The Misdiagnosis of Hysteria

I was very interested in the report about hysteria and how so many diseases throughout time were misdiagnosed as hysteria, but since the topic was so broad and I found lots of information, I decided to narrow it down to one specific person who commonly diagnosed diseases as hysteria.

Jean Martin Charcot – neurologist

– genius for anatomical dissection and post-mortem diagnosis.
– His greatest handicap was that he practiced neurology at a time when:
instruments of investigation which have made modern neuroscience possible did not exist:
– X-rays
– Electroencephalogram (EEG) wasn’t invented until the 1940s
– Magnetic Resonance Imaging (MRI), was not introduced until the closing decades of the twentieth century.
– During Charcot’s time, leading neurologists believed that the work of neurology was almost complete.
– Today we know that there is still a very long way to go.
– Many subtle neurological disorders, such as temporal lobe epilepsy, and frontal-lobe epilepsy, were unrecognized in Charcot’s day.
– Internal pathology of head injuries remained an almost complete mystery.
– Closed head injuries, which produce concussion without leaving any external injury, were not recognized.

There was one specific case that I read that proves how little the neurologists at that time knew about brain injuries.

October 1885

A florist’s delivery man in Paris was wheeling his barrow home through busy streets when it was hit from the side by a carriage which was being driven at great speed. The delivery man had been holding the handles of his barrow tightly. He was spun through the air and landed on the ground. He was picked up completely unconscious and taken to the nearby hospital where he remained unconscious for five or six days. Six months later the lower extremities of his body were almost completely paralyzed, there was a twitching or tremor in the corner of his mouth, he had a permanent headache and there were blank spaces in the tablet of his memory’. He could not even remember the accident. According to Charcot, because there had never been any signs of external injury, his patient was a victim of traumatic hysteria and that his symptoms had arisen as a result of the psychological trauma he had suffered. Charcot came to this conclusion knowing full well that some weeks after his accident the man had suffered heavy nose-bleeds and a series of violent seizures seizures which Charcot deemed hysterical.

If Charcot’s patient were to be brought today to a hospital doctors would recognize a case of closed head injury complicated by late epilepsy and raised intracranial pressure.

More Medical Mistakes

Over the years, failure to make accurate medical diagnoses had almost inevitably led to a diagnosis of hysteria’.

When Charcot was confronted by patients who compulsively arched themselves backwards, he did not know that this posture was a characteristic manifestation of frontal lobe epilepsy. This form of epilepsy would not be fully described until another hundred years had passed. Confronted by the symptoms of these medically uncharted conditions, Charcot had little option but to call it hysteria’.

I wanted to know how many other conditions and diseases were classified as hysteria’ and these are some of the ones I found:

head injury
cerebral tumors
multiple sclerosis
Parkinson’s disease
Tourette’s syndrome
torsion dystonia
viral hepatitis
reflux oesophagitis