Case XXX. Hysterical Cataleptic Fits of Long Duration—Operation—Cure.
H. L., æt. 25, single; admitted into the London Surgical Home January 27, 1864.
History.—This patient was sent to me by Dr. Pennefather, of Tottenham, with the following letter:—
“Dear Sir,—The girl —— was some time since suffering from religious monomania; she is of hysterical habit and weak constitution, ever complaining of abdominal pain or uneasiness.”
She also gave the following additional account of herself:—
“Began to feel unwell about twelve months since. Had a very bad fever about five months ago, which left her perfectly prostrated. Always felt weak, and more or less subject to fits. Menstruation regular and never profuse. Great pain in the back and bearing-down feeling in the lower part of the body. Complains of great pain in defecation. Sea-bathing has benefitted her temporarily. Is incessantly crying without cause or power to prevent herself.”
The day following admission she had a fit of a cataleptic nature, and lasting twenty-five minutes. After the fit the patient was left very prostrated.
In addition to symptoms of pudic irritation, there was a small fissure of the rectum.
January 24. Clitoris excised, and fissure divided. There was considerable secondary hæmorrhage in the excising, which, however, seemed to have a beneficial effect, as after it the patient expressed herself as more comfortable, and slept quietly.
Feb. 14. Much more cheerful; has had no cataleptic attack or symptom of hysteria since the operation.