A case of Séglas', from whom stigmata of hysteria were absent, was
possessed, among other things, with the fear of having swallowed
certain objects, such as pins, knives, etc. The obsession
eventually became so vivid and so intense at certain moments, that
it began to be accompanied with a sensation as of a foreign body
arrested in the œsophagus, and the anguish thus created revealed
itself by various reactions, one of which consisted in excessive
salivation and ceaseless expectoration, entailing the carrying
about and use of numbers of handkerchiefs.
It is scarcely possible for the mechanism of deglutition, the orderly
succession of muscular contractions, to be interfered with by the will,
but increased frequency of these movements may constitute an
abnormality. Hartenberg's[107] case of deglutition tic was characterised
by a continual desire of swallowing saliva; the patient, it is true, was
an hysteric.
Rossolimo[108] has called attention to what he distinguishes as
amyotaxic troubles of deglutition, a dysphagia of which three types,
motor, sensory, and psychic, may be specified. Cases of the last form
had already been described by Bechterew.[109] The patient either suffers
from a genuine obsession, or is ever at the mercy of an involuntary or
even an unconscious dread of choking as he eats, a dread with which he
is powerless to cope, though in the case of others the phobia and the
dysphagia may alike be intermittent. In the majority of instances there
are grave hereditary or personal neuropathic antecedents.
Some people are afflicted with eructations so continual that they amount
to tics. One of us is acquainted with a family several of whose members
present this peculiarity in different degrees, yet none of them suffers
from hysteria.
Otto Lerch[110] has published a case of multiple tics, among which may
be enumerated opening and closing the eyes, rolling of the ocular
globes, tilting back of the head, with instantaneous recovery of
position, inclination of the whole trunk to right or left--each and all
of which movements are frequently attended, especially at night and in
the morning, by profound eructations.
Of course, the prominent place occupied by these signs in hysteria is
well recognised: the demonologues of old regarded them as an index of
the departure of the devils that dwelt in the possessed. In a case of
hysteria that came under the notice of Raymond and Janet,[111] a general
tremulousness of the whole body was replaced by a chorea of the right
arm, which in its turn was succeeded by the perpetual emission of
sonorous eructations. In another instance[112] inspiratory hiccoughs and
expiratory eructations co-existed. A similar example is cited by Cruchet
in his thesis.
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