“The only other case to which I desire to make allusion at present is one in which I am, fortunately, in a position to furnish a sequel to an incomplete narrative, not without resemblance to the one lately published in this journal.CASE REPORTED BY PROF. W. T. GAIRDNER. ‘A Case of Trance’ was the subject of a paragraph in the British Medical Journal of May 31, 1879, p. 827, from which it appeared that in the London Hospital a woman, twenty-seven years of age, was at the time under the care of Dr. Langdon Down, being of rather small stature and weak mental capacity, and affected for at least two years with organic disease of the heart. About three weeks before the date of the report she had become suddenly somnolent, with most of the peculiarities in her sleep which have been already alluded to. She was fed partly by nutrient enemata, and for some days by a tube passed through the nostrils into the stomach. The resemblance is noted between this case and that of ‘the famous Welsh fasting girl,’ then attracting much attention in newspapers and otherwise. There being no further reference to this case in the journal, I wrote to Dr. Langdon Down, who kindly furnished me with the following additional particulars, which will, no doubt, be read even now with interest:—‘My patient, who was in a state of trance, recovered somewhat suddenly after about four weeks, and left the hospital. The first indication of returning consciousness was observed when I was reading to my class at her bedside one of the numerous letters that I had received entreating me not to have her buried until something which the writers recommended had been done. The paragraph of the medical journal got into some Welsh paper, and then went the round of the provincial press, hence the number of letters I received. This special one was from an old gentleman of eighty-four years, who, when he was twenty-four, was thought to be dead, and whose friends had assembled to follow him to the grave, when he heard the undertaker say, “Would anyone like to see the corpse before I screw him down?” The undertaker at the same time moved the head a little and struck it against the coffin, on which he aroused and sat up. On reading this aloud a visible smile passed over the face of my patient, and she returned to obvious consciousness soon after. She has not come under observation since she left the hospital.’
“Although this case is probably only one among many, I mention it here because the receipt of the letter just given led me to investigate more particularly the state of the hearing in Mrs. M’I.’s case, and also to try the experiment of reading aloud Dr. Down’s letter in her presence and that of the class. I had often remarked to bystanders that, although the subjects of these apparently unconscious states appeared inaccessible to the ordinary tests of sensibility, it was on record as regards some, even of those regarded as cases of ‘apparent death,’ that after recovery they affirm to have heard everything that passed, although unable to lift hand or foot to save themselves from premature burial. Neither the reading of the letter nor a violent shout into her ear produced any visible effects.”
Thomas More Madden, M.D., F.R.C.S. (Edin.), in an article on “Death’s Counterfeit,” in the Medical Press and Circular, vol. i., April 27, 1887, pp. 386-8, relates the following case “of so-called hysteric trance”:—
“A young lady, Miss R——, apparently in perfect health, went to her room after luncheon to make some change in her dress. A few minutes afterwards she was found lying on her bed in a profound sleep, from which she could not be awakened. When I first saw her, twenty-four hours later, she was sleeping tranquilly; the decubitus being dorsal, respiration scarcely perceptible, pulse seventy, and extremely small; her face was pallid, lips motionless, and the extremities very cold.DEATH’S COUNTERFEIT. At this moment, so death-like was her aspect, that a casual observer might have doubted the possibility of the vital spark still lingering in that apparently inanimate frame, on which no external stimulus seemed to produce any sensorial impression, with the exception that the pupils were normal and responded to light. Sinapisms were applied over the heart and to the legs, where they were left on until vesication was occasioned without causing any evidence of pain. Faradisation was also resorted to without effect. In this state she remained from the evening of December 31 until the afternoon of January 3, when the pulse became completely imperceptible; the surface of the body was icy cold, the respiratory movements apparently ceased, and her condition was to all outward appearance undistinguishable from death. Under the influence of repeated hypodermic injections of sulphuric ether and other remedies, however, she rallied somewhat, and her pulse and temperature improved. But she still slept on until the morning of the 9th, when she suddenly woke up, and, to the great astonishment of those about her, called for her clothes, which had been removed from their ordinary place, and wanted to come down to breakfast, without the least consciousness of what had occurred. Her recovery, I may add, was rapid and complete.
“The next case of lethargy that came under my notice was that of a boy, who, after an attack of fever, fell into a state of complete lethargic coma, in which he lay insensible between life and death for forty-seven days, and ultimately recovered perfectly.
“In a third instance of the same kind, in a lady under my care, the patient, after a lethargic sleep of twenty-seven days, recovered consciousness for a few hours, and then relapsed into her former comatose condition, in which she died.
“The fourth case of lethargy which I have seen was, like the first, a case of trance, which lasted for seventy hours, during which the flickering vital spark was only preserved from extinction by the involuntary action of the spinal and nervous centres. In this instance the patient finally recovered.
“The fifth and last instance of profound lethargy that has come within my own observation occurred last autumn in the Mater Misericordiæ Hospital in a young woman.... In that instance, despite all that medical skill could suggest or unremitting attention could do, it was found impossible to arouse the patient from the apparently hysterical lethargic sleep in which she ultimately sank and died.”
I have referred to the foregoing cases, occurring in one physician’s experience, as disproving the general opinion that lethargy or trance is so rarely met with as to be of little medical importance. For my own part, I have no doubt that these conditions are of far more frequent occurrence than is generally supposed. Moreover, I have had reason to know that death is occasionally so exactly thus counterfeited that there is good cause for fearing the probability of living interment in some cases of hasty burial.
DR. MORE MADDEN’S OPINION.