228 A. The next case is taken from an article entitled "Duplex Personality: Report of a Case," by William F. Drewry, M.D., of Petersburg, Virginia, U.S.A., in the Medico- Legal Journal for June 1896: -

The following case, which came under my observation within the past year, and the details of which were kindly given me by an eminent practitioner of Virginia,1 who was the family physician of the patient, typifies the peculiar phases of duplex personality and periodic extinction of memory, and is interesting from a psychologic, as well as clinical point of view. It is also of interest as regards forensic medicine.

Mr. K. was a man fifty years old, of splendid physique, in good health, in fairly comfortable circumstances, doing a mercantile business, sober, moral and industrious, of affable disposition, popular with a large circle of friends, member of several secret benevolent orders, and happy and contented in his domestic relations. He was born and reared in the State; had resided and conducted business in------for twenty or more years, and deservedly bore the reputation of being a correct, straightforward man in every particular. He had for years been one of the town officials.

One of his near relatives (an uncle, I think) at about the age of fifty, without any apparent reason whatever, went out West, leaving his wife and children, and was not heard of for many years. Finally he came back on a visit, and remained a short time with his family and old acquaintances. No explanation was given of his strange conduct. It was thought that he had some form of mental disease. I mention this case to show that Mr. K. might have inherited some neuropathic taint or eccentricity.

One day, while apparently in perfect health, without any premonitory symptoms of mental derangement, Mr. K. went to a northern city to purchase goods for his store. While there two days he transacted a great deal of business, met many old friends, and exhibited no indication of aberration of mind. Starting homeward, he registered as a passenger on a certain steamer; feeling very tired he secured a state-room, to which at once he repaired, changed his linen. etc. When tickets were collected he was missing. He had suddenly and mysteriously disappeared. No one had seen him leave the boat, jump or fall overboard. An acquaintance, however, said that he was reasonably certain that he saw Mr. K. several hours after the boat had left in one of the depöts in the city.

1 Dr. H. G. Leigh, Sr., of Petersburg, Va.

He was sitting down, hat pulled over his face, and seemed to be in a "deep study," so he was not disturbed. Mr. K.'s open valise and all his clothes, except those he wore, were found in his state-room. The room door was open, but the key had been taken away.

Some suspected he had been robbed and thrown overboard; others thought he had (suddenly) become insane, or had had a fit and fallen into the sea; the suicide theory was also indulged in, and the opinion was entertained by some that he had absconded. But what had become of him, why, when, and how he disappeared were mysteries. He had, unobserved, simply " stepped out into the great unknown." A vigorous search was made to find him, dead or alive, detectives were employed, the newspapers teemed with accounts of the strange and unaccountable going away of this well-known man, but no clue was to be had that would throw any light whatever upon his mysterious disappearance.

Finally search was abandoned, the theory that he was dead accepted, and the court appointed an administrator of his estate and a guardian for his children. His business was purchased by his son, and everything was moving along smoothly, when, six months after he was last heard of, he suddenly and unexpectedly appeared at the home of a relative in a distant southern city. He was brought home in a composed, but partially dazed condition, able to recognise but few of his friends. He was an entirely changed man - the physical and psychical metamorphoses were quite complete. He was hardly recognised by his friends. He had reduced in weight from 250 to 150 pounds, and was very feeble. He wore the same suit of clothes he had on at the time he disappeared, and had in his pocket the check and key which were given him on the boat.

He was at once put under treatment, and in four weeks he recovered his previous bodily and mental health, and has since conducted his same old business with his accustomed skill and industry. A day or two after his return home an abscess, deep down in the auditory canal, broke and discharged a large quantity of sanguino-purulent matter. Immediately thereupon improvement began and went on rapidly. This was a remarkable fact, and is, I think, worthy of special note.

Hear Mr. K.'s own account of his strange case: "I was feeling very tired thoroughly fatigued - after a very busy day in the city, so went to my stateroom immediately upon going aboard the boat and changed my clothes. Up to that time I was thoroughly conscious, but after that I recall nothing - all was oblivion - till six months later when ' I came suddenly to myself in a distant city in the South, where I knew no one. I found myself driving a fruit-waggon on the street. I was utterly astounded. Why I was there, how and when I got there, where I came from, what I had been doing, were puzzling questions to me. Upon inquiry I learned that I had been there, and at work, for some time. My life since I was in that state-room had been an absolute blank to me. I can give no account of myself during that period of time. I started at once for Virginia, but on the way I again lost consciousness, though only for a day or two. When further on my way home, I felt so utterly worn out, I stopped in a certain town and went to the house of a very near relative. From there I was taken home. I was in a half-dazed, confused condition, and remained so some days longer.

I am now feeling well and all right".

This case bears many striking resemblances to others that have been from time to time reported, but there are two points of special interest. First, the inherited tendency to eccentricity, if not to insanity. His mysterious disappearance occurred at the same age at which his progenitor so strangely disappeared. Second, the abscess in the ear, the discharge of which was followed by a rapid return to normal mentality. Is it not probable that this abscess had some etiologic connection with the mental trouble, by producing a maladjustment of the cerebral functions, a disturbance of the circulation, an endarteritis, which would induce a condition of encephalic anaemia, or a suppression of suppuration, which would effect a hyperæmia?

"Loss of memory," says Rosse, "following organic lesion, dynamic trouble, or any sudden metabolic disturbance of the brain, may recover rapidly." Certainly Mr. K. made a rapid, uninterrupted recovery after the abscess had discharged. His physician said that there was a perceptible change for the better just as soon as the ear was relieved.