Studies in the Psychology of Sex (Vol. 1-6). Havelock Ellis
condition. This was the view of Virchow, who regarded chlorosis as essentially dependent on a congenital hyoplasia of the arterial system. Stieda, on the basis of an elaborate study of twenty-three cases, has endeavored to prove that chlorosis is due to a congenital defect of development (Zeitschrift für Geburtshülfe und Gynäkologie, vol. xxxii, Part I, 1895). His facts tend to prove that in chlorosis there are signs of general ill-development, and that, in particular, there is imperfect development of the breasts and sexual organs, with a tendency to contracted pelvis. Charrin, again, regards utero-ovarian inadequacy as at least one of the factors of chlorosis. Chlorosis, in its extreme form, may thus be regarded as a disorder of development, a sign of physical degeneracy. Even if not strictly a cause, a congenital condition may, as Stockman believes (British Medical Journal, December 14, 1895), be a predisposing influence.
However it may be in extreme cases, there is very considerable evidence to indicate that the ordinary anæmia of young women may be due to a storing up of iron in the system, and is so far normal, being a preparation for the function of reproduction. Some observations of Bunge's seem to throw much light on the real cause of what may be termed physiological chlorosis. He found by a series of experiments on animals of different ages that young animals contain a much greater amount of iron in their tissues than adult animals; that, for instance, the body of a rabbit an hour after birth contains more than four times as much iron as that of a rabbit two and a half months old. It thus appears probable that at the period of puberty, and later, there is a storage of iron in the system preparatory to the exercise of the maternal functions. It is precisely between the ages of fifteen and twenty-three, as Stockman found by an analysis of his own cases (British Medical Journal, December 14, 1895), that the majority of cases occur; there was, indeed, he found, no case in which the first onset was later than the age of twenty-three. A similar result is revealed by the charts of Lloyd Jones, which cover a vastly greater number of cases.
We owe to Lloyd Jones an important contribution to the knowledge of chlorosis in its physiological or normal relationships. He has shown that chlorosis is but the exaggeration of a condition that is normal at puberty (and, in many women, at each menstrual period), and which, there is good reason to believe, even has a favorable influence on fertility. He found that light-complexioned persons are more fertile than the dark-complexioned, and that at the same time the blood of the latter is of less specific gravity, containing less hæmoglobin. Lloyd Jones also reached the generalization that girls who have had chlorosis are often remarkably pretty, so that the tendency to chlorosis is associated with all the sexual and reproductive aptitudes that make a woman attractive to a man. His conclusion is that the normal condition of which chlorosis is the extreme and pathological condition, is a preparation for motherhood (E. Lloyd Jones, "Chlorosis: The Special Anæmia of Young Women," 1897; also numerous reports to the British Medical Association, published in the British Medical Journal. There was an interesting discussion of the theories of chlorosis at the Moscow International Medical Congress, in 1898; see proceedings of the congress, volume in, section v, pp. 224 et seq.).
We may thus, perhaps, understand why it is that hysteria and anæmia are often combined, and why they are both most frequently found in adolescent young women who have yet had no sexual experiences. Chlorosis is a physical phenomenon; hysteria, largely a psychic phenomenon; yet, both alike may, to some extent at least, be regarded as sexual aptitude showing itself in extreme and pathological forms.
[251] Genèse et Nature de l'Hystérie, 1898; and, for Sollier's latest statement, see "Hystérie et Sommeil," Archives de Neurologie, May and June, 1907. Lombroso (L'Uomo Delinquente, 1889, vol. ii, p. 329), referring to the diminished metabolism of the hysterical, had already compared them to hibernating animals, while Babinsky states that the hysterical are in a state of subconsciousness, a state, as Metchnikoff remarks (Essais optimistes, p. 270), reminiscent of our prehistoric past.
[252] Professor Freud, while welcoming the introduction of the term "auto-erotism," remarks that it should not be made to include the whole of hysteria. This I fully admit, and have never questioned. Hysteria is far too large and complex a phenomenon to be classed as entirely a manifestation of auto-erotism, but certain aspects of it are admirable illustrations of auto-erotic transformation.
[253] The hysterical phenomenon of globus hystericus was long afterward attributed to obstruction of respiration by the womb. The interesting case has been recorded by E. Bloch (Wiener Klinische Wochenschrift, 1907, p. 1649) of a lady who had the feeling of a ball rising from her stomach to her throat, and then sinking. This feeling was associated with thoughts of her husband's rising and falling penis, and was always most liable to occur when she wished for coitus.
[254] As Gilles de la Tourette points out, it is not difficult to show that epilepsy, the morbus sacer of the ancients, owed much of its sacred character to this confusion with hysteria. Those priestesses who, struck by the morbus sacer, gave forth their oracles amid convulsions, were certainly not the victims of epilepsy, but of hysteria (Traité de l'Hystérie, vol. i, p. 3).
[255] Aretæus, On the Causes and Symptoms of Acute Diseases, Book ii, Chapter II.
[256] It may be noted that this treatment furnishes another instance of the continuity of therapeutic methods, through all changes of theory, from the earliest to the latest times. Drugs of unpleasant odor, like asafœtida, have always been used in hysteria, and scientific medicine to-day still finds that asafœtida is a powerful sedative to the uterus, controlling nervous conditions during pregnancy and arresting uterine irritation when abortion is threatened (see, e.g., Warman, Der Frauenarzt, August, 1895). Again, the rubbing of fragrant ointments into the sexual regions is but a form of that massage which is one of the modern methods of treating the sexual disorders of women.
[257] Les Démoniaques dans l'Art, 1887; Les Malades et les Difformes dans l'Art, 1889.
[258] Glafira Abricosoff, of Moscow, in her Paris thesis, L'Hystérie aux xvii et xviii siécles, 1897, presents a summary of the various views held at this time; as also Gilles de la Tourette, Traité de l'Hystérie, vol. i, Chapter I.
[259] Edinburgh Medical Journal, June, 1883, p. 1123, and Mental Diseases, 1887, p. 488.
[260] Hegar, Zusammenhang der Geschlechtskrankheiten mit nervösen Leiden, Stuttgart, 1885. (Hegar, however, went much further than this, and was largely responsible for the surgical treatment of hysteria now generally recognized as worse than futile.) Balls-Headley, "Etiology of Nervous Diseases of the Female Genital Organs," Allbutt and Playfair, System of Gynecology, 1896, p. 141.
[261] Lombroso and Ferrero, La Donna Delinquente, 1893, pp. 613–14.
[262] Charcot and Marie, article on "Hysteria," Tuke's Dictionary of Psychological Medicine.
[263] Axenfeld and Huchard, Traité des Névroses, 1883, pp. 1092–94. Icard (La Femme pendant la Période Menstruelle, pp. 120–21) has also referred to recorded cases of hysteria in animals (Coste's and Peter's cases),