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
2. Then she became more preoccupied, the restlessness was
much less in evidence, it became necessary to tube-feed
her, she retained her urine, answered a few questions, and
when asked where she was, she said, “Calvary, ain’t it?”
(What house?) “Heaven, ain’t it?” She still called the
physician by the name of her brother. After a few days this
gave way to a more marked stupor which lasted nearly two
years. This was characterized most frequently by a complete
inactivity. She usually lay or sat motionless, sometimes
with mouth partly open, letting the flies crawl over her
face, gazing in one direction, soiling, wetting, resisting
moderately or markedly any interference, and had to be
tube-fed. But this was not the invariable state. The most
constant feature was her mutism, but even that was a few
times interrupted. Thus, when after a visit from her uncle
(towards the end of July, 1902) she tried to get out of the
window and was prevented, she swore at the nurse. Or in
August, 1902, when she got into another patient’s bed and
was taken out, she resisted and said promptly: “I think it
is a damned shame I can’t get into my own bed.” But this
was the extent of her talk for a year and a half. Nor was
she always totally inactive. In the middle of July, 1902,
she sometimes tried to get out of bed, wandered about, got
into other patients’ beds. It was on such an occasion that
the above incident happened. In August, 1902, she sometimes
tried to get out when the door was opened, and we have
seen that she tried to get out of the window, but she did
not change her placid expression at such times. Her motive
was not known. On two occasions towards the end of 1902,
when she was taken to a dance and was made to take part,
she waltzed with considerable animation but did not speak.
This was quite striking in that these incidents occurred in
a setting of marked inactivity (i.e., a condition in which
she had to be pushed to the table, pushed to the closet).
She did not soil any more, but she sometimes drooled and
had to be spoon-fed. However, on a third occasion when this
was tried, she had to be dragged around. Finally, though
her facial expression showed at times a preoccupied
staring, she more often looked around, sometimes quite
freely and often looked up promptly enough when accosted.
But there was very little evidence of any affect at any
time. We have seen that twice she swore a little when
opposed. On another occasion she slapped a patient when the
latter helped her. Twice she was seen crying a little
without apparent provocation, but she did not laugh, and
the only suggestion of pleasurable emotion was that at the
two dances mentioned she could be led into a certain
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