Cases of Insanity—Grande Hystérie—Moral Insanity, Vicious and Degenerate Children — Nail-biting — Enuresis Nocturna — Alcoholism—Abuse of Narcotics
No. 7. Mrs. X aged 35. Nervous family and personal history. On June 7th, 1898, the patient’s husband informed me that she had made a determined attempt at suicide, during an attack of acute mania. She had then been certified, and sent to the Priory, Roehampton, on June 3rd. She was violent, slept badly, never spoke, refused all nourishment, and had to be fed artificially. Her husband was anxious that I should treat her, and had, obtained the consent of Drs. Savage and Chambers to the experiment.
I visited the patient on June 8th, apparently succeeded in slightly influencing her, and suggested that she should take her food naturally, sleep well, cease to be violent, etc. From that—date she never required artificial feeding, and soon began to be quieter and to sleep better. One day, by a ruse, I succeeded in making her speak, and from that time she talked more and more freely. Suggestive treatment was continued till the end of July, when she was convalescent. Recovery confirmed by later reports.
No. S. Mrs. X aged 30; April 26th, 1897. Father and several brothers and sisters markedly nervous. The patient had always been nervous; had bitten her nails since early childhood, and never slept well. After her first confinement, in 1891, she became afraid of driving, and got into a panic during thunderstorms; on one occasion this was followed by a short attack of aphonia.
Her second confinement took place in January, 1897. Almost immediately afterwards she became profoundly melancholic, suffered from insomnia, constipation, indigestion, and loss of appetite amounting to absolute disgust for food. She refused to see her child; and her home became wholly distasteful to her. Careful medical treatment and change of scene were without result. She was sent to me by Dr. Boulting, of Hampstead, on April 26th, 1897. In addition to the symptoms just described, she was haunted by the idea of suicide, and could think of nothing else. She was extremely agitated, could neither sit still nor keep her attention fixed, and had frequent attacks of uncontrollable weeping.
After a few weeks’ treatment by suggestion she commenced to improve, and before the end of July had recovered and returned home. Not only did her morbid ideas and suicidal impulses disappear, but she also lost many of the nervous symptoms which had existed before her illness. Recovery confirmed by later reports.
No. 9. Mrs. ---, aged 46; June 22nd, 1900. Father and an uncle on the mother’s side committed suicide. Patient had always been nervous, emotional, and a bad sleeper: Since 1897, after influenza, the insomnia had been much worse, and she rarely got more than three hours’ sleep at night. She suffered constantly from a peculiar sensation in the neck, with a feeling that she must fall forward. She was very depressed, had fits of uncontrollable weeping, and had lost interest in life. There were also strong suicidal impulses, and the fixed idea that she would commit suicide like her father and uncle.
The patient was sent to me by Dr. Seton, of Kensington, and completely recovered after a month’s treatment. There had been no relapse up to the last report (November, 1902).
No.,10. Miss ---, aged 38; November, 1900. Mother suffered front religious melancholia,-and died in an asylum. Maternal uncle weak-minded. One of the patient’s cousins committed suicide, several are insane, and one suffers from obsessions. One sister has delusions, another obsessions. The patient had good health up to puberty, then became quiet and depressed. In 1892 she had an attack of acute melancholia, which lasted several months; since then she has always been depressed and peculiar. In 1895, after a shock, she had a second attack of acute melancholia, and a further one in July, 1900 following a similar cause. When Ifirst saw her, in November, 1900, she hardly ever spoke, was profoundly depressed, had morbid religious ideas, and was untidy and extremely eccentric. She was never permitted to go out alone, as she was quite incapable of taking care of herself, or of avoiding the traffic.
After the first treatment, on November 2nd, 1900, the patient commenced to talk brightly, and told me next dayof the various religious fears which had been tormenting her, but which had now entirely vanished. She was seen on fear subsequent occasions up to November 14, when all morbid symptoms had disappeared. A few days later she was well enough to go alone to San Francisco to nurse a sister during her confinement. In November, 1902, Dr. Ozanne, of Harrogate, who had sent the case to me, reported that the patient was in good health and leading a useful life; there had been no relapse.
No. H. Mr --, aged 37; May, 1899. Father insane and under restraint. Twelve months previously the patient began to suffer from constant pain at the back of the head and neck, which was followed by marked decrease in his powers of attention and work. He then became profoundly depressed, lost all affection for his wife and children, and had the fixed idea that he would become insane. Drugs, lengthy holidays with plenty of exercise in the open air, and, finally, treatment in an asylum, were tried without benefit. Complete recovery, however, took place after six weeks’ treatment by suggestion. On December 18th, 1902, the patient wrote to say that he was in good health, and there had been no return of any of his morbid symptoms, despite the fact that he had much family trouble. He had recently lost both parents, and one sister had become insane. In January, 1903, Dr. Wonnacott, of Wandsworth, who had originally sent the case to me, wrote confirming this report.
No. 12. Mrs.---, aged 56, had a bad family history, her mother, sister, and two brothers having suffered from insanity. The patient had her first attack of melancholia fifteen years previously; this was followed by others, both prolonged and severe. Treatment by suggestion was begul\ on February 12th, 1902, at the request of Dr. Sainsbury. At that time the patient bad kept her bed for several months, she was profoundly depressed,had frequent attacks of hysterical weeping, suicidal impulses,etc. Her physical health was good, but she asserted that she could not leave her bed as her mind was gone, and she did not know what to do, or even what clothes to put .on. She felt that nothing in life could ever interest her again. At the end of four months’ treatment she was well, and at the last report (February, 1903) there had been no relapse. She was leading an active, happy life, without the slightest trace of any nervous trouble.
No. 13. Miss --, aged 26, was sent to me by Sir Malcolm Morris, on November 12th, 1907. Four months previously she had applied something to her eyebrow to make the hair grow on a bald patch, and then believed that . she had touched her upper lip with the same preparation, and that this would make the hair grow there. This passed into the distinct delusion that she was growing a moustache. She told me that it was no use my trying to get rid of this idea, as she could see the hair growing every hour. She was very emotional and excited, and was constantly looking at her face in the glass. She slept badly, despite the fact that drugs were taken every night. She entirely lost her morbid ideas after nineteen treatments, and slept well. Up to the last report (February, 1909) there had been no relapse.
No. 11. Miss —, aged 40, was sent to me by Dr. Stanley Smith, on March 7th, 1907. She had had morbid scruples from early childhood and believed she had committed various sins. For the. Last twelve years she had suffered from folie dudoute,which had passed into distinct insane delusions. She believed, for example, that the money in her purse was not her own and that she had stolen it. She had similar delusions in reference to nearly everything she possessed, and was irresistibly impelled to confess ber supposed sins to her clergyman and to make vows. “When I first saw her, she was very nervous and apprehensive. She not only insisted that her sister should always be in the room when she visited me, but she would not consent to my sitting near her when I made suggestions. Recovered; later reports (1909) satisfactory.
No. 15. Miss—, aged 32; April 4th, 1909. Family history of insanity; mother suffers from depression. The patient’s physical health has always been good. Eight years ago, without apparent exciting cause, she had an attack of profound depression which lasted five months. Three years later, she had a similar one for seven months. The present attack began in November, 1908, and was preceded by insomnia. Since then she had been profoundly depressed. It was only with great difficulty that she could be induced to get up and put on her clothes. She was frequently violent; struck her mother and other relatives and destroyed their things. She spent most of her time sitting over the fire and tearing her hair out by the roots. After five treatments all these symptoms disappeared, and she is now (June, 1909) well and normal in every respect.
No. 11-6. Mr. —, aged 23, was sent to me by Dr. Kerr, on June 1st, 1908. His mother was in bad health when he was born; as an infant he had convulsions and vomiting, and also neurasthenia for eight months at the age of 13. He studied in Paris, took a good degree, and afterwards went to Cambridge, where he devoted himself to higher mathematics and advanced physics. In August, 1907, after overwork and emotional shock, he began to have attacks of urgent vomiting every day or two, with constant headaches and much prostration. In September lie had no vomiting and felt better. He went to Italy in October, and commenced to have muscular spasms in the train, after which one side of the face and body became paralysed. Then the vomiting recommenced and the paralysis disappeared. He returned to Paris in November, ill and vomiting, and on the 20th of that month, the anniversary of his mother’s death, his father found him in bed vomiting, unable to speak, and ignorant of what was taking place around him. This attack recurred twice, with four days’ interval, and a specialist diagnosed tubercular meningitis, and prophesied that he would be dead in a few days. December was a bad month: he had attacks of vomiting every other day, particularly during the night. Then, hearing that some of his friends were 1.11 Switzerland, he insisted on being taken there. He started from Paris by night, in a “sleeper”; half an hour later he commenced fo have delusions and to talk nonsense with imaginary persons. The journey was completed in a sledge, and he became quite maniacal, and had to be held down to prevent him from jumping out. Soon after he arrived at the hotel, he was running about the corridor in his night-shirt. Dr. Kerr, who happened to be staying at the hotel, remained with him most of the night, but he never slept. Next day the local doctor and a male nurse were called in, but were unable to manage him. He knocked his head against the walls, smashed things, kicked the glass out of the window, and attempted to jump from it. He attacked the local doctor many times. He attempted to jiu-jitsu Dr. Kerr, and twisted IIA hand badly. Three days later he was quite reasonable, but had general muscular tremor, a very ataxic gait, and frequent vomiting. From that date until May, 1908, he was sometimes better, sometimes worse. He then became very ill, and had incessant vomiting, muscular tremor, and a temperature of 103°. A consultation was held and the possibility of cerebral tumour discussed.
I first saw the patient on June 1st, 1908. He was much emaciated,. profoundly depressed, and suffered from vomiting, constipation, and insomnia. His gait, which had been described as markedly ataxic, more closelyresembled that of a drunken man, and he could not walk across the room without assistance.
The vomiting ceased after the first treatment, and from that day the patient made a steady and continuous recovery. During August he led an active, open-air life; bathing, boating, sea-fishing, etc. Between July 20th and October 5th, 1908, he gained eighteen pounds in weight. During treatment he never became drowsy; he simply rested quietly and mentally repeated verses from his favourite poets.
The following are extracts from recent letters received from the patient:
January 5th, 1909. “We tobogganed down sheer precipices in a snowstorm, and were nearly killed and suffocated by the speed—about 40 miles an hour down a slope much steeper than the roof of a house—and here I am fitter than ever.”
January 23rd, 1909. “1 keep as fit as a fiddle; Iam so steady of foot that I can climb the-most precipitous places quite surely,” February 9th, 1909. “To give you an idea of my state of health, hearken to this: Last week we set out on a two days’ walk and covered sixteen miles the first day. On the second westarted out at 7 a.m., climbed a mountain some five thousand feet high, and trudged through the snow for hours. The snow -was merely very -exhausting, but I have been doing some quite breathless work (i.e. climbs) on rock. Not so bad when you remember at what pains I was to reach that arm-chair of yours “without falling.”
Recovery confirmed by later reports. (Aligust, 1909.)
No. 17. Miss aged 19; June, 1900. A tall, well developed Italian girl, educated and highly intelligent. Mother suffered from hysteria. The patient had her first hysterical attack in November, 1894, after overworking for an examination. This was preceded by headaches and boisterous laughter; then muscular twitchings, at first confined to the shoulders, appeared. Soon these movements became more violent and generalised, and alternated with various muscular contractures; the latter sometimes affected the jaws, and the teeth became firmly clenched. This condition lasted till May, 1895, then disappeared after a short hypnotic treatment.
In July, 1895, clonic spasms reappeared during sleep. In September, 1896, she came to England to teach in a high school, and shortly afterwards began to haVe spasms in the daytime. At first these affected the left side only, then practically all the voluntary muscles. From the later date until December, 1899, the patient was hypnotised by Dr. --- at irregular intervals. At first the attacks ceased after one or two sittings, but the longest remission was only eleven weeks, and they frequently returned at the end of a few days. By degrees the treatment lost its influence the spasms became more violent and sere, a contracture of the left leg appeared, and the patient could only limp a few steps. She suffered much from headache, was extremely emotional, often depressed, had morbid ideas, and frequent attacks of hysterical laughter and weeping.
In December, 1899, hypnotic treatment was discontinued, and the patient consulted a well-known neurologist. She was placed in a medical man’s house; but, as her condition grew worse, she was removed in two months, and admitted as a contributing patient to the National Hospital, Queen Square, Bloomsbury. There she was treated by isolation, rest in bed, and hot baths. Blisters were also applied, in order to render the movements painful. Later, large doses of hyoscine, -chloral, bromide, etc., were given, and the patient kept in a more or Less narcotised condition for weeks. Despite this, the twitchings, convulsions, and contracture of the leg increased in severity, and she was discharged on June 18th, 1900, much worse than when she entered.
She was then brought to me by Dr. Sainsbury, and I began treatment by suggestion the following day., At that time, except during sleep, the patient had constant jerking movements of’ the left side, involving tile face, arm, leg, and trunk, while the head was drawn violently to the left. She had also frequent attacks—sometimes ten or twelve a day—of the true Salpetriere type of grands hysteric.After violent generalised convulsions lasting several minutes, the head was drawn backwards towards the heels (arc de cards)and the face became cyanosed; then, after much abdominal gurgling, the spasm relaxed, the attack ceased, and the unilateral muscular movements recommenced. She never lost. consciousness and the seizures were not followed by amnesia; there were no signs of organic disease.
For the first fortnight, every time I treated the patient she had a convulsive attack, but, despite this, I made suggestions in the usual way. She then gradually became quieter, and a week later the morbid symptoms disappeared. Treatment, ho w ever, was continued until July 31st, but neither during that time nor afterwards were any drugs given.
On September 20th, 1900, she returned to work, and from then up to the last report (March, 1909) there had been no relapse, despite the fact that she was always overworked.
In several somewhat similar cases equally good results were obtained. In one of these the patient bad frequent attacks of generalised convulsions invariably followed by amnesia. She also suffered from storms of neuralgic pain; these occurred several times a day, and were absolutely sudden both in their appearance and termination.
In another case the patient bad attacks of convulsions followed by generalised catalepsy. During the latter condition, which frequently lasted forseveral hours, the patient was apparently unconscious and insensible to external stimuli. In both cases recovery followed treatment by suggestion, and there has been no relapse.
The following conclusions as to the value of hypnotism in the treatment of vicious and degenerate children were submitted by Wrillon to the International congress of Hypnotism, Paris, 1889:—
Many carefully observed facts prove the therapeutic value of suggestion in the following diseases of children incontinence of urine and faeces, nervous twitchings, nocturnal terrors, onanism, lalepharospasm; and other disturbances of the nervous system of a functional character.
So far, no appreciable results have been obtained in cretinism, idiocy, or deaf-mutism
Suggestion constitutes an excellent auxiliary in the education of vicious and degenerate children, especially where there are habits of lying, cruelty, inveterate idleness, or cowardice.
4. Suggestion should be confined to cases where the usual methods of education have failed, and medical men alone should employ it. It is not necessary to hypnotise normal children; ordinary training ought to be sufficient for them. When, however, children are addicted to theft, and other vicious or repulsive habits, or are afflicted with disgusting infirmities, we ought to try to cure them by hypnotism, especially when their parents are in despair owing to the failure of all other forms of treatment.
These conclusions were adopted unanimously by the Congress, and were transmitted to the Minister ‘of Public Instruction and the Minister of the Interior.
I append some illustrative cases from myown practice.
No. 1S. Mr. --, aged 19, February 26th, 1893. Family history bad; mother highly nervous, father died insane. Up to the age of 14 the patient was lively and intelligent; he then commenced to masturbate, and his mental condition rapidly deteriorated. He lost interest in his studies, and frequently stole; generally in a purposeless manner. He had been expelled from school and, when I first saw him, was under the care of Dr. Kingston, of Willesden, who sent him to me. I was informed that the patient was still guilty of theft, addicted to self-abuse, untruthful, absolutely untrustworthy, and strangely apathetic and lazy. There was little or nothing, even in the way of amusement, in which he took the least interest.
After two months’ treatment by suggestion he, began to improve; before the end of a year he had recovered and learnt a business in which he took great interest. Later reports satisfactory.
No. 19. Miss --, aged 6, was sent to me in June, 1908, When she was nine months old, her mother notices that she had daily attacks of excitement with flushing of the face and perspiration, but it was only two years later that it was recognised that she masturbated daily. Her temper became very bad and she had frequent attacks of violent rage, apparently without reason. On one occasion the attack was almost maniacal, and afterwards the patient did not remember what had happened. When I first saw her she was badly nourished, very nervous and emotional, and slept badly.
Result: recovered. On April 28th, 1909, her Mother reported that the child slept well, and was not excitableor bad-tempered. There bad been no return of masturbation.
No. 20. Miss --, aged 15, January 22nd, 1894. Her mother, who had a family history of insanity, was morally insane, and lived a vagabond, drunken life. Her father and uncle both drank, and died insane. I was informed that the patient was deceitful, rebellious, and mischief-making. She frequently complained of queer feelings in her head, but it was difficult to tell how much was real and. how mueh pretence. She was quick and intelligent, and could do her lessons in about a quarter of the time most children took. She was impatient of . restraint; she had been sent to two or three families and one school, but in each instance had been dismissed, as she was so insubordinate and unmanageable. I was also informed that the patient lied, stole, and had frequent outbursts of violent passion. I found her strong, muscular, and well developed; palate normal, menstruation regular.
On January 22nd, 1894, after consultation with the late Dr. Hack Tuke, she was placed in a nursing home, and regularly, treated for a month. This was followed by marked improvement, and for the next three years she was seen occasionally, but at distant intervals. She grew into a bright, healthy, attractive woman, who, in 1903, With the exception that she was still somewhat emotional, showed no trace of her former defects. Recovery confirmed by later reports.
No. 21. Miss --, aged 13, March, 1894. Bad family history. Before the patient was born, her mother suffered from melancholia. The child herself had been mentally peculiar from infancy; she was persistently untruthful, deceitful, insolent, and dirty in her habits. She had been addicted to self-abuse since the age of 7. On several occasions she had stolen money from servants and others— sometimes considerable amounts. She had been expelled from school, and had to be kept at home. She was strong, healthy, and well grown, with nothing abnormal about the head or palate.
After consultation with Dr. Savage, the patient was treated three times a week from March to May, 1894 this was followed by marked improvement. She was seen at intervals during the next two years, and complete recovery took place. Up to the. present date (1909) there has been no relapse.
No. 22. In a similar case masturbation was discovered at the age of 8, but the patient admitted that she had indulged in it as far back as she could remember. She recovered under treatment, and recently her mother wrote to say: “My daughter is the joy of my life, and is everything that I could desire—mentally, morally and physically. I can hardly now realise those dark days when I first brought her to you.”
No. 23. Mr. --, aged 27, April, 1900. When I first saw this patient I was informed that he never spoke except when questioned, and that his replies were generally unintelligible. Nothing seemed to interest him, and he neither worked nor amused himself. He was heir to an entailed estate, a fact which added importance to his mental condition, The latter, in the opinion of a well-known alienist, was more likely to terminate in idiocy than improvement.
Apparently the patient had been backward in development, and in consequence had been the butt of his companions. As the result of this, he had progressively lost confidence in himself, and become more and more self-conscious. Behind all this, however, he appeared to possess much more intelligence than he was credited with; and this view was shared by Dr. Fletcher Beach, who saw the patient in consultation with me.
Treatment was begun on April 19th, 1900, and repeated on 44 occasions up to February, 1901. During that time the patient spoke more and more distinctly, and became less shy and self-conscious. His life became progressively more normal; he engaged in active work, and even spoke in public. The: last report, in December, 1902, was thoroughly satisfactory.
Bérillon has recorded numerous cases of nocturnal terror in children, in which recovery took place after a few hypnotic treatments. Equally good results were obtained in various nervous “tics”; amongst these patients, one constantly made a noise with his tongue, and another suffered from involuntary winking of the right eyelid.
The same author has reported many cases of nail-biting which have been cured by suggestion. In some this habit was the only symptom of degeneracy, in others it was associated or followed by other nervous symptoms.
Bérillon terms nail-biting onyeltophagie, and considers the condition a serious one for the following reasons:—
It is a sign of degeneracy, and is frequently followed by other symptoms of this condition, e.g. onanism, nocturnal terrors, sleep-walking, nervous irritability, etc.
It may be the means of introducing the germs of disease into the mouths of the patients.
Nail-biters become clumsy in the use of their hands; and the condition is often associated with a certain amount of local ancesthesia.
The habit is a common one: in one school, 34 % of the children bit their nails, and 36 % their penholders. In another, 20 % of the boys and 52 % of ‘the girls were nail-biters.
I give an illustrative case from my own practice.
No. 24. Miss S ---, aged 13, February, 1900, was sent to me by Professor William James, of Harvard University. She had always been emotional and highly nervous. For several years she had walked in her sleep, and during the last four had been addicted to constant nail-biting. Wearing gloves at night and other careful treatment failed to check the habit, and the nails were always gnawed to the quick. S. was easily influenced, and neither bit her nails nor walked in her sleep after the second treatment. Later reports satisfactory.
Enuresis nocturna is of frequent occurrence in degenerate children, and in 1887 Liébeault published 77 cases, of which 45 were boys and 32 girls; the average age was a little over 7, the youngest patient being 3 years old, the eldest 18. With all, except 9, the habit dated from birth.
Results.—Of the 77 cases, 56 recovered,. 9 were improved, 8 showed no improvement; while 4 were only seen once, and of these there was no further news.
In my own practice, 18 consecutive cases were all successfully treated. Of these, 12 were girls and 6 boys, their ages varying from 4 to 12 years. In every instance the recovery was confirmed by later reports. The following is an illustrative case, the notes of which were given to me by Dr. Wright, Halstead, Essex, who sent the patient to me:—
No. 25. Miss —, aged 15, art student, a bright, intelligent girl, of good family history, had suffered from enuresis nocturna since early childhood, generally every night; ‘no other neurosis. She had been treated with belladonna and other drugs, hut without success: She always dreaded the incontinence, and was miserable and depressed. She was treated by Dr. Bramwell early in 1906, and remained well until June, 1907, when there was a relapse, attributed to overstrain during an examination, I then repeated treatment by suggestion daily for a week; immediate relief was obtained, and there has been no relapse up to the present date (May, 1909). During treatment the patient only became restful and slightly drowsy.”
No. 26. Dr. ---, aged 32, February, 1893. Began taking stimulants at college, and did so regularly afterwards, although rarely in excess till 1888. At that date he had been in practice for two years and was doing well, then had frequent drinking bouts. Despite continued and careful supervision, he drank rectified spirits in secret, sometimes several gallons a month. His health suffered greatly, he was often on the verge of delirium tremens, and on one occasion was supposed to have had slight cerebral haemorrhage. He complained of palpitation and angina pectoris, and asserted that it was the pain of the latter which made him drink. As his bouts of drunkenness became more frequent and severe, he was compelled to abandon work and to return home. He became steadier, and his parents purchased another practice for him. At first he did well, but soon began drinking again and often took narcotics. I was told that, unless I could cure him, he would have to give up work and be kept by his parents.
He was treated 44 times from February 21st to April 18th, 1893; he then returned to his practice at a distance from town,and I have not seen him since. Shortly after beginning treatment he entirely abandoned stimulants and narcotics, and soon lost all craving for them. He rapidly improved in health and weight, and ceased to complain of palpitation or angina. After passing twelve months without relapse, he married. On February 27th, 1891, his mother wrote as follows:—“The treatment has been completely successful. My son is pe rf ectly well, and quite like his old self—sound in mind and body, and without the slightest wish to take drugs or stimulants in any form whatever. His practice increases steadily. Could anything be more satisfactory?” About the same date Dr. --- wrote to say that he had never felt better in his life, and bad no desire for stimulants. Since then up to the present date (March, 1909) I have heard occasionally from my patient or his wife. All the reports have been of the same character; he was strong, well, happy, prosperous, and a total abstainer.
No. 27. Mr. --- came to me on February 17, 1908, and the following history of his case was given me by Dr. Astley Cooper, of Cockermouth, in whose retreat he had been for some time under the Habitual Drunkards Act.
“Mr. -came to me in November, 1905. He had been drinking to excess for six years, and had also taken laudanum in doses of two or three drachms several times a day. He had. had two attacks of delirium tremens. He had homo-sexual desires, but had not given way to them.
“He relapsed in J uly, 1906, and again in September, 1906, when away on leave. He again relapsed in October, 1906, and in February, 1907. On May 8th, 1907, two bottles of whisky and an 8 oz. bottle of laudanum were found concealed in his top boots in his bedroom.
“He was discharged in November, 1907, and meant to go to British Columbia. He spent a fortnight visiting friends and then relapsed badly. I was sent for, and brought him back here, once more signed under the Inebriates Act with his own full consent.
“In February, 1008, I sent him to you with an attendant, who found a flask of spirits in his possession, but, as far as I am aware, except one drink at the beginning of hypnotic treatment, this is the last alcohol he tasted.
“I saw a good deal of him from the time he returned from your care till he sailed for British Columbia, in August, 1908, and found him greatly changed in every way for the better, and of my knowledge an absolute abstainer. I have had several very satisfactory letters from him since, and believe him to be keeping quite right. I looked upon him as a typical chronic inebriate; a person with good intellect, but utterly wanting in ballast and self-control.”
Mr. - was under my care seven weeks. He rapidly lost all craving for stimulants, and worked at various things which he thought might be useful to him in his colonial life. In March, 1909, a friend who had been staying with Mr. -in British Columbia called and reported that he was keeping well in every way. The patient himself wrote to say that he was thoroughly enjoying his new life, and was working hard on his fruit ranch.
No. 28. Mrs. --, aged 38, was sent to me by Dr. Colley on October 9th, 1907. She had been drinking heavily for about ten years, and latterly the attacks had become more and more frequent and severe. If anything worried her or put her out, she started drinking and continued doing so until she became ill. Then a couple of nurses would be put in charge; the patient would gradually get over her -attack and abstain entirely for a short time, and then-begin again as before.
After the first treatment the patient became a total abstainer, and there has been no relapse up to the present date (1909), although she has passed through a time of unusual strain and stress.
No. 29. Mr. --, aged 25, February, 1899. Suffered from chronic diarrhoea at the age of 16, for which a mixture containing laudanum was prescribed. This was the commencement of an opium habit which had continued ever since. It was difficult to ascertain the exact amount taken, as the patient tried to conceal this, but be admitted -to a daily consumption of 6 drachms of laudanum. Latterly he had much changed in character, while his memory. and general business capacity were markedly impaired. The patient was sent to me by Dr. Ware, of Hampstead, on February 24tb, 1899, and treated 40 times up to July 19, 1899. Result: recovery, confirmed by later reports.
No. 30. Mrs. ---, aged 37, February, 1898. Twelve months previously, after an attack of influenza, the patient began to suffer from insomnia and severe depression. Sleep was never obtained without narcotics, and there was one attempt at suicide. Six months later, frequent attacks of intercostal neuralgia began, for the relief of which morphia was injected subcutaneously. This treatment had been continued ever since, and repeated several times daily. The amount of the drug taken varied, but it was never less than 3 grains. After a fortnight’s treatment the morphia was abandoned, and all morbid symptoms quickly disappeared. Up to the last report (1903) there had been no relapse.
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