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Page 35
"_October_ 16.--Twenty-two ounces of milk were taken, in divided doses,
in twenty-four hours; on the 17th, fifty ounces of milk; on the 18th,
the same quantity of milk repeated; massage for half an hour; on the
19th, milk as before; bread-and-butter and egg; massage for an hour and
a half; twenty minims of dialyzed iron twice daily; on the 21st, a
mutton-chop in addition to the above; massage an hour and fifty minutes.
To-day she passed water for the first time for four years, and the
catheter was never again used. Chloral discontinued, and she slept
naturally all night long. On the 23d, porridge and a gill of cream were
added to her former diet; massage three hours daily, and electricity for
half an hour, and this was continued until the end of the treatment.
Maltine was now given twice daily.
"_October_ 30.--She is now consuming three full meals daily of fish,
meat, vegetables, cream, and fruit, besides two quarts of milk and two
glasses of burgundy. Considerable muscular power is returning in her
limbs, which she can now move freely in bed.
"_November_ 6.--Sat in a chair for an hour. The massage and electricity
are being gradually discontinued, and the amount of food lessened.
"_November_ 17.--Walked down-stairs, and went out for a drive, and
henceforth she went out daily in a Bath-chair. She has increased
enormously in size, and looks an entirely different person from the
wasted invalid of a few weeks ago.
"On November 26 she went to Brighton quite convalescent, and on December
11 came up of her own accord to see me, drove in a hansom to my house,
and returned the same afternoon. She has since remained perfectly strong
and well, and has resumed the duties of life and society.
"A somewhat curious phenomenon in this case, which I am unable to
account for, was the formation on the anterior surface of the legs,
extending from below the patell� half-way down the tibi�, of two large
sacs of thin fluid, containing, I should say, each a pint or more,
freely fluctuating, and quite painless. I left them alone, and they have
spontaneously disappeared."
"In May, 1880, I saw with Dr. Julius, of Hastings, an unmarried lady,
aged thirty-one. Her history was that she had been in fairly good health
until five years ago, when, during her mother's illness, she overtaxed
her strength in nursing, since which time she has been a constant
invalid, suffering from backache, bearing down, inability to walk,
disordered menstruation, and the usual train of uterine symptoms. She
used to get a little better on going to the sea-side, but soon became
ill again, and in October, 1879, she was completely laid up. The least
standing or walking brought on severe pain in her back and side, and she
gave up the attempt, and had since remained entirely confined to her bed
or sofa, suffering from constant nausea, complete loss of appetite, and
depending on chloral and morphia for relief. Many efforts had been made
to break her of this habit, but in vain. Her medical attendant had
recognized the existence of a retroflexion, but no pessary remained _in
situ_ for more than a day or so, and he suspected that she herself
pulled them out. I was unable to do more than confirm the diagnosis that
had been made as to her local condition, but the pessary I introduced
shared the fate of its predecessors, and she remained in the same
condition,--in no way benefited by my visit. Things going on from bad to
worse, Dr. Julius sent her to London for treatment in the early part of
December. I now determined to try the effect of the method I am
discussing, of which I knew nothing when I first saw her. It was
commenced on December 11, and everything went on most favorably. A week
after it was begun, when her attention was fully occupied with the diet,
massage, etc., I introduced a stem pessary, being tempted to try this
instrument, which I rarely use, by the knowledge that she was at perfect
rest, and that no form of Hodge had previously been retained. I do not
think she ever knew she had it, and it remained _in situ_ for a month,
when I removed it and inserted a Hodge, which was thenceforth kept in
without any trouble. I may say that I do not think the retroflexion had
much to do with her symptoms, except, doubtless, at the commencement of
her illness, and she probably would have done quite as well without any
local treatment. She rapidly gained flesh and strength, and very soon I
entirely stopped both chloral and morphia, and she never seemed to miss
them. On December 11, when the treatment was commenced, she weighed 5
st. 9 lbs. On January 20 she weighed 7 st. On January 25 she walked
down-stairs, and went out for a drive, and from that time she went out
twice daily. She complained of no pain of any kind, and, although she
wore a Hodge, she did not seem to have any uterine symptoms. On February
1 she went to the sea-side, looking rosy, fat, and healthy, and has
since returned to her home in the country, where she remains perfectly
strong and well. A few days ago she came to town, a long railway
journey, on purpose to announce to me her approaching marriage."
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