An essay on hysteria : being an analysis of its irregular and aggravated forms ; including hysterical hemorrhage, and hysterical ischuria / by Thomas Laycock.

  • Laycock, Thomas, 1812-1876.
Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: An essay on hysteria : being an analysis of its irregular and aggravated forms ; including hysterical hemorrhage, and hysterical ischuria / by Thomas Laycock. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    From the 4th to the 22d of March, the daily quantity of urine reported to have been vomited varied from twenty to forty ounces. It was occasionally precisely like healthy urine, sometimes mixed with food, and sometimes blood-coloured, when it had a peculiarly faint smell, which resembled the washings of slightly tainted meat. It coagulated by heat and nitric acid. About six ounces of a fluid resembling saliva mixed with blood flowed once from her mouth. On the 22d the navel was found full of a thick sanguineo-purulent fluid, smelling like placenta. Little or no urine was found in the bladder when the catheter was introduced. She frequently declined having the instrument used, because she was sore. For some days she complained of pain in the left shoulder, and pain and inability to move the arm of that side, which hung as if paralysed. She had sleepless nights, and pain in the head and back. On the 4th, her bowels were moved without an enema for the first time during eight weeks. Her abdomen was exceedingly tense: measured round the abdomen, it was thirty-one inches and a half in circum- ference ; that of a stout healthy girl, measured at the same time, was twenty-six inches and a-half. It was also very painful, and on one occasion, she having fainted, a line of tumours was observed in the right iliac region. These were of the size of a nut, and painful on pressure. Her pulse varied between 88 and 148, sinking and rising rapidly in a few seconds. Twelve leeches were applied to the abdomen, and bled rather profusely: the bleeding was followed by violent pain in the head, and increased action of the heart; pulse 138; syncope, delirium, and jactitation followed. There was ex- tensive ecchymosis round the leech-biles. On the afternoon of the same day I resolved to sit with her and watch her vomit. So soon as she ascertained my intention, she became very restless, twisting herself about as though she had the colic. She said that she vomited soonest when upon her back, and accordingly she placed herself in that position. I sat with her for two hours, and then called for the catheter. During the moment I turned my back upon her for this purpose, she sat up in the bed, and when I looked round I observed her putting urine out of her mouth. Some of this I gave to Mr. Stott, an intelligent pupil of the hospital, who satisfactorily ascertained that it contained urea, a small portion of albumen, sulphates, muriates, and phosphates, lime, magnesia, and ammonia. On the 18th she again discharged urine from her mouth. Up to this period nothing had occurred in the conduct of the patient to excite any suspicion of deception on her part. She seemed a quiet, inoffensive, and exceedingly reserved female, patiently sub- mitting to every remedial measure. But the vomiting of pure urine in such large quantities was enough to excite distrust; and on the 22d, with a view to ascertain whether there were urine in the sto- mach, Dr. Belcombe ordered an emetic to be given. In about half an hour after its administration, vomiting commenced, and a clear amber-coloured fluid was shown as having been brought up. It