History.—For six years has suffered from a feeling of fulness, weight, and heat at the lower part of abdomen, with pain in the back, and “bearing down.” At this time her menses had just ceased. Has not slept well for three or four years. Wakes every hour. Is always restless and fidgety. Frequent desire to micturate, with pain on doing so, and often desire without power to void it. Bowels costive; digestion indifferent.
She is a nervous, restless woman, with glistening and constantly wandering eye—pupils dilated. Has suffered from peripheral irritation for many years.
Nov. 21, 1861. Usual operation performed. A week later, slept well for four hours, the first time for many years.
Dec. 1. Has lost the irritability of the bladder, and passes water every four hours only; lost also the bearing-down pain; restless excitement gone.
Dec. 7. Eats and sleeps well; is cheerful and grateful; leaves the Home cured, having been in only three weeks.
In 1863 was perfectly well.
Case V. Fissure of the Rectum, with Hysteria—Operation for the former—Relief—Subsequent Operation for Hysteria—Cure.
Mrs. L., æt. 55; admitted into the London Surgical Home Dec. 9, 1861.
History.—Is a widow. Has for many years suffered from all the inconveniences of a fissure of the rectum, combined with bad digestion, undue nervous excitability, and sleepless nights. Is very anxious to be cured. It being thought that all these symptoms might be due to a painful fissure of the rectum, the ordinary operation for this affection was performed on December 12. The bowels were opened in a few days without pain, and the fissure was healing well. Being, however, still sleepless, excitable, and irritable, questions were asked which showed that a further operation for removal of another source of irritation was advisable; therefore, on December 24, I performed my usual operation. The next night she slept well. She became quiet and cheerful, and on January 6, 1862, she was discharged quite well.
Remarks.—This case is very interesting, as it shows that there may exist at the same time more than one irritation exerting inhibitory influence.