Ladies, are you suffering from anxiety, confusion, depression, edema, fainting, forgetfulness, giddiness, headaches, hyperemia, insomnia, irritability, lassitude, loss of appetite, muscle spasms, nervousness, palpitations of the heart, heaviness in the abdomen, paralytic states, shortness of breath, stomach upsets, tendency to cause trouble for others, ticklishness, weepiness, writing cramps, indifference to marital duty, lustful yearnings or excessive vaginal lubrication?

If so, you may benefit from the 19th-century medical remedy, a hysterical paroxysm.

The City Fathers were delighted that Jacob Stratton, MD, chose to set up practice in Capton Springs, as a county seat needs qualified medical practitioners. Dr. Polk had abruptly left town, and not that Doc Langston couldn’t set bones, of course, but everyone knew that his title came from not a proper medical college.

Capton Springs was indeed a community of progress: courthouse, gas streetlights, six churches, opera house, railhead, natatorium and businesses ranging from Adler’s Mechanical Works to Ziegler & Sons, Fine Attire and Sundries.

Dr. Stratton, the Town Fathers acknowledged, had only academic experience, but no one saw a problem. Capton Springs was about moving forward. Give the young doctor time to work out the practicalities and they’d have themselves a fine physician. Give the fellow time to court -- one of their daughters, the Town Fathers were rather hoping -- and he’d be building a fine house north of Main.

For a time, however, Dr. Stratton would take a room at Mrs. Witherspoon’s. She’d keep him properly nourished and prod him to church each Sunday. The Town Fathers arranged an office above Emmons’ Pharmacy.

Interest in Capton Springs’ newest professional ran high among the leading ladies. Not only would he be refined in manner, he’d perhaps consent to lecture Eastern Star on recent medical advances. Most had, in fact, already identified a malady needing an immediate consultation. The first to examine the examiner would have the most to report.

Stephanie Mullins, wife of Lewis Mullins of Good & Plenty Farm Implements, took the initiative to telegraph Dr. Stratton even before his arrival. She’d experienced a shocking shortness of breath lately and hoped to consult with him at his first possible opening.

Dr. Stratton, pleased at the prospect of a paying consultation, immediately wired back, “9:00 Monday, August 5. Dr. Stratton.”

Alice Witherspoon, in fact, had first opportunity to mine the newcomer for personal tidbits while explaining the working of her boarding house, but none of the leading ladies would have reason to cross paths with one having such a profession.

“Well, Stephanie, do tell us,” prodded Suzette Edmond, wife of the owner of Emmons’ Pharmacy, “out new doctor, what sort of gentleman is he?”

“Oh, I hardly noticed. He’s no taller than am I, slight of build, not a braggart. Maybe a bit tentative, even, in a younger sort of way, but I’m sure he knows his medicine. He didn’t check my heart that thoroughly, but he complimented my posture.”

“Does our new doctor have a satisfactory examination table?”

“I mentioned the subject, and he indicated that he’d ordered the finest.”

“And is he up to date regarding hysterical paroxysms?”

“I’d hope so, though I didn’t want to bring up the subject too early. There’s a copy of The Female Medical Guide on his bookshelf, though. Perhaps he’s also brought something mechanical.”

“That we shall find out.”

Jacob Stratton, diploma from Omaha College of Medicine, was enthusiastic about his prospects. His professors advised that the route to professional acumen was attendance at an established hospital, but he’d tossed himself into the vastness of the open plains where towns such as Capton Springs afforded no end of professional opportunity.

The Town Fathers had assured him that his preference in cigars would be stocked by the tobacconist. The community had a Presbyterian Church. Mrs. Witherspoon’s boarding house appeared to be properly run and the proprietress certainly made a fine roast beef. The other boarders, a teacher of Latin, a traveler, and a dealer in grain stocks, seemed well-read.

None of the patients requesting immediate attention seemed in imminent danger. The woman reporting palpitations of the heart exhibited no symptoms requiring a more than a quick listen with his stethoscopic tube. She’d offered to remove some of her busting, but he’d thought it unnecessary, his tube being the latest model.

He was surprised how the ladies of such a small berg dressed so fashionably, but the Town Fathers had boasted that Capton Springs was only a railway ticket from the finest of Chicago.

As a medical student, he’d left it to the nurse to assist a patient’s preparation. A corset required a woman’s hand. As he’d little idea of how the laces worked; what was under it, on the other hand, was described in the literature.

Mrs. Mullins was disappointed to not see the examination table in place on her second visit, but wasn’t one to waste the consultation.

“Dr. Stratton, I know this may be minor, but I’ve been overcome as of late with inability to sleep, nervousness and even a heaviness in the abdomen. It is most unsettling.”

Jacob prepared to apply his tube below her collarbone, what his reference advised for matrons. Some of his classmates had joked that non-matrons could checked lower, but Mrs. Mullins didn’t seem to qualify.

“In my case, sir,” she informed him, “Dr. Polk found listening through a blouse to be muffled. Would you be so kind as to help with the buttons? The satin’s rather nice, don’t you think?”

That he did, doing his best to touch no more than the closures.

“Dr. Polk said that to eliminate extraneous noises, what works best, given my bust, is to apply your ear directly, not that metal thing. It’s why I’m without my corset,” and saying no more, pulled up her camise.

Jacob, not knowing what else to do, applied his ear to the side of her chest.

“You appear to be sound,” daring not to tarry.

“Dr. Polk always checked both sides,” she pointed out, so again he listened. Being of medical mind, noticing that her nipples were fully erect.

“All seems well,” he again assured, moving his ear to one of them and again listening.

“Well, my condition comes and it goes,” his patient added. “Sometimes with -- if I may say so in pure confidentiality -- with a sensation that affects my lower parts.”

Jacob was unsure what to advise. “Well, it could be a number of things.”

“I see The Female Medical Guide on your shelf, doctor. Dr. Polk said it’s quite modern.”

Jacob was impressed with her interest in medicine.

Mrs. Mullins re-buttoned, requesting his assistance with the more difficult ones, and exited with a, “Your office will be so up-to-date when your examination table arrives.”

“It’s due next Wednesday.”

“We’re so pleased you’ve located in Capton Springs, Dr. Stratton. Might you schedule me for a follow-up, say, next Thursday?”

Jacob was perusing The Female Medical Guide -- a reference covering topics with which he was less familiar -- when Mrs. Mullins arrived for her next visit.

“Ah, yes, Dr. Stratton, the table,” her comment before proceeding. “It’s almost as if I find myself sinking into lassitude and a faintness of spirit,” the words very much resembling ones in the book.

He paused, trying to formulate a query. “Your husband, Mr. Mullins. Would you consider him to be, shall we say, a vigorous gentleman?”

Mrs. Mullins blushed. “Mr. Mullins is most dutiful.”

“Of that I was of course certain,” Jacob hurried to add, recalling as best he could what he’d just read, “Mrs. Mullins, it appears that you may suffer from hysterical crisis.”

“Oh my! Certainly it must be something less egregious.”

“Were you unmarried, madam, I’d recommend horseback riding, but even spousal familiarity is sometimes insufficient. But let me assure you, it can be countered by provoking a corrective crisis. Had we a hot spring, perhaps by hydriatic massage.”

“But we have none.”

“In that case,” mustering up is courage and tapping his volume, “a hysterical paroxysm is recommended.”

“Such a long word,” his patient fluttering her eyes in admiration. “Surely we should begin immediately.”

It didn’t occur to Jacob to wonder how she seemed to know to get on the table. “Let me forewarn you, though. Some husbands find it difficult to accept published medical practice.”

“I’m sure Mr. Mullins wishes the most-modern treatment for me, but he’s far too busy to know the details, just as you’d not burden him with the details of childbirth. We ladies respect our spouses’ unease with such things.”

Jacob was relieved, their husbands not being medical practitioners.

“And speaking of Mr. Mullins, perhaps he’s not as dutiful as might be wished,” she explained, “as he has so many pressing business concerns.”

“Of course,” Jacob not wishing to ask about business matters. “The treatment involves the vulvar manipulation of the womb area, a part of the uterus,” omitting the bit regarding “massage the genitalia with one finger inside using oil of lilies or musk root”

“Here’s what it says,” finding the page. “The patient may feel contractions, secrete necessary fluids and experience a fit before relieving her tension, sometimes to the point of somnolence.”

“As I lack medical education,” his patient pointed out, “it might be better just to show me,” dispensing with footwear and reaching under her petticoat to pull down her stockings.

“Should I lie back, doctor?”

He turned to look for mineral oil, and when he turned back, she was prone on the table, naked above the waist, and, staring at the ceiling.

“Perhaps you could help with my bloomers,” raising her hips.

Jacob had of course assisted in deliveries at medical school.

“Do you think my waist too large?”

“It’s very womanly,” Jacob assured her. “I fear I lack a tremoussoir, however,” remembering from the book. “A mechanism from France. Perhaps I can order one.”

“Mr. Mullins would certainly pay for it,” she offered, “itemized imprecisely.”

“According to the most trusted sources,” Jacob went on, “the hysterical paroxysm effect can also be achieved by pelvic massage”

“Indeed you must do so,” she agreed.

“Your task is to submit to your natural reflexes. It may at first feel disturbing, but it’s nature’s way. You may clutch the grips.”

Jacob’s began just below her waist and proceeded downward, finding her vulva most moist. Fortuitous, he thought

His reference recommended a single digit applied to the button-like protrusion located beneath the small hood where the inner labia meet. Entice this to emergence by application of delicate strokes. Administer repetitive stimulation while massaging the patient’s breasts with the free hand. A patient in her hysteria may manifest involuntary reflexes, but do not cease the procedure until full paroxysm.

“This will take but a moment, Ms. Mullins,” enticing out the protrusion.

“I’ve nothing scheduled after this,” she informed him.

Drawing his finger over the emergence, he detected a hint of tremor. “Am I disturbing you, ma’am? If so...”

“Oh, not at all, Dr. Stratton. If anything, I’m beginning to sense an invigoration.”

Within several minutes, his patient was freely thrusting. Though he’d forgotten to apply additional oil, it seemed not to matter. It was well that the table included grips.

Within another minute, she emitted the first of what were to become deeper and deeper inhalations and exhalations.

“Shall I cease?” as he didn’t want to provoke an issue of the heart.

“To leave me but half-treated won’t do at all, doctor.”

Jacob picked up the pace and when at last Mrs. Mullins erupted in convulsive throbs, he had to hold her on the table until complete release of her tensions. The female body is mysteriously complicated.