Opera minora : a collection of essays, articles, lectures and addresses from 1866 to 1882 inclusive / by Edward C. Seguin.
- Edward Constant Seguin
- Date:
- 1884
Licence: Public Domain Mark
Credit: Opera minora : a collection of essays, articles, lectures and addresses from 1866 to 1882 inclusive / by Edward C. Seguin. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
672/708 page 658
![As regards the mode of production of the attacks, I have thought of sev- eral causes. When the boy was first brouglit to me, I at once investigated the question of self-abuse, or genital irritation, and obtained a negative result ; the organs were found healthy, and the boy repeatedly declared his freedom from the evil habit referred to. It then occurred to me that the attacks of melancholia might be the result of slight or unobserved epilepti- form seizures; and, to elucidate this question, I caused Agie's parents to watcli him closely, and made strict inquiries into his past life. As seen in the his- tory of the case, only once was anything observed wliich might pass for a fit, on February 7, 1875, when he fainted dead away, and his father, an unre- liable witness, thought that he twitched. Against the epileptiform nature of the disease we have, furthermore, the failure of treatment by the compound bromide solution given in large doses from the beginning of February to the end of April. When, during the month of February, I learned of the injury to the head, it occurred to me that a morbid state of the meninges under the injured bone might be the cause of the symptoms. I accordingly performed an operation, and kept a sore running for weeks, at the seat of injury, but without relief. I was not prepared to advise trephining until a further trial of medicines had been made. The opium treatment appears to have had the best effect, when conjoined with cod-liver oil and other tonics. The approx- imate success obtained during the last six months by these means would point to mal-nutrition of the brain, as a cause of the melancholia : a pathological state not rare in the melancholia of adults.* Another case which has been treated at the clinic, and with greater suc- cess than the preceding, is that of Mary L., a married woman, aged 25 years, brought ^ere August 29, 1874. Has been married about four years, and lias borne two children, nursing them both. About two and a half years ago, after the birth of the first child, she experienced a choking sensation in her throat ; felt as if she wanted to cry. This disappeared after a while, but re- appeai'ed after the birth of the second child, a few months ago, the attacks of choking being preceded by a sense of cold in soles of feet and at wrists, accompanied by nausea, and by desire to weep. Is low-spirited and imagines that she is going to be sick, or that some disaster is to happen. Has nursed child constantly and freely, and has besides had sexual intercourse very often. Is thin, pale, and weak. Facies very despondent, patient is convinced that she cannot get well. Confesses that for many weeks she has had fearful im- pulses, to go and drown herself in the river, and to kill her children. The latter impulse surges up frequently within her, and she has had to fight hard to resist it. She has made it a rule to lock up all knives or other sharp in- struments in her rooms; and lately has, by her express wish, been closely watched by a w^oman in the day, and by her husband in the evening. Denies most positively having had any hallucination of sight or hearing. Has been careless of her home, of her dress, and person; has lost interest in everything; is extremely depressed, and often weeps. Reasons well upon all matters which usually are talked of by a woman in her station of life. Remembers every- * In a few months after the publication of this lecture, Agie was quite cured, found employment, and has remained well.—[E. C. S.]](https://iiif.wellcomecollection.org/image/b21077435_0672.jp2/full/800%2C/0/default.jpg)
