Hysterical fits (hysteria)
One of my aside interests is to trawl through very old medical and first aid texts to see what doctors and prehospital responders ‘used to do way back when’. This little gem comes straight from the 1908 edition of the St John Ambulance Association First Aid to the Injured. They describe how to deal with what they call hysterical fits. Over one hundred years later, I am left wondering, would you be able to write anything like this?
‘The patient, usually a young girl, in consequences of mental excitement, suddenly loses command of her feelings and actions. She subsides on a couch or in some comfortable position, throws herself about, grinding her teeth, clenching her fists, shaking her hair loose; she clutches at anyone or anything near her, kicks, cries and laughs alternately. The eyeballs may be turned upwards, and the eyelids opened and shut rapidly. At times froth appears at the lips, and other irregular symptoms may develop.’
The book certainly managed to make this acute presentation sound quite alarming. Indeed some of these people actually were truly having a fit or a genuine mental health crisis. The beauty of female problems then was that you could simply dismiss them all with the one diagnosis. This led to hysteria being at least as ‘common as fever’ back then, before the time of antibiotics and immunisations. You can’t help but wonder just what else got trapped into this diagnosis. The best bit though isn’t the problem, it is the cure. Once again, try writing something like this into practice today.
1 – Avoid sympathy with the patient and speak firmly to her.
2 – Threaten her with a cold water douche, and if she persists in her “fit,” sprinkle her with cold water
3 – Apply a mustard leaf at the back of the neck.
Medical treatment is necessary to cure the condition of mind and body which gives rise to hysterical attacks. End of quote.
The passing of time has made this sound almost ridiculous but for centuries this was a common and respectable diagnosis. Intrigued though, I found myself reading a little more on this matter. Since this was essentially aimed at women, it is interesting that either excessive sexual drive or lack of the same could both be considered symptoms. Another key observation of this problem was ‘a tendency to cause trouble’. Note that at one time as many as one quarter of all women were thought to suffer from this problem!
This is made even more interesting when it is considered that forced admission to an asylum was one possible remedy. Whilst wondering if the women had any say in the matter, forced hysterectomy could also be considered to help cure her ‘problems’. This last bit stemmed from the actual belief that a woman’s uterus could essentially be the cause of a huge range of behavioural disturbances. The Royal Society of Medicine took a great leap forward in the early twentieth century when it stated that the womb actually wasn’t the culprit and the problems were all in the victim’s head. Therapy then began to include forcing the patient to intentionally act out a hysterical fit in the doctor’s room so that they could see for themselves what it looked like.
If any of this has been confronting, prepare yourself. Seeking a cure for hysteria in the late nineteenth century, the mechanical vibrator was developed. These could be frequently employed by physicians given that it was not considered a sexual act provided penetration did not take place. I would stress most earnestly for prehospital responders to consider that the law today might take an extremely different and dim view of any such approach.
Up to that point the ‘massage’ was being performed by the doctor’s hand. The vibrator was actually designed to make the physicians life easier! Surprisingly, early practitioners described how much more acceptable their patients found the diagnosis of hysteria after this. When this therapy eventually became available in portable devices for home use, one marketing slogan stated that it could ‘restore bright eyes and pink cheeks’. Another revelation is that up to this point, hysteria was mostly amongst the well to do. From then on the diagnosis became much more widespread amongst the masses. Medicine just never fails to surprise does it?
Also surprisingly enough, the earlier described prehospital approach was not nearly as well received in practice as the physicians approach. The avoidance of sympathy and blatant threats was clearly intended to help steer through the crisis moment. They must have been perilously close to adding something like ‘deliver judicious sharp blows to the face using the back of the hand, carefully alternating between left and right cheek whilst avoiding the eyes.’ Mustard leaves were a nice touch and are still employed by some for all manner of ills including burns, rubbing on feet for colds and bee stings. Nonetheless, the victim I can only imagine that during this prehospital phase the poor woman must have invariably cried out most earnestly ‘just get me to the doctor quickly’.
Jeff Kenneally www.prehemt.com