“Early in August I was asked to see a lady, aged thirty-seven, with the following history:—­’As a girl of sixteen she had a severe neuralgic illness, extending over months:  excepting that, she seems to have enjoyed good health until her marriage.  Soon after this she had a miscarriage, and then two subsequent pregnancies, accompanied by albuminuria and the birth of dead children.’  ’During gestation I was not surprised at all sorts of nervous affections, attributing them to uraemia.’  The next pregnancy terminated in the birth of a living daughter, now nearly three years old; during it she had ’curious nervous symptoms,—­e.g., her bed flying away with her, temporary blindness, and vaso-motor disturbances.’  Subsequently she had several severe shocks from the death of near relatives, and gradually fell into the condition in which she was when I was consulted.  This is difficult to describe, but it was one of confirmed illness of a marked neurotic type.  Among other phenomena she had frequently-recurring attacks of fainting.  ’These were not attacks of syncope, but of such general derangement of the balance of the circulation that cerebration was interfered with.  She was deaf and blind; her face often flushed, sometimes deadly cold; her hands clay-cold, often blue, and difficult to warm with the most vigorous friction.  These attacks passed off in from twenty minutes to a couple of hours.’  Soon ’the attacks became more frequent, with the reappearance of another old symptom,—­acute tenderness of the spine, especially over the sacrum.  Then came frequent and persistent attacks of sciatica, and gradual loss of strength.’  About this time there appears to have been some uterine lesion, for a well-known gynaecologist went down to the country to see her.  Eventually ’she became unable to do anything almost for herself, for the nervous irritability had distressingly increased.  To touch her bed, the ringing of a bell, sometimes the sound of a voice, sunlight, &c., affected her so as to make her almost cry out.’  ’If she stood up, or even raised her hands to dress her hair, they immediately became blue and deadly cold, and she was done for.’  Then followed palpitations of a distressing character, with loud blowing murmur, and pulse of 120 to 140, for which she was seen by an eminent physician, who diagnosed them to be caused by ’slight ventricular asynchronism, with atonic condition of the cardiac as well as of all other muscles of the body.’  ‘She has no appetite whatever.’  ’Any attempt at walking brings on sciatica.  She cannot sit, because the tip of the spine is so sensitive; any pressure on it makes her feel faint.  She cannot go in a carriage, because it jars every nerve in her body.  She cannot lie on her back, because her whole spine is so tender.’