Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

and general. The pain about such joints is excruciatingly severe, far beyond what attends ulceration ; but it lasts as long, and only so long, as the mind dwells upon it, and it recurs as instantly and as often as the mind reverts to it. Divert the patient's mind powerfully to another affair, and it is remark- able how almost instantaneously the suffering will vanish. These cases of simulated disease may not always be pure, — that is, without some simultaneous change of structure ; but, usually, there is no sign of local disease beyond a slight swelling of the joint, and the temperature of the joint and limb is rarely changed; but not always so by any means, as heat and swelling do, now and then, attend hysterical affections of the joints and neuralgic affections generally. Dr. Skey, of St. Bartholomew's Hospital, in speaking of this, says, " We have, perhaps, in the history of mankind, no manifestation of the intimate relation between mind and body more remarkable than this — the entire and almost sudden cessasion of severe pain simply through the curative agency of a train of healthy thoughts." (See p. 570.) We see, perhaps, a delicate girl suffering " very greatly" with pain in the back, or hip, or knee, as a mysterious recent case; or we see a " maiden lady," perhaps, within ten years of thirty, who has long suffered with precisely the same state as a chronic affection, — an old case. We are told that "the pain is dread- ful " — in some cases so severe that the patient holds her body in some perpetually reclining posture, or her leg as constantly semi-flexed and immovable. In some cases, though the patient is unceasingly complaining, she still walks about, at least at times. The pain and the pseudo-joint malady are generally in the direct inverse ratio with other hysterical symptoms ; for here the hysteria is concentrated, and the pain is increased about the menstrual period. In the earlier stages the worst and most frequent pain is referred to a spot about the ligamentum patella;, which is often greatly aggravated by the merest touch, but especially if the skiu and sub-cutaneous fat here situated be gently pinched up between the thumb and finger. The knee joint is more apt to be thus affected than any other, and that without local mischief adequate to account for its intensity. 35*