Itching of the whole or parts of the body is sometimes very troublesome. Herpes zoster (shingles), an eruption following the distribution of the nerve filaments upon the trunk, occasionally occurs, as also does urticaria (nettle rash). The very disorder for which the drug was first taken, is, in some instances, aggravated or perpetuated. This was first noticed by Dr. T. Clifford Allbutt[8], of England, and I have seen the same in some instances.

In the condition of delirium sometimes occurring, the pupils, usually contracted, are occasionally irregular and dilated.

The whole nervous system is unstrung, or more properly, too highly strung, so that it vibrates to little things that in health would pass unnoticed. They jump at the falling of a book or the shutting of a door.

Hysterical women still continue to have their customary attacks, sometimes in an aggravated form.

The following interesting case history has been kindly sent me by Dr. Judson B. Andrews:—

A woman,[9] thirty years of age, single, seamstress, with no hereditary tendency to insanity; was of a highly nervous and excitable organization, emotional and irregular in feeling; at times buoyant and lively, and then gloomy and depressed. Her health during early life was delicate, though she suffered from no definite form of disease. At the age of twenty, in April, 1862, she was seized with pain in the head. It was of short duration, but very severe, and during its continuance the patient was delirious. Attacks of the same character, both in the severity of the pain and the mental disturbance, have occurred since, at intervals of from one to three months.[10] In 1864 she had acute rheumatism, and in 1865 a severe attack of diphtheria.

After the local disease of the throat had apparently subsided vomiting supervened, and was repeated every few hours for some five weeks. To relieve this condition and procure sleep, hypodermic injections of morphia were successfully employed for about one week, and the patient rapidly regained her health. Some two years after this, or in July, 1867, she had an attack of inflammation of the bowels and peritoneum, and for four weeks was delirious most of the time. She improved somewhat in health, but for the four months succeeding had frequent attacks of frenzy, during which she often threatened to take her own and her mother’s life, and became very difficult to control. In October following she had improved so far as to pass from the immediate charge of her physician. Soon after this he ascertained she was using hypodermic injections of morphia, to relieve pain in her limbs and different parts of her body. I quote from his letter:—

I was informed that she was using it (morphia) to a considerable extent, and called immediately to explain to her the effects and danger attending the practice. I believe every effort was made that could be to prevail upon her to desist, but all to no purpose. She was cunning and artful, and would almost always study out some plan to get the morphia. She has used as much as two drachms in a week, in one or two well-authenticated instances. The usual amount was one drachm per week. She used but little, if any, for three or four months before she was sent to the asylum, for it was very difficult for her to get it. She has acted very strangely ever since her first sickness. She has been truly a mystery, which no one could solve.

Her mother says:—

That for years she has complained of pain, and pressed her hand on either side of her head, with the exclamation, “Oh, mother, mother, I shall die!” That for six years she has complained of such soreness of the head that when she passed her hand over it, in smoothing her daughter’s hair, she would cry out: “Oh, mother, don’t; it hurts me so!” That five years ago, in 1867, she was obliged to call in help, as the patient threatened and intended to take her own life. That both before and after she began the use of morphia, her conduct was peculiar and erratic; that she was emotional and easily disturbed by trifles. That after the morphia habit was known, her conduct for many years preceding was wrongly attributed to this cause.