# Popular Science Monthly/Volume 49/August 1896/Epidemics of Hysteria

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* EPIDEMICS OF HYSTERIA.
By Dr. WILLIAM HIRSCH.
IT is a pretty widespread opinion that nervous diseases, and especially hysteria, have alarmingly increased during the last decades, and that they are about to increase much more. In all civilized countries, we are told, and in every stratum of the population, a weakness of the nervous system manifests itself of which our forefathers had no knowledge. Neurasthenia and hysteria spread wider and wider, like a devastating epidemic, attacking not merely the lower classes but just the "upper ten thousand." It is educated society which is threatened with total overthrow by utter derangement of the nerves. "Whither is this to lead, and how is it to end?" lament some solicitous prophets who already see yawning before them the gulf by which the enervated human race is about to be swallowed up.
Let us weigh the reasons which occasion this apprehension. What real proof is there of this enormous increase of nervous diseases and of the continually progressive degeneration of civilized man? First of all, there are the statistics. "Numbers," we have been told, "can not lie." Perhaps not; but those who collect them may fasten upon them very seriously mistaken labels.
The assiduous statistician ascertains that the insane asylums contain more women than men. So far, so good. But if he tells us that more women are insane than men, he labels those numbers erroneously, for the inequality is really due to the fact that insane males die off, while insane females survive, relatively speaking. Suppose the statistics of different countries do show that the number of inmates of insane asylums is increasing out ​of all proportion to the growth of the general population, would it not be superficial in the extreme to conclude, without further data, that insanity was on the increase? At present these statistics mean nothing more than that the number of patients in such institutions has considerably increased. But when we consider what great advances have been made in the diagnosis of mental diseases, and consider also that a great number of such cases, which were formerly treated unsuccessfully at home, are now treated in such institutions with good results, because there they are removed from the detrimental influences of familiar surroundings, while the proper means and methods for rational treatment are at hand, we shall find that the seemingly enormous increase of mental disturbances need not cause us uneasiness.
Other extensive statistical material for nervous diseases is afforded by the numerous dispensaries of the great cities; but no extended experience is required to teach that a large proportion of such cases would not appear if the patients had to pay fixed fees, and round ones, as they had to do in the good old times when physicians saw comparatively little of nervous diseases. Our grandmothers had their "headaches" and their "twitchings in the limbs" like the women of to-day; but they never dreamed of calling a doctor or going to the dispensary for such things, so that they were not "statistical material."
In the dispensaries for nervous diseases there are numerous chronical patients who, becoming discouraged in one place, think they would like to try another doctor; and some of them make a round of sojourns in different hospitals. Each of them is counted as many times over in the statistics as there are places where he is treated. This perceptibly increases the numbers.
These considerations give some idea, though but a slight one, of the extreme difficulty of making even rough approximate inferences from sanitary statistics. But certain observers tell us that exact enumeration is not required. Hysteria and degeneration of the race stare us, as they aver, daily in the face. In every department of human activity disorders of the nervous system are seen. The very style and methods of the art and literature of the day proclaim a general nervous prostration.
Max Nordau is the protagonist of this widespread opinion. In his eyes, mental degeneration has seized upon the majority of civilized men to such a degree that "the upper strata of urban population" form but a "suffering hospital." The art, the poetry, the fiction, the philosophy of the day present the most manifold embodiments of degeneration and of secular hysteria.
Nordau admits, of course, that degeneration and hysteria have always existed. "But," says he, "they were formerly sporadic and were of no importance for the whole life of society."
​In declaring that in former times hysteria was but of sporadic occurrence and attained no importance for the life of society as a whole, Nordau falls into a grave error. Mental diseases, and especially hysteria, have, from the earliest times to the present, exercised a tremendous influence upon the current metaphysical conception of the universe and upon the whole mental development, and that precisely because they not only occurred sporadically, but, as we shall soon see, attacked the masses in the form of epidemics, and so became of the highest significance and importance for the life of society as a whole.
Religious enthusiasm and proneness to the mystic and the occult formed, even in the highest antiquity, an important factor of those degenerate and hysterical individuals who entertained the delusion that they were in communication with good or with bad spirits, and who by that channel influenced the masses not a little. A great number of the priestesses who delivered oracular responses to the Greeks "with strong quaking of their body" were psychopathic subjects undergoing the hysterical convulsions well known to us to-day. Hence epilepsy, which in those days was not discriminated from hysterical cramps, came to be called the morbus sacer, or sacred disease. Plutarch, in his description of the Pythian priestess, delineates the typical image of a hysterical subject who, in ecstatic convulsion, stammered unintelligible words, into which the priests injected some sense. But hysteria, with its inclination to religious enthusiasm, was not limited to separate persons. On the contrary, we meet with it among all peoples and in all periods of history; and among all peoples we meet with it in the form of epidemics of various kinds. But never did this disease find a better or more fertile soil in which to thrive than in the middle ages of northern Europe, marked as they were by ignorance and superstition; and, accordingly, we find that epidemics of hysteria then assumed dimensions surpassing those of any similar outbursts in other centuries. A great many fine books have been written about the individual and epidemic crazes of those ages. The French have made particularly careful researches into the matter.
Calmeil describes a great number of hysterical epidemics of different forms. One of the principal eruptions in Germany was demonomania, or Teufelswahn. "In the year 1549," says Calmeil, "a delusion called Vaudoisie prevailed in Artois, that the devils carried many secretly in the night to the assemblies, where compacts were made with Satan and where carnal intercourse took place. Without knowing how, the participants of the nocturnal meetings found themselves next morning back in their dwellings."
A manifestation equally widespread in Germany was ​anthropophagy—that is, the delusion that the devil and his worshipers lived on human flesh. Men were believed to live in the neighborhood of Berne and of Lausanne who had given themselves to the devil, and who ate their own children. Hundreds of men were for this stretched on the rack or burned at the stake. Indeed, there were a number of insane persons who thought that they themselves were in league with the devil, and that they slew children.
The bull of Innocent VIII, which appeared in 1484, showed how deep-rooted the devil-delusion was in Germany. Everywhere people talked of how there was a great league with devils whose votaries committed deeds of shame in their assemblies; of how they were under obligation to destroy and consume newborn babes before they were baptized. In one year after the publication of the bull, forty-one women were executed in Burbia because in their nocturnal assemblies they always strangled, boiled, and ate a child. Toward the middle of the sixteenth century there broke out in many places in Germany, especially in convents, epidemic convulsions which exhibited the typical image of la grande hystérie and were connected with symptoms of religious delusions and of sexual excitement. Of one convent we read: "It was singular that as soon as one nun had her fit, the others, even in distant parts of the building, would immediately go off into fits as soon as they heard the noise of a person falling. The nuns had no power of will at all; they bit themselves, struck and bit their mates, knocked against one another, and endeavored vehemently to wound strangers. Upon any attempt to control the indecency of their conduct, their tumult and exaltation would become more angry. If they were left to themselves, they would soon come to biting and wounding without seeming to feel the least pain." Such subjects were considered to be bewitched or possessed of the devil. They were treated by exorcisms and conjurations which often increased their sufferings.
Not women alone were attacked by the disease; men were visited in the same way. Gilles de la Tourette gives an account of such an epidemic, according to a description by Hecker. We read: "In Aix-la-Chapelle, in 1574, troops of men and women from Germany were seen laboring under a common madness and displaying in the streets and churches this singular spectacle. With clasped hands, and carried away by an inward compulsion which they could not master, they danced for hours and kept up the spectacle without being abashed by those who were about, until they would fall exhausted to the ground. Then they would complain of their great agony, and would groan as though they were going to die, until people wrapped their abdomen with linen cloths, whereupon they would come to themselves and be free for ​a time from their sufferings. The object of this was to dispel the wind which set in after the attack. People often resorted to the simpler method of planting blows of the fist or kicks upon their abdomens. During their dance the subjects had visions. They did not see or hear; but in their imagination they beheld spirits whose names they pronounced, or rather shrieked out. . . . fell snorting to the ground without consciousness, and foamed at the mouth. Then, all at once, they got up and began their dance with frightful wrenchings. In a few months this plague extended from Aix-la-Chapelle as far as the Netherlands." Like the men and women, children were likewise attacked.
A phenomenon often seen to-day in insane asylums is that patients think themselves to be beasts, such as dogs, cats, monkeys, wolves, etc., and behave accordingly. In the middle ages this gave rise to the superstition of the Werewolf. The word is formed from wolf and the obsolete word wer, in Gothic vair, in Latin vir, man. Such persons, who during epidemics were sometimes found in great numbers, ran about the woods on all fours, lived and behaved exactly like beasts, fell upon men who might pass by, attacked even riders and vehicles, and stole children and devoured their flesh. Such things were known to the ancients too.
The influence which hysterical subjects exercised upon the whole metaphysics, or view of the universe of those times, was tremendous. While superstition and fanaticism may truly be called the best fertilizers to yield a crop of hysteria—and they have vastly contributed to its extension and large growth—at the same time, hysteria, in its turn, with its astonishing symptoms, far beyond the classificatory powers of those ages, has had the effect of enormously feeding and propagating superstition. In short, the two phenomena, hysteria and superstition, played into one another's hands; each was alternately cause and effect; and between them they called forth that dismal period in which the human mind was loaded with fetters, and postponed for centuries its free possession of its heritage. The author who is capable of saying that before this our time "hysteria only occurred sporadically, and was of no importance for the life of society in general," is not acquainted with the history of insanity and the biography of the human race. In order to pass judgment upon the present times from a psychological point of view, the very first requisite is an acquaintance with times gone by, and a tracing out of the path which has brought our culture to its present height.
Before passing on to the study of the present, let us first ask why and how it was that diseases of the mind took on an epidemic character. Most of those authors who have made hysteria the ​subject of deep investigations agree in this: that suggestibility (using this word approximately in its psychological sense) is a particular mark of the state of soul of the hysterical.
No doubt hysterical epidemics based upon religion continue even to this day. The last century was by no means poor in such phenomena.
The principal causes of the spread of epidemics of insanity and of the so-called secular hysteria are, then, suggestibility, emotionalism, the impulse to mimicry, and the tendency to mysticism.
Secular hysteria has by this time gradually assumed a different character. Belief in the devil and witches has faded quite away. Nowadays phenomena that seem unaccountable are produced in great variety by the hysteria which still subsists, and lead to crazy doctrines and errors, but they are new ones. Spiritualism, which flourished most in the middle part of the century, had such an origin. All those surprising phenomena that in earlier times had been referred to the agency of the devil and of witches were now treated as evidences of spiritual presence, telepathy, etc. Hysteria and religious superstition had formerly communicated each vitality to the other; now hysteria and pseudo-science intensified and propagated one another. The literature to which spiritualism has given rise is perfectly enormous, and forms a pendant to the old books on witchcraft. Scientific men of standing write in our times thick books to discuss the evidences of the most incredible theories about spirits, about veracious dreams, about prophecies, about telepathy, about clairvoyance, about premonitions, etc.
With our present knowledge of hysteria, its causes and symptoms, men of science and all who are enlightened by its teachings are under a positive obligation, which can not be shaken off and must not be shirked, to combat everything which tends to further superstition or to nourish the inclination of the people toward mysticism. Our duty it equally is to set our faces against those pernicious practices which are calculated to favor and augment that fatal symptom of hysteria, a heightened suggestibility.