Nervous and mental diseases . cted impress characteristic attitudes upon the limbs. The arm is usuallyadducted ; the elbow wrist, and fingers forcibly flexed. The hand,when alone affected, may be flexed into a fist, with thumb under or be-tween the fingers, or the hand may be extended or held in the writingposition. The lower extremity is commonly extended in all its , the foot is dorsally flexed. The muscles of the trunk arenot infrequently contractured, causing deviations of the spinal columnmimicking scoliosis and anterior and posterior curvatures. The toesmay be
Nervous and mental diseases . cted impress characteristic attitudes upon the limbs. The arm is usuallyadducted ; the elbow wrist, and fingers forcibly flexed. The hand,when alone affected, may be flexed into a fist, with thumb under or be-tween the fingers, or the hand may be extended or held in the writingposition. The lower extremity is commonly extended in all its , the foot is dorsally flexed. The muscles of the trunk arenot infrequently contractured, causing deviations of the spinal columnmimicking scoliosis and anterior and posterior curvatures. The toesmay be extended or flexed. Many of these attitudes are transientlyrepresented in the hysterical attacks, as shown in the figures on pages615 and 616, and in some sense hysterical contractures or palsies maybe considered prolonged localized attacks, or as a hysterical status offractional extent. Some of the more common varieties of hysterical motor accidentsfollow. Hysterical hemiplegia affects either side with about equal 1\ Fig. 265.—Hysterical contracture in foot and leg. Ernest Jones 1 in a tabulation of 277 cases found it approximately 55 timeson the right to 45 times on the left side. The distal portions of the limbsare most affected. Instead of walking with the rigidity of organic hemi-plegia, the foot and leg are limply dragged along the ground, the advancebeing made by the sound side. Ordinarily, there is anesthesia of similarhemilateral extent or other sensory stigmata on the same or opposite the face escapes, and, wThen affected, the lower half is most im-plicated. Almost invariably limited contractures will at the same timebe found, or they may predominate over the flaccidity or alternate with it. Hysterical monoplegias may be single or multiple. Their distributionmay be unilateral or crossed. The face and limb on the same or op-posite sides, or both lower limbs, or all four limbs may be the paralytic member is not affected in it
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