Benign Stupors: A Study of a New Manic-Depressive Reaction TypeHoch, August
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Benign Stupors: A Study of a New Manic-Depressive Reaction Type
Hoch, August
Manic-depressive illness; Stupor
442) compares these two kinds of stupors
to deep sleep when intelligence is completely suspended and to sleep
with dreams. (These two types would correspond to our “absorbed mania”
and true deep stupor.) He urges strongly the separation of stupor from
melancholia as an entirely different type of reaction, in this
connection citing the views pro and con of various authors. Of these
Delasiauve is particularly cogent in discriminating stupor from
melancholia on the grounds of the difference of the emotional reactions
and of the intellectual disorder and the real paucity of thought in the
former psychosis.
After quoting these and other authors, Dagonet offers an explanation for
the diversity of opinion. He says that stupor following another
psychosis may retain some of its symptoms, so that a mixture obtains, as
often in medicine. He then gives excellent descriptions of three types:
the deep stupor with paralysis of the faculties, the cases that are
absorbed in false ideas, and ecstatic cataleptics.
The remainder of his paper is concerned with cases and discussions about
them. He cites examples of stupor following fear or other emotional
shocks, following grave injuries such as the loss of a limb, following
head trauma and with typhoid fever. As to the last he points out that
delirious features are prominent. Many authors have assigned sexual
excesses as a cause of stupor. The psychosis, Dagonet says, is not pure
but more a mixture of hypochondria and depression. Relationship with
mania is next considered. He says that stupor may succeed, alternate
with or precede mania. His cases seem mainly to have been what we call
absorbed manics or manic stupors. In fact, he uses the last term. The
commonest introductory psychosis, he claims, is depression, but from his
brief case reports it would seem that most of his patients were not
stuporous, in the narrow sense of the term, but severely retarded
depressions. In fact, in perusing his case material comprising “stupors”
in the course of many types of functional insanity, or as a complication
of epilepsy or general paralysis, it is evident that in practice he does
not follow the discriminative definitions of the earlier portion of his
paper. For him, apparently, patients who are markedly inaccessible to
examination from whatever cause are “stuporous.” He closes with
excellent remarks on physical and psychic treatment. As to prognosis he
has nothing to say beyond the opinion that most of the cases recover.
Public-domain text, read in full here on John Shaqi.
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