A medical friend of the Doctor’s, travelling over Shooter’s Hill, observed a gentleman walking up it, his carriage following him. When opposite to each other, the stranger suddenly fell on his knees in the dirt, and lifted up his hands, as if in earnest prayer. The friend stopped his post-chaise at so extraordinary a sight, and soon found by his looks and manners that the poor gentleman was insane. He immediately accompanied him back to London, and placed him under Dr. B.’s care till his relations were informed of his state.
The history of the case was this:—The patient was a cavalry officer of rank, aged thirty-five, and had particularly distinguished himself at the recent battle of Waterloo. On that occasion he had two horses killed under him, and was himself wounded in four places. He was first struck on the crown of his helmet by the splinter of a shell, which wounded the scalp and stunned him; he was next shot through the fleshy part of the thigh by a grape shot, which at the same time killed his first horse; from these two wounds he lost much blood. Whilst lying under his second horse, he was pierced in the groin by a lance; and in this helpless condition he received from a French drummer, who was rifling the dead and dying, a violent blow on the temple from the butt-end of a musket, from the effects of which, he remained some time insensible. He was afterwards conveyed in a most deplorable state as a prisoner within the French lines, and though released the same evening by the victorious allies, a long while elapsed before his wounds and exhausted condition received any attention.
He inherited a predisposition to insanity, and was naturally reserved, diffident, and taciturn, but affectionate and generous.
When he recovered from his wounds, he often complained of pains in his head; and it was observed that his temper became fretful and suspicious; that he slept ill, was depressed in spirits, and courted solitude. These symptoms increased latterly. At length he imagined himself the sport of his brother officers, and many other delusions arose.
There was a moral cause likewise operating which, on a constitution that had recently received so severe a shock, no doubt greatly influenced his disorder. He had applied for promotion in consequence of his sufferings in the service. This was withheld, as he thought, ungraciously, and too long; and when he was raised a step, his mind was already too much disturbed duly to appreciate it. The anniversary of the glorious battle of Waterloo was just passed, and the recollection of it was painful to him. In this state he came to town.
He was exceedingly sober and temperate by habit; but during the day before, with a brother officer, he was persuaded to commit an unusual excess in wine, with the hope of raising his spirits.
This proved a match to the mine. It exploded, and his intellects became completely deranged.
Dr. Burrows found him with his countenance very wild, the eyes injected and pupils contracted, pulse quick and weak, tongue white, and great thirst. He had had no sleep for five nights. Sometimes exalted, violent, and loquacious; sometimes depressed and taciturn. He was rather languid, which was imputed to his having lost full twenty ounces of blood from the rupture of an hæmorrhoidal vessel.
It is not necessary to detail the medical treatment adopted, but we will proceed to those points in the case which are relevant.