H., 28 years
of age, a robust brunette, with fully developed figure, without
any trace of anaemia or chlorosis, but with an apathetic
expression, bluish rings around the eyes, with hypochondriacal
and melancholy feelings. She complains of pressure on the head
("as if head would burst"), giddiness, ringing in the ears,
photopsia, hemicrania, pains in the back and at sacrum, and
symptoms of spinal adynamia, with a sense of fatigue on the least
exertion in walking or standing; she sways when standing with
closed eyes, tendon-reflexes exaggerated; there is a sense of
oppression, intercostal neuralgia, and all the signs of
neurasthenic dyspepsia; and cardialgia, nausea, flatulence,
meteorism, and alternate constipation and diarrhoea. She chiefly
complains of a feeling of weight and pain in the abdomen, caused
by the slightest movement, and of a form of pollution (with
clitoridian spasms), especially near menstruation, with copious
flow of mucus, characteristic pains, and hyperexcitability.
Menstruation was irregular and profuse. Examination showed tumid
and elongated nymphae, with brown pigmentation; rather large
vagina, with rudimentary hymen; and retroflexion of uterus.
After much persuasion the patient confessed that, when a girl of
12, and as the result of repeated attempts at coitus by a boy of
16, she had been impelled to frequent masturbation.
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