Hysteria, as it involves the medical profession, is a form of sickness that is defined as being without disease or illness. This lack of a biomedical explanation has limited progress in its understanding. In this essay we propose that hysteria might be better thought of as a form of pretending, elaborated in transaction with the medical system. In medicine, to pretend usually means to deceive. From the perspective of play, however, pretend is a state more akin to acting, magic, belief, and hypnosis. We provide a number of reasons why sickness is an attractive focus for pretending. We show how enactments of sickness can be scripted by a group of involved persons, each contributing from their own perspective, as occurs in the parlour game of 'Consequences', except in hysteria the consequences are often dire.