over many portions of the backbone.  Pain in the head is a very common and distressing symptom, and is usually on the top.  Pain in the back is common.  Abdominal pains may be very severe and the abdomen may be so tender as to be mistaken for peritonitis.  Various parts of the body may have neuralgic pains.  There may be intense pain around the heart.  There may be complete blindness, the taste and smell may be disturbed or complete loss of hearing.  Third—­Paralysis is frequently present.  It may be one-sided or only of the lower extremities, or only one limb.  The face is usually not involved when it is on one side.  The leg is more affected than the arm.  Sensation is lessened or lost on the affected side.  Paralysis of the lower extremities is more frequent than one-sided paralysis.  The power in the limbs hardly ever is entirely lost; the legs may usually be moved, but the legs give way if the patient tries to stand.  The affected muscles do not waste.  The feet are usually extended and turn inward.  Sudden loss of voice occurs in many cases.  The paralysis is generally paroxysmal, and is frequently associated with contractures, shortening of the muscle.  The contractures may come on suddenly or slowly, and may last minutes, hours, or months, and some cases even years.  Movements of the hands, arms, etc., like the motions in chorea are often seen in the young.  A trembling (tremor) is sometimes seen in these patients.  It most commonly involves the hands and arms, more rarely the head and legs.  These movements are small and quick.  Fourth—­Swallowing may be difficult on account of spasms of the muscles of the pharynx.  The larynx may be involved and interfere with respiration.  Indigestion in some form is often present.  The stomach and bowels may be very much bloated with gas.  There may be a “phantom tumor” in the intestine (bowel).  Constipation may be very obstinate, vomiting may be present and persistent and hiccough present.  The action of the heart may be irregular, and rapid heart action is common.  The least motion may cause difficult breathing and false Angina Pectoris (heart pang); the urine is retained not infrequently in female patients.

[Nervous system 285]

Symptoms of the Paroxysms.—­Convulsive seizures are common manifestations of hysteria, and frequently present a great similarity to epilepsy.  The prodromal (fore-running) symptoms are frequently present and may begin several days before the convulsion occurs.  In milder forms, in which the cause may be due to a temporary physical exhaustion, or emotional shock, the fore-running symptoms are of short duration.  The patient may become very nervous, irritable, impatient, have fits of laughing and crying, alternately, or have a feeling of a chill rising in the throat.  The convulsion follows these symptoms.  The patient generally falls in a comfortable place; consciousness is only apparently lost, for she frequently remembers what has taken place; the tongue is rarely bitten,