Two Cases of Acute Mania

Brief case reports from Middletown State Homeopathic Hospital at Middletown, N.Y.   Jan. 1895

Female, admitted January 4, 1894, age 40, married, native of Poland. Occupation, none, religion, unknown, education, unknown, temperate.  Diagnosis: mania, acute.

Medical certificate states that “She is destructive and excitable. Unfruitful marriage for a number of years, and now believes she is pregnant. Said she had been married sixteen years to J. P., and had no children. Four months ago she met J. G., and now claims she is pregnant, and is very happy. Talks in a rambling manner, looks wild and excitable. About ten o’clock at night she disrobed herself, tore her chemise to pieces, pulled the bedclothes off other women occupying the same room, and swore at them.”

On admission patient said that she was five months pregnant with “Jesus Christ baby.” Abdomen is rather large, but she increases its size by the way she stands. She also pins cloth around her to make her look larger. Vaginal examination did not reveal any enlargement of the uterus.  In fact, cervix is smaller than normal. Patient is very demonstrative; kept kissing my band, and kneeling to me; crosses herself, and with significant gestures toward her abdomen said: “ Miss Doctor, in four months you bring the baby and I give you money, for I have much gold.”

January 10th, steals everything she can get hold of.  26th, acting badly, wont keep her clothes on; she has pain in her stomach. February, same delusions. March 6th, abdomen enormously bloated. 7th, abdomen still much swollen; limbs are oedematous.

25th, much improved mentally; is quiet, orderly and neat.

April, doing very well mentally; suffers some with toothache; has Herpes Zoster.

May, improving from day to day; eats and sleeps well; quiet and well behaved. June, greatly improved; sews and conducts herself rationally; is pleasant, and says nothing about her former delusions.

July, is quiet and well-behaved. Patient continued to do well and was discharged recovered September 27, 1894. Diagnosis: mania, acute.

Remedies:  Hyos,  Nux,  Lycopod,  Kali Ferr , Rhus,  Ars,  Merc. viv, Colocynth

 Case 2

Male, admitted August 25, 1892. Age, 37, single, native of United States. occupation, farmer; habits, intemperate, father was insane, first attack, duration of  attack, three weeks.

Diagnosis, mania, acute

Certificate of insanity states that he had threatened to kill those about him; wanders about the house at night watching for robbers; imagines robbers are in the house; would break  into the rooms of different members of the family. Says that “niggers and strange men are trying to get into the place.”  At times is very depressed; at other times very excited.  On admission temperature, 99f , pulse 100, pupils widely  dilated, heart’s action weak and irregular; face changes from one expression to another, representing fear, anger, anguish, etc

Gesticulates violently when talking; throws himself about the bed; very weak; all his symptoms are worse at night. August 26th, passed urine in his bed during night; said he was in a great many different beds during the night; slept all night;  pulse, 108; temperature, 100.  27^th:  stronger; eating fairly well; liquid nourishment.

30^th: pulse. 108; temperature, 99f ; frontal headache, very restless, language  incoherent “ Lizzie expected to see you here. Did you drive into the town, doctor?” Mistakes the identity of those about him.

31st : mumbling incoherently; very restless; slips  down in bed.

September 1st: very restless and tremulous.  3^rd: : temperature, 99 ; pulse, 96, weak  respiration, 24.  “Now let that woman go home about her business, and let me  alone . I want to see that woman go to the bottom of the sea.”  Hallucinations of sight and hearing.  5 th: “ I have not had anything to eat since the milk train left last night.” Says they do not give him anything to eat; temperature, 100; pulse, 108;  respiration, 32.

Continues in about this condition until September 17th, when he became more excited, very apprehensive and fearful of his life. “They all cry down on. Shoot him ! Kill him 1 Kill .” Hears voices come through the steam radiator plotting to kill him.

This condition continued until September twenty-first, with high temperature and  pulse, when the voices almost ceased. Said he felt scared, but could not tell why. Still very restless and depressed. Continues to improve from this time, and on October 7th was up and dressed, free from hallucinations, eating and sleeping well.  October tenth, doing well. Walks about the ward; says he has a distinct recollection of coming to the institution, but no recollection of anything else since, until he came to himself a few days ago. Had no recollection of friends visiting him.

Continued to improve, and was discharged May 28th  recovered. He weighed when discharged 156 pounds, an increase of twenty-one pounds.

Remedies:  Nux Vom,  Stramonium,  Belladonna,  Cannabis Indica, and Ignatia 

(From:  Annual report of the managers of the Middletown State Homeopathic Hospital at Middletown, N.Y. to the State Commission in Lunacy)