PSYCHICA L SYMPTOMS.—These vary with the individual temperament of the patient, and are always present to a greater or less degree in every hysterical subject. Such a person seems defective in will-power, although Sachs observes that the will is more misdirected than weakened. The impulses of inclination are followed regardless Of thought or reason. There is an increased impres sionability and suggestibility; so that conscious impressions are more numer ous than in health and suggest to the patient all kinds of fancies, whims, ca prices, and perverted actions. In the worst cases self-control is lost, and, in all, it is impaired. The patient is irri table, unduly sensitive, and is annoyed by trifles. Self-consciousness is in creased, trifles are magnified, the patient becomes emotional, and is easily elated or depressed, laughing and crying alter nately without any apparent cause for either. The tendency to become dis couraged and despondent is almost as great in some cases of hysteria as it is in melancholia. Some are painfully conscious of the action of every organ in the body. Every subjective sensation
suggests the idea of a dreaded disease of this or that organ. Let an idea be sug gested to the patient, especially if it re lates to some physical or mental disabil ity, and the thing suggested will likely follow. Thus we may often account for the presence of pain, paralysis, contract ure, spasm, disturbance in sensation, and for various visceral derangements, espe cially of the heart, stomach, and kidneys. A multiplicity and variability of various kinds of subjective sensations are char acteristic of hysteria, such as are rarely ever due directly to organic disease. We must remember, however, and too great stress cannot be laid on this fact, that we may encounter organic lesion of the nervous system and hysteria associated in the same person, and that in many such cases the pronounced symptoms of the latter will obscure the less obtrusive evidences of the former, unless a careful search is made for them.