THE 
Condition of the Blood in Certain 
Mental States. 
BY 
S. G. WEBBER, M.D., 
BOSTON. 
Reprinted from the Boston Medical and Surgical Journal 
of March 24, 1892. 
DAMRELL & UPHAM, Publishers, 
BOSTON: 
283 Washington Street. 
1892. CONDITION OF THE BLOOD IN CERTAIN 
MENTAL STATES. 
BY S. G. WEBBER, M.D., BOSTON. 
The following cases of mental depression, of greater 
or less severity, in which the blood-corpuscles were 
counted, are of much interest. The patients 
were treated at the Adams Nervine Asylum. The 
first two cases were the severest, both were sent away 
on account of the amount of depression. In them the 
blood was poor in red corpuscles, which were also de- 
formed, resembling in this respect the blood of perni- 
cious anaemia. The other cases were less serious and 
the blood was in a more healthy condition, yet not 
quite up to the normal standard, except in two cases 
of dyspepsia. 
It may be a question as to how much the mental 
depression affected the blood, or whether the poor 
blood was one factor in causing the depression. I be- 
lieve the latter is the correct statement of the sequence 
of events. 
Case I. Miss C. E., age thirty-eight, was at one 
time melancholic, with suicidal tendency. The family 
history is bad nervously, there being insanity and 
eccentricity in the family. The patient has been some- 
what depressed for a year, and more or less low- 
spirited. She had been subject to sick-headaches, less 
lately than when younger; these continued one or two 
days with nausea and vomiting. She has had pain in 
her back and abnormal sensations in her legs. Hands 
and feet were habitually cold. She had a *• thumping 4 
and beating " in her head, tinnitus aurium ; did not 
hear voices. She had attacks during which she cried 
and lay awake nights crying. There were no objec- 
tive symptoms except a great degree of pallor, lips and 
tongue as well as skin showing anaemia. 
The blood was examined, and there 
was found a diminution of the red cor- 
puscles, 4,190,000; a very large num- 
ber were misshaped, being elongated, 
budded and without concavity. 
Valerianate of zinc, iron, and quinine was given, also 
arsenic; she had massage, and attention was paid to 
diet and the digestive organs, moderate exercise and 
as much out-door life as possible. 
After five months the patient had gained in flesh, 
color and spirits. The blood was again examined and 
showed 4.790,000 red and 10,000 white corpuscles; 
the deformed corpuscles were very rare, only a few 
being seen. 
The patient was much disturbed by the prospect of 
leaving, uncertain as to her future, feeling that she 
ought to take up the duties of life again and yet con- 
scious that she was not able so to do. A visit from a 
relative, who talked with her on these subjects dis- 
turbed her, and she left in a much less cheerful dispo- 
sition, tearful and despondent. 
Case II. Mrs. N. S. R., was forty-four years old 
when received. She had been ailing many years, 
had never been strong. She had no living children ; 
one child was born at seven months; had one mis- 
carriage twelve months before entrance. Her physi- 
cian told her the cause was the low state of her blood. 
She did not get up well after the miscarriage; the 
catamenia appeared six weeks after with much more 
pain than on previous occasions. Five years ago her 5 
left leg became weak, and there was pain in that limb 
if she hit her toes while walking. Two years ago the 
right leg began to trouble her in the same way. She 
formerly had sick-headaches, but not for some years 
lately. 
Her parents were subject to sick-headaches. Her 
father's family were consumptive ; of eleven only three 
lived to be thirty-seven years old. Father's parents 
had headache and neuralgia. 
On admission the patient complains of weakness in 
the legs, with tingling and prickling, not much pain. 
Sometimes she has backache. She has a fair appetite ; 
does not sleep well. She is low-spirited and despond- 
ent. She is not kept awake at night by pain, but by 
" thinking to no purpose." 
The pupils and eyes acted naturally ; the tongue was 
protruded straight, was fissured and flabby. Sensa- 
tion was natural and equal in the limbs; motion was 
not impaired. The patellar tendon reflex was normal ; 
there was no ankle clonus, there was no tremor of the 
hands; there was a slight degree of tenderness in 
each groin, rather more on the right, also slight ten- 
derness on each side over the sciatic nerves, the crests 
of the ilia and the sacro-iliac synchrondrosis. There 
was no spinal tenderness. Pulse was 76, a faint mur- 
mur at the apex with the first sound. The patient 
was pale, anaemic in appearance, seemed to have little 
or no spirit nor ambition. 
Subsequently the blood corpuscles were examined. 
There were found to be 4,625,000 red corpuscles; 
15,000 white corpuscles. Some of the red were mis- 
shapen, being budded, having an elongated shape with- 
out concavity. The number of these deformed corpuscles 
were much fewer than in the previous case. 
Under tonics, generous feeding, rest, she gained in 
flesh, slept better and improved in many ways; at 6 
times she was much less despondent, but the gain in 
cheerfulness was not permanent. 
Case TIL Miss F., age forty-two, was never strong ; 
her family history is not good. Her father died in- 
sane, her mother is queer, for years she has not seen 
any one but cousins, and is weak mentally ; one brother 
has an unbalanced mind and is " queer." The patient 
began to run down when about thirty-three, taking 
care of her mother. She complained of pain in her 
legs, abdomen, back and head, sometimes all over. 
Frequently purpuric spots appear on different parts of 
the body, especially the legs, during attacks of pain, 
also on the arms and shoulders. 
Mentally the patient is peculiar. She craves atten- 
tion, is rather inclined to be jealous if others seem to 
have more attention than herself. At home she taxed 
the household to wait on her. If she is not humored 
she lies abed and complains of pain, of weakness. It 
was a constant contest to get her up and to keep her 
about after it was evident that she needed to exert 
herself. She was at times moody, sulky, and had cry- 
ing spells. She gained much in cheerfulness and in 
strength, the purpuric spots appeared less frequently, 
she was evidently much better until it was time for her 
to go home when she cried much, was less cheerful, 
had a diarrhoea and sore throat. 
The first count of blood was made about a month 
after entrance, 4,920,000 red, the white at, or just 
below, the normal. The second count was made about 
four months later, 4,128,000 red, 20,009 white. 
Case IV. Miss B., age twenty-five, was never 
strong, always nervous; probably overstudied in the 
high school; was obliged to give up studying. She 
had insomnia, a disagreeable feeling of heaviness in 7 
the back of her neck. She became despondent and 
lost her interest in things about her. She had no 
headache, but a sense of weight on the top of her 
head, she felt like screaming. 
She was said to be naturally of a quiet, rather taciturn 
disposition : while at the asylum she preferred to lie 
out doors, to be by herself, did not voluntarily take 
part in conversation, but answered when spoken to ; 
her memory was not good, she was negligent in regard 
to dress. She ate well; slept poorly, though proba- 
bly more than she thought she did. 
Her blood was not examined till she had been there 
some weeks. There were 3,880,000 red, 20,000 white 
corpuscles. A few of the red were crenated, a very 
few were irregular in shape ; there were very many 
small globules or spheroids. 
She improved somewhat and subsequently a trip by 
water to a warmer climate seemed to be of benefit. 
Case V. Mrs. A., age thirty-five, has been ailing 
for four or five years, had been running down in health 
for a year when her five children had whooping-cough. 
For three years or more she has been having nervous 
feelings, trouble in her head, tinnitus, backache in the 
lower lumbar region. At times she says she seems to 
take no pleasure in life, everything seems a burden to 
her. She is troubled much with low spirits. She has 
slept poorly. She showed very little of this depres- 
sion and after three weeks, on account of a child's ill- 
ness, she left much improved in spirits. 
After eighteen months she returned very tired and 
with many of the old symptoms. In the interval she 
was much of the time better than previous to her first 
entrance. Red corpuscles 4,380,000, white corpuscles 
10,000. 
In two other cases of dyspepsia with much nervous 8 
disturbance, but with less depression of spirits than in 
those just reported, and no other special mental dis- 
turbance, a count of the blood gave, in one case, 
5,260,000 red and the white below normal, and both 
red and white rather small in size. The other case 
gave 5,080,000 red, 30,000 white, a very few of the 
red showed budded processes. In some cases of simple 
nervous exhaustion or of headache I have found no 
change in the condition of the blood as shown by the 
numbers and shape of the corpuscles.