Printed in the "The Medical and Surgical Reporter", Volume 5 edited
by Harold Havelock Kynett, Samuel Worcester Butler, D G Brinton, 1861.
Champaign, Illinois, Jan. 25th, 1861.
Messrs. Editors:—I have a patient under my care of so peculiar a nature that I wish you would give my report of
it an insertion in your journal, hoping that the correct pathology will thereby be elicited.
The patient is a boy of now about fifteen years of age, of sanguine temperament, and of good muscular and osseous
development, equal to the majority of boys of that age. He had enjoyed good health until one year ago last July.
During one afternoon of that month, while sitting on a hay mower, driving the horses—the day being quite warm and
clear— he was suddenly noticed not to be conscious of what he was doing—unsteady in his movements. He was taken
to the house of his father, some forty rods off, where I first saw him. He was then unconscious, comatose legs
and arms occasionally cramping; pulse increased about ten beats in a minute, and rather full. Mustard was used
to the chest and spine (upper part,) cold to the head, and a brisk cathartic administered. He recovered in a day
or two; consciousness returned before the power of speech. He could write on a slate his wishes a few hours before
he could speak The same peculiarity was manifest in several attacks since.
After recovering from the first attack, he appeared in his usual health for about two months when he was seized
with another paroxysm and has occasionally suffered in that way up to this time, with no regularity however. Excitement
seems to favor the attacks. Some attacks are more severe than others, lasting from half an hour to twenty-four
hours. They are sometimes accompanied with cramps; he will sometimes gape and stretch. The pulse does not vary
from health, either in force or frequency; the surface remains of the ordinary temperature during the paroxysms.
He has no recollection of what occurs at the time of these attacks, or what he was doing immediately receding,
with the exception of the last but one; there is no discharge of urine during or after them ; sometimes he can
swallow, and at other times not.
During some of the attack, he is excited, and when any one goes near his bed, seems to wish to get away from them,
and refuses to take medicine or even water. He frequently will come out of this condition all at once, and call
for his pants or boots, or whatever he needs to finish his apparel, and go about as though nothing had happened.
There is no frothing at the mouth during any of these attacks. The last two attacks (with an intervening) were
brought on by some light blow, or dropping an empty basket on his head. The treatment has consisted of counter-irritants
to the upper portion of spine, back of the neck, and preparations of iron; lastly, hydrocyanate of iron. He is
not improving; and as his parents are much distressed about his condition, you and your readers will confer a favor
by rendering any suggestions as to pathology and treatment that you think judicious. I would say that his bowels
are regular, appetite good, but capricious. Just at this time he complains that one side of the left foot is somewhat
numb. This is a very recent symptom.
C. H. Mills, M. D.
Transcribed by K. Torp