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
Another feature should here be mentioned, namely, that isolated facts
may be remembered when the rest is blank. We have seen above that Annie
K. (Case 5), while very vague about most occurrences, recalled a sudden
angry outburst in detail. Another patient, though the period of the
stupor was a blank, recalled some visits of her mother. At these times,
as she claimed, she thought she was to be electrocuted and told her
mother so, “Then it would drop out of my mind again.” These facts are
very interesting. We can scarcely account for such phenomena in any
other way than by assuming that certain influences may temporarily lift
the patient out of the deepest stupor. In spite of the fact that stupors
often last for one or two years almost without change, a fact which
would argue that the stupor reaction is a remarkably set, stable state,
we see in sudden episodes of elation that this is not the case, and
other experiences point in the same direction. A similar observation was
made on a case of typical stupor with marked reduction of activity and
dullness. A rather cumbersome electrical apparatus (for the purpose of
getting a good light for pupil examination) was brought to her bedside.
Whereas before, she had been totally unresponsive, she suddenly wakened
up, asked whether “those things” would blow up the place, and whether
she was to be electrocuted. During this anxious state she responded
promptly to commands, but after a short time relapsed into her totally
inactive condition. We have, of course, similar experiences when we try
to get stuporous patients to eat, who, after much coaxing may, for a
short time, be made to feed themselves, only to relapse into the state
of inactivity.
Such variations are paralleled, as we shall later show, by a suddenly
pronounced deepening of the thinking disorder. We have already seen that
the onset may be quite sudden. All this indicates that, in spite of a
certain stability, sudden changes are not uncommon. Finally, we know
that, in spite of the fact that stupor is an essentially affectless
reaction, certain influences may produce smiles or tears, or, above all,
angry outbursts, which again can hardly be interpreted otherwise than by
assuming that those influences have temporarily produced a change in the
clinical picture, in the sense of lifting the patient out of the depth
of the stupor. All these facts suggest that inconsistencies in
recollection are correlated with changes in the clinical picture.
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