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femur was about throe inches shorter than the other, and the
leg on that side, from the under edge of the patella to the heel,
was four inches shorter than its fellow, showing that the limb
had not grown in proportion with the general development of
this otherwise beautiful girl. Besides, the limb below the knee
was atrophied, cold, and lifeless, while the thigh muscles were
remarkably well developed, and the hip muscles were drawn
together, tilting the pelvis, and largely projecting the whole hip.
By any experienced and skilful eye this would be at once recog-
nized as mainly a " hysteric-hip joint." There was no sign of local
disease in progress, beyond a general swelling or enlargement of
the whole hip. Pain — pain, not the concomitant of inflamma-
tion or idceration, but pain per se — seems here to constitute the
disease. These cases are said to possess, in one sense, a quality
of wrercality ; but it is not to be for one moment supposed that
all these patients willingly deceive their medical attendant and
best friends, nor that the pain complained of so long and inces-
santly has no real existence. If so, why does she not complain
when pressure is made gradually but firmly from the foot
towards the pelvis, which would be likely to give pain in almost
every other hip joint or pelvis malady ? *
In fact, or effect, this disease may be originally produced by
the peculiar circumstances and conditions of woman's life ; but
I believe it soon becomes a disease of habit, or a true neurosis,
and now more or less independent of uterine action or inaction ;
but is rather become the peculiar contingency of the uncon-
trolled emotional feelings and morbid imaginations of the
patient. Dr. Barwell says great harm is done by prescribing
the indiscriminate and long use of steel, ethers, aloes, &c, for
these patients. If this view be correct, the treatment should be
general as well as local, and directed to the cerebral condition
that produces this manifestation of pain, and to that faculty of
Will, that sways the disease by its own or the emotional state.
To control the emotions and will, is to cure the disease. Hence a
plain, coarse, and low diet, with plenty of regular exercise for both
body and mind, will be best calculated to break up this morbid
habit and state. Let the patient have mainly plain, light, crusty
* See Dr. Walter Channing's work on the " Bed Case."