The following case is reported by Dr. John Keating, who watched it with care throughout: 

P.D., male, aet. 53, after more than thirty years of close attention to business, which severely tried both mental and physical endurance, found himself, in January, 1877, at the close of some months of gradually increasing feebleness, absolutely unable to fulfil his usual duties, and the most alarming symptoms manifested themselves.  There was a remarkable loss of nervous and muscular force; his limbs refused their support; his appetite failed; the recollection of ordinary phrases involved distinct and painful effort; sleep became unattainable, except under the influence of powerful narcotics, and even that brief slumber was rendered valueless by the incessant convulsive twitching of the muscles.

His physician prescribed iron and strychnia; ordered an immediate abandonment of all business, and instant departure to a point where telegraph-wires were unknown and mails infrequent.  He went at once to the Bahamas, passing a month in that delicious climate in absolute inaction; more than another month was consumed in slowly returning; but, though some flesh had been gained, there was only a trifling improvement in the nervous condition.

May 1, 1877, Dr. Mitchell examined Mr. P.D.  The patient was sallow and emaciated, and coughed every few moments.  He had night-sweats, nervous twitching, and slight dulness on percussion at the apex of the right lung, with prolonged expiration and roughened inspiration, and some increase of vocal resonance.

Mr. P.D. was allowed to be out of bed once a day four hours, and to spend one hour at his place of business.  The treatment was as follows: 

At 6 A.M., a tumbler of strong, hot beef-tea, made from the Australian extract.

At 8 A.M., half a tumbler of iron-water, and breakfast, consisting of fruit, steak, potatoes, coffee, and a goblet of milk.  At 8.30 A.M., a goblet of milk mixed with a dessertspoonful of Loefland’s extract of malt, with six grains of citrate of iron and quinine.

At 10 o’clock Dr. Keating administered the electricity.

At 12 o’clock Mr. P.D. might be dressed, making as little personal effort as possible.  The second goblet of milk and malt was administered, and a carriage took him to his office, where he might remain till two o’clock, when the carriage brought him for dinner, preceded by half a tumbler of iron-water.  All walking was forbidden.

After dinner (which included a goblet of milk) the third goblet of milk and malt was swallowed; then a short drive might be taken, but by four o’clock the patient must be undressed and in bed.

At 6 P.M. the third dose of iron-water presented itself, and a light supper of fruit, bread-and-butter, and cream, followed by the fourth goblet of milk and malt.  Two quarts of milk were thus swallowed every day in addition to all other food.

At 9 P.M., massage one hour, with cocoa-oil, followed by beef-soup, four ounces.