She gradually got worse, and came under the care of Dr. Forbes Winslow, to whom I am indebted for the case. Her husband says that for the last two or three months she has slept pretty well from 10 p.m. till 2 a.m., when she would suddenly wake, and warn him that a “frenzy” was coming on. This frenzy consisted in her rising up, fighting out with her arms, and scratching or tearing any one near her; in the paroxysm the desire was always to destroy her husband. After a few minutes the mania would subside, and be succeeded, first by a kind of stupor, and then very profuse perspirations. One peculiarity about her is, that when in this state she does or says anything foolish, she knows it, and is afterwards very annoyed and ashamed of her conduct. She has a great fear that she will be permanently mad.
The appetite has always been good, though she has said lately that she cannot bear food, and that it always causes a horrid taste in her mouth. She has, in a desultory manner, read many medical works, and fancies that every one of her organs is in some way or other diseased.
On examination, she had the appearance of a woman about 60. Her eyes, of a dark grey, were never quiet, and could not look you straight in the face; the pupil was much and constantly dilated. The tongue quite clean, and pulse good. Heart, lungs, and other organs seemed to be healthy. She owned with great shame to long-continued pernicious habits.
Dec. 14. I performed my usual operation.
Dec. 21. Has very much improved, and had no “frenzies” since the operation; sleeps well, and for many hours, but will not own to being better. Complains of her skin being dry, and “burning hot.” It is, however, moist and cool; at times she perspires freely.
Dec. 26. Both husband and nurse consider her much improved. She has been up both yesterday and to-day; sleeps and eats well. She is, however, sulky; says she is very bad, and shall soon die.
A fortnight later she was quite well, being entirely free since the operation from maniacal attacks; but she complained to my son, Mr. Boyer Brown, that I had unsexed her. He answered that nothing of the sort had been done, but that the operation had prevented her from making herself ill. From this time she steadily improved, and walked out with her husband every day, who called on me many weeks later to express his gratitude for the complete restoration of his wife to health; for whereas before his nights were passed in constant fear, rendering his life most wretched, his home was now one of comfort and happiness both night and day.
Case XLVII. Acute Hysterical Mania—Four Months’ Duration—Operation—Cure.
Miss ——, æt. 23, was sent to me by Mr. Radcliffe, stating that she had been brought over from Ireland as an insane patient, and that everything had been settled for her admission to some asylum, when he was induced to consult me on the last day before her entering one. He stated that the paroxysms always came on at half-past five or six every evening: I replied, if the attacks depended on peripheral irritation, that an operation would at once prevent recurrence of the attacks. She was accordingly admitted into the London Surgical Home Feb. 6, 1864.
When admitted, said she had taken no food for three days, and asked for a cup of tea, which was given her. Enema was also administered.