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In 1880, Dr. Ira Russell published a case report about a patient whom he treated for compulsive handwashing. NOTE: The following is this website's synopsis, not a quotation.
SYNOPSIS: On an autumn day in 1877, a patient arrived at a private hospital in Massachusetts. The patient was a large, friendly fellow from a wealthy family. Now 47 years old, he was having serious difficulties with compulsive handwashing. He "imagined his hands were dirty, and began constantly washing them," explained the chief physician, Dr. Ira Russell, who went on to describe the man's bedtime washing ritual.
"Before he would begin to undress, his attendant must fill the wash bowl with water, as he dared not touch the stop-cock with his hands; then the water must be let off, the bowl washed and filled again for three times, then he would wash his hands three times, the bowl being filled anew each time," Dr. Russell explained. "Then after the removal of each garment he must wash, finally he would wash his face, rinse his mouth, each, three times, say his prayers and retire, consuming three or four hours, and using twenty or more towels. In the morning he went through a similar process, taking two or three hours to dress."
In between these marathon washing sessions, the patient rode, bowled, played billiards, and often went to dancing parties in the evening. While he was engaged in these activities "no one would suspect that anything was the matter with him," Dr. Russell noted.
Dr. Russell prescribed him various drugs, including bromides (commonly used sedatives of the time period) and "Esquirol's Red Mixture—strychnine, quinine, and syr. of hypophosphites of iron, lime and soda." After mulling over whether to restrict his washings, Dr. Russell gave the man the freedom to wash as often and to use as many towels as he liked. But Dr. Russell also appealed to his reason and made a concerted effort to persuade him "to make an effort to lessen the number of washes each day." As the man did this, he gradually gained self-control over his washing. Eventually he recovered and set sail for Europe, according to Dr. Russell's case report, which was published in October, 1880.1
1Ira Russell, Mysophobia, The Alienist & Neurologist, October 1880, 1:529-533. (On the meaning of "mysophobia" see William Hammond.)