picture of John Woodward Physician John Woodward (1665-1728) kept careful records of his patients. Below is a case history of one patient who suffered from a harm obsession.

Mrs. Holmes, London Bridge was born March 3, 1689-90, being one of two girls at that birth; the other died seven weeks after.... She was married January 20, 1712-13; has had three miscarriages, and two children born alive, but both since dead....

In May, 1716, looking out of a window, she observed a large porpoise, in the Thames; and was much delighted with the viewing of it. About a fortnight after, when she was gone about twenty weeks with child, and just quickened, she was suddenly invaded by a very great gnawing pain at the pit of her stomach.... followed, instantly, with a strong perplexing thought of the porpoise; and a fright, lest that should mark her child. She had not, till then, once thought of the porpoise since the time that she saw it, which was a fortnight before, when she saw it with pleasure. But the thought was now attended with dread, fright, and melancholy; and obtruded itself upon her, much to her surprise, teased, and put her into a disorder, so great as almost to distract her. Thus she continued till the time she was brought to bed, in October, 1716.... She frequently endeavoured to cast that thought out; and to introduce another, that might be more pleasing to her; in which she sometimes succeeded; but the new thought, however pleasant at first, became, in a little time, as troublesome and disturbing as that of the porpoise....

Upon her being brought to bed, the thought and the pain were, for three days, somewhat less troublesome; but afterwards various teasing thoughts, and many not rational, began to perplex her; and became more molesting than ever. Amongst others, she had thoughts of the devil, as tempting and vehemently urging of her to ill; particularly to fling her child into the fire, beat its brains out, and the like; to which she had the utmost horror and aversion; being naturally mild, good natured, and very virtuous....

She consulted me, November 6, 1716. I directed her an oily draught; and... purge... to be taken next morning; and a clyster, half an hour after it.... It worked plentifully, giving at least a dozen stools.... She had, after this, a better night than usual; and the next day the pain of her stomach was easier, and her thoughts not so unruly as before.... In the operation of the third purge, which was very plentiful, her stomach became wholly easy, her thoughts free, and what she calls the suggestions of the devil, wholly ceased. Nor has she perceived any thing more of that sort; but been lightsome, cheerful, easy, and well, ever since.

From John Woodward, Select cases, and consultations, in physick. By the late eminent John Woodward... Now first published by Dr. Peter Templeman (London: Davis & Reymers, 1757), 259-65; also excerpted in Richard Hunter & Ida Macalpine, eds., Three Hundred Years of Psychiatry, 1535-1860 (London: Oxford Univ. Press, 1963), 338-41.

NOTE: Psychiatrist Ian Osborn comments on Woodward's use of laxatives and enemas to treat this patient. Osborn writes:

[D]espite a good deal of insight into the psychology of obsessions, Dr. Woodward, when finally consulted, merely prescribed strong purgatives and enemas, which, he tells us, 'worked plentifully, giving at least a dozen stools.' He repeated this therapy a number of times, after which the intrusive thoughts disappeared and, Dr. Woodward assures us, Mrs. Holmes became 'cheerful, easy, and well.' (What cured the patient? Not the laxatives and enemas....) [Osborn, 1998, p. 224]


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