THE progress in our understanding of hysteria has come largely through the
elaboration of the so-called mechanisms by which the symptoms arise. These
mechanisms have been declared to reside or to have their origin in the
subconsciousness or coconsciousness. The mechanisms range all the way from
the conception of Janet that the personality is disintegrated owing to
lowering of the psychical tension to that of Freud, who conceives all
hysterical symptoms as a result of dissociation arising through conflicts
between repressed sexual desires and experiences and the various censors
organized by the social life. Without in any way intending to set up any
other general mechanism or to enter into the controversy raging concerning
the Freudian mechanism, which at present is the storm center, the writer
reports a case in which the origin of the symptoms can be traced to a more
simple and fairly familiar mechanism, one which, in its essence, is merely
an intensification of a normal reaction of many women to marital
difficulties. In other words, women frequently resort to measures which
bring about an acute discomfort upon the part of their mate, through his
pity, compassion and self-accusation. They resort to tears as their
proverbial weapon for gaining their point. In this case the hysterical
symptoms seem to have been the substitute for tears in a domestic battle.
Case History--Patient is a woman, aged thirty-eight, of American birth and
ancestry. Family history is negative so far as mental disease is concerned,
but there seems to have been a decadence of stock as manifested in the
steady dropping of her family in the social scale. She is one of two
children, there being a brother, who, from all accounts, is a fairly
industrious, but poverty-stricken farmer. Her early childhood was spent in
a small village in Massachusetts. She received but little education,
largely because she had no desire to study and no aptitude for learning,
although she is by no means feeble-minded. The menstrual periods started at
fourteen, and have been without any noteworthy accompanying phenomena ever
since. History is negative so far as other diseases are concerned. She
worked as a domestic and in factories until she was married for the first
time at the age of twenty. She had no children by this marriage. It is
stated on good authority that she took preventive measures against
conception and if pregnant induced abortion by drugs and mechanical
measures. At the end of eight years there was a divorce. Just which one of
the partners was at fault is impossible to state, but that there was more
than mere incompatibility is evident by the reticence of all concerned.
Shortly afterward, she married her present husband with whom she has lived
for about nine years. He is a steady drinker, but is a good workman, has
never been discharged, and, apparently, his drinking habits do not interfere
with the main tenor of his life. He lives with the patient in a small house
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