and as much easily digested food as the patient can be got to take is started die novo. The patient should pass through a stage of short convalescence and recover, mentally and physically. Case 1.?Gropal Govind Deshpande, Hindoo, Brahman, male, age 22, clerk in private service, admitted 011 27th November 1913. TWO CAUSES OF ANERGIC STUPOR Previous history.?Patient says that two years TREATED WITH " THYROID ago his head used to turn round." He never GLAND EXTRACT. fell down or became unconscious. He had con- tinued fever at this time and was delirious. By B. S. BHIDAY, About nine years ago he had a quarrel about his SUB-ASST. SURGN., ancestral property. Was addicted to ganja- till two not since then. Central Asylum, Yeravda. smoking years ago: Present condition.?Will sit for hours in one As it has been observed that some cases of position if not disturbed, when asked anything he anergic stupor and melancholia-make a rapid says he is tired of his life and begins to cry of acute recovery after an attack physical illness, aloud. Looks sullen and morose. Is dirty in his in his " and its e.cj.. erysipelas, Stoddart Mind habits. Does not take his food and does not sleep " Disorders recommends that an acute physical well. Hears men's and women's voices at night illness should be induced, and the illness that he which frighten him. selects for the purpose is hyperthyroidism. Two Superficial reflexes normal. Knee-jerk dimi- patients suffering from anergic stupor in the nished on both sides. No rigidity. Orientated Central Asylum, Yeravda, were selected for this for space not for time. Height 5' 4". Weight treatment and the following is a short summary 100 lbs. of what happened. 20th December 1913.?Lately made an attempt cases no of Unfortunately both showed signs to escape. Will speak a little more than at first. improvement at the end of the induced hyper- Habits clean. Weight 94 lbs. of the cases all thyroidism but aspects may not, 21st January 1914.?Very depressed still. Will be without interest to those the same, entirely hardly work and very rarely speaks. Weight the for them- who may like to try treatment 9G lbs. selves. 30th January 1914.?No change in mental con- Stoddart recommends the modus following dition. Always sits on the floor with his head to be observed : operandi drooping down. Is very depressed. Will not is to bed and treated for a The patient put or answer Heart normal. Weight in the speak questions. week with thyroid gland conveniently 98 lbs. Thyroid treatment commenced from tabloids. the course of the form of During to-day. Temperature, pulse, etc., as per chart = First day, he takes 30 grs. of gland 6 tabloids, 5 grs. eacb. enclosed. 40 ,, " 8 .. >> >? Second ,, ,, Absolute rest in bed. ? 5'J ? 10 ? ,, Tabloid Gland 5 Third ? ? Thyroid (gr. each). 60 ? >. 12 ? ? ? to tbe Fourth ? ? No. 6 be given during day. ,, 50 10 ,, ? .. Marked Gland Tabloids No. 8. Fifth ? 31st January 1911. Thyrdid >> o 40 ,, o ii Is Sixth ,, ? increase in pulse rate. ,, ?? 6 ,, ,, ? Seventh ,, ,, 30 otherwise the same. No. 10. 1st February 1914. Is the ,, ,, ,, same. at suitable intervals. The should be temperature '2nd February 1914. No change Thyroid Gland Tabloids No. 12. taken regularly and the pulse carefully watched. in mental condition. 2nd 6 P.M. Pulse R/ rises of are but February, 1914, Slight temperature unimportant, small and irregular, 116 per Liqr, Strychnin. Hydroeblor. of the pulse should be treated with minute. M. 15. irregularities 'l'inct. Digitalis M. 25. Patients with a small digitalis and strychnine. Aqua. Mentb. Pip. ad. ozs. 3 must be treated with smaller doses of the M. Ft. Mist. thyroid One ounce twice a day.

gland. is the Continue mixture. The loses 5 to lOlbs. in during 3rd February 1914. Pulse patient weight same. Thyroid Gland Tabloids No. 10. the treatment (in the two cases reported the loss 4th 1914. No improve- Continue mixture three times in was 6 and 7ilbs. February weight respectively). ment. a day. The mental condition may change for the Rum drachms 4 twice a day. Thyroid Gland Tabloids No. 8. but more often it the Pulse better ,, ,, No. 6. better during treatment, fith February 1914. ,, Towards the end of the week in volume, 108 per minute. Continue mixture, etc. deteriorates.& 6th 1914. Looks Omit rest in bed. ill. At the February all, except patient begins to look physically brighter than before. Wciglit 6 end of the week the ordinary treatment of 92 lbs. (Lost lbs.) 7th February 1914. Answers questions more Is not rest bed if quickly. melancholia, i.e., complete (in possible) so depressed as ho was before the thyroid treatment. 430 THE INDIAN MEDICAL GAZETTE. [Nov., 1914.

17th February 1914. Improvement in mental condition con- in the of these notes and his kind tinues. Does not droop down his neck as before. Weight preparation 99 lbs. permission to publish the same. 27th February 1914. Will not answer questions. Is returning to his former depressed state of mind. Yekavda. 10th March 1914. Is in the same depressed condition. 24th April 1914. A typical case of anergic stupor. Will not move except to go to the latrine. Case II.?Usmanbeg Chandbeg, Musalman, male, age 28, maker of fireworks, etc., admitted on 26th November 1913. Previous history.?No family history of in- sanity is known so far. Attributes his deranged mental condition to his late brother's indifference to his advice during his (brother's) illness, and his subsequent death, and also to quarrels between his late brother's two wives and children and himself. Suffered from gonorrhoea two years ago. Was addicted to alcohol, but has not taken it for the last two years. Present condition.?A stout plethoric man. Is morose in appearance and manners. Is quiet and apparently well behaved. He says that he hears Voices at times talking to him in English which he does not understand. Superficial reflexes exaggerated. Knee-jerk normal. No rigidity. Height 5' 41". Weight 146 lbs. 20th December 1913. Improving. Clean and quiet. Does no work, Weight 137 lbs. 21st January 1914. Slowly improving. Talks very reluctantly. Does practically nothing. Weight 139 lbs. 20th February 1914. In hospital with bubo r in the right groin, which has been opened and dressed. 3rd March 1914. Wound in the groin is heal- ing. Thyroid treatment commenced from to-day. Heart normal. Weight 136| lbs. Pulse, temper- ature, etc., as per chart enclosed. Absolute rest in bed. Thyroid Gland Tabloids No. 6. 4th March 1914. Is the same. ,, ,, ,, No. 8. 5th March 1914. Slight rise in ,, ? ,, No. 10. evening temperature and in- creased pulse-rate. 6th March 1914. No change. ,, ,? ,, No. 12. 7th March 1914. No change... ,, ,, ,, No. 10. p.m. F. ,, ? 5 Temp. 99*4 con- 8th March 1914. Mental ,, ,, ,, No. 8. dition is the same. 9th March 1914. Same. ... ,, ,, ,, No. 6. 10th March 1914. Same. Weight 129 lbs. (lost 7^ lbs.) 17th March 1914. Is the same. Weight 130 lbs. 20th March 1914. No change in mental condition. Says he will do any work to which he is put. 24th April 1914. Does a little work at cleaning up and sorting out grain for grinding. It will be seen from both the above cases that the thyroid treatment has failed to produce any acute physical illness and consequent change in the mental condition of the patients. The tabloids used were those of Messrs. Burroughs, Wellcome and Co., and it is believed that they were fresh. I am greatly indebted to Capt. O. A. R. Berke- ley-Hill, M.B., I,M.S., for the valuable instructions