Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and HysteriaMitchell, S. Weir (Silas Weir)
Science
Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria
Mitchell, S. Weir (Silas Weir)
Hysteria; Neurasthenia; Rest
The following case is reported by Dr. John Keating, who watched it with
care throughout:
P.D., male, æt. 53, after more than thirty years of close attention to
business, which severely tried both mental and physical endurance, found
himself, in January, 1877, at the close of some months of gradually
increasing feebleness, absolutely unable to fulfil his usual duties, and
the most alarming symptoms manifested themselves. There was a remarkable
loss of nervous and muscular force; his limbs refused their support; his
appetite failed; the recollection of ordinary phrases involved distinct
and painful effort; sleep became unattainable, except under the
influence of powerful narcotics, and even that brief slumber was
rendered valueless by the incessant convulsive twitching of the muscles.
His physician prescribed iron and strychnia; ordered an immediate
abandonment of all business, and instant departure to a point where
telegraph-wires were unknown and mails infrequent. He went at once to
the Bahamas, passing a month in that delicious climate in absolute
inaction; more than another month was consumed in slowly returning; but,
though some flesh had been gained, there was only a trifling improvement
in the nervous condition.
May 1, 1877, Dr. Mitchell examined Mr. P.D. The patient was sallow and
emaciated, and coughed every few moments. He had night-sweats, nervous
twitching, and slight dulness on percussion at the apex of the right
lung, with prolonged expiration and roughened inspiration, and some
increase of vocal resonance.
Mr. P.D. was allowed to be out of bed once a day four hours, and to
spend one hour at his place of business. The treatment was as follows:
At 6 A.M., a tumbler of strong, hot beef-tea, made from the Australian
extract.
At 8 A.M., half a tumbler of iron-water, and breakfast, consisting of
fruit, steak, potatoes, coffee, and a goblet of milk. At 8.30 A.M., a
goblet of milk mixed with a dessertspoonful of Loefland's extract of
malt, with six grains of citrate of iron and quinine.
At 10 o'clock Dr. Keating administered the electricity.
At 12 o'clock Mr. P.D. might be dressed, making as little personal
effort as possible. The second goblet of milk and malt was administered,
and a carriage took him to his office, where he might remain till two
o'clock, when the carriage brought him for dinner, preceded by half a
tumbler of iron-water. All walking was forbidden.
After dinner (which included a goblet of milk) the third goblet of milk
and malt was swallowed; then a short drive might be taken, but by four
o'clock the patient must be undressed and in bed.
At 6 P.M. the third dose of iron-water presented itself, and a light
supper of fruit, bread-and-butter, and cream, followed by the fourth
goblet of milk and malt. Two quarts of milk were thus swallowed every
day in addition to all other food.
At 9 P.M., massage one hour, with cocoa-oil, followed by beef-soup, four
ounces.
Public-domain text, read in full here on John Shaqi.
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