Anomalies And Curiosities Of Medicine Part 67

Kleptophobia, examples of which have been cited by Cullere, is the fear of stealing objects in view, and is often the prelude of kleptomania.

The latter disease has gained notoriety in this country, and nearly every large store has agents to watch the apparently growing number of kleptomaniacs. These unfortunate persons, not seldom from the highest cla.s.ses of society, are unable to combat an intense desire to purloin articles. Legal proceedings have been inst.i.tuted against many, and specialists have been called into court to speak on this question.

Relatives and friends have been known to notify the large stores of the thieving propensities of such patients.

Le Grande du Saulle has given to the disease in which there is a morbid doubt about everything done, the name folie de doute. Gray mentions a case in a patient who would go out of a door, close it, and then come back, uncertain as to whether he had closed it, close it again, go off a little way, again feel uncertain as to whether he had closed it properly, go back again, and so on for many times. Hammond relates the history of a case in an intelligent man who in undressing for bed would spend an hour or two determining whether he should first take off his coat or his shoes. In the morning he would sit for an hour with his stockings in his hands, unable to determine which he should put on first.

Syphilophobia is morbid fear of syphilis. Lyssophobia is a fear of hydrophobia which sometimes a.s.sumes all the symptoms of the major disease, and even produces death. Gelineau, Colin, Berillon, and others have studied cases. In Berillon's case the patient was an artist, a woman of brunet complexion, who for six years had been tormented with the fear of becoming mad, and in whom the symptoms became so intense as to const.i.tute pseudobydrophobia. At their subsidence she was the victim of numerous hallucinations which almost drove her to the point of suicide.

Spermatophobia has been noticed among the ignorant, caused or increased by inspection of sensational literature, treatises on the subject of spermatorrhea, etc. Ferre mentions a woman of thirty-six, of intense religious scruples, who was married at eighteen, and lost her husband six years afterward. She had a proposition of marriage which she refused, and was prostrated by the humid touch of the proposer who had kissed her hand, imagining that the humidity was due to s.e.m.e.n. She was several times overcome by contact with men in public conveyances, her fear of contamination being so great. Zoophobia, or dread of certain animals, has been mentioned under another chapter under the head of idiosyncrasies. Pantophobia is a general state of fear of everything and everybody. Phobophobia, the fear of being afraid, is another coinage of the wordmakers. The minor 'phobias, such as pyrophobia, or fear of fire; stasophobia, or inability to arise and walk, the victims spending all their time in bed; toxicophobia or fear of poison, etc., will be left to the reader's inspection in special works on this subject.

Demonomania is a form of madness in which a person imagines himself possessed of the devil. Ancient records of this disease are frequent, and in this century Lapointe reports the history of demonomania in father, mother, three sons, and two daughters, the whole family, with the exception of one son, who was a soldier, being attacked. They imagined themselves poisoned by a sorceress, saw devils, and had all sorts of hallucinations, which necessitated the confinement of the whole family in an asylum for over a month. They continued free from the hallucinations for two years, when first the mother, and then gradually all the other members of the family, again became afflicted with demonomania and were again sent to the asylum, when, after a residence therein of five months, they were all sufficiently cured to return home.

Particular aversions may be temporary only, that is, due to an existing condition of the organism, which, though morbid, is of a transitory character. Such, for instance, are those due to dent.i.tion, the commencement or cessation of the menstrual function, pregnancy, etc.

These cases are frequently of a serious character, and may lead to derangement of the mind. Millington relates the history of a lady who, at the beginning of her first pregnancy, acquired an overpowering aversion to a half-breed Indian woman who was employed in the house as a servant. Whenever this woman came near her she was at once seized with violent trembling; this ended in a few minutes with vomiting and great mental and physical prostration lasting several hours. Her husband would have sent the woman away, but Mrs. X insisted on her remaining, as she was a good servant, in order that she might overcome what she regarded as an unreasonable prejudice. The effort was, however, too great, for upon one occasion when the woman entered Mrs.

X's apartment rather unexpectedly, the latter became greatly excited, and, jumping from an open window in her fright, broke her arm, and otherwise injured herself so severely that she was confined to her bed for several weeks. During this period, and for some time afterward, she was almost constantly subject to hallucinations, in which the Indian woman played a prominent part. Even after her recovery the mere thought of the woman would sometimes bring on a paroxysm of trembling, and it was not till after her confinement that the antipathy disappeared.

Circular or periodic insanity is a rare psychosis. According to Drewry reports of very few cases have appeared in the medical journals. "Some systematic writers," says Drewry, "regard it as a mere subdivision of periodic insanity (Spitzka). A distinguished alienist and author of Scotland however has given us an admirable lecture on the subject. He says: 'I have had under my care altogether about 40 cases of typical folie circulaire.' In the asylum at Morningside there were, says Dr.

Clouston, in 800 patients 16 cases of this peculiar form of mental disease. Dr. Spitzka, who was the first American to describe it, found in 2300 cases of pauper insane four per cent to be periodic, and its sub-group, circular, insanity. Dr. Stearns states that less than one-fourth of one per cent of cases in the Hartford (Conn.) Retreat cla.s.sed as mania and melancholia have proved to be folie circulaire.

Upon examination of the annual reports of the superintendents of hospitals for the insane in this country, in only a few are references made to this as a distinct form of insanity. In the New York State hospitals there is a regular uniform cla.s.sification of mental diseases in which 'circular (alternating) insanity' occupies a place. In the report of the Buffalo Hospital for 1892, in statistical table No. 4, 'showing forms of insanity in those admitted, etc., since 1888,' out of 1428 cases, only one was 'alternating (circular) insanity.' In the St.

Lawrence Hospital only one case in 992 was credited to this special cla.s.s. In the inst.i.tution in Philadelphia, of which Dr. Chapin is the superintendent, 10,379 patients have been treated, only three of whom were diagnosed cases of manie circulaire. Of the 900 cases of insanity in the State Hospital at Danville, Pa., less than four per cent were put in this special cla.s.s. There are in the Central (Va.) State Hospital (which is exclusively for the colored insane) 775 patients, three of whom are genuine cases of circular insanity, but they are included in 'periodic insanity.' This same custom evidently prevails in many of the other hospitals for the insane."

Drewry reports three cases of circular insanity, one of which was as follows:--

"William F., a negro, thirty-six years old, of fair education, steady, sober habits, was seized with gloomy depression a few weeks prior to his admission to this hospital, in September, 1886. This condition came on after a period of fever. He was a stranger in the vicinity and scarcely any information could be obtained regarding his antecedents.

When admitted he was in a state of melancholic hypochondriasis; he was the very picture of abject misery. Many imaginary ills troubled his peace of mind. He spoke of committing suicide, but evidently for the purpose of attracting attention and sympathy. On one occasion he said he intended to kill himself, but when the means to do so were placed at his command, he said he would do the deed at another time. The most trivial physical disturbances were exaggerated into very serious diseases. From this state of morbid depression he slowly emerged, grew brighter, more energetic, neater in personal appearance, etc. During this period of slow transition or partial sanity he was taken out on the farm where he proved to be a careful and industrious laborer. He escaped, and when brought back to the hospital a few weeks subsequently he was in a condition of great excitement and hilarity. His expression was animated, and he was, as it were, overflowing with superabundance of spirit, very loquacious, and incessantly moving. He bore an air of great importance and self-satisfaction; said he felt perfectly well and happy, but abused the officers for keeping him 'confined unjustly in a lunatic asylum.' It was his habit almost daily, if not interfered with, to deliver a long harangue to his fellow-patients, during which he would become very excited and noisy. He showed evidences of having a remarkable memory, particularly regarding names and dates. (Unusual memory is frequently observed in this type of insanity, says Stearns.) He was sometimes disposed to be somewhat destructive to furniture, etc., was neat in person, but would frequently dress rather 'gorgeously,' wearing feathers and the like in his hat, etc. He was not often noisy and sleepless at night, and then only for a short time. His physical health was good. This 'mental intoxication,' as it were, lasted nearly a year. After this long exacerbation of excitement there was a short remission and then depression again set in, which lasted about fifteen months. At this time this patient is in the depressed stage or period of the third circle. So, thus the cycles have continuously repeated their weary rounds, and in all probability they will keep this up 'until the final capitation in the battle of life has taken place.'"

Katatonia, according to Gray, is a cerebral disease of cyclic symptoms, ranging in succession from primary melancholia to mania, confusion, and dementia, one or more of these stages being occasionally absent, while convulsive and epileptoid symptoms accompany the mental changes.

It is manifestly impossible to enter into the manifold forms and instances of insanity in this volume, but there is one case, seldom quoted, which may be of interest. It appeared under the t.i.tle, "A Modern Pygmalion." It recorded a history of a man named Justin, who died in the Bicetre Insane Asylum. He had been an exhibitor of wax works at Montrouge, and became deeply impressed with the beautiful proportions of the statue of a girl in his collection, and ultimately became intensely enamored with her. He would spend hours in contemplation of the inanimate object of his affections, and finally had the illusion that the figure, by movements of features, actually responded to his devotions. Nemesis as usual at last arrived, and the wife of Justin, irritated by his long neglect, in a fit of jealousy destroyed the wax figure, and this resulted in a murderous attack on his wife by Justin who resented the demolition of his love. He was finally secured and lodged in Bicetre, where he lived for five years under the influence of his lost love.

An interesting condition, which has been studied more in France than elsewhere, is double consciousness, dual personality, or, as it is called by the Germans, Doppelwahrnehmungen. In these peculiar cases an individual at different times seems to lead absolutely different existences. The idea from a moralist's view is inculcated in Stevenson's "Dr. Jekyl and Mr. Hyde." In an article on this subject Weir Mitch.e.l.l ill.u.s.trated his paper by examples, two of which will be quoted. The first was the case of Mary Reynolds who, when eighteen years of age, became subject to hysteric attacks, and on one occasion she continued blind and deaf for a period of five or six weeks. Her hearing returned suddenly, and her sight gradually. About three months afterward she was discovered in a profound sleep. Her memory had fled, and she was apparently a new-born individual. When she awoke it became apparent that she had totally forgotten her previous existence, her parents, her country, and the house where she lived. She might be compared to an immature child. It was necessary to recommence her education. She was taught to write, and wrote from right to left, as in the Semitic languages. She had only five or six words at her command--mere reflexes of articulation which were to her devoid of meaning. The labor of re-education, conducted methodically, lasted from seven to eight weeks. Her character had experienced as great a change as her memory; timid to excess in the first state, she became gay, unreserved, boisterous, daring, even to rashness. She strolled through the woods and the mountains, attracted by the dangers of the wild country in which she lived. Then she had a fresh attack of sleep, and returned to her first condition; she recalled all the memories and again a.s.sumed a melancholy character, which seemed to be aggravated. No conscious memory of the second state existed. A new attack brought back the second state, with the phenomenon of consciousness which accompanied it the first time. The patient pa.s.sed successively a great many times from one of these states to the other. These repeated changes stretched over a period of sixteen years. At the end of that time the variations ceased. The patient was then thirty-six years of age; she lived in a mixed state, but more closely resembling the second than the first; her character was neither sad nor boisterous, but more reasonable. She died at the age of sixty-five years.

The second case was that of an itinerant Methodist minister named Bourne, living in Rhode Island, who one day left his home and found himself, or rather his second self, in Norristown, Pennsylvania. Having a little money, he bought a small stock in trade, and instead of being a minister of the gospel under the Methodist persuasion, he kept a candy shop under the name of A. J. Brown, paid his rent regularly, and acted like other people. At last, in the middle of the night, he awoke to his former consciousness, and finding himself in a strange place, supposed he had made a mistake and might be taken for a burglar. He was found in a state of great alarm by his neighbors, to whom he stated that he was a minister, and that his home was in Rhode Island. His friends were sent for and recognized him, and he returned to his home after an absence of two years of absolutely foreign existence. A most careful investigation of the case was made on behalf of the London Society for Psychical Research.

An exhaustive paper on this subject, written by Richard Hodgson in the proceedings of the Society for Psychical Research, states that Mr.

Bourne had in early life shown a tendency to abnormal psychic conditions; but he had never before engaged in trade, and nothing could be remembered which would explain why he had a.s.sumed the name A. J.

Brown, under which he did business. He had, however, been hypnotized when young and made to a.s.sume various characters on the stage, and it is possible that the name A. J. Brown was then suggested to him, the name resting in his memory, to be revived and resumed when he again went into a hypnotic trance.

Alfred Binet describes a case somewhat similar to that of Mary Reynolds: "Felida, a seamstress, from 1858 up to the present time (she is still living) has been under the care of a physician named Azam in Bordeaux. Her normal, or at least her usual, disposition when he first met her was one of melancholy and disinclination to talk, conjoined with eagerness for work. Nevertheless her actions and her answers to all questions were found to be perfectly rational. Almost every day she pa.s.sed into a second state. Suddenly and without the slightest premonition save a violent pain in the temples she would fall into a profound slumber-like languor, from which she would awake in a few moments a totally different being. She was now as gay and cheery as she had formerly been morose. Her imagination was over-excited. Instead of being indifferent to everything, she had become alive to excess. In this state she remembered everything that had happened in the other similar states that had preceded it, and also during her normal life.

But when at the end of an hour or two the languor reappeared, and she returned to her normal melancholy state, she could not recall anything that had happened in her second, or joyous, stage. One day, just after pa.s.sing into the second stage, she attended the funeral of an acquaintance. Returning in a cab she felt the period coming on which she calls her crisis (normal state). She dozed several seconds, without attracting the attention of the ladies who were in the cab, and awoke in the other state, absolutely at a loss to know why she was in a mourning carriage with people who, according to custom, were praising the qualities of a deceased person whose name she did not even know.

Accustomed to such positions, she waited; by adroit questions she managed to understand the situation, and no one suspected what had happened. Once when in her abnormal condition she discovered that her husband had a mistress, and was so overcome that she sought to commit suicide. Yet in her normal mind she meets the woman with perfect equilibrium and forgetfulness of any cause for quarrel. It is only in her abnormal state that the jealousy recurs. As the years went on the second state became her usual condition. That which was at first accidental and abnormal now const.i.tutes the regular center of her psychic life. It is rather satisfactory to chronicle that as between the two egos which alternately possess her, the more cheerful has finally reached the ascendant."

Jackson reports the history of the case of a young dry-goods clerk who was seized with convulsions of a violent nature during which he became unconscious. In the course of twenty-four hours his convulsions abated, and about the third day he imagined himself in New York paying court to a lady, and having a rival for her favors; an imaginary quarrel and duel ensued. For a half-hour on each of three days he would start exactly where he had left off on the previous day. His eyes were open and to all appearances he was awake during this peculiar delirium. When asked what he had been doing he would a.s.sert that he had been asleep.

His language a.s.sumed a refinement above his ordinary discourse. In proportion as his nervous system became composed, and his strength improved, this unnatural manifestation of consciousness disappeared, and he ultimately regained his health.

A further example of this psychologic phenomenon was furnished quite meetly at a meeting of the Clinical Society of London, where a well known physician exhibited a girl of twelve, belonging to a family of good standing, who displayed in the most complete and indubitable form this condition of dual existence. A description of the case is as follows:--

"Last year, after a severe illness which was diagnosed to be meningitis, she became subject to temporary attacks of unconsciousness, on awakening from which she appeared in an entirely different character. In her normal condition she could read and write and speak fluently, and with comparative correctness. In the altered mental condition following the attack she loses all memory for ordinary events, though she can recall things that have taken place during previous attacks. So complete is this alteration of memory, that at first she was unable to remember her own name or to identify herself or her parents. By patient training in the abnormal condition she has been enabled to give things their names, though she still preserves a baby-fashion of p.r.o.nouncing. She sometimes remains in the abnormal condition for days together and the change to her real self takes place suddenly, without exciting surprise or dismay, and she forthwith resumes possession of her memory for events of her ordinary life.

During the last month or two she appears to have entered on a new phase, for after a mental blank of a fortnight's duration she awakened completely oblivious of all that had happened since June, 1895, and she alludes to events that took place just anterior to that date as though they were of recent occurrence; in fact she is living mentally in July, 1895. These cases, though rare, are of course not infrequently met with, and they have been carefully studied, especially in France, where women appear more p.r.o.ne to neurotic manifestations. The hypothesis that finds most favor is that the two halves of the brain do not work in unison; in other words, that there has been some interference with the connections which in the ordinary normal being make of a wonderful composite organ like the brain one organic whole."

Proust tells a story of a Parisian barrister of thirty-three. His father was a heavy drinker, his mother subject to nervous attacks, his younger brother mentally deficient, and the patient himself was very impressionable. It was said that a judge in a court, by fixing his gaze on him, could send him into an abnormal state. On one occasion, while looking into a mirror in a cafe, he suddenly fell into a sleep, and was taken to the Charite where he was awakened. He suffered occasional loss of memory for considerable lengths of time, and underwent a change of personality during these times. Though wide awake in such conditions he could remember nothing of his past life, and when returned to his original state he could remember nothing that occurred during his secondary state, having virtually two distinct memories. On September 23, 1888, he quarreled with his stepfather in Paris and became his second self for three weeks. He found himself in a village 100 miles from Paris, remembering nothing about his journey thereto; but on inquiry he found that he had paid a visit to the priest of the village who thought his conduct odd, and he had previously stayed with an uncle, a bishop, in whose house he had broken furniture, torn up letters, and had even had sentence pa.s.sed upon him by a police court for misdemeanor. During these three weeks he had spent the equivalent of $100, but he could not recall a single item of expenditure. Davies cites a remarkable case of sudden loss of memory in a man who, while on his way to Australia, was found by the police in an exhausted condition and who was confined in the Kent County Insane Asylum. He suffered absolute loss of all memory with the exception of the names of two men not close acquaintances, both of whom failed to recognize him in his changed condition in confinement. Four months later his memory returned and his ident.i.ty was established.

In the Revue Philosophique for 1885 there are the details of a case of a young man who seemed able to a.s.sume six states of what might be fairly called different personalities. The memories attached to each of these states were very different, though only one was completely exclusive of the others. The handwriting varied from complete competence to complete incompetence. His character varied between childish timidity, courteous reserve, and reckless arrogance; and to four of his conditions there was a form of hysteric paralysis attached.

Mere suggestion would not only induce any one of these varied forms of paralysis, but also the memories, capacities, and characters habitually accompanying it.

A young man named Spencer, an inmate of the Philadelphia Hospital, was exhibited before the American Neurological Society in June, 1896, as an example of dual personality. At the time of writing he is and has been in apparently perfect health, with no evidence of having been in any other condition. His faculties seem perfect, his education manifests itself in his intelligent performance of the cleric duties a.s.signed to him at the hospital, yet the thread of continuous recollection which connects the present moment with its predecessors--consciousness and memory--has evidently been snapped at some point of time prior to March 3d and after January 19th, the last date at which he wrote to his parents, and as if in a dream, he is now living another life. The hospital staff generally believe that the man is not "shamming," as many circ.u.mstances seem to preclude that theory. His memory is perfect as to everything back to March 3d. The theory of hypnotism was advanced in explanation of this case.

The morbid sympathy of twin brothers, ill.u.s.trated in Dumas's "Corsican Brothers," has been discussed by Sedgwick, Elliotson, Trousseau, Layc.o.c.k, Cagentre, and others. Marshall Hall relates what would seem to verify the Corsican myth, the history of twin brothers nine months of age, who always became simultaneously affected with restlessness, whooping and crowing in breathing three weeks previous to simultaneous convulsions, etc. Rush describes a case of twin brothers dwelling in entirely different places, who had the same impulse at the same time, and who eventually committed suicide synchronously. Baunir describes a similar development of suicidal tendency in twin brothers. A peculiar case of this kind was that of the twin brothers Laustand who were nurses in a hospital at Bordeaux; they invariably became ill at the same time, and suffered cataract of the lens together.

Automatism has been noticed as a sequel to cranial injuries, and Huxley quotes a remarkable case reported by Mesnet. The patient was a young man whose parietal bone was partially destroyed by a ball. He exhibited signs of hemiplegia on the right side, but these soon disappeared and he became subject to periodic attacks lasting from twenty-four to forty-eight hours, during which he was a mere automaton. In these attacks he walked continually, incessantly moving his jaw, but not uttering a word. He was insensible to pain, electric shock, or pin-p.r.i.c.k. If a pen was placed in his hand he would write a good letter, speaking sensibly about current topics. When a cigarette-paper was placed in his hand he sought his tobacco box, and adroitly rolled a cigarette and lighted it. If the light went out he procured another, but would not allow another to subst.i.tute a match. He allowed his mustache to be burned without resistance, but would not allow a light to be presented to him. If chopped charpie was put in his pocket instead of tobacco he knew no difference. While in his periods of automatism he was in the habit of stealing everything within his grasp.

He had been a concert singer, and a peculiar fact was that if given white gloves he would carefully put them on and commence a pantomime of the actions of a singer, looking over his music, bowing, a.s.suming his position, and then singing.

It is particularly in hypnotic subjects that manifestations of automatism are most marked. At the suggestion of battle an imaginary struggle at once begins, or if some person present is suggested as an enemy the fight is continued, the hypnotic taking care not to strike the person in question. Moll conceded that this looked like simulation, but repet.i.tion of such experiments forced him to conclude that these were real, typical hypnoses, in which, in spite of the sense-delusions, there was a dim, dreamy consciousness existing, which influenced the actions of the subject, and which prevented him from striking at a human being, although hitting at an imaginary object. Many may regard this behavior of hypnotics as pure automatism; and Moll adds that, as when walking in the street while reading we automatically avoid knocking pa.s.sers-by, so the hypnotic avoids. .h.i.tting another person, although he is dimly or not at all aware of his existence.

Gibbs reports a curious case of lack of integrity of the will in a man of fifty-five. When he had once started on a certain labor he seemed to have no power to stop the muscular exercise that the task called forth.

If he went to the barn to throw down a forkful of hay, he would never stop until the hay was exhausted or someone came to his rescue. If sent to the wood-pile for a handful of wood, he would continue to bring in wood until the pile was exhausted or the room was full. On all occasions his automatic movements could only be stopped by force.

At a meeting in Breslau Meschede rendered an account of a man who suffered from simple misdirection of movement without any mental derangement. If from his own desire, or by direction of others, he wanted to attempt any muscular movement, his muscles performed the exact opposite to his inclinations. If he desired to look to the right, his eyes involuntarily moved to the left. In this case the movement was not involuntary, as the muscles were quiet except when called to action by the will, and then they moved to the opposite.

Presentiment, or divination of approaching death, appearing to be a hypothetic allegation, has been established as a strong factor in the production of a fatal issue in many cases in which there was every hope for a recovery. In fact several physicians have mentioned with dread the peculiar obstinacy of such presentiment. Hippocrates, Roma.n.u.s, Moller, Richter, Jordani, and other older writers speak of it.

Montgomery reports a remarkable case of a woman suffering from carcinoma of the uterus. He saw her on October 6, 1847, when she told him she had a strong presentiment of death on October 28th. She stated that she had been born on that day, her first husband had died on October 28th, and she had married her second husband on that day. On October 27th her pulse began to fail, she fell into a state of extreme prostration, and at noon on the 28th she died. In substantiation of the possibility of the influence of presentiment Montgomery cites another case in which he was called at an early hour to visit a lady, the mother of several children. He found her apparently much agitated and distressed, and in great nervous excitement over a dream she had had, in which she saw a handsome monument erected by some children to their mother. She had awakened and became dreadfully apprehensive, she could not tell as to what. The uneasiness and depression continued, her pulse continued to grow weak, and she died at twelve that night without a struggle. Andrews has made several observations on this subject, and concludes that presentiment of death is a dangerous symptom, and one which should never be overlooked. One of his cases was in a man with a fractured leg in the Mercy Hospital at Pittsburg. The patient was in good health, but one day he became possessed of a cool, quiet, and perfectly clear impression that he was about to die. Struck with his conviction, Andrews examined his pulse and general condition minutely, and a.s.sured the patient there was not the slightest ground for apprehension. But he persisted, and was attacked by pneumonia three days later which brought him to the verge of the grave, although he ultimately recovered. In another instance a young man of ruddy complexion and apparent good health, after an operation for varicocele, had a very clear impression that he would die. Careful examination showed no reason for apprehension. After five or six days of encouragement and a.s.surance, he appeared to be convinced that his reasoning was foolish, and he gave up the idea of death. About the ninth day the wound presented a healthy, rosy appearance, and as the patient was cheerful he was allowed to leave his bed. After a few hours the nurse heard the noise of labored breathing, and on investigation found the patient apparently in a dying condition. He was given stimulants and regained consciousness, but again relapsed, and died in a few moments. At the necropsy the heart was found healthy, but there were two or three spots of extravasated blood in the brain, and evidences of cerebral congestion. Vos remarks that he remembers a case he had when dressing for Mr. Holden at St. Bartholomew's Hospital: "A man who had been intemperate was rolling a sod of gra.s.s, and got some grit into his left palm. It inflamed; he put on hot cow-dung poultices by the advice of some country friends. He was admitted with a dreadfully swollen hand. It was opened, but the phlegmonous process spread up to the shoulder, and it was opened in many places, and at last, under chloroform, the limb was amputated below the joint. The stump sloughed, and pus pointing at the back of the neck, an opening was again made. He became in such a weak state that chloroform could not be administered, and one morning he had such a dread of more incisions that, saying to us all standing round his bed, 'I can bear it no more, I must now die,' he actually did die in a few minutes in our presence. His was the last arm that Mr. Holden ever amputated at St.

Bartholomew's."

CHAPTER XVIII.

HISTORIC EPIDEMICS.

A short history of the princ.i.p.al epidemics, including as it does the description of anomalous diseases, many of which are now extinct, and the valuable knowledge which finally led to their extinction, the extraordinary mortalities which these epidemics caused, and many other a.s.sociate points of interest would seem fitting to close the observations gathered in this volume. As the ill.u.s.trious Hecker says, in the history of every epidemic, from the earliest times, the spirit of inquiry was always aroused to learn the machinery of such stupendous engines of destruction; and even in the earliest times there was neither deficiency in courage nor in zeal for investigation. "When the glandular plague first made its appearance as a universal epidemic, whilst the more pusillanimous, haunted by visionary fears, shut themselves up in their closets, some physicians at Constantinople, astonished at the phenomena opened the boils of the deceased. The like has occurred both in ancient and modern times, not without favorable results for Science; nay, more mature views excited an eager desire to become acquainted with similar or still greater visitations among the ancients, but, as later ages have always been fond of referring to Grecian antiquity, the learned of those times, from a partial and meagre predilection, were contented with the descriptions of Thucydides, even where nature had revealed, in infinite diversity, the workings of her powers."

There cannot but be a natural interest in every medical mind to-day in the few descriptions given of the awful ravages of the epidemics which, fortunately, in our enlightened sanitary era, have entirely disappeared. In the history of such epidemics the name of Hecker stands out so prominently that any remarks on this subject must necessarily, in some measure, find their origin in his writings, which include exhaustive histories of the black death, the dancing mania, and the sweating sickness. Few historians have considered worthy of more than a pa.s.sing note an event of such magnitude as the black death, which destroyed millions of the human race in the fourteenth century and was particularly dreadful in England. Hume has given but a single paragraph to it and others have been equally brief. Defoe has given us a journal of the plague, but it is not written in a true scientific spirit; and Caius, in 1562, gave us a primitive treatise on the sweating sickness.

It is due to the translation of Hecker's "Epidemics of the Middle Ages"

by Babbington, made possible through the good offices of the Sydenham Society, that a major part of the knowledge on this subject of the English-reading populace has been derived.

The Black Death, or, as it has been known, the Oriental plague, the bubonic plague, or in England, simply the plague, and in Italy, "la Mortalega" (the great mortality) derived its name from the Orient; its inflammatory boils, tumors of the glands, and black spots, indicative of putrid decomposition, were such as have been seen in no other febrile disease. All the symptoms were not found in every case, and in many cases one symptom alone preceded death. Although afflicted with all the manifestations of the plague, some patients recovered.

According to Hecker the symptoms of cephalic affliction were seen; many patients were stupefied and fell into a deep sleep, or became speechless from palsy of the tongue, while others remained sleepless and without rest. The fauces and tongue were black and as if suffused with blood; no beverage could a.s.suage the burning thirst, so that suffering continued without alleviation until death, which many in their despair accelerated with their own hands. Contagion was evident, for attendants caught the disease from their parents and friends, and many houses were emptied of their inhabitants. In the fourteenth century this affection caused still deeper sufferings, such as had not been hitherto experienced. The organs of respiration became the seats of a putrid inflammation, blood was expectorated, and the breath possessed a pestiferous odor. In the West an ardent fever, accompanied by an evacuation of blood, proved fatal in the first three days. It appears that buboes and inflammatory boils did not at first appear, but the disease in the form of carbuncular affection of the lungs (anthrax artigen) caused the fatal issue before the other symptoms developed.

Later on in the history of the plague the inflammatory boils and buboes in the groins and axillae were recognized at once as prognosticating a fatal issue.

The history of this plague extends almost to prehistoric times. There was a pest in Athens in the fifth century before Christ. There was another in the second century, A.D., under the reign of Marcus Aurelius, and again in the third century, under the reign of the Gauls; following this was the terrible epidemic of the sixth century, which, after having ravaged the territory of the Gauls, extended westward. In 542 a Greek historian, Procopius, born about the year 500, gives a good description of this plague in a work, "Pestilentia Gravissima," so called in the Latin translation. Dupouy in "Le Moyen Age Medical," says that it commenced in the village of Peleuse, in Egypt, and followed a double course, one branch going to Alexandria and the other to Palestine. It reached Constantinople in the Spring of 543, and produced the greatest devastation wherever it appeared. In the course of the succeeding half century this epidemic became pandemic and spread over all the inhabited earth. The epidemic lasted four months in Constantinople, from 5000 to 10,000 people dying each day. In his "History of France," from 417 to 591, Gregorius speaks of a malady under the name inguinale which depopulated the Province of Arles. In another pa.s.sage this ill.u.s.trious historian of Tours says that the town of Narbonne was devastated by a maladie des aines. We have records of epidemics in France from 567 to 590, in which bubonic symptoms were a prominent feature. About the middle of the fourteenth century the bubonic plague made another incursion from the East. In 1333, fifteen years before the plague appeared in Europe, there were terrible droughts in China followed by enormous floods in which thousands of people perished. There are traditions of a plague in Tche in 1334, following a drought, which is said to have carried off about 5,000,000 people. During the fifteen years before the appearance of the plague in Europe there were peculiar atmospheric phenomena all over the world, besides numerous earthquakes. From the description of the stinking atmosphere of Europe itself at this time it is quite possible that part of the disease came, not from China, but originated in Southern Europe itself. From China the route of caravans ran to the north of the Caspian Sea, through Asia, to Tauris. Here ships were ready to take the produce of the East to Constantinople, the capital of commerce, and the medium of communication between Europe, Asia, and Africa. Other caravans went from Europe to Asia Minor and touched at the cities south of the Caspian Sea, and lastly there were others from Bagdad through Arabia to Egypt; the maritime communication on the Red Sea to Arabia and Egypt was also not inconsiderable. In all these directions contagion found its way, though doubtless Constantinople and the harbors of Asia Minor were the chief foci of infection, whence it radiated to the most distant seaports and islands. As early as 1347 the Mediterranean sh.o.r.es were visited by the plague, and in January, 1348, it appeared in the south of France, the north of Italy, and also in Spain. Place after place was attacked throughout the year, and after ravishing the whole of France and Germany, the plague appeared in England, a period of three months elapsing before it reached London.

The northern kingdoms were attacked in 1349, but in Russia it did not make its appearance before 1351.

As to the mortality of this fearful epidemic Dupony considers that in the s.p.a.ce of four years more than 75,000,000 fell victims, that is, about half of the population of the countries visited. Hecker estimates that from 1347 to 1351, 25,000,000 people died, or one-quarter of the total population of Europe. It was reported to Pope Clement that throughout the East, probably with the exception of China, nearly 24,000,000 people had fallen victims to the plague. Thirteen millions are said to have died in China alone. Constantinople lost two-thirds of its population. When the plague was at its greatest violence Cairo lost daily from 10,000 to 15,000, as many as modern plagues have carried off during their whole course. India was depopulated. Tartary, Mesopotamia, Syria, Armenia, and Arabia were covered with dead bodies.

In this latter country Arabian historians mention that Maara el nooman, Schisur, and Harem in some unaccountable manner remained free. The sh.o.r.es of the Mediterranean were ravaged and ships were seen on the high seas without sailors. In "The Decameron" Boccaccio gives a most graphic description of the plague and states that in Florence, in four months, 100,000 perished; before the calamity it was hardly supposed to contain so many inhabitants. According to Hecker, Venice lost 100,000; London, 100,000; Paris, 50,000; Siena, 70,000; Avignon, 60,000; Strasburg, 16,000; Norwich, 51,100. Dupony says that in one month there were 56,000 victims in Ma.r.s.eilles, and at Montpellier three-quarters of the population and all the physicians were stricken with the epidemic.

Johanna of Burgundy, wife of King Philip VI of Valois; Johanna II, Queen of Navarre, granddaughter of Philippe le Bel; Alphonse XI of Castile, and other notable persons perished. All the cities of England suffered incredible losses. Germany seems to have been particularly spared; according to a probable calculation, only about 1,250,000 dying. Italy was most severely visited, and was said to have lost most of its inhabitants. In the north of Europe two of the brothers of Magnus, King of Sweden, died; and in Westgothland alone 466 priests died. The plague showed no decrease in the northern climates of Iceland and Greenland, and caused great havoc in those countries.

The moral effect of such a great pandemic plague can be readily surmised. The mental shock sustained by all nations during the prevalence of the black plague is beyond parallel and description. An awful sense of contrition and repentance seized Christians of every community. They resolved to forsake their vices, and to make rest.i.tution for past offenses; hence extreme religious fanaticism held full sway throughout Europe. The zeal of the penitents stopped at nothing. The so-called Brotherhood of the Cross, otherwise known as the Order of Flagellants, which had arisen in the thirteenth century, but was suppressed by the mandates and strenuous efforts of the Church, was revived during the plague, and numbers of these advocates of self-chastis.e.m.e.nt roamed through the various countries on their great pilgrimages. Their power increased to such an extent that the Church was in considerable danger, for these religious enthusiasts gained more credit among the people, and operated more strongly on their minds than the priests from whom they so entirely withdrew that they even absolved each other. Their strength grew with such rapidity, and their numbers increased to such an extent daily, that the State and the Church were forced to combine for their suppression. Degeneracy, however, soon crept in, crimes were committed, and they went beyond their strength in attempting the performance of miracles. One of the most fearful consequences of this frenzy was the persecution of the Jews. This alien race was given up to the merciless fury and cruelty of the populace.

The persecution of the Jews commenced in September and October, 1348, at Chillon on Lake Geneva, where criminal proceedings were inst.i.tuted against them on the mythic charge of poisoning the public wells. These persecuted people were summoned before sanguinary tribunals, beheaded and burned in the most fearful manner. At Strasburg 2000 Jews were burned alive in their own burial-ground, where a large scaffold had been erected, their wealth being divided among the people. In Mayence 12,000 Jews were said to have been put to a cruel death. At Eslingen the whole Jewish community burned themselves in their synagogue, and mothers were often seen throwing their children on the pile, to prevent them from being baptized, and then precipitating themselves into the flames. The cruel and avaricious desires of the monarchs against these thrifty and industrious people added fuel to the flames of the popular pa.s.sion, and even a fanatic zeal arose among the Jews to perish as martyrs to their ancient religion. When we sum up the actual effects as well as the after effects of the black death, we are appalled at the magnitude of such a calamity, the like of which the world had never seen before.