The patient, aged 25, was a neurotic female. She has had scarlet fever, and had studied diligently for proficiency upon the piano from early life, and was subject to severe headaches since menses were established at 15. Her father died of tuberculosis; mother, of cancer of uterus. A sister had chorea; two sisters were exceedingly irritable.
She came under observation Jan. 14, 1902, complaining of gastric disturbances, headaches, languidness and general malaise. In about a week she said she was all right in regard to previous trouble, but complained of strange noises and delusions. She seemed conscious of these troubles and said she tried to avoid them, but found it impossible. She appeared then to be a neurasthenic of pronounced type. At that time her sister was told of the possibility of acute melancholia developing, which derangement occurred one week later. At the time of the melancholia developing, care was