| 20-25 | 80 | 4 | 3 | 71 | 64 | 289 |
| 25-30 | 40 | 3 | — | 24 | ||
| 30-35 | 38 | — | — | 9 | 78 | 149 |
| 35-40 | 15 | — | — | 9 | ||
| 40-45 | 7 | 1 | — | 1 | 44 | 65 |
| 45-50 | 8 | — | 1 | 3 | ||
| 50-55 | 4 | — | — | 3 | 11 | 25 |
| 55-60 | 4 | — | 1 | 2 | ||
| 60-80 | 2 | — | — | — | 3 | 5 |
| 355 | 21 | 18 | 426 | 217 | 1037 |