HIBEKNATION AND ALLIED STATES IN ANIMALS 97 



During the present attack she has fasted on several 

 occasions, and once went fifteen days without food. 



It must be remembered that the nurses were speaking 

 of the last attack, and at a time when the patient had 

 been in a state of lethargy for more than eleven years. 



In September 1890, I saw the patient with Dr 

 Clarke. This was my first, but Dr Clarke's second 

 visit. We found the patient, an old woman, in bed. 

 She was lying on her back with her eyes half closed. 

 Her face, when we first entered, was somewhat flushed 

 and respiration rapid. When respirations were closely 

 observed it was noticed that they were most irregular, 

 and at times ceased for several moments. They 

 averaged 22 per minute. Pulse was 104, fairly strong 

 and regular, arteries almost free from rigidity. Axillary 

 temperature 98f. The nurse stated that ordinarily 

 the patient's bowels moved but once in three days, but 

 latterly she had developed a tendency to diarrhoea, and 

 since that had evinced a sense of discomfort until the 

 bowels were relieved. This sense of discomfort was 

 evinced by whining like a dog. Ordinarily she would 

 not give any indication that she wished to relieve her- 

 self, but the presence of the bed-pan would excite the 

 reflexes. She does not soil the bed. The statement of 

 the nurse in regard to the amount of urine passed 

 every day was, that a little more than half a pint would 

 be a fair average. 



A physical examination of the patient was made. 

 The left foot was drawn as if there were a contracted 

 Tendo-Achillis ; right foot drawn down but not in such 

 a marked manner as the left. Marked rigidity of the 

 right knee and leg ; left leg and knee not rigid. Eight 

 ankle easily moved; left rigid. Patellar reflexes 

 absent. Tickling the soles of the feet did not cause 

 any evidence of sensibility. Each great toe was drawn 

 under the second toe, this condition being especially 



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