We now can add some of the other replies which she gave. Once she was asked "Do you know where you are?" She promptly said, "Yes." (Where?) No reply. On another occasion, at the initial examination, she said she was home or "in papa's house." Once when asked "Do you know me?" she said "Yes." (What is my name?) "Miss D." (her name). On the occasion on which she had stated that she had taken off her clothes, she was asked "Where have you taken off your clothes?" She made the irrelevant reply, "That was the girl the one I had."
2. Then she improved somewhat. On January 5 she walked about a little more, though slowly, and still looked slightly puzzled when questioned. She spoke more readily, counted promptly though once stopped in the middle of the exercise. In calculation she multiplied correctly 3 × 7, but for 4 × 9 repeated the 21, and when given 9 × 9 she did not answer. A few days later, though she lay again motionless with her head raised as before, and, as she had sometimes done, smiled brightly when accosted, she gave few replies, but when asked to write down the month she slowly wrote "December." Asked to write it the second time, she did it promptly. She also replied promptly by saying "Yes" when asked whether Christmas, and again whether New Year's, had passed, but did not reply to the questions how long ago Christmas, or how long ago New Year's, had occurred. On January 23 she was decidedly more free and prompt in her replies, yet she still wet and soiled (in fact this did not cease until the end of the month, when great improvement occurred). At this time she gave quite a number of calculations promptly, about an equal number wrongly. She knew where she was, knew the names of a number of people about her, but thought she had
been here about two weeks (four months), and gave the year and the date, the latter as the 28th of January. When then told that it was Thursday, January 23, and that she must remember it, and asked five minutes later what she had been told, she again said "January 28" and left out Thursday. To some questions to which she did not know the answers, since she had an amnesia for the time of their occurrence (the incidents of coming here), she simply remained silent. Even on February 7, when she was much freer, helped the nurses, and said herself she was "smarter," she had difficulty in thinking, said she was 17 (21), gave the date of her birth correctly, but the current year as 1909 (1908) and still insisted she was 17. She then did the calculations on paper, and with considerable difficulty got correctly "22." But she could not straighten out the discrepancy. At that time, also, she still wrote "Hospitital," calculated even simple multiplications with some mistakes, could not get the point of a story, and to retention tests gave poor results. Indeed, even seven days later, when she wrote a very rational letter and appeared quite natural, she made some omissions in her writing, and a few mistakes in spelling.
However, she now improved rapidly, and by March 31 she made a very natural impression, was frank, free, had good insight, calculated well, etc., understood a story, retention was good.
She then gave the retrospective account embodied in the history, and in addition told that she had no recollection of going to the Observation Pavilion, the coming here, or the first part of her stay, including presentation of the case at a staff meeting, a physical examination and a blood examination, and she claimed for a long time not to know where she was, "I was in a kind of dazed condition." She also said she could not understand the questions which were asked her. This probably refers, however, to the second part, i.e., the partial stupor lasting for two months. She did not "feel like talking," the limbs "felt stiff-like."
Case 5.—Annie K. Age: 22. Admitted to the Psychiatric Institute January 7, 1907.
F. H. The father was an alcoholic, who died when patient was a child. A paternal aunt had a nervous breakdown, with recovery. The mother appeared to be normal.
P. H. The mother stated that the patient was a rather delicate child. She attended school irregularly, never felt much interest in it, and was always glad to be at home and help the mother take care of the other children. On the other hand, she is said to have been quite lively, rather a tomboy, with a temper. She left school at 14; learned dressmaking for a year, but did not get along well. Then she took several other positions, which she held for about a year, getting on pretty well.
She married at 20. Her husband never supported her well and often beat her. She had to borrow money to get along and worried much. During pregnancy she seemed to worry more, had crying spells, and often seemed absorbed in thought.
Three weeks before admission she gave birth to a child. The labor was somewhat difficult, but she had no fever. She got up on the tenth day, and then seemed to lose all interest, did not attend to the baby, said she was not strong enough. She sat about, appearing depressed. The mother then took her and the baby to her house. There she sat or walked about, said very little. But she repeatedly came to her mother, said she had something to tell her, or that she had "done something," although she could never be induced to say what. Once she came to her and said, "You are not going to die." She often moaned. Finally, she claimed a neighbor had been saying she was poisoning the baby.