HYSTERICAL CONVULSIONS AND HEMI-ANAESTHESIA IN AN 
ADULT MALE : CURE BY METALLO-THERAPY (GOLD). 
E. C. SEGUIN, M.D. 
Examples of hysterical convulsions in the male sex are rather 
frequent in youth and boyhood, but after twenty they become so 
rare as to be worthy of record. Still more unusual is it (in this 
country at least) for hemi-ansesthesia to follow the succession of 
convulsions. For these reasons, and because the case presents 
points of interest as regards diagnosis and therapeutics, I desire 
to place it before the readers of the Archives. 
James A., 21 years old, single, and a laborer by occupation, was 
brought to the Manhattan Eye and Ear Hospital by Dr. Smith of 
Newtown, Ct., for the diagnosis and treatment of an alarming set 
of nervous symptoms ; briefly summed up as convulsions, extreme 
staggering, left-sided hemi-ansesthesia. 
History.—A year ago the patient fell from the upper platform 
of a freight car, a distance of at least ten feet, striking the ground 
upon the back of his head. He thinks that he was unconscious 
for a few moments, but did not vomit. Remained well after this 
fall until some six weeks ago. Denies sexual excesses or irregu- 
larities. At that time, some six weeks ago, he had an ill-defined ill- 
ness—apparently a severe “ cold,” characterized chiefly by pains 
all over his body, in the muscles mostly. Thinks that he had no 
fever (locality is malarious, however), and is positive that he had 
no articular swelling or sore throat. The account of the order of 
appearance of the nervous symptoms is obscure, as Dr. Smith did 
not see patient until two weeks ago. Then had already had 
several “ fits,” apparently of an epileptic nature ; he was not 
paralyzed, but exhibited complete insensibility to pricking on the 
left side of his head, face, tongue, and body. He also staggered 
somewhat. He complained of headache, near the vertex, and 
over the right parietal region. Convulsions occurred every night; 
and one night about ten days ago there were several, which were 
witnessed by Dr. Smith. In these attacks the patient was stiff; 
eyes closed, showing, when the lids were raised, normal pupils ; 
Reprinted from the Archives of Medicine, vol. viii, No. 2, Oct., 1882. 2 
ARCHIVES OF MEDICINE. 
the respiration was slow and gasping ; the spasm was only tonic, 
and lasted, quite certainly, not less than three minutes. There 
was no frothing of the mouth, or subsequent drowsiness. The 
patient claimed not to know any thing of these seizures. Attacks 
occurred yesterday. A friend of the patient describes attacks 
lasting an hour and a half. The staggering gradually increased 
during the fortnight of observation ; clear (colorless ?) urine was 
often voided ; no globus or emotional seizures. Has seemed 
rather obtuse or stupid. Much bromide of potassium has been 
administered ; at first he had forty grains (2.75 grammes) every 
four hours, and later every two hours, and less often. Altogether, 
has taken about 45 grammes ( § jss) in ten days. 
Examination.—Patient is an average, dull-looking Irishman, gen- 
erally pale, and with the neurotic white circle about his mouth 
strongly marked. Comes into the room supported by two per- 
sons ; staggers preposterously ; when not supported plunges off to 
one side or the other. No paralysis ; sees and hears well (to 
simple tests). Pupils normal. Left side of body, face, and 
tongue presents complete analgesia. Ends of fingers are a little 
sensitive to deep pricking (only in last two or three days). The 
various modes of sensibility and the special senses were not criti- 
cally studied, because we purposed doing this on another day. 
To watch-test and to ordinary objects there was no deafness or 
blindness of the left ear and eye. An interesting experiment was 
made upon the patient as regards his equilibrium. I placed him 
in the middle of the room, loosened his friend’s hold of his arm, 
and told him to look up at the ceiling and try to see certain fine 
marks upon it. Thinking that I was testing his eyesight, he strongly 
directed his attention that way and stood perfectly well, without a 
trace of his staggering ; which, however, returned the moment that 
the test was over and he was told to stand alone—that he could 
not do (while thinking of it). 
Without saying anything to the patient or to the physicians and 
students standing by, I applied two twenty-dollar gold pieces to 
the patient’s left hand, and afterward to his forearm, cheek, and 
tongue. I most positively said or did nothing which could sug- 
gest any thing to him. He could not tell whether I meant this as 
a continuation of the examination, or as a remedial measure ; he 
looked and spoke as if he thought I was amusing myself in apply- 
ing the gold. 
In a few moments, one to three minutes, sensibility returned in 
■each spot where the metal had been laid ; completely so in the ORIGINAL OBSERVATIONS. 
3 
tongue, and partially in the cheek, forearm, and hand. The 
patient was amazed. I ordered a capsule containing .30 of 
citrate of iron and quinine and .01 of extract of nux vomica to 
be taken four times a day. 
The next day, September 21st, the patient was examined by my 
colleague, Dr. W. R. Birdsall, who found him nearly free from 
staggering; pricking with a needle was felt a little less than nor- 
mally on the left face, quite normally on the left arm and hand. 
On the left leg (not yet treated) pricking was somewhat felt, but 
simple touch was not perceived. A belt of gold plates was applied 
round about the calf for ten minutes, when sensibility was found 
to be restored, not simply where the plates had been laid, but 
throughout the extremity. On neither day was any phenomenon 
of “transfer ” observed. 
On Sept. 23d patient, claiming to be perfectly well, left the 
hospital contrary to my request. 
The diagnosis of the case presented but slight difficulties, in 
spite of its extreme rarity. The staggering was evidently over- 
done, or at least greater than in any organic or functional cere- 
bral disease known to me ; and it was made to cease by diverting 
the patient’s attention in an interesting manner. The convulsions 
were too long to be any thing but hysterical, and the state of the 
pupils indicated the non-epileptic nature of the seizures. The 
continuation of the symptoms—nay, their aggravation—under 
severe bromide treatment was in accordance with my own experi- 
ence in hysterical cases. 
The brilliant success of metallo-therapy in this case is interest- 
ing and very puzzling. I believe that every physician present 
when the gold was first applied, will agree with my statement that 
there was no sort of suggestion made to the patient—nothing was 
said until after the patient himself looked up in amazement at the 
restoration of sensibility to his hand and tongue. 
It might be added that in the last two years I have had several 
successful cases of metallo-therapy in my practice—all of them 
reactions to gold. One of the most striking was that of a girl 
aged about sixteen, showing decided chloro-ansemia, but free from 
hysterical symptoms except analgesia of the whole left upper ex- 
tremity, and the neurotic white circle about the mouth. In this 
case an elongated oval area on the extensor surface of the fore- 
arm remained analgesic in spite of several short applications of 
the gold, but yielded to their continued contact for twenty-four 
hours. g. p. putnam’s sons, printers, 27 it 29 west 23D street, new york.