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rel="nofollow" href="#ulink_de9ca1b0-881e-5fad-b2a6-8b9eddbd9d8a">^[278] "on which we strike in a thorough pursuit of the analysis is this: From whatever side and from whatever symptoms we start, we always unfailingly reach the region of the sexual life. Here, first of all, an etiological condition of hysterical states is revealed. … At the bottom of every case of hysteria—and reproducible by an analytical effort after even an interval of long years—may be found one or more facts of precocious sexual experience belonging to earliest youth. I regard this as an important result, as the discovery of a caput Nili of neuropathology." Ten years later, enlarging rather than restricting his conception, Freud remarks: "Sexuality is not a mere deus ex machina which intervenes but once in the hysterical process; it is the motive force of every separate symptom and every expression of a symptom. The morbid phenomena constitute, to speak plainly, the patient's sexual activity."^[279] The actual hysterical fit, Freud now states, may be regarded as "the substitute for a once practiced and then abandoned auto-erotic satisfaction," and similarly it may be regarded as an equivalent of coitus.^[280]

It is natural to ask how this conception affects that elaborate picture of hysteria laboriously achieved by Charcot and his school. It cannot be said that it abolishes any of the positive results reached by Charcot, but it certainly alters their significance and value; it presents them in a new light and changes the whole perspective. With his passion for getting at tangible definite physical facts, Charcot was on very safe ground. But he was content to neglect the psychic analysis of hysteria, while yet proclaiming that hysteria is a purely psychic disorder. He had no cause of hysteria to present save only heredity. Freud certainly admits heredity, but, as he points out, the part it plays has been overrated. It is too vague and general to carry us far, and when a specific and definite cause can be found, the part played by heredity recedes to become merely a condition, the soil on which the "specific etiology" works. Here probably Freud's enthusiasm at first carried him too far and the most important modification he has made in his views occurs at this point: he now attaches a preponderant influence to heredity. He has realized that sexual activity in one form or another is far too common in childhood to make it possible to lay very great emphasis on "traumatic lesions" of this character, and he has also realized that an outcrop of fantasies may somewhat later develop on these childish activities, intervening between them and the subsequent morbid symptoms. He is thus led to emphasize anew the significance of heredity, not, however, in Charcot's sense, as general neuropathic disposition but as "sexual constitution." The significance of "infantile sexual lesions" has also tended to give place to that of "infantilism of sexuality."^[281]

The real merit of Freud's subtle investigations is that—while possibly furnishing a justification of the imperfectly-understood idea that had floated in the mind of observers ever since the name "hysteria" was first invented—he has certainly supplied a definite psychic explanation of a psychic malady. He has succeeded in presenting clearly, at the expense of much labor, insight, and sympathy, a dynamic view of the psychic processes involved in the constitution of the hysterical state, and such a view seems to show that the physical symptoms laboriously brought to light by Charcot are largely but epiphenomena and by-products of an emotional process, often of tragic significance to the subject, which is taking place in the most sensitive recess of the psychic organism. That the picture of the mechanism involved, presented to us by Professor Freud, cannot be regarded as a final and complete account of the matter, may readily be admitted. It has developed in Freud's own hands, and some of the developments will require very considerable confirmation before they can be accepted as generally true.^[282] But these investigations have at least served to open the door, which Charcot had inconsistently held closed, into the deeper mysteries of hysteria, and have shown that here, if anywhere, further research will be profitable. They have also served to show that hysteria may be definitely regarded as, in very many cases at least, a manifestation of the sexual emotions and their lesions; in other words, a transformation of auto-erotism.

      The conception of hysteria so vigorously enforced by Charcot and his school is thus now beginning to appear incomplete. But we have to recognize that that incompleteness was right and necessary. A strong reaction was needed against a widespread view of hysteria that was in large measure scientifically false. It was necessary to show clearly that hysteria is a definite disorder, even when the sexual organs and emotions are swept wholly out of consideration; and it was also necessary to show that the lying and dissimulation so widely attributed to the hysterical were merely the result of an ignorant and unscientific misinterpretation of psychic elements of the disease. This was finally and triumphantly achieved by Charcot's school.

      There is only one other point in the explanation of hysteria which I will here refer to, and that because it is usually ignored, and because it has relationship to the general psychology of the sexual emotions. I refer to that physiological hysteria which is the normal counterpart of the pathological hysteria which has been described in its physical details by Charcot, and to which alone the term should strictly be applied. Even though hysteria as a disease may be described as one and indivisible, there are yet to be found, among the ordinary and fairly healthy population, vague and diffused hysteroid symptoms which are dissipated in a healthy environment, or pass nearly unnoted, only to develop in a small proportion of cases, under the influence of a more pronounced heredity, or a severe physical or psychic lesion, into that definite morbid state which is properly called hysteria.

This diffused hysteroid condition may be illustrated by the results of a psychological investigation carried on in America by Miss Gertrude Stein among the ordinary male and female students of Harvard University and Radcliffe College. The object of the investigation was to study, with the aid of a planchette, the varying liability to automatic movements among normal individuals. Nearly one hundred students were submitted to experiment. It was found that automatic responses could be obtained in two sittings from all but a small proportion of the students of both sexes, but that there were two types of individual who showed a special aptitude. One type (probably showing the embryonic form of neurasthenia) was a nervous, high-strung, imaginative type, not easily influenced from without, and not so much suggestible as autosuggestible. The other type, which is significant from our present point of view, is thus described by Miss Stein: "In general the individuals, often blonde and pale, are distinctly phlegmatic. If emotional, decidedly of the weakest, sentimental order. They may be either large, healthy, rather heavy, and lacking in vigor or they may be what we call anæmic and phlegmatic. Their power of concentrated attention is very small. They describe themselves as never being held by their work; they say that their minds wander easily; that they work on after they are tired, and just keep pegging away. They are very apt to have premonitory conversations, they anticipate the words of their friends, they imagine whole conversations that afterward come true. The feeling of having been there is very common with them; that is, they feel under given circumstances that they have had that identical experience before in all its details. They are often fatalistic in their ideas. They indulge in day-dreams. As a rule, they are highly suggestible."^[283]

There we have a picture of the physical constitution and psychic temperament on which the classical symptoms of hysteria might easily be built up.^[284] But these persons were ordinary students, and while a few of their characteristics are what is commonly and vaguely called "morbid," on the whole they must be regarded as ordinarily healthy individuals. They have the congenital constitution and predisposition on which some severe psychic lesion at the "psychological moment" might develop the most definite and obstinate symptoms of hysteria, but under favorable circumstances they will be ordinary men and women, of no more than ordinary abnormality or ordinary power. They are among the many who have been called to hysteria at birth; they may never be among the few who are chosen.

We may have to recognize that on the side of the sexual emotions, as well as in general constitution, a condition may be traced among normal

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