The following was the first case that came under my notice, after I had satisfied myself of the correctness of my views on the subject:—
Case I. Hysteria—Five Years’ Illness—Operation—Cure in Two Months.
D. E., æt. 26, single; admitted into the London Surgical Home Oct. 12, 1859.
History.—She had been a dressmaker in Yorkshire to all the best families around, but for the last five years had been so ill as to render her unable to do any work, and had been entirely supported by her former customers. When in that neighbourhood, on a professional visit to a lady, I was requested to see, amongst others, this poor ci-devant dressmaker. Her physiognomy at once told me the nature of the case; she was much attenuated, having for a longtime been unable to retain any food, always being sick, with great pain, immediately after meals. She had constant acid eructations; was so weak as to be at times unable to cross the room; complained of a burning, aching pain, with great weakness at the lower part of the back. Her catamenia were irregular, with much leucorrhœa; bowels generally costive. She was very melancholy, and expressed a most earnest desire to be cured. I advised her admission to the “Home,” and on October 15, I divided the clitoris subcutaneously. This being my first operation, I did not know the consequences of performing the operation in this manner. For two days the hæmorrhage was profuse and uncontrollable. Sleep was procured by opiates. I ordered ℥ij of olive oil to be rubbed into her chest every night, with a view to nutrition of her attenuated frame. A moderately generous diet was given, but no stimulants. She was quite well in two months, and has never since had a day’s illness. She resumed her occupation as a dressmaker, and recovered nearly all her former customers. 1865.—I have heard almost yearly of this patient, and lately had a letter from the lady to whom I previously referred, saying that my patient is perfectly well and in robust health.
Case II. Two Years’ Illness—Operation—Cures.
P. F., æt. 21, single; admitted into the London Surgical Home Jan. 7, 1861.
History.—Attributes her illness to having strained herself two years ago, when lifting a heavy saucepan from the fire. Has ever since that time suffered great pain in the back and side, much worse when she walks, but tolerably easy in the prone position. Catamenia very irregular, both as to time and quantity. Great pain in defecation. Bowels very constipated. Has been eleven weeks in a metropolitan general hospital, and thirteen weeks in a special hospital for women, from both of which she was discharged as having nothing the matter, because she had no evident disease. She had, however, been treated for uterine disease.
On examination, the uterus was found to be quite healthy; there was, however, evidence of excitation of the pudic nerve.
Jan. 10. The clitoris completely excised.
Jan. 16. Is much better.