June 23. Passed a quiet night; but did not sleep much, though she had a grain of opium. Dressing removed. Wound looking well. June 24. Has not passed quite such a good night—rather noisy. June 25. Menses came on. Has had a very bad night, and been very troublesome. Chloroform administered to insensibility several times in the course of the day. A liniment, containing seven drachms of soap liniment and one drachm of laudanum, to be rubbed in to the chest constantly. This seemed to quiet her. June 27. Has passed a rather better night, sleeping a little; but towards morning she became very noisy, and chloroform was again administered. To have the liniment rubbed in at night. June 28. A much better night. June 29. Has had a very fair night; and from this time she gradually improved, sleeping well and being generally quite rational; her appetite also improved. July 7. Menstruation occurred, and she was not so well for a day or two, as she attempted to irritate the wound; but, being carefully watched, was prevented. July 10. Catamenia ceased. Is quiet again. July 11. Went out in a bath chair, and said she enjoyed the airing. From this time she gradually got better, and on the 28th she went into the country for change. Her menses came on five weeks from the last appearance; she was quite quiet all the time. Since then she has menstruated regularly every three weeks, and in normal quantity. A year after operation she had a slight relapse of melancholy, and fears were entertained that she was again going to be ill; but a brisk purgation of calomel completely dispersed all symptoms. 1866. I have frequently heard of this young lady. She is now in good health, moving in high society, and universally admired. CASE XLVI. HYSTERICAL HOMICIDAL MANIA—ONE YEAR’S DURATION—OPERATION—CURE. In December, 1861, Mrs. —— came under my care, by the recommendation of Dr. Forbes Winslow. She gave me the following history of herself:— _History._—She was 57, and had had four children and two premature labours. The last child was born twenty-three years ago. Twenty months since had an attack of erysipelas in the face, with eruptions on different parts of the body. Has never been well since, and last August had another attack of erysipelas. Is constantly suffering with shiverings, followed by burning heat and sweating, with prickling heat of the skin. For the last year has never slept for more than an hour; always waking with a _start_; feeling frantic, and very hot and flushed. Has a constant feeling that she will be lost eternally, and of this she is constantly speaking. From her husband I learnt the following:—