Benign Stupors: A Study of a New Manic-Depressive Reaction TypeHoch, August
Science
Benign Stupors: A Study of a New Manic-Depressive Reaction Type
Hoch, August
Manic-depressive illness; Stupor
For five days she remained lying quietly in bed for the
most part, although once she called out “Come in, I am
here,” “Jimmie, Jimmie” (husband’s name). Several times she
threw her bed clothes off. Otherwise she made no attempt to
speak and took insufficient food unless spoon-fed. At one
examination she looked up rather dreamily but did not
answer. When shaken she breathed more quickly and seemed
about to cry but made no effort to speak. When left to
herself she closed her eyes and did not stir when told she
could go back to the ward. She was then lifted out of her
chair and took a step or two and stopped. Such urging had
to be repeated, as she would continue to remain standing,
looking about dreamily, although finally when taken hold of
she whimpered. When she got to the dining-table she put her
hand in the soup and then looked at it. So far there is
nothing in this case atypical of what we would call a
partial stupor. The cardinal symptoms of apathy,
inactivity, with a thinking disorder, are all present and
dominate the clinical picture. There is, further, the
history of a delusion of death during the onset of the
psychosis. Had her condition remained like this, there
would be no difficulty in classifying the case, but other
symptoms appeared.
Five days after admission she was restless, somewhat
distressed, and announced that she wanted to talk to the
physician. When examined, the distress, with some
whimpering, continued. She asked the doctor not to be harsh
to her, frequently said there was something wrong and began
to cry. A normal interest appeared only once, when she
spontaneously said she wanted to see her relatives. A most
interesting feature, however, was a certain perplexity that
now appeared. She spoke of this directly: “I do not know
what it is all about. I know you are a doctor, that is all.
I don’t know whether I passed out and came back again or
what--I don’t know what to make of it.” She also felt
confused about her marriage--“There is where all the mixup
is. I was married when I was 16.” She was reminded that she
had said she was single, and replied “I am single.” Then
where is your husband? she was asked. “He must be dead.”
She recalled the examination on admission and remembered
some of the questions that she was asked then, also knew
that she had been at the Observation Pavilion and that she
had reached this hospital by boat. On the other hand she
still claimed that the year was 1917, and in connection
with the delusion of having died was quite unclear as to
the time. She said that it seemed as if she had died many
years ago and that she had come to the hospital years ago.
She also spoke of having died at a summer resort the year
Public-domain text, read in full here on John Shaqi.
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