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Page 37
"When consulted about this lady, I gave it as my opinion that any
attempt at cure was hopeless as long as she remained in the country
house in which she lived. I was informed that it was absolutely
impossible to get her away, as she could not bear the motion of any
carriage, still less of a railway, without the most acute suffering.
Eventually the difficulty was got over by an�sthetizing her, when she
was carried on a stretcher to the nearest railway station, and then
brought over two hundred miles to London, being all the time more or
less completely under the influence of the an�sthetic, administered by
her medical attendant, who accompanied her. I found this lady's state
fully justified the account given of her. She was intensely sensitive to
all sounds and to touch. Merely laying the hand on the bed caused her to
shrink, and she could not bear the lightest touch of the fingers on her
spine or any part near it. She lay in a darkened room at the back of the
house, to be away from the noise of the streets, which distressed her
much. She was a naturally fine and highly-cultivated woman, greatly
emaciated, with a dusky, sallow complexion, and dark rims round her
eyes. I could find no evidence of organic disease of any kind. Whatever
lesion of the uterine organs had previously existed had disappeared, and
I therefore paid no attention to them. Within a week I had the patient
lying in a bright sunlit room in the front of the house, with the
windows open, and she complained no longer of the noise. Within ten days
the whole spine could be rubbed freely from top to bottom, and from the
first I directed the masseuse to be relentless in her manipulation of
this part of the body. In a few weeks she had gained flesh largely, the
dusky hue of her complexion had vanished, and she looked a different
being. The only trouble complained of was sleeplessness, but it did not
interfere with the satisfactory progress of the case, and no hypnotic
was given. After the first few days we had no return of the nerve-crises
which in the country had formed so characteristic a part of her illness.
Her hands and feet also, at first of a remarkable deadly coldness, soon
became warm, and remained so. In five weeks she was able to sit up, and
before the fifth week of treatment was completed I took her out for a
drive through the streets in an open carriage for two hours, which she
bore without the slightest inconvenience, and the result of which she
thus described in a letter the same evening: 'I never enjoyed anything
more in my life. I cannot describe my delight and my astonishment at
being once more able to drive with comfort. My back has given me no
trouble, and I was not really tired.' This lady has since remained
perfectly well, and I need give no better proof of this than stating
that she has started with her husband on a tour round the world, _vi�_
India, Japan, and San Francisco, and that I have heard from her that she
is thoroughly enjoying her travels."
"The last example with which I shall trespass on your patience I am
tempted to relate because it is one of the most remarkable instances of
the strange and multiform phenomena which neurotic disease may present,
which it has ever been my lot to witness. The case must be well known to
many members of the profession, since there is scarcely a consultant of
eminence in the metropolis who has not seen her during the sixteen
years her illness has lasted, besides many of the leading practitioners
in the numerous health-resorts she has visited in the vain hope of
benefit. My first acquaintance with this case is somewhat curious. About
two months before I was introduced to the patient, chancing to be
walking along the esplanade at Brighton with a medical friend, my
attention was directed to a remarkable party at which every one was
looking. The chief personage in it was a lady reclining at full length
on a long couch, and being dragged along, looking the picture of misery,
emaciated to the last degree, her head drawn back almost in a state of
opisthotonos, her hands and arms clenched and contracted, her eyes fixed
and staring at the sky. There was something in the whole procession that
struck me as being typical of hysteria, and I laughingly remarked, 'I am
sure I could cure that case if I could get her into my hands.' All I
could learn at the time was that the patient came down to Brighton every
autumn, and that my friend had seen her dragged along in the same way
for ten or twelve years. On January 14 of this year, I was asked to meet
my friend Dr. Behrend in consultation, and at once recognized the
patient as the lady whom I had seen at Brighton. It would be tedious to
relate all the neurotic symptoms this patient had exhibited since 1864,
when she was first attacked with paralysis of the left arm. Among
them--and I quote these from the full notes furnished by Dr.
Behrend--were complete paraplegia, left hemiplegia, complete hysterical
amaurosis, but from this she had recovered in 1868. For all these years
she had been practically confined to her bed or couch, and had not
passed urine spontaneously for sixteen years. Among other symptoms, I
find noted 'awful suffering in spine, head, and eyes,' requiring the use
of chloral and morphia in large doses. 'For many years she has had
convulsive attacks of two distinct types, which are obviously of the
character of hystero-epilepsy.' The following are the brief notes of the
condition in which I found her, which I made in my case-book on the day
of my first visit. 'I found the patient lying on an invalid couch, her
left arm paralyzed and rigidly contracted, strapped to her body to keep
it in position. She was groaning loudly at intervals of a few seconds,
from severe pain in her back. When I attempted to shake her right hand,
she begged me not to touch her, as it would throw her into a
convulsion. She is said to have had epilepsy as a child. She has now
many times daily, frequently as often as twice in an hour, both during
the day and night, attacks of sudden and absolute unconsciousness, from
which she recovers with general convulsive movements of the face and
body. She had one of these during my visit, and it had all the
appearance of an epileptic paroxysm. The left arm and both legs are
paralyzed, and devoid of sensation. She takes hardly any food, and is
terribly emaciated. She is naturally a clever woman, highly educated,
but, of late, her memory and intellectual powers are said to be
failing.'
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