Case XVIII. Hysteria and Spinal Irritation Twelve Years—Fissure of Rectum, recent Duration—Operation—Cure.
R. C. R., æt. 35 years, single; admitted into the London Surgical Home April 15, 1861.
History.—Has been suffering for nearly twelve years, at intervals of from six months to six weeks, with pain in the womb and right side, sudden spasms of the limbs, coming on at frequent and irregular intervals. Great pain down the spine and lower part of the back and loins. Has often attacks of severe sickness. Is usually costive. Has lately suffered great pain in defecation. Catamenia regular. Great want of sleep and appetite. Says she is always low-spirited, moping, and listless. Has had much medical treatment.
On examination there was found evidence of peripheral excitement of the pudic nerve, and there also existed a fissure of the rectum.
April 18. The usual operation performed, and the fissure of the rectum incised.
After this time defecation was performed without pain. Sleep, appetite, and cheerful spirits returned. She had no more spasmodic twitchings, but she still complained of intense pain in the back on sitting and walking. She was discharged in June much relieved, but not well.
Nov. 9 1861. I received a letter from this lady, stating that she now suffered no pain and was perfectly well. She was stout, and better in every respect than she had been for the last twelve years.