Hammond56 has described under the name Miryachit an affection which seems to be essentially the same disorder as that of which the Jumpers are the victims. He quotes from a report of a journey from the Pacific Ocean through Asia to Europe by Lieutenant B. H. Buckingham and Ensigns Geo. C. Foulk and Walter McLean of the United States Navy, an account of this disease. The party made their first observations on this affection while on the Ussuri River in Siberia. The captain of the general staff approached the steward of the boat suddenly, and without any apparent reason or remark clapped his hand before his face; instantly the steward clapped his hand in the same manner, put on an angry look, and passed on. When the captain slapped the paddle-box suddenly, the steward instantly gave it a similar thump. Some of the passengers imitated pigs grunting or called out absurd names, etc.; the poor steward would be compelled to echo them all. The United States naval officers were informed that the affection was not uncommon in Siberia, and that it was commonest about Yakutsk, where the winter cold is extreme. Both sexes were subject to it, but men much less than women. It was known to Russians by the name of Miryachit.
56 New York Med. Journ., Feb. 16, 1884.
In both these classes of cases a suggestion of some kind was required, and then the act took place independently of the will. “There is another analogous condition known by the Germans as Schlaftrunkenheit, and to English and American neurologists as somnolentia or sleep-drunkenness. In this state an individual on being suddenly awakened commits some incongruous act of violence, ofttimes a murder. Sometimes this appears to be a dream, but in others no such cause could be discovered.” Curious instances are mentioned by Hammond of this disorder.
The phenomena of automatism at command in hypnotized subjects have much similarity to the phenomena of these affections, and the same explanation to a certain extent will answer for both.
Paget57 has ably discussed the subject of neuromimesis in general, and Mitchell58 devotes two lectures to its consideration. As already stated when discussing the synonyms of hysteria, the mistake must not be made of supposing all cases of hysteria to be instances of neuromimesis; but, as Mitchell remarks, the hysterical state, however produced, is a fruitful source of mimicry of disease in its every form, from the mildest of pains up to the most complete and carefully-devised frauds. “Its sensitiveness and mobility, its timidity and emotionalness, its greed of attention, of sympathy, and of power in all shapes, supply both motive and help, so that while we must be careful not to see mimicry in every hysteric symptom, we must in people of this temperament be more than usually watchful for this form of trouble, and at least reasonably suspicious of every peculiar or unusual phenomenon.”
57 Op. cit.
58 Op. cit.
SYMPTOMATOLOGY.—At the outset of the discussion of the symptomatology of hysteria, hysterical cases should be divided into four classes—viz. (1) Cases in which the symptoms are involuntary; (2) cases in which the symptoms are artificially induced and become involuntary; (3) cases in which the symptoms are acted or simulated, but in which the patient, because of impaired mental power, is irresistibly impelled to their performance; (4) cases in which the symptoms are purely acts of deception which are under the control of the patient.
Keeping in mind these different classes, we will always be able to link to the phenomena of hysteria the psychical element which is present in all genuine cases of this disorder. To comprehend the existence of the psychical element in the first class, in which the manifestations are absolutely involuntary, may offer difficulties. In these cases, at a period more or less recent or remote, psychical stimuli may have acted to produce the hysterical phenomena, and, once produced, these have been repeated and intensified by habit, and continue independently both of volition and consciousness. The experiments of Dercum and Parker show how hysterical symptoms may be artificially induced and may get beyond the patient's control. The difference between induced and simulated manifestations must always be clearly borne in mind. To induce a set of phenomena a certain mechanism must be set in action, and this, through rational, explicable processes, leads to certain results. The psychical element enters here both positively and negatively—positively, in the determination to produce a certain train of events; negatively, in the condition of mental concentration or abstraction which is a part of the procedure. In the third class of cases acting or simulation is dependent upon the irresistible inclinations of the patient. This may seem to some an uncertain and even dangerous ground to take. I am convinced, however, after observing many hysterical cases, that acts clearly purposive, so far as the particular performance is concerned, are sometimes the result of a general unstable mental condition. Some at least of these patients are as irresistibly impelled to swallow blood and vomit, to scream and gesticulate, etc., as is the monomaniac to commit arson, to ravish, or to kill. In the fourth class, the cases of pure, unmitigated, uncontrollable deception, the psychical element is very evident, although some may question whether such cases should be ranged under the banner of hysteria, where it is both convenient and customary to place them.
The symptoms of hysteria may develop in any order or after any fashion. The graver hysterical phenomena, such as convulsions, paralysis, and anæsthesia, often seem to come on suddenly, but usually this suddenness of onset is apparent rather than real. Minor hysterical symptoms, such as general nervous irritability, pains, aches, and discomforts, and mental peculiarities, have usually been present for a long time. These minor evidences of the hysterical constitution are sometimes the only phenomena ever presented.