13

MEDICAL ATTEND'NT

REMARKS, WITH RESULT.

willing to continue, and she is fully convinced
that they decidedly control the metrorrhagia.
The result thus far in this case may be said
to be favorable.

Abortion in third No sponge tents November,
or fourth month, needed; injected December,
not positive six times, as fol-
1867.
which; profuse lows: 1. Solution
hæmorrhage for of Squibb's per-
ten days; the os sulphate of iron
dilated, aboutthree one part, and seven
fourths of an inch of water, about an
in diameter, and ounce. 2, 3, 4,
still more dilat- the same, increas-
able; clots passed ing iron slightly
with great pain; at each injection.
much prostration; 5. Neutral solution
great anæmia; of sesquichloride
pulse feeble, rapid of iron and water;
and small, varying one-third of iron
from 100 to 130 to two-thirds of
per minute.

water. 6. The same with less of iron.

C. E. Briggs.
M. A. Pallen.

The uterine cavities in this instance were
particularly lax, and that of the neck was con-
tinually clogged with blood coagula, varying
in shape and size from that of a large leech, to
half the size of a cricket ball. The oozing and
drainage were constant, and until the sixth
injection never ceased for any period of time
during fifteen days or more. Her recovery
was slow and tedious, but no hæmorrhage ever
supervened during its progress. Her general
condition was most unfavorable, as she was
phthisical, excessively nervous, and very much
alarmed. The shock from both the operation,
made for the purpose of bringing about abor-
tion, and the great loss of blood, coadded to
her constitutional cachexia, rendered her very
prone to an unfavorable result; yet it proved
otherwise, and the method adopted to check
the flow undoubtedly saved her life, which in
all probability would not have been preserved
under any other plan of treatment.

Chronic hypertro- Two sponge tents March 28,

phy; metritis and used; two ounces
cervicitis, corpo- of fluid, composed
real and mucous; one part of neutral
menorrhagia and solution of sesqui-
metrorrhagia of chloride of iron,
more than a year's and two parts of
standing. The water, injected.
patient had had a

mucous

polypus

1868.

M. M. Pallen. M. A. Pallen.

A slight amelioration of hæmorrhage after first injection, but the blood continued to ooze constantly until the next injection, with about the same result; no irritative fever supervened; no diminution of leucorrhoea. The patient complained of a most disagreeable and constant burning pain in both femora and in the region of the sacrum. Bromide of potassium administered in large doses at night to promote sleep, forty grains to a half pint of water; ergotine, extract of cannabis indica, and phosphate of manganese in pill, three times daily. Depth of cavities four inches. For the third injection very large sponge tents were used, and the dilatation produced was most complete; the officinal tincture of iodine was slowly thrown in to the amount of two ounces, and permitted to remain in the cavity before being pumped out (such, at least, as had not drained out of the os tinca) for about three minutes. No shock was perceptible, and patient complained less than when the iron was thrown in. The next morning she had a decided chill, followed by fever, and stated that the "womb felt drawn up;" there was soreness and tenderness over the hypogastrium. The fever (irritative undoubtedly) ceased in about thirty-six hours, under the use of quinine and opium in powder, together with the fluid extract of gelseminum and tinct. of aconite (eight drops of gelseminum, two drops of aconite) every four hours; hot poultices over abdomen. Six days afterwards, as no further flow of blood took place, the uterine sound was passed, and the cavities measured less than three inches. Lumbar pains but slight, and femoral pains disappearing. No discharge per vaginam whatsoever. On the 22d of April she menstruated; it ceased on the 26th, and was quite normal in quantity and quality.

She is rapidly convalescing, and the metritis and cervicitis almost cured.

April 8, 1868.

M. M. Pallen.
M. A. Pallen.

constant; pulse feeble and rapid.

External os slight- Two tents and an

ly patulous; cavity injection of two of neck lined with ounces of tincture ja velvety, shreddy of iodine. looking erosion; inflammation of membrane.

313

CASE OF PARAPLEGIA* FROM MENTAL SHOCK,

Coming on suddenly, and disappearing suddenly from exhilaration and joy ; for five months the patient almost entirely sustained by tonic medicines.

Reported by EDWARD MONTGOMERY, M.D., of St. Louis.

Miss R. is a girl about fourteen years of age, very sprightly and intelligent, and of a very sensitive and affectionate disposition: although not very robust, has always enjoyed excellent health until the attack which I am about to describe.

About the latter part of last June, she became very much alarmed about the safety of her father, a man of very regular and domestic habits,-who failed to come home one evening at his usual hour. Towards midnight the mother showed much uneasiness, seeing which, the daughter became exceedingly depressed and fearful, and when her father reached his domicile he found both wife and child in a state of terror bordering on despair. In the morning the girl did not appear at the breakfast table as usual, and being asked why she did not get up, replied that she had tried, and found that she had lost the power of her lower extremities; said she had a headache and had slept none, and had a peculiar painful sensation along her back and in her legs. On learning the above facts, I endeavoured to impress the parents and the patient with the belief that the apparently alarming symptoms were only nervous and of a hypochondriacal character, resulting from the mental trouble

*We object to the name of Paraplegia given to this interesting case by Dr. MONTGOMERY, but consider it an illustrative contribution to our knowledge of that class of cases to which Dr. CHARLES F. TAYLOR has given the name of “Carnomania," (Quart. Journal of Psychology, Medicine, April 1868, p. 266). There was evidently no organic lesion of the nervous centres; therefore no paralysis, strictly speaking; nor was the case one of hysteria properly so called.

Dr. TAYLOR reasons thus: "As there was no organic lesion there must be a LATENT capacity; but this capacity was not recognized by the mind because the mind had received false impressions from the leg as to its actual power. Volition is in the ratio, not of the actual, but of the supposed, capacity of the organ commanded by the volition."

As the article on “carnomania" is not well suited to making extracts we must confine ourselves to calling the attention of our readers to that valuable essay.-ED.

and anxiety of the previous evening. I also tried to rally and banter the girl out of the notion that she was paralysed, and insisted on her getting up and walking; after her mother got her out of bed I caught hold of her, and in a jocular and persuasive manner, dragged her along the floor, but she seemed to have no power to move her lower limbs, and I had to hold her up whilst they hung dangling after her. I could pinch them or prick them with a needle without her evincing much feeling, although their temperature was normal and her general symptoms favorable with the exception of a slight acceleration of the pulse.

I then told her since she would not arouse her nervous energies, I would be compelled to cup and blister her, and administer much disagreeable medicine.

I ordered scarified cups to the upper portion of the spine, a stimulating liniment all along the back and lower extremities; a purgative of calomel and rhubarb, to be followed by a mixture of asafœtida, valerian, and ammonia three or four times a day. I charged the family and friends to exhibit to her no solicitation or anxiety, but to cheer her up, and endeavour to make her believe that her case was only a nervous attack and would soon pass away. On visiting her next day, I found no amelioration of symptoms; her bowels had been moved with difficulty, after taking three of the calomel and rhubarb powders; she had slept badly, had passed little water, still complained of headache, and declared she had not the least degree of power over her lower limbs.

I advised a continuance of the mixture and also five grains of bromide of potassium three times a day; if the bowels should be torpid, an enema containing spir. terebinth., and free and frequent friction with the stimulating liniment. After three or four days she improved in some respects, her bowels and kidneys acted better, the headache left her, she slept well; but her appetite was gone, she appeared dull, languid and apathetic, and disliked greatly, even to try to stand or attempt to walk, saying that it pained