geons and neurologists are sent. These report the facts which usually are conspicuous enough. The patient gets still worse. All chances of settlement on any reasonable basis are now gone and the case finds its way to court. Once in the court-room, the patient is at the acme of all the symptoms. Paralysis, insensibility to pain, convulsions, loss of special senses, all make profound impressions on judge and jury. The medical opinions are too often flatly contradictory; and the jurors, thus deprived of the advantage of special knowledge, judge for themselves from what they see.
The verdicts are always large. None too large, perhaps, as actual amounts, in view of the suffering and delays the plaintiffs have gone through. But excessive when compared with the amounts paid for other injuries, more modest in their symptoms, but with far less hopeful outcome. A young girl with hysteria can generally secure a higher compensation in the courts than a working man with some lifelong disability. The amounts thus unjustly graded may indicate that juries can not grasp the dramatic power of idea; or else that they believe that symptoms conjured up from subconscious depths are even more persistent than those of tangible causation.
In strong contrast to the verdicts is the fact that hysteria from injury, in America at least, is cured in nearly every case. Such is my personal conviction, based upon information obtained about the plaintiffs after the suit is closed. Into a detailed examination it is rarely possible to go. For after the trial these individuals, with surprising frequency, fold their tents and silently steal away. Those that remain within a reasonable radius rebel at the idea of reexamination. They seem to resent their recovery. A young man who was injured in one of the terrible wrecks occurring near New York a few years ago, lay in bed for two years with hysterical paralysis, awaiting the trial of his case. There were two trials. At each of them he heard, from his stretcher, his experts say his injuries were permanent. In spite of that he was up and walking freely and was commuting to his work, as he used to do, within eighteen months of the last trial. But a request, prompted by the writer, for permission to reexamine him, brought a response to the effect that "no information would be vouchsafed which could in any way be used to prevent others who had suffered as he had from being less generously compensated."
From such information as is obtainable, it would seem that full functional recovery is the rule. The women who were cripples often marry, the men return to work. But their assumptions or resumptions of activity are often slow. The patients may be well again in a few months. But the miraculous and instantaneous recoveries, such as we
- In "Diseases of the Nervous System Resulting from Accident and Injury," Appleton, 1906, the writer presented the after histories of a number of cases of litigated hysteria. Since then he has added many to the series.