A Case of Hysteria with Somnambulism

Abstract

This case shows some features common to the foregoing one, and evidently belongs to the same class. It is that of a young woman, 23 years old, who showed no hysterical tendency till the age of 20, when she received a severe mental shock by being witness to an attack of suicidal mania on the part of her mother, who was removed to the St. Anne Asylum. From that time she became triste, and complained of epigastric sensations. The developed attacks did not occur till three years later. She was a well-developed, chlorotic girl, subject to attacks of vomiting and precordial pain; ordinarily placid, she was yet emotional, but not delirious or excitable. She constantly dwelt on her mother's madness, and the scene she had then witnessed played a large part in her somnambulic state. She had no anaesthesia or analgesia; no ovarian tenderness or neuralgia. The somnambulic state was of two forms—the one simple, quiet sleep; the other accompanied by various nervous disturbances and by talking. They occurred spontaneously, and could also be provoked by pressure on the ovarian region, by closing the eyelids, &c, and she described their onset as accompanied by a sensation ot some kind of a ball rising from the lower part of the abdomen to the throat and stifling her. Then she passed into deep sleep, in which she could be made to converse, to answer questions slowly, performing voluntary actions, but with diminished sensibility. The return to the normal state was as abrupt as the lapse from it, and either occurred spontaneously or by opening her eyes, blowing on the neck. After the attack she was quiet; complained of pain in the head and limbs, and appeared fatigued, retaining no recollection of what she had passed through or done whilst in the hypnotic condition; a loss of memory that held also for the events immediately preceding her entrance into that state. Sometimes she was much surprised on waking not to find the tonic which she had drunk during the attack, and sharply accused the bystanders of having robbed her of it. Sometimes she was astonished to find herself sitting in a chair at some distance from the bed. The other kind of seizure took the form of delirium, in which she would hold conversations with imaginary individuals, and enact scenes she had passed through previously. By simply suggesting topics to her when in this state, anyone could start a long attack of this sort. It seems that every vivid moral impression, or even intellectual fatigue would give rise to a somnambulistic attack. Once the admission of an insane patient into the ward affected her so much, apparently by calling up the recollection of her mother's attack, that a few hours afterwards, whilst seated with her companions trying to work, but unable to do so, she suddenly closed her eyes, fell into a lethargic state lasting a quarter of an hour. An attack could also be induced by wearying her with conversation and questionings, as well as by various mechanical and sensorial excitations, as pressure on the ovarian region, a bright light, the “magnetic forms” of Braid—magnetism itself. M. Chambard adds some interesting comments.