Some illnesses defy scientific explanation. One such has symptoms ranging from blindness to deafness to paralysis to seizures. The attacks are inconsistent and erratic, they tend to come and go. Patients are usually taken to the friendly neighbourhood physician (unexplained symptoms account for up to 40 per cent of primary care consultations) who can usually reach no medical diagnosis despite repeated visits. Patients then typically proceed to specialised tertiary care hospitals to have a battery of expensive diagnostic tests done. Even there, eventually, four per cent of illnesses remain scientifically unexplained.

These illnesses, however, are not lifestyle diseases specific to the modern age. Patients with inexplicable symptoms were present even during the time of Socrates. Greek physicians noticed that women were more likely have such symptoms. So they decided that the uterus was the root cause of all these illnesses and labelled them hysteria from the Greek word hysterus for uterus.

Hysteria has myriad manifestations. One such manifestation is called “possession” and is found all over the world. The person’s body appears to have been taken over by spirits or a demon. The voice changes and he or she may harm themselves or others. They may suddenly have the strength of 10 people. Their actions are bizarre and often frightening.

Another is “somatisation” in which various body parts develop “diseases”. There may be peppery hot sensations, loss of feeling and numbness or actual paralysis. Sometimes food may appear to stick in the throat. There are hundreds of symptoms that can be attributed to hysteria, but the symptoms overlap with some very real illnesses. Hysteria, therefore, becomes a diagnosis by exclusion.

Another symptom of hysteria — seizures — can also occur because of epilepsy, brain tumours, brain fever or even high fever in children. Some seizures may be atypical, with staring spells or repetitive twitches. Hysterical seizures can usually be distinguished as they do not fit any of these patterns. Instead, they represent what the patient thinks seizures should look like.

Today, hysterical symptoms are attributed to the brain’s attempt to protect the person from stress. It may be for gain, such as staying home from a hated job or to avoid a social requirement. It may also be to control a third person like a parent or spouse.

Recently, scientific brain scans were done on patients diagnosed with hysteria. As the person attempted to move the apparently paralysed hand, the motor cortex that controls movement did not light up. Instead, brain activity was confined to the temporal and frontal lobes, which control emotion. The person thought they she was paralysed and the brain supported her belief.

Nobody likes to be labelled hysterical. And no one wants to hear that their symptoms have no scientific basis. So a host of inoffensive synonyms for “hysteria” have appeared in medical parlance such as functional, nonorganic, psychogenic and the favourite “medically unexplained” disease. Clinicians tend to use these bland terms to retain their patients and stop doctor hopping.

A chunk of hysteria patients also visit native healers, exorcists and mediums for treatment. Some of them have excellent rates of cure. They may beat the patients, douse them with water or burn them. Some of the rituals have, in fact, ended in the death of the patient.

Fortunately, though hysteria has have not changed much through the centuries, the medical profession’s understanding of it has. Instead of beating, burning and trial by fire, medical and scientific therapy is available today. Basically, hysteria is a cry for help, often by people trapped in a “no win” situation from which there is no escape.

Many of the symptoms disappear with psychotherapy. Attention seeking symptoms, like sudden blindness or loud inappropriate belching, respond if the appropriate amount of attention is given, or when the person realises that the end no longer justifies the means. Depression, which can precipitate hysteria, responds to medication.

Segments of the population are said to be suffering from collective or mass hysteria when several people have the same symptoms — like nausea, headache, muscle weakness, rash or seizures — at the same time. One person may complain of light-headedness at a social function and the symptom may spread like wild fire. A majority of those present may be affected. There is no rational scientific reason for these occurrences. They usually peter out gradually.

Hysteria may also not be confined to illnesses. It may involve seeing aliens or God. Quite often it involves attacks on persons believed to have a “black tongue” or an “evil eye”. A crowd can be whipped up to a frenzy with devastating and often fatal consequences.

When you develop a worrisome symptom, listen to your doctor. Ask for a rational explanation. If none is forthcoming, look within. In society, before you act and blindly follow the crowd, remember you have a brain, pause and THINK.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in