Especially do the first two described types of trouble follow exhaustion, acute illness, sudden fright, and long painful ordeal.  The ground is prepared for these conditions, e.g. by the strain of long attendance on a sick husband or child.  Then, suddenly one day, comes a queer fear or a faint dizzy feeling which awakens great alarm, is brooded upon, wondered at, and its return feared.  This fearful expectation really makes the return inevitable, and then the disease starts.  If the patient would seek competent advice at this stage, recovery would usually be prompt.  Instead, there is a long unsuccessful struggle, with each defeat tending to make the fear or anxiety or obsession habitual.  Sometimes, perhaps in most cases, and in all cases according to Freud and his followers, there is a long-hidden series of causes behind the symptoms; subconscious sexual conflicts and repressions, etc.  It may be stated here that the present author is not at all a Freudian and believes that the causes of these forms of nervousness are simpler, more related to the big obvious factors in life, than to the curiously complicated and bizarrely sexual Freudian factors.  People get tired, disgusted, apprehensive; they hate where they should love; love where they should hate; are jealous unreasonably; are bored, tortured by monotony; have their hopes, purposes, and desires frustrated and blocked; fear death and old age, however brave a face they may wear; want happiness and achievement, and some break, one way or another, according to their emotional and intellectual resistance.  These and other causes are the great factors of the conditions we have been considering.

Of all the forms of nervousness proper, the psychoneuroses, hysteria is probably the one having its source mainly in the character of the patient.  That is to say, outward happenings play a part which is secondary to the personality defect.  Hysteria is one of the oldest of diseases and has probably played a very important role in the history of man.  Unquestionably many of the religions have depended upon hysteria, for it is in this field that “miracle cures” occur.  All founders of religions have based part of their claim on the belief of others in their healing power.  Nothing is so spectacular as when the hysterical blind see, the hysterical dumb talk, the hysterical cripple throws away his crutches and walks.  In every age and in every country, in every faith, there have been the equivalents of Lourdes and St. Anne de Beaupre.

In hysteria four important groups of symptoms occur in the housewife as well as in her single sisters and brothers.

There is first of all an emotional instability, with a tendency to prolonged and freakish manifestations,—­the well-known hysterics with laughing, crying, etc.  Fundamental in the personality of the hysterics is this instability, this emotionality, which is however secondary to an egotistic, easily wounded nature, craving sympathy and respect and often unable legitimately to earn them.