Forgotten disorders | medical contact

fashion diagnoses. These are diagnoses that are made over a period of time, and refer to a symptom complex that we usually don’t understand well, only to sink into oblivion again. The diagnosis of hysteria is an example. It certainly refers to a symptom complex that we still encounter. Only now it falls under a different, more acceptable diagnosis: MUS.

I’m trying to clear out my collection of old psychiatric books. But that does not work. Every time I grab an old book to possibly get rid of, I open it. And go read it. In the Textbook of functional neuroses from 1898, by professor Gerard Jelgersma (1859-1942) I find the description of the hysterogenic and hyperalgic points. If you press on hysterogenic points, for example, a violent convulsion occurs. At the level of the ovaries is a very important hysterical and hyperalgic pressure point. And yes, men can also have hysterical pains around the location of the ovary. That symptom was known as “ovarian.” It occurs in both men and women! When suspected of hysteria, every doctor should in the first place investigate the presence of ‘ovaries’. The knowledge of these points was already known to members of the Inquisition, according to Jelgersma. Those points were known as ‘stigmata diaboli’. The exorcists and members of the Inquisition “pressed the hysteriac with great zeal and knowledge.” If such pressure points were found, the owners were burned according to canon law.

Since ovaries can also be found in men, Jelgersma comes to the conclusion that the origin of the hysterical pain cannot be the ovary.

Jelgersma chaired the first international conference for ‘Psychiatry, Neurology, Psychology and Care for Lunatics’ in Amsterdam in 1907. In the presence of celebrities such as Babinski and Bechterew, Jelgersma gave a lecture on how modern society can promote mental disorders . He is still very right there.

Jelgersma makes every effort to describe the concept of hysteria as clearly as possible in his textbook, and the essence is described in his book in a striking font as follows: ‘The original deviation from hysteria is the tendency of the disease to suppress mental processes, which accompanying the normal human being with consciousness, to make them become unconscious. The whole spiritual life of the hysteric has shifted to the unconscious.’ So SOLK. Or maybe not quite?

A common symptom of hysteria is ‘abouli’, coming to nothing. Sitting apathetic and not knowing what to do. Or can’t. Aboulia is said to be the most common manifestation of hysteria, even in mild cases it is never absent. There is usually a history of trauma identifiable. That would apply to all hysterical symptoms. That trauma can be conscious and cause an idea-fixe. Or it is unconscious and gives rise to a delusion. The idea that a psychological trauma from the past strongly influences our behavior and happiness in life is increasingly being embraced. Nothing new under the sun.

In this century we rarely see phenomena of the nature that Jelgersma describes. Jelgersma’s book brings us into contact with a forgotten world of disorders. Show how culturally bound symptoms of disease can be. It is good to take note of these old descriptions, so that we realize the great impact of society and the time on the symptomatology of disorders. And also so that we realize that every time and every culture colors the syndromes in a very special way. Reading old psychiatric literature can open our eyes to clinical experiences that, although not evidence-based, were or may still be a clinical reality.



More from Jan Keppel Hesselink


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