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
The patient herself gave, after recovery, the onset as
follows: When she married she knew her husband was not what
he should be, but not that he was so bad as he proved to
be. He was a gambler, did not support her, and this caused
her much worry. When she became pregnant, eight months
after marriage, this increased her worry, and throughout
the pregnancy she spoke much to a neighbor about her
worries, and said she did not know how she could manage,
pay the doctor, and the like, but she did not say much
about it to her mother (because the latter would have made
such a fuss about it, or would have said, “It serves you
right”). Then the childbirth came. This further accentuated
her worries. She felt her difficult circumstances, wondered
how she could get the necessary money, “I lay there
worrying.” And she claimed she did not sleep at all. About
her statement, mentioned by the mother, that she had done
something, she said that she thought she had poisoned the
child by giving it fennel tea, and that she thought a
neighbor who visited her said she had poisoned it. She was
then put to bed again, and one night she had a vision of
her father. This frightened her. She thought this meant he
had come for her and she wanted to die.
At the _Observation Pavilion_ she was dull, staring,
resisting attempts at passive motions.
_Under Observation:_ 1. There was nothing noteworthy in her
physical condition, except for a rise of temperature to
100° occasionally during the first month of her admission.
For the first four months she was often found lying in bed
with her head half raised from the pillow, or standing or
sitting about in constrained positions, immobile,
frequently she let saliva collect in her mouth. She usually
wet and sometimes soiled the bed. Sometimes, when sitting
in a constrained position, she let herself gradually slide
on the floor. She often began to feed herself when urged,
but would not finish, and had to be spoon-fed, as a rule.
She was never tube-fed. She was often quite stiff and
showed marked resistance. This was manifested either when
passive motions were tried, at which times she usually
resisted passively, i.e., she became more tense; or when
there broke through a more active aggression and she would
strike. Above all, the opposition showed itself towards the
nurses’ attention; in this she also showed either a
passive, aimless opposition and stiffness, or a more active
one; but even in the latter an open show of angry affect,
or plain irritation, though present at times, was by no
means constant. When it was present, she would strike quite
aimfully; once she struck the nurse and said, “You are the
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