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(op. cit., vol. i, p. 123). See also, for references, Féré, L'Instinct Sexuel, p. 59.

[264] Man and Woman, 4th ed., p. 326. A distinguished gynæcologist, Matthews Duncan, had remarked some years earlier (Lancet, May 18, 1889) that hysteria, though not a womb disease, "especially attaches itself to the generative system, because the genital system, more than any other, exerts emotional power over the individual, power also in morals, power in social questions."

[265] Gilles de la Tourette, Archives de Tocologie et de Gynécologie, June, 1895.

[266] Rivista Sperimentale di Freniatria, 1897, p. 290; summarized in the Journal of Mental Science, January, 1898.

[267] From the earliest times it was held that menstruation favors hysteria; more recently, Landouzy recorded a number of observations showing that hysterical attacks coincide with perfectly healthy menstruation; while Ball has maintained that it is only during menstruation that hysteria appears in its true color. See the opinions collected by Icard, La Femme pendant la Période Menstruelle, pp. 75–81.

[268] Krafft-Ebing, "Ueber Neurosen und Psychosen durch Sexuelle Abstinenz," Jahrbücher für Psychiatrie, vol. iii, 1888. It must, however, be added that the relief of hysteria by sexual satisfaction is not rare, and that Rosenthal finds that the convulsions are thus diminished. (Allgemeine Wiener Medizinal-Zeitung, Nos. 46 and 47, 1887.) So they are also, in simple and uncomplicated cases, according to Mongeri, by pregnancy.

[269] "All doctors who have patients in convents," remarks Marro (La Pubertà, p. 338), "know how hysteria dominates among them;" he adds that his own experience confirms that of Raciborski, who found that nuns devoted to the contemplative life are more liable to hysteria than those who are occupied in teaching or in nursing. It must be added, however, that there is not unanimity as to the prevalence of hysteria in convents. Brachet was of the same opinion as Briquet, and so considered it rare. Imbert-Goubeyre, also (La Stigmatisation, p. 436) states that during more than forty years of medical life, though he has been connected with a number of religious communities, he has not found in them a single hysterical subject, the reason being, he remarks, that the unbalanced and extravagant are refused admission to the cloister.

[270] Parent-Duchâtelet, De la Prostitution, vol. i, p. 242.

[271] It may not be unnecessary to point out that here and throughout, in speaking of the psychic mechanism of hysteria, I do not admit that any process can be purely psychic. As Féré puts it in an admirable study of hysteria (Twentieth Century Practice of Medicine, 1897, vol. x, p. 556): "In the genesis of hysterical troubles everything takes place as if the psychical and the somatic phenomena were two aspects of the same biological fact."

[272] Pierre Janet, L'Automatisme Psychologique, 1889; L'Etat mental des Hystériques, 1894; Névroses et Idées fixes, 1898; Breuer und Freud, Studien über Hysterie, Vienna, 1895; the best introduction to Freud's work is, however, to be found in the two series of his Sammlung Kleiner Schriften zur Neurosenlehre, published in a collected form in 1906 and 1909. It may be added that a useful selection of Freud's papers has lately (1909) been published in English.

[273] We might, perhaps, even say that in hysteria the so-called higher centres have an abnormally strong inhibitory influence over the lower centres. Gioffredi (Gazzetta degli Ospedali, October 1, 1895) has shown that some hysterical symptoms, such as mutism, can be cured by etherization, thus loosening the control of the higher centres.

[274] Charcot's school could not fail to recognize the erotic tone which often dominates hysterical hallucinations. Gilles de la Tourette seeks to minimize it by the remark that "it is more mental than real." He means to say that it is more psychic than physical, but he implies that the physical element in sex is alone "real," a strange assumption in any case, as well as destructive of Gilles de la Tourette's own fundamental assertion that hysteria is a real disease and yet purely psychic.

[275] See, e.g., his substantial volume, Die Traumdeutung, 1900, 2d ed. 1909.

[276] Sammlung, first series, p. 208.

[277] Studien über Hysterie, p. 217.

[278] Sammlung, first series, p. 162.

[279] Sammlung, second series, p. 102.

[280] Ib. p. 146.

[281] Sammlung, first series, p. 229. Freud has developed his conception of sexual constitution in Drei Abhandlungen zur Sexualtheorie, 1905.

[282] As Moll remarks, Freud's conceptions are still somewhat subjective, and in need of objective demonstration; but whatever may be thought of their theories, he adds, there can be no doubt that Breuer and Freud have done a great service by calling attention to the important action of the sexual life on the nervous system.

[283] Gertrude Stein, "Cultivated Motor Automatism," Psychological Review, May, 1898.

[284] Charcot's most faithful followers refuse to recognize a "hysteric temperament," and are quite right, if such a conception is used to destroy the conception of hysteria as a definite disease. We cannot, however, fail to recognize a diathesis which, while still apparently healthy, is predisposed to hysteria. So distinguished a disciple of Charcot as Janet thoroughly recognizes this, and argues (L'Etat mental, etc., p. 298) that "we may find in the habits, the passions, the psychic automatism of the normal man, the germ of all hysterical phenomena." Féré held a somewhat similar view.

[285] A. F. A. King, "Hysteria," American Journal of Obstetrics, May 18, 1891.

[286] M. Rosenthal, Diseases of the Nervous System, vol. ii, p. 44. Féré notes similar cases (Twentieth Century Practice of Medicine, vol. x, p. 551). Long previously, Gall had recorded the case of a young widow of ardent temperament who had convulsive attacks, apparently of hysterical nature, which always terminated in sexual orgasm (Fonctions du Cerveau, 1825, vol. iii, p. 245).

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