CASES OF By NIBBOWUNDAS
HYSTERIA,
MOHEISH, Chief Medical Officer,
Junagadh State Hospital. 1.
Parvati years, is
Aditram, Hindoo female, aged subject to hysterical symptoms since ten years. In the beginning she suffered from mental grief on account of some disagree-
thirty
with her mother-in-law. With a view to commit suicide she ate twice powdered glass, shortlyafter which she brought up blood by mouth for about seven days, next she passed blood with stools for four or five days, and meanwhile menstrual discharge set in. On the fifth day of this discharge she had a regular fit of convulsions and unconsciousness. She had these fits for eight days successively. Bleeding per mouth, and fits recurred after a month. Ever since she is subject to haemorrhage by mouth preceded by pain in stomach. Her husband, who is a native Yaid, say8 the source of blood is not the mouth, but the stomach. She suffers also from fits or temporary loss of consciousness. The fits assume various forms, last for longer or shorter time, and Fits and recur at longer or shorter intervals. unconsciousness may occur together or separment
ately.
Since about three years au additional sympShe gets up and walks a longer or shorter distance until progress is stopped by something in her way or until she tumbles down. While walking her eyes are kept closed, and, therefore, her gait is unsteady, as if of a drunken She has in this conperson. dition proceeded occasionally a few miles, and there found lying unconscious or conscious. While proceeding if she comes against a wall or some other hindrance, she falls down there, and then she regains consciousness immediately or after a short time. She may go a long distance if there is no hindrance. This walking symptom is often preceded by slight shock of fright, but sometimes there is no She may go away such premonitory symptoms. during day-time, or she may get up from sleep and proceed. She may descend downstairs, open the door and proceed on; while in this state she is not in her senses and does not feel. She may be led from one direction to another by holding her hand and she offers no resistance. She thus escapes from the house, and is therefore kept under constant watch. During night she is restrained by being tied to her bedstead, and during day either the doors are locked, or a watch is constantly kept upon her. Patient belongs to a respectable family. Suffers from leucorrhoeal discharge since several tom has been added.
June
CASE OF "CATHETER FEVER."
1891.]
years. Monthly course is irregular in quantity and period. First conception took place when she was 17 years of age, and had seven pregnancies in all. First pregnancy terminated at full period in the birth of a girl that died in three or four days. All the subsequent pregnancies have terminated at the end of seven or eight months in the births of stillborn children, and catamenial discharge has continued throughout each pregnancy.
She has received Native and ment both here
and at
European treatBombay without any
material and permanent improvement. Her general health is good, and during intervals she feels all right. 2. Raji Bajibhai, female, aged 25 years. All deliveries natural. Had four children. After the last delivery she suffered from fever and cough together with costiveness and impairment of appetite. Fever and cough subsided, aud she began to suffer from chilliness and perspiration. Her general health was very delicate, but she gradually improved. There was a relapse, and she began to suffer from regular fits of shivering lasting for an hour or two, without any rise in temperature, but followed by copious out pourings of perspiration. The attacks of rigors were regular and periodic at first, once in the morning, and then twice About this time she a day, morning aud noon. complained of severe pains in one part of the body or another, and immobility and acute pain in certain joints. When engaged in talk and her attention drawn away, the joint could be moved without complaint of pain. The socalled attacks of rigors were, it was gradually noticed, not quite characteristic of the feeling of cold, although she desired to have covering at the time the whole body, and especially the head, moved more violently. By aud by the period of these attacks of shaking of the body increased in point of time and severity. Instead of one or two hours they lasted for three or four hours, and her body tossed from side to side, and rolled from one end of the bedstead to the other, perspiration ceased, and there was no feeling of chilliness. She took her food fairly well during the interval, and her bowels were kept open. During the fits, which were punctual in point of time like fits of ague, she began to make a noise like moaning, the duration of fits gradually increased, till the morning and noon fits merged together and it lasted for ten, twelve, sixteen hours, or sometimes twenty-four hours or more. During the fit she was conscious in the beginning, but manifested unconsciousness subsequently. She has been subject to this illness for the last ten months, and still out of twenty-four hours of the day she is free from it for an hour or two. She has received both
Native aud
influencing
177
European
its
treatment
without much
course.
course has been irregular, sometimes and sometimes scanty.
Monthly
copious
Moti Dayashauker, female, aged 14 years. 3. About a year ago she appeared to be somewhat chlorotic and suffered from leucorrhoea, for Then which she was treated and got better. she complained of habitual and intractable constipation. Though constipated for a number of days, she could take her food fairly well. Occasionally she complained of pains in stomach, nausea, and want of appetite. She passed worms and then began to have hysterical conThe fits assume various characvulsive fits. ters, tossing about, kicking about, crying, screaming, weeping, laughing, biting, &c., some-
times lasting for a few minutes and sometimes for a few hours. For the last five months fits recur daily from five, ten to twenty times. Catameuial discharge copious, and recur every three weeks. Fits are the same during this period. Treatment with aseafoetida, valerian, bromide, chloral, morphia injection, blisters, cannabis, and several other drugs without permanent benefit. These three hysterical fits have been observed and traced from the bejrinninor. The first case presents the following points of interest?(a) The bleeding from the stomach which recurs at intervals of months for the last ten years; (b) The apparent cause of bleeding swallowing of powdered glass; (c) The continuance of catamenia during each pregnancy; (d) The termination of pregnancy at the seveuth or eight month; (e) The sudden tendency to run away either during day-time or from sleep with closed eyes and unconscious state just like sonambulism. In the second case, the beginning wa9 of ordinary bronchitis, it simulated ague-like symptoms more like pyoemia; brain mischief was also suspected, but gradually the hysterical nature developed. However, the train of symptoms still makes it a doubtful case. In the third case, the symptoms are purely o
hysterical. They all
have some bearing with the uterus; in the first case, catamenia is irregular, continues throughout, pregnancy, short termination of pregnancy and leucorrhoea; in the second, catamenia scanty; and in the third catamenia meuorr-
hagic.
HYSTERIA,
MOHEISH, Chief Medical Officer,
Junagadh State Hospital. 1.
Parvati years, is
Aditram, Hindoo female, aged subject to hysterical symptoms since ten years. In the beginning she suffered from mental grief on account of some disagree-
thirty
with her mother-in-law. With a view to commit suicide she ate twice powdered glass, shortlyafter which she brought up blood by mouth for about seven days, next she passed blood with stools for four or five days, and meanwhile menstrual discharge set in. On the fifth day of this discharge she had a regular fit of convulsions and unconsciousness. She had these fits for eight days successively. Bleeding per mouth, and fits recurred after a month. Ever since she is subject to haemorrhage by mouth preceded by pain in stomach. Her husband, who is a native Yaid, say8 the source of blood is not the mouth, but the stomach. She suffers also from fits or temporary loss of consciousness. The fits assume various forms, last for longer or shorter time, and Fits and recur at longer or shorter intervals. unconsciousness may occur together or separment
ately.
Since about three years au additional sympShe gets up and walks a longer or shorter distance until progress is stopped by something in her way or until she tumbles down. While walking her eyes are kept closed, and, therefore, her gait is unsteady, as if of a drunken She has in this conperson. dition proceeded occasionally a few miles, and there found lying unconscious or conscious. While proceeding if she comes against a wall or some other hindrance, she falls down there, and then she regains consciousness immediately or after a short time. She may go a long distance if there is no hindrance. This walking symptom is often preceded by slight shock of fright, but sometimes there is no She may go away such premonitory symptoms. during day-time, or she may get up from sleep and proceed. She may descend downstairs, open the door and proceed on; while in this state she is not in her senses and does not feel. She may be led from one direction to another by holding her hand and she offers no resistance. She thus escapes from the house, and is therefore kept under constant watch. During night she is restrained by being tied to her bedstead, and during day either the doors are locked, or a watch is constantly kept upon her. Patient belongs to a respectable family. Suffers from leucorrhoeal discharge since several tom has been added.
June
CASE OF "CATHETER FEVER."
1891.]
years. Monthly course is irregular in quantity and period. First conception took place when she was 17 years of age, and had seven pregnancies in all. First pregnancy terminated at full period in the birth of a girl that died in three or four days. All the subsequent pregnancies have terminated at the end of seven or eight months in the births of stillborn children, and catamenial discharge has continued throughout each pregnancy.
She has received Native and ment both here
and at
European treatBombay without any
material and permanent improvement. Her general health is good, and during intervals she feels all right. 2. Raji Bajibhai, female, aged 25 years. All deliveries natural. Had four children. After the last delivery she suffered from fever and cough together with costiveness and impairment of appetite. Fever and cough subsided, aud she began to suffer from chilliness and perspiration. Her general health was very delicate, but she gradually improved. There was a relapse, and she began to suffer from regular fits of shivering lasting for an hour or two, without any rise in temperature, but followed by copious out pourings of perspiration. The attacks of rigors were regular and periodic at first, once in the morning, and then twice About this time she a day, morning aud noon. complained of severe pains in one part of the body or another, and immobility and acute pain in certain joints. When engaged in talk and her attention drawn away, the joint could be moved without complaint of pain. The socalled attacks of rigors were, it was gradually noticed, not quite characteristic of the feeling of cold, although she desired to have covering at the time the whole body, and especially the head, moved more violently. By aud by the period of these attacks of shaking of the body increased in point of time and severity. Instead of one or two hours they lasted for three or four hours, and her body tossed from side to side, and rolled from one end of the bedstead to the other, perspiration ceased, and there was no feeling of chilliness. She took her food fairly well during the interval, and her bowels were kept open. During the fits, which were punctual in point of time like fits of ague, she began to make a noise like moaning, the duration of fits gradually increased, till the morning and noon fits merged together and it lasted for ten, twelve, sixteen hours, or sometimes twenty-four hours or more. During the fit she was conscious in the beginning, but manifested unconsciousness subsequently. She has been subject to this illness for the last ten months, and still out of twenty-four hours of the day she is free from it for an hour or two. She has received both
Native aud
influencing
177
European
its
treatment
without much
course.
course has been irregular, sometimes and sometimes scanty.
Monthly
copious
Moti Dayashauker, female, aged 14 years. 3. About a year ago she appeared to be somewhat chlorotic and suffered from leucorrhoea, for Then which she was treated and got better. she complained of habitual and intractable constipation. Though constipated for a number of days, she could take her food fairly well. Occasionally she complained of pains in stomach, nausea, and want of appetite. She passed worms and then began to have hysterical conThe fits assume various characvulsive fits. ters, tossing about, kicking about, crying, screaming, weeping, laughing, biting, &c., some-
times lasting for a few minutes and sometimes for a few hours. For the last five months fits recur daily from five, ten to twenty times. Catameuial discharge copious, and recur every three weeks. Fits are the same during this period. Treatment with aseafoetida, valerian, bromide, chloral, morphia injection, blisters, cannabis, and several other drugs without permanent benefit. These three hysterical fits have been observed and traced from the bejrinninor. The first case presents the following points of interest?(a) The bleeding from the stomach which recurs at intervals of months for the last ten years; (b) The apparent cause of bleeding swallowing of powdered glass; (c) The continuance of catamenia during each pregnancy; (d) The termination of pregnancy at the seveuth or eight month; (e) The sudden tendency to run away either during day-time or from sleep with closed eyes and unconscious state just like sonambulism. In the second case, the beginning wa9 of ordinary bronchitis, it simulated ague-like symptoms more like pyoemia; brain mischief was also suspected, but gradually the hysterical nature developed. However, the train of symptoms still makes it a doubtful case. In the third case, the symptoms are purely o
hysterical. They all
have some bearing with the uterus; in the first case, catamenia is irregular, continues throughout, pregnancy, short termination of pregnancy and leucorrhoea; in the second, catamenia scanty; and in the third catamenia meuorr-
hagic.
