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
_Physical condition during the stupor:_ At first she had a
coated tongue, foul breath and a fetid diarrhea. The latter
was treated with high colonic flushing and mild diet. Urine
normal--gynecologically normal. General neurological and
physical examination not possible. At the same time she had
for two weeks a temperature which often reached 100° or a
little above, a weak, irregular but not rapid pulse, a
leucocytosis of 17,500 and 80% hemoglobin. When she began
to refuse food and before she was tube-fed regularly, she
twice had syncopal attacks and lost considerable flesh
which was gradually regained under tube-feeding. After the
diarrhea she was habitually constipated. Cyanosis of the
extremities seemed to have been present only at first.
3. Six months after admission she began to make very free
facial movements--winking, raising the eyebrows--and soon
developed an excitement with marked elation. She had to be
kept in the continuous bath, talked continuously, whistled,
sang, was markedly erotic towards the physician, careless
in exposing herself and often obscene in her talk. Most of
her productions were determined by the environment. She was
therefore quite distractible, very alert; sometimes she was
meddlesome, again irritable, irascible. The following
illustrates her productions: “Send for my husband, S.--He
had one sister as big as that. She likes candy.... My
father is underneath and my mother is on top because she is
fat and he is skinny.... Wait till the sun shines,
Nellie--we will be happy, Nellie--don’t you sigh,
sweetheart, you and I--wait till the sun shines by and
by.... Come in (as noise is heard)--I bet that is my
husband--my name is Regina K. (mother’s name)--my mother’s
name is the same--I got a little sister named Regina--she
is my husband.” When she heard the word pain, she said,
“Who says paint, Pauline used paint, I used paint,” etc.
Towards the end of August she had pneumonia, which did not
change her condition.
By October she was well, having gradually settled down. She
had good insight.
_Retrospectively:_ She laid very little stress on the false
report of the father’s death. She claimed to remember being
at the Observation Pavilion, but to recall very little of
the other hospital. Unfortunately an inquiry was not made
regarding her memory during the stupor period under
observation with the exception of the fact that she said
she wanted to die and therefore refused food.
She was seen in March, 1913, appeared perfectly well, and
stated she had been well during the entire interval.
Public-domain text, read in full here on John Shaqi.
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