she has visited in the vain hope of
benefit. My first acquaintance with this case is somewhat curious. About
two months before I was introduced to the patient, chancing to be
walking along the esplanade at Brighton with a medical friend, my
attention was directed to a remarkable party at which every one was
looking. The chief personage in it was a lady reclining at full length
on a long couch, and being dragged along, looking the picture of misery,
emaciated to the last degree, her head drawn back almost in a state of
opisthotonos, her hands and arms clenched and contracted, her eyes fixed
and staring at the sky. There was something in the whole procession that
struck me as being typical of hysteria, and I laughingly remarked, 'I am
sure I could cure that case if I could get her into my hands.' All I
could learn at the time was that the patient came down to Brighton every
autumn, and that my friend had seen her dragged along in the same way
for ten or twelve years. On January 14 of this year, I was asked to meet
my friend Dr. Behrend in consultation, and at once recognized the
patient as the lady whom I had seen at Brighton. It would be tedious to
relate all the neurotic symptoms this patient had exhibited since 1864,
when she was first attacked with paralysis of the left arm. Among
them--and I quote these from the full notes furnished by Dr.
Behrend--were complete paraplegia, left hemiplegia, complete hysterical
amaurosis, but from this she had recovered in 1868. For all these years
she had been practically confined to her bed or couch, and had not
passed urine spontaneously for sixteen years. Among other symptoms, I
find noted 'awful suffering in spine, head, and eyes,' requiring the use
of chloral and morphia in large doses. 'For many years she has had
convulsive attacks of two distinct types, which are obviously of the
character of hystero-epilepsy.' The following are the brief notes of the
condition in which I found her, which I made in my case-book on the day
of my first visit. 'I found the patient lying on an invalid couch, her
left arm paralyzed and rigidly contracted, strapped to her body to keep
it in position. She was groaning loudly at intervals of a few seconds,
from severe pain in her back. When I attempted to shake her right hand,
she begged me not to touch her, as it would throw her into a
convulsion. She is said to have had epilepsy as a child. She has now
many times daily, frequently as often as twice i