Great restlessness and jactitation set in with the renewal of the circulation in the extremities. An enema of two ounces of strong beef-tea was administered at 10 P.M. The amount of organic effluvium thrown off by the lungs on the re-establishment of respiration was very great and tainted the atmosphere of the room and adjoining ward. The pupils, previously widely dilated, began to contract to light at 11 P.M. Imperfect consciousness returned at 5 P.M. the following day (Dec. 1), and about an hour later she vomited the contents of the stomach (bread, etc., taken on Nov. 30). Small quantities of beef-tea were given by the mouth during the night. At 9 A.M. air entered the lungs freely, and there were no symptoms of pulmonary engorgement beyond slight basic hypostasis; the pulse remained at 140, and the heart sounds reduplicated; she was semiconscious, very drowsy, in a state of mental torpor, with confused ideas when roused, and she complained of rheumatic-like pains all over her.
The temperature was 100.2°; the facial expression more natural; the tongue remained somewhat swollen and sore; she was no longer restless; she took tea, beef-tea, milk, etc., well; the functions of the secreting organs were being restored; she perspired freely; had micturated; the mucous membrane of the mouth was moist, and there was a tendency to tears without corresponding mental depression. The patient was ordered a mixture of ether and digitalis every four hours. On December 2 the pulse was 136, and the heart sounds reduplicated. The following day she was given bromide of potassium in place of the ether in the digitalis mixture. On the 4th the pulse was 126; reduplication gone. On the 6th the pulse was 82, and the temperature fell with the pulse rate. She was well enough to get into the ward for a few hours. Her memory, especially for recent events, was at that time greatly impaired. On the 12th she still complained of muscular pains like those of rheumatism. Apart from that, she was enjoying good bodily health.
A curious fact in connection with this case is that since this attempt at suicide she has steadily improved mentally, has lost her delusions, is cheerful, and employs herself usefully with her needle. She converses rationally, and tells me she recollects the impulse by which she was led to hang herself, and remembers the act of suspension; but from that time her memory is a blank, until two days subsequently, when her husband came to see her, and when she expressed great grief at having been guilty of such a deed. Her bodily health is now (June 30, 1884) more robust than formerly, and she is on the road to mental convalescence.