The first period is analogous to the attack of epilepsy proper. An abrupt loss of consciousness takes place. The patient falls to the floor; her muscles contract, stiffen; her face turns blue; the features are wrought into a horrible grimace; the arms bend; the hands clinch; in a few instants afterward the muscles quiver with convulsive tremblings, which at first grow more marked, then become weaker and weaker. At last, the muscles, exhausted by the long and violent strain, relax, and a deep, stupid sleep succeeds the convulsive spell.
This lasts only for a little while, and then begins the second period, which M. Charcot calls the period of clownism, because it recalls the curious attitudes and contortions of the clowns in the circus. At this stage the patient executes prodigious bounds; the body, bent into the arc of a circle, rests on the bed only by the head and feet; the face is disfigured, sometimes terribly so, and the twisted features give it a hideous expression; and at times the whole body will bound up, then fall heavily upon the bed. "The patient goes into a fury against herself," says M. P. Richer, describing one of the attacks; "she tries to scratch her face, to tear her hair, she utters pitiful cries, she hits her breast with her fist so hard that the attendants have to interpose a cushion; she springs at the persons who are around her, tries to bite them, and, if she can not get at them, tears everything within her reach, the bedclothes, her own clothes, bellows like a calf, strikes the bed with her head and her fists as if she could never get enough of it; she jumps up, throws her arms around, bends her legs up and kicks them out again, shakes her head back and forth uttering hoarse cries all the time, or, if she sits down, twists her body around from one side to the other, and keeps her arms moving."
Not less surprising than the violence of the attack is the ease with which it can be stopped. All the excess ceases at once on simply compressing the abdomen. The demoniac spell originates apparently in the ovary, for, on pressing the hand on the abdomen precisely at the point that answers to the ovary, the rage immediately ceases. The poor demoniac, restored to herself, casts an astonished look at the persons around her, as if she does not understand why they are there, for she was alone when she was seized, and has been unconscious since. She keeps her consciousness as long as the ovary is compressed, and is able to put the clothes in order, to talk, laugh, and enjoy herself cheerfully with her associates; but, if the compression is relaxed a little, the attack begins again with all its original force, to cease again if the ovary is compressed anew. By a coarse but intelligible comparison, the working of this pressure may be likened to the action of a faucet on the flow of water in a pipe. The flow ceases when the valve is turned off, to begin again as soon as it is turned on. The patients at the Salpêtrière understand the relation so well that, when one of them is attacked, the others straightway go to her bed and press on her abdomen, for several hours if it is necessary, till the
