After having had a good night’s sleep the patient woke up in good
condition; appetite was good. Voice was clear, though low. She was
in a state of lassitude and relaxation. I attempted to examine her
and kept testing her condition, physical and mental. I was anxious
to make a psychognosis of the patient’s case. The tests and the
questions strained her nervous system by requiring to hold her
attention, and by keeping her in a state of nervous and mental
agitation. She looked scared, anxious,--the scared, haunted look in
her face reappeared. The patient was no more than about twenty to
twenty-five minutes under experimentation when a severe headache of
the vertex and of the left side of the head set in. The eyeballs
began to roll up, eyelids were half closed; lids and eyeballs
were quivering and twitching. The hands were relaxed and looked
paralyzed. When raised they fell down by her side in an almost
lifeless condition. There was marked hypoaesthesia to pain and heat
sensations. The anaesthesia was more marked on the left than on the
right side. The left arm when raised and kept for a few seconds
showed marked tremor as compared with the right arm. This is to be
explained by the fact that the exacerbations of the headache, of
pain, and the general cataleptic seizures set in usually during or
after the nursing periods. The infant while nursing was kept by the
mother on the left arm, the left side thus bearing the pressure,
weight, and strain,--it was with the left side that fear became
mainly associated.
During the height of the attack the patient was quietened, her
fears allayed, and a five-grain tablet of phenacetine was given her
with the authoritative remark that the drug was sure to help her.
As soon as she swallowed the tablet the patient opened her eyes,
and said she felt better. About an hour later, when another attempt
at an examination was made, patient had an attack of headache,
cried, said she was afraid, but she answered in a whisper when
spoken to. She talked slowly, in a sort of staccato way. I insisted
that she should talk a little faster and pronounce the words
distinctly. She made violent attempts to carry out my command, but
got scared, began to hesitate, and stammer, her voice and speech
rapidly deteriorating with her efforts, ending in complete mutism.
During the day I tried from time to time to keep up the experiment
of insisting that the patient should speak, and every time with
the same result of bringing about an attack.[12] The patient began
to stammer and stutter, becoming more and more frightened the
more the nurse and myself insisted that she should make an effort
and reply to our questions. Still, when the patient’s attention
became distracted, when she was handled gently, when her fears were
allayed, the speech and sound improved in quality and in loudness,
and at times her sentences were quite fluent, her enunciation quite
distinct.
Public-domain text, read in full here on John Shaqi.
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