Dr. Toedenström who describes the case states that she looked incredibly young. Two weeks after she left her bed she had become strong enough to take charge of the household.
Stekel, discussing this strange case in one of his lectures, said: “This woman spent the entire time of her womanhood in sleep, for she fell asleep at the time of her first menstruation period and her awakening coincided with her climacteric. She was a child and wished to remain a child. The first question she asked on arising, ‘Where is mama?’ shows that she was suffering from psychic infantilism. It is probable that dreams of childhood filled her thirty-year sleep and she may even have dreamt that she was still an unborn child for whom life had not yet begun.”
Medical literature contains many reports of freakish cases in which the subject falls asleep suddenly, while attending to duties of an uninteresting character; a young waiter, for instance, falling asleep while waiting on a table, remaining absolutely motionless for a whole minute and then waking up and resuming his work. Manacéine mentions two similar cases she observed personally. Both patients were illiterate and of slow intellect. One of them, a housemaid of nineteen, was a sound sleeper at night and yet, in the day time, one could never be sure of her remaining awake. She fell asleep once in the act of announcing a visitor and while bringing in a tray loaded with cups of coffee. The other was a woman of fifty, who was employed as a nurse until one day, falling asleep suddenly, she dropped an infant on the floor and almost killed him. In both the pulse was remarkably slow (a vagotonic symptom): in the girl it varied from 50 to 70 when awake, in the older woman from 40 to 60.
An epidemic of sleeping fits, lasting only a few minutes at a time, raged for several years in a small German town near Würzburg. The attacks took place at any moment and were liable to leave the patient immobilized in some curious position. It was the weaker part of the population, physically and mentally, which was affected by that curious trouble, apparently transmitted from parents to children, probably, as all neurotic complaints are, through imitation.
Stekel considers hysterical and epileptic fits as forms of morbid sleep during which hysterics gratify sexual cravings and epileptics sadistic cravings.
This is how Dr. Isador Abrahamson describes, from recent cases observed at Mount Sinai Hospital, the course of lethargic encephalitis which is one of the scientific names coined to designate the sleeping sickness:
“At the onset of the disease, there is a period of variable duration in which the patient experiences increasing difficulty in attending to his work. Next a time of yawning ensues, in which there may be also the irritability of the overtired. Then the eyes close, chiefly from lack of interest.... (The patient’s) pulse, temperature, and respiration may all be of a normal character.... From the depth of this seeming slumber, he may respond immediately when questioned and his short but coherent answers show no loss either of memory or of orientation.... His answer given, he straightway resumes his seeming sleep.... His attitude expresses a desire to be let alone, a desire which is sometimes articulate in him.... The somnolence may deepen into a stupor from which the patient is not easily aroused to conscious repose.... In the night watches ... a restless delirium of inconstant severity often appears. Spontaneous movements and sounds are made. The movements are purposeful graspings and pointings at unseen things, tossings and turnings....”
The author adds in another part of his article that “The depth of the somnolence and also its duration are unrelated to the severity of the cerebral lesions.... The extent of the mental disturbance bears no correspondence to the extent of the lesions, the amount of fever or the blood picture....” [Italics mine.]
We have a perfect picture of a flight from reality into a somnolence into which the unconscious complexes force at times a terrifying presentation of the dreaded reality through nightmares.
The few cases of sleeping sickness reported in recent medical literature show a decided neurotic trend in the subjects affected and reveal circumstances in the patient’s life which would make a flight from reality highly desirable.