INDIAN MEDICAL GAZETTE.
432
DIURNAL VOMITING. To the Editor,
"
Indian Medical (xAzette.
'
Sir. ?After perusing that very interesting article on " Diurnal Vomiting." by James R. Wallace, M.D.. in the Indian Medical Record of the 16th instant, I was not a little surprised owing to the strange coincidence between the one described therein and the one I have had on hand practice I do not care lately in the course of my privatethe case verbatim from to trouble you with my notes of is not the least stiade of difference in my case book, as there the history of the two cases, but you may reckon upon the following as an extract of the case, aud you have my full consent to publish it if you please. My patient is a strong, affluence, and like others of her plethoric, native woman in two to only meals, the first at 12 noon class and the second and last at 7 P.M., in the night. It is now about 18 years since she was married, but never anxious on that score. became a mother, though very She is a women of nervous temperament, and is one of a neurotic family. Her only brother has early shown signs of insanity, aud epilepsy developed of late in her sister. She is climacteric and her periods" have now bordering on her been very irregular since of late. husband was forced by his relaAs she was barren, her tions to form another fruitful connection to raise issues for four years ago when my patient his property. This happened Ere long vomiting superfirst showed signs of dyspepsia. effort she continued to throw up vened, and in spite of every at 8 P.M. without any effort on her night meals precisely of any feeling of discomfort her part, nor did she complain She said she could even stomach '? pillau." durin^ the act. it had if formed part of her day the dainty of Mussalmans not be retained if it was meal, but even plain milk could Her constitution did not in the taken at or before 8 P.M. least suffer in spite of this nocturnal vomiting. When first she placed herself under my treatment in April 1892. she was, to alla appearance, in good health for a first rate health. Emission of native woman?hers was her ni?-ht meal was the only complaint she suffered from.? she vomited so regularly every night that I could positively have been eight by the clock. Her thoracic say that it must abdominal organs were normal, her appetite was good,
was'accustomed
"
and and the bowels regular. Beyond menShe never suffered from malarious fever. tal depression for her barren state, there was nothing to
I turned over to the brain as the seat of mischief. all the authoritative books on medicine and therapeutics, and dosed her with all the drugs mentioned therein, but to After perusing: the notes of the case described no avail. in the Indian Medical Record and that of mine own, I am obliged to infer that this complaint, at the onset, is but a disturbed state of mind, and is neurotic in symptom of a nature. When once the stomach is set in motion from some disturbing cause or other it begins to act of itself like the clock A habit of vomiting like the habit pendulum of asa iu the case of th^ uterus is thus induced of abortion, which it is difficult if not impossible by any means to overcause be removed or wears come till the primary exciting My patieuo was well-nigh getting tired of out of itself. when at least I hit up >n arsenic as a weapon my treatment, of dernier resort to combat the trouble. I commenced to give her, just On the first of June 1892, doses of the Fowler's solution of after meals. 5 minimum arsenic in a little chloroform water. Within a fortnight of vomit on alternate days. A this treatment she ceased to under arsenic treatment a curious day or two later while turned the tide of fortune little accident befel her which tenant of hers on a cerentirely in her favour. A drunken tain morning at about 3 A M.. after having been to the backnature went to bed with her, yard to answer the calls of The sore-tronbled lady mistaking her bed-room for his own. that part of the night for a child, half-drowsy as she was at welcomed thu intruder, mistaking him for her husband and regarded the act of prevailing on her as a piece of favour extended to her by her lord since his second marriage. At dawn of day both the parties soon found their ^mistake, in consequence of which she proved with child. Since that memorable day up to this present hour even she never showed a single symptom of any trouble either mental or " *' bodily. Shedid not expjrieuce even the morning sickness of pregnancy, and went through her labour and puerperism
point
easy
enough.
?-/.
[Dec.
1893.
Her huabanl. knowing as be did tbat be bad nothing to do with her since his s;c>nd marriage, couvened a meeting of bis relatives and gave her to understand tbat she was from the society of Fallen though she be outlasted. friends and relations she is still happy in her own way in the p >ssession ot' a live male child. Wnen the question of settling my fee arose, it transpired from the lip of this crest-fallen lady tbat my treatment was of no avail to her. and that all the benefit she derived was all owing to the little accident above narrated. In my opinion arsenic if continued for some time longer would have completely cured the symptom by itself without the intervention of the little accideut, but as the case stands I make a present of the difficulty to the many readers of your much esteemed journal to solve.
Dachepalle, October 30th, 1893.
T.
E'GAPPA,
l.m.S.
Medical Officer, Dacliepalle.
432
DIURNAL VOMITING. To the Editor,
"
Indian Medical (xAzette.
'
Sir. ?After perusing that very interesting article on " Diurnal Vomiting." by James R. Wallace, M.D.. in the Indian Medical Record of the 16th instant, I was not a little surprised owing to the strange coincidence between the one described therein and the one I have had on hand practice I do not care lately in the course of my privatethe case verbatim from to trouble you with my notes of is not the least stiade of difference in my case book, as there the history of the two cases, but you may reckon upon the following as an extract of the case, aud you have my full consent to publish it if you please. My patient is a strong, affluence, and like others of her plethoric, native woman in two to only meals, the first at 12 noon class and the second and last at 7 P.M., in the night. It is now about 18 years since she was married, but never anxious on that score. became a mother, though very She is a women of nervous temperament, and is one of a neurotic family. Her only brother has early shown signs of insanity, aud epilepsy developed of late in her sister. She is climacteric and her periods" have now bordering on her been very irregular since of late. husband was forced by his relaAs she was barren, her tions to form another fruitful connection to raise issues for four years ago when my patient his property. This happened Ere long vomiting superfirst showed signs of dyspepsia. effort she continued to throw up vened, and in spite of every at 8 P.M. without any effort on her night meals precisely of any feeling of discomfort her part, nor did she complain She said she could even stomach '? pillau." durin^ the act. it had if formed part of her day the dainty of Mussalmans not be retained if it was meal, but even plain milk could Her constitution did not in the taken at or before 8 P.M. least suffer in spite of this nocturnal vomiting. When first she placed herself under my treatment in April 1892. she was, to alla appearance, in good health for a first rate health. Emission of native woman?hers was her ni?-ht meal was the only complaint she suffered from.? she vomited so regularly every night that I could positively have been eight by the clock. Her thoracic say that it must abdominal organs were normal, her appetite was good,
was'accustomed
"
and and the bowels regular. Beyond menShe never suffered from malarious fever. tal depression for her barren state, there was nothing to
I turned over to the brain as the seat of mischief. all the authoritative books on medicine and therapeutics, and dosed her with all the drugs mentioned therein, but to After perusing: the notes of the case described no avail. in the Indian Medical Record and that of mine own, I am obliged to infer that this complaint, at the onset, is but a disturbed state of mind, and is neurotic in symptom of a nature. When once the stomach is set in motion from some disturbing cause or other it begins to act of itself like the clock A habit of vomiting like the habit pendulum of asa iu the case of th^ uterus is thus induced of abortion, which it is difficult if not impossible by any means to overcause be removed or wears come till the primary exciting My patieuo was well-nigh getting tired of out of itself. when at least I hit up >n arsenic as a weapon my treatment, of dernier resort to combat the trouble. I commenced to give her, just On the first of June 1892, doses of the Fowler's solution of after meals. 5 minimum arsenic in a little chloroform water. Within a fortnight of vomit on alternate days. A this treatment she ceased to under arsenic treatment a curious day or two later while turned the tide of fortune little accident befel her which tenant of hers on a cerentirely in her favour. A drunken tain morning at about 3 A M.. after having been to the backnature went to bed with her, yard to answer the calls of The sore-tronbled lady mistaking her bed-room for his own. that part of the night for a child, half-drowsy as she was at welcomed thu intruder, mistaking him for her husband and regarded the act of prevailing on her as a piece of favour extended to her by her lord since his second marriage. At dawn of day both the parties soon found their ^mistake, in consequence of which she proved with child. Since that memorable day up to this present hour even she never showed a single symptom of any trouble either mental or " *' bodily. Shedid not expjrieuce even the morning sickness of pregnancy, and went through her labour and puerperism
point
easy
enough.
?-/.
[Dec.
1893.
Her huabanl. knowing as be did tbat be bad nothing to do with her since his s;c>nd marriage, couvened a meeting of bis relatives and gave her to understand tbat she was from the society of Fallen though she be outlasted. friends and relations she is still happy in her own way in the p >ssession ot' a live male child. Wnen the question of settling my fee arose, it transpired from the lip of this crest-fallen lady tbat my treatment was of no avail to her. and that all the benefit she derived was all owing to the little accident above narrated. In my opinion arsenic if continued for some time longer would have completely cured the symptom by itself without the intervention of the little accideut, but as the case stands I make a present of the difficulty to the many readers of your much esteemed journal to solve.
Dachepalle, October 30th, 1893.
T.
E'GAPPA,
l.m.S.
Medical Officer, Dacliepalle.
