paroxysms, the pulsations of the carotids were very quick, and so strong as to be plainly counted at sight through the integuments of the throat; at the same time the pulse was feeble and slow.

Jan. 1st. All the symptoms were suddenly aggravated; she became a perfect statue; sensation and volition were quite suspended; the evacuations were involuntary; there was a constant sardonic expression in her features; mouth open, and a large quantity of saliva flowed unrestrained; the eyes were immovable, and embedded in the upper eyelids; every limb retained the position in which it was placed; even the most painful was endured without any apparent suffering, and that for a space impossible to be preserved by any one in health. How long she would have continued in any particular posture, I cannot say. I tried the experiment often, and long enough to ascertain the fact longer would have been inhuman. She was equally insensible to all external feeling, and resisted without flinching every attempt to rouse her by moderate pinching and pricking. These paroxysms generally continued through the day, varying, however, in intensity. Sometimes locomotion was quite suspended; at other times she stepped out. She now exercised, in fact, only one voluntary animal function, and that was, to swallow whatever was put into her mouth; the power of discriminating, either by taste or smell, she did not possess. The pulse was soft and slow.

My friend, Dr. A. T. Thomson, who was attending in the house, saw Mrs. in this stage of the

case.

During this condition she was twice cupped, and once leeches were applied to the head. Tartarised antimony was exhibited, but moderate doses produced no effect on the stomach; she was briskly purged; the spine

was well rubbed with stimulating embrocations; blisters' to the extremities, and irritating clysters were prescribed; and the warm bath was continued.

6th. Little alteration; the head was again shaved, and a blister was applied over the whole scalp, which was thrice renewed in the course of the following week.

7th. She evinced much more animation; for she spoke, though incoherently, noticed surrounding objects, fed herself, and walked unassisted. The pulse was fuller.

11th. Improving. She is sensible to the calls of

nature.

16th. Small blisters were applied in succession along the whole course of the vertebral column.

26th. Limbs much more mobile, but she is rather stupid. The tongue being very foul, an antimonial emetic was given an ordinary dose now had a due effect. It brought off a great quantity of viscid phlegm, and seemed to emulge and rouse the whole system. Emetics were continued twice a week, and with evident advantage; for all the corporeal functions improved, and there were occasional glimpses of returning reason.

.

February 3d. She assisted in several little domestic

offices.

4th. The stupor returned, but not the immobility of limbs.

6th. Her husband and brother visited her; but she did not recognise them.

She varied till the 12th, when she arose in the morning in possession of every faculty, both corporeal and mental. She voluntarily assisted in domestic affairs, and talked rationally and cheerfully. She had a perfect recollection of being brought into the house, and of most things prior to the attack of catalepsy; but from the accession of that affection all was a blank. Sometimes,

however, during this day a slight stupor came on, from which she roused herself with difficulty.

13th. I was greatly mortified to find her quite torpid and mute. She was again cupped, and afterwards

emetics were more frequently given.

20th. Not improved. I urged the introduction of a seton near the occiput, which I had before proposed, but to which her husband had objected. But he now intimated his intention of removing her into the country; and on the 26th I lost sight of this interesting case.

Nevertheless, I made diligent inquiries as to the progress and final result of it. I learnt that she resided six months in lodgings, during which the seton I had so strongly recommended was tried. From its effect, she has since informed me, she derived very great benefit. The stupor and confusion of ideas she before experienced left her as soon as the discharge from it was established. She then removed to the sea-side, where she used both the warm and cold sea-bath, and took a great deal of exercise. At length the menses re-appeared, and the flow was as great as occurs in many miscarriages. Up to this event she had experienced slight returns of her cataleptic symptoms.

From this date, however, her cure was complete; and she went to live with her husband. She kept the seton open near a year.

She has since borne several children. More than ten years have passed, and she has never experienced a return of any of the above symptoms.

Many circumstances in this case indicate determination of blood to the brain: the interruption of the menstrual flux, the discordance between the force of the carotid and radial arteries, and the temporary relief always produced by abstracting blood by cupping from the head during the existence of the cataleptic symptoms, support

this inference. I therefore several times tried the effect of Dr. Parry's experiment of pressure on the carotids; but I was never so fortunate as to arrive at the same results from it.

It has been observed, that catalepsy is a malady most prevalent in the female sex; and likewise, that it is rarely preceded by mental derangement. I very recently, however, had a young gentleman, a native of Peru, though of Spanish origin, under my care, with symptoms of catalepsy. Here the attack commenced with slight symptoms of mania; in about a month they changed to those of melancholia; then, in a fortnight more, degenerated into fatuity, with entire unconsciousness. Frequently, volition and locomotion were quite suspended. Wherever he was placed, there he would remain; and in whatever position, that he would retain for some time. In this state he was embarked to return to South America.

Throughout the two months he was under my care, there were few symptoms of corporeal derangement. The circulation was little affected, and the functions of the prima via were uninterrupted. No regular treatment was attempted in this case, as he remained only till an opportunity offered of sending him to his native country.

Another case in a young man, complicated also with melancholia, has recently come to my knowledge, in which the cure, both of the cataleptic symptoms and mental derangement, was effected in about six weeks by the carbonate of barytes.

7. Hysteria.

Hysteria, which alternates with headach, vertigo, and epilepsy, sometimes degenerates into mania. Females only are generally supposed to be subjected to this affection; but males also are certainly occasionally affected by it.

C. Piso,* T. Willis, Sydenham, Boerhaave, Cullen, and the best authorities, attest this fact a fact of considerable importance in the diagnosis of this disease.

Here, again, therefore, as in the acceptation and application of the word apoplexia, we are misled by the derivation; the radical of hysteria being orga, the

uterus or vulva.

Nervous susceptible women between puberty and thirty years of age, and clearly the single more so than the married, are most frequently visited by hysteria; and such constitutions have always a greater aptitude to strong mental emotions, which, on repetition, will superinduce mental derangement, or perhaps epilepsy.

When, however, men are subject to the hysteric passion, an accession of mania is more to be apprehended than when women are so affected; because the nervous temperament is thereby characterised more strongly than` is usual in the male sex, in whom, comparatively with the female sex, it is certainly a very rare disease.

In a disorder so well known, a description of the corporeal symptoms is needless; but many will be recognised as indicative of sanguineous determination to the brain and other parts. All the exciting causes of it are those which are accessory to this effect.

Salivation, which is supposed to be derived from an increased action in the capillary circulation, is a frequent symptom in hysteria. Sydenham remarks, that he has often known salivation attend for a whole week in this disease; and this is also a frequent symptom both in mania and melancholia, and also in hypochondriasis. Either an excessive flow of tears or of urine is a very common symptom and termination of this malady: this is only determination to other parts.

sunt.

Hysterica symptomata omnia ferè viris cum mulieribus communia - Select. Observ. et Consil.