Introduction

In the first chapter of this book, the historical underpinnings of today's theories were outlined. Hysteria, the paradigm of female illnesses, was genital, and remained so for some 2000 years. The wandering womb of the Greeks, chorea lascivia, Charcot's ovarian tenderness, and the theories of Breuer and Freud all echo ancient mythologies, of sexual energies released or denied, of sparagmos, of Kundrian capriciousness, of metamorphoses. These lingering ideas came up against the shift in localisation of the disorder from the abdomen to the brain in the seventeenth century, and the clear association of symptoms with the emotions. There then was an assimilation of the latter two ideas, especially with Briquet, that somehow intense emotional states acted through specific parts of the brain to provoke pathological symptoms.

With railway spine and shellshock came not only clarification of the concept of traumatic hysteria, but also a renewed organic wave of theories, up-to-date with concepts of molecular change, anaemia and concussion. However, it was never very clear how the nervous shock transmogrified into some pathological brain state, and even advocates of the neurological approach like Erichsen acknowledged in many cases the importance of the shock, of the emotional state aroused by the trauma.