The chief trouble in treatment proved to be the irritability of the intestines, which was brought on in most unexpected fashion by foods of the simplest kind. For some time it was so persistent that the suspicion of intestinal tuberculosis was entertained; but it finally disappeared, and after that the case progressed more favorably and she was out of bed with a tight belt and kidney-pad in a little more than twelve weeks. The kidney was then, and has remained since, in its normal position. The patient gained twelve pounds in weight, and should have gained more, but she found the hot weather during the latter weeks of her treatment very trying. The intestinal indigestion was only partially relieved, but the gastric symptoms, the general pains, and weakness all disappeared, and with precaution she will continue to improve. It is best to advise the constant use of the belt in such a case. In a patient who has made a large gain in flesh, as this one did not, and who has been found after some months to maintain the increased weight, the belt might gradually and experimentally be left off; but repeated examinations should be made for a year or two to be sure that no displacement results.
I could relate cases of gain in flesh without manifest relief. As I have said, these are rare; but it is less uncommon to see great relief without improvement in weight at all, or until the patient is up and afoot for some weeks; and I could also state several cases in which a repetition of the treatment won a final and complete success after the first effort at cure had failed or but partially succeeded; and of this, I believe, Professor Goodell has seen several examples.
I have mentioned more than once the singular return of menstruation under this treatment, and as examples I add a brief list of some notable instances.
Mrs. N., æt. 29, no menstruation for five years; return of menstruation at thirtieth day of treatment; continued regularly ever since during three years.
Mrs. C., æt. 42, eight years without menstruation; return at fourteenth day of treatment; now regular during five months.
Miss C., æt. 22, no menstruation for eight months; return at close of sixtieth day of treatment; regular now for four months.
Miss A., æt. 26, irregular; missing for two or three months, and then menstruating irregularly for two or three months. No flow for two months. Menstruated at nineteenth day of treatment, and regular during thirteen months ever since.
I had at one time intended to give, in the first edition of this work, a summary of all my cases, with the results; but what is easy to do in definite maladies like typhoid fever becomes hard in cases such as I here relate. In fevers the statistics are simple,—patients die or get well; but in cases of nervous exhaustion, so called, it is impossible to state accurately the number of partial recoveries, or, at least, to define usefully the degrees of gain. For these reasons I have not attempted to furnish full statistics of the large number of cases I have treated.
In the debate before the British Medical Association the question of the permanence of cures by this method was the subject of discussion. I have lately been at some pains to learn the fate of many of my earlier cases, and can say with certainty that every case then treated was selected because all else had failed, and that I find relapses into the state they were in when brought to me to have been very uncommon. A vast proportion have remained in useful health, and a small number have lost a part of their gains. I now make it a rule to keep up some relation with patients after discharge, by occasional visits or by letter, and believe that in this way many small troubles are hindered from becoming large enough to cause relapses.
I said in my first edition that I did not doubt that the statements I made would give rise in some minds to that distrust which the relation of remarkable cures so naturally excites; and this I cannot blame. Every physician can recall in his own practice such cases as I have described, and every medical man of large experience knows that many of these women are to him sources of anxiety or of therapeutic despair so deep that after a time he gets to think of them as destined irredeemably to a life of imperfect health, and finds it hard to believe that any method of treatment can possibly achieve a rescue.