APPENDICES
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at bloody operations without turning a hair, while they tremble all over with fear and loathing at the touch of a cat. I remember a young woman who suffered from acute hysteria following a sudden fright. She had been to an evening party and was on her way home about midnight in the c ompany of s everal a cquaintances, w hen a cab cam e u p b ehind them a t f ull t rot. T he o thers g ot ou t of t he w ay, bu t s he, a s t hough spellbound with terror, kept to the middle of the road and ran along in front of the horses. The cabman cracked his whip and swore; it was no good, she ran down the whole length of the r oad, which led across a bridge. There her strength deserted her, and to avoid being trampled on by the horses she would in her desperation have leapt into the river had not the passers-by prevented her. Now, this same lady had happened to be in St. Petersburg on the bloody twenty-second of January [1905J, in the ve ry s treet w hich w as c leared by t he vol leys of t he s oldiers. A ll round he r pe ople w ere f alling t o the gr ound de ad or w ounded; s he, however, quite calm and clear-headed, espied a gate leading into a yard through which she made her escape into another street. These dreadful moments cau sed h er n o f urther ag itation. Sh e f elt p erfectly w ell afterwards-indeed, rather better than usual. This failure to react to an apparent shock can frequently be observed. Hence it ne cessarily f ollows that t he intensity of a trauma has very little pathogenic significance in itself; everything depends on the p articular ci rcumstances. H ere w e h ave t he k ey t o t he predisposition [, or at least to one of its anterooms]. We have therefore to as k o urselves: w hat ar e t he p articular ci rcumstances o f t he s cene with the cab? T he patient's tear began with t he sound of the trotting horses; for an instant it seemed to her that this portended some terrible doom-her death, or something as dreadful; the next moment she lost all sense of what she was doing. The real shock evidently came from the horses. The patient's predisposition to react in so unaccountable a way to this unremarkable incident m ight therefore c onsist i n t he f act t hat h orses ha ve some special significance for her. We might conjecture, for instance, that she once had a dangerous accident with horses. This was actually found to be the case. As a child of about seven she was out for a drive with the coachman, when suddenly the horses took fright and at a wild gallop made for the precipitous
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