Page:Popular Science Monthly Volume 31.djvu/620

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602
THE POPULAR SCIENCE MONTHLY.

given, such as "Open your eyes," "Sit up," etc., and to answer simple questions by writing. He could be made to write anything to dictation; but whenever ordered to indite a letter, he constantly reproduced one he had written shortly before this attack.

Finally, be was found to have lost sensation in the left side; and the application of magnets to the skin produced some of the alterations of feeling characteristic of hysterical hemianæsthesia. Powerful electrization, though it failed to rouse him up, induced convulsions and spasms, typical of the regular hystero-epilectic seizure.

There is thus no doubt left us as to the nature of the case of "the Soho sleeper." Among other instances of attacks of sleep in the course of hystero-epilepsy, I may mention a patient whom Professor Charcot has had under his observation for many years:

She first came to the Salpêtrière Hospital in 1862, and presented many of the alterations of sensation and movement characteristic of the disorder. On April 7, 1875, she was seized with somnolency, which persisted with temporary awakenings till the 27th. There occurred then a violent outburst of paroxysmal laughter and weeping. From that moment the patient passed into a cataleptic condition, with occasional hysterical fits of the same description. She had to be fed with a spoon; she swallowed as if automatically, with a noise, but without any signs of consciousness. She awoke quite abruptly on the 7th of June, and affirmed that she had no recollection of what had taken place during the past two months. There occurred in 1876 another fit of the same kind, that lasted about a fortnight.

In order to illustrate further the intimate connection between certain morbid forms of sleep and the hysterical state, I shall briefly allude to the so-called "hysterogenic" and "hypnogenic" pressure-points discovered by Professors Charcot and Pitres.

A very remarkable phenomenon connected with grave hysteria is the artificial production and arrest of attacks by pressure on certain points on the surface of the body. The number and distribution of these points are very variable, and they differ in every case. They usually can only be found out by careful search, the patients themselves ignoring the existence of them.

On pressure being exerted upon one of these "hysterogenic" spots, the patient falls into a convulsive or tetanic spasm, and the various phases of the attack succeed one another much in the same order as in a spontaneous fit. Now it is a curious fact that a repetition of the pressure on the same spot, or on some other spot experimentally discovered, will often abruptly modify or arrest the attack. The great theoretical and practical importance of this singular property of certain circumscribed cutaneous areas, has directed the investigations of several careful observers, and led to the discovery of similar spots, called "hypnogenic," pressure upon which determines, not a muscular spasm or convulsion, but an attack of hypnotic sleep.

These hypnogenic areas are likewise irregular in their number and