she then reproached herself for this idea, felt that she had done this person a wrong, felt that she must make amends in some way, confessed her idea to the person, and was met by natural remonstrances which increased her distress. She lives with some relatives, and has a frequent impulse to go behind them and push them downstairs. She has never done so, but reproaches herself for the idea. If she sees a rug on the floor lying crooked, the idea comes to her that one of these relatives may stumble on it, and this for the moment gratifies her; then she reproaches herself for the thought, goes and fixes the rug; is not satisfied with the way she has fixed it; wonders if she could have placed it so that it could trip up this relative; fixes it again, over and over, sometimes twenty or thirty times, and can not get rid of the idea that after fixing it she would be guilty if her relative slipped upon it. The doubts extend to other things. She will turn out the gas on going to bed, then has to go back and feel of the fixture to be sure that it is turned out, and often repeats this twenty times before she can get rid of the idea that it is really turned on. In her room she has to arrange everything in a very precise manner, and often spends hours placing and replacing objects before she can satisfy herself that they are right. It is impossible for her to argue with herself regarding these matters, and if she resists the tendency to repeat an act she gets into a state of distress, with palpitation of the heart and every evidence of intense anxiety, which nothing will quiet except the repetition of the act.
A lady aged twenty-nine had mental symptoms since the age of eighteen, when great timidity in driving began. She gets nervous at any excitement. She is subject to morbid fears; sees a match-box, wonders if the matches are safe—might they get out, and be lighted and set things on fire?—hence, goes to the matchbox, and makes sure it is shut; then goes back again, and so may repeat this twenty times. She can not reason with herself. Or, she wonders if the windows are shut; has to go and put her hand on the window to be sure, and this she does again and again. If she has medicine, she fears it will get out of the bottle; she goes and feels to see if the bottle is corked. She has the constant fear that things are not right, and has to reassure herself. Has to say things in a special way, and over and over, so it is hard for her to talk, and she repeats words. In reading she notices each word and can not read fast, but must read exactly; hence, she takes no pleasure in reading. Her condition makes her restless and melancholy. She is perfectly sane, but she is the victim of a morbid tendency to doubt the certainty of any idea which presents itself to the mind.
In all these cases the act which is done, and which is apparent-