Traumatic neurasthenia is like simple neurasthenia in {234} most details. It is called also nerve shock, spinal irritation, railway spine. There is always a causative shock or injury, which is followed at once or after an interval by the symptoms of neurasthenia. In acute traumatic neurasthenia there may be, in addition to the symptoms observed in simple neurasthenia, high fever, and such a fever has been observed to go as high as 113 degrees Fahrenheit. AUSTIN ÓMALLEY. {235} XIX HYSTERIA The term Hysteria ([Greek text] uterus) has been handed down from the days when physicians thought there was a connection between womb-disorders and the set of nervous symptoms grouped under the title hysteria. It is now etymologically meaningless,--men also grow hysterical. Briquet found 11 male to 204 female hysterics, and later statistics increase the number of males. The disease is not readily definable. The patient is usually a young emotional woman, oftenest between 15 and 20 years of age. She commonly has anaesthetic spots on her body, concentric limitations of the field of vision, and hystero-genetic zones, or tender points, which, when pressed, appear to inhibit the hysterical fit. The symptoms enumerated here are not, however, found in every case of hysteria, and it is difficult at times to diagnose the disease. The various manifestations of hysteria are (1) apt to come and go suddenly. A severe paralysis that suddenly disappears for a time is hysterical; (2) even if they last for years they may be suddenly cured; (3) they are dominated more by mental and moral influences than are the symptoms of any other disease; (4) we find no organic lesion with which we can connect the symptoms. The conditions that bring about hysteria are hysteria in a parent, or insanity, alcoholism, or some similar neurotic taint in an ancestor. There is no direct connection between hysteria and the disorders of the sexual organs. Immediate causes are acute depressive emotions, shocks from danger, sudden grief, severe revulsions of feeling, as from disappointment in love; and, secondly, cumulative {236} emotional disturbance, as from worry, poverty, ill treatment, unhappy marriage, or religious revivals. Certain diseased conditions, as anaemia, chronic intoxications, pelvic trouble, cause hysteria, or, more exactly, start it into activity where it is latent. It is also communicated by imitation and it may become epidemic. After the great plague, the Black Death, in the fourteenth century, there were very remarkable epidemics of imitative hysteria in Germany and elsewhere. In 1374, at Aix-la-Chapelle, crowds of men and women danced together in the streets until they fell exhausted in a cataleptic state. These dances spread over Holland and Belgium and went to Cologne and Metz. It is said that in Metz there were 1100 of the dancers seen at the same time. The "Dancing Plague" broke out again in 1418 at Strasburg, in Belgium, and along the Lower Rhine.