S. F., æt. 41, single; admitted into the London Surgical Home Dec. 16, 1861.
History.—Was always ailing, and hysterical for many years. Catamenia appeared early, and always rather profuse. For the last twelve years has suffered from epileptic fits; recurring frequently every week or fortnight, and lately as often as every day. Has constant headaches; is losing memory and all power of concentrating her ideas. Has no premonition of seizure; falls down; is unconscious; has frequently bitten her tongue; and “froths” at the mouth. Says she has had several attacks of hæmatemesis. She was a dressmaker, and had so frequently, on her way to or from business, fallen in the streets, that she had been carried into almost every hospital in London, and a large number of open surgeries.
On examination there was found every indication of irritation about the vulva, and also a small polypus of the os uteri, which latter was large and patulous.
Dec. 19. Usual operation of excision; polypus uteri also removed.
The recovery of this patient was rapid and uninterrupted. After the operation, she never had a fit, and hardly a headache. She was discharged Jan. 20, 1862, perfectly well, and with greatly increased mental power. When heard of at commencement of 1864, she remained well, and had had no recurrence of any of her old symptoms.
Case XXXV. Epileptic Fits—Five Years’ Duration—Preceded by Cataleptic Fits, during the Ten previous Years—Operation—Cure.
In the beginning of April, 1862, a single lady, æt. 28, came under my notice, giving the following account of herself.—When about ten years old had a fit, whilst she was sitting at needlework; she fell down suddenly as if dead, and remained insensible for two hours; was very ill for three weeks after the attack. Was quite well until the age of fourteen, when she began to have them every three months. When about twenty-two had an interval of eleven months without a fit, but frequently fainted during that period. During the time she was in the fits she would be perfectly unconscious. She was told that her limbs were quite rigid, and always remained in the exact position in which they were when the fit commenced. In 1857 the fits changed in their nature—the patient at first falling down quietly, but subsequently becoming very convulsed, and trying to hurt herself. The first of this nature lasted two hours and three-quarters. Has lately had them much oftener, but not always of the severe form. Has had eight severe fits in the last two years and a half, besides the milder, which come sometimes a dozen in a fortnight. Is unconscious, but always knows when she has had one. Foams at the mouth, but makes no noise. Has frequently fallen down suddenly in church and other public places. Has been under many physicians, all of whom have been of opinion that she is suffering from genuine epilepsy.
April 2. Clitoris excised.
April 6. Has had no attack, but complains of occasional pain in the top of her head.
She never had an attack after the operation. Returned home in a month, and shortly afterwards she was thrown out of a pony chaise; she had no fit, but wrote that, prior to treatment, a very much slighter accident would have immediately produced one.