HlBBËNATlON, ETC., m ANIMALS. S9 



On October 9th, 1890, the patieut came under Dr. Clarke's care, and a series of obser- 

 vations of the most complete chai'acter was made. 



The patient, a thin old woman, apparently not weighing more than sixty pounds, 

 was carried into the infirmary from the ambulance, and placed in bed. She was asleep 

 and did not seem disturbed by the jolting to which she had been subjected. Her tempera- 

 ture was 971°, pulse 107, and respirations 20. Efforts were made to arouse her, but with- 

 out avail. Friends stated that she had been in her present state of lethargy for more 

 than eleven years. 



Her eyes were half closed, and it was found almost impossible to get her to swallow 

 anything. Next morning her temperature was about normal ; pulse 117, respiration 18 ; 

 still asleep with the eyes half closed, as she remained nearly the whole time she lived. 



She was \inder observation from October, 1890, until February, 1891, when she died. 

 In these four months she was closely watched, and until the last week of her life gave 

 little indication that she had the slightest knowledge of the fact that she lived. 



She would remain in any position in which she was placed in bed, and if not fed, 

 would undoubtedly have died without making any sign that she required or desired food. 

 Her temperature was almost invariably subnormal, sometimes falling to 95", although 

 occasionally it would rise to nearly 102 , without any cause that could be determined. 

 Her appetite was capricious, although she undoubtedly had decided likes and dislikes in 

 regard to food. She preferred beef and potatoes to anything else. The process of eating 

 was very slow, and sometimes it would be more than an hour before she could finish a 

 meal. When she drank anything, milk was evidently preferred. She was very clean in 

 her personal habits, and never soiled the bed. 



The quantity of urine passed was very small, not averaging more than one-seventh 

 of normal. The bowels moved but seldom, sometimes only once in six or seven days. It 

 was possible to rouse her for a moment or so, to the extent of making her open her eyes, 

 but beyond this she would give no indication of consciousness, and went to sleep again 

 immediately. Her legs were nearly always drawn up, although when the patient 

 was admitted it was stated that she always straightened her legs at night. Her feet 

 were almost invariably very cold, and the hands sometimes so. Occasionally her eye- 

 lids would tremble and quiver, just as they will in a patient suffering from hysteria. 

 Generally when much bothered, she would ibr a few moments make a sort of whining 

 protest. 



The facial expression was quiet, almost deathlike, under ordinary circumstances, but 

 sometimes when undergoing examination, an expression suggestive of pain would appear ; 

 at th^ame time it is questionable if pain was really experienced, as the heart and respir- 

 ations did not show the least disturbance. 



A large amount of food for one so frail was consumed in a day, although on some 

 occasions the appetite was completely lost. Sometimes when suddenly disturbed she 

 would start nervously, and her hands would tremble. Trained nurse Osborne, who was 

 with her very constantly, seemed to think that there were times when she was nearer a 

 condition of consciousness than at others, and as this statement was also made by the 

 former nurses, possibly it is correct. 



Occasionally she would push down the bed clothes with her hands, and the history 

 of the case would go to show that heavy coverings were always objectionable. 



