rather than led to her meals, and urged to eat. For the most part, she would not answer questions, but would either smile in a sneering way, or just walk away, or say, "Oh, don't bother me," or "I don't want to talk," and generally her attitude was rather sulky. Nor was this only towards the physicians but towards the husband, sister and child as well. When on May 17 the sister came, she would not speak to her but said "Go away." The baby she simply pushed away sulkily when it was brought to her. To the husband she said on May 31, "Go away, you stink." In the first part of this period, she presented some bursts of elation, on one occasion turned somersaults, indulged in a few pranks with laughter, or once, when a knock at the door was heard, she called out "Holy gee, cheese it, the cop." But these occurred only in the first part of the period. On June 1 she spoke to the nurse, said, "What is the matter with these people, they must be crazy," asked to go home, and was then by the nurse found to be oriented, and to know the names of people around her. But when she was asked about the baby she would not answer, and questioned whether she was not married, she said "I don't know." Yet when the physician desired to talk to her, she was just the same as before and remained so for two more weeks. Another somewhat isolated occurrence was when on June 18 she spoke a little to the physician, but she sat in a constrained position when taken into the office and answered many questions by "I don't know," namely, those regarding her condition and feelings, the questions about orientation, about her mother's address, and her child's age; but when asked how long she had been married she said correctly "Two years."
At the beginning of July she improved quite rapidly, and on July 5 appeared fairly free and gave a fair retrospective account, with some urging, and it was thought that she smiled somewhat too freely. However, on July 27, she seemed perfectly well, had normal insight, and then gave the second retrospective account, which, together with the first, will now be taken up.
Retrospectively: She claimed to remember things at home, and at both interviews said she recalled being taken to the Observation Pavilion. While there she thought she knew where she was, remembered that she did not talk. She had a feeling she
was going to die and said "I thought I would die if I kept still." However, the transfer to this hospital was vague in her mind, as was the entrance on the ward, and she claimed not to have known for quite a while where she was. She added that she used to wonder where she was, how she had gotten here, and how she could get out, and thought the questions which were asked were queer. Individual occurrences, too, specifically inquired into were not recollected, such as an examination in a special room. Of the mixed-up writing at the end of the second week, she had no recollection even when it was shown to her. She did not recall having her picture taken (with eyes open) two months after entrance. Yet a sudden angry outburst ten weeks after admission was remembered. She stated that she struck the patient because the latter annoyed her by her shouting. She had a general recollection of being stiff, having her head raised, and of soiling and drooling, but could not account for it. She felt stubborn. She also claimed not to have been hungry and not to have felt pin pricks.
In regard to ideas which she had, she claimed to be afraid at first that she would be cut up. She remembered repeated visions of her father at night, also once of her dead aunt, who said "Come to me." She thought she was in a cemetery, all the family were dead, the baby dead. In the beginning, too, she sometimes heard a priest whom she had known, say "Be good and God will look after you."
In regard to the later period, she recalled that she got up in May and felt cross. She did not answer because she did not want to be bothered. She pushed the baby away because she did not think it belonged to her, the husband because she did not like him. (She did not think she was not married.) She evidently remembered the visits, thought she knew where she was, knew she stood near the door "because I wanted to go home." Besides the idea that the baby was not hers, she recalled none, and thought she had no hallucinations.
She was discharged perfectly well six months after admission to the hospital. Soon after that, she left the husband, once had him arrested in 1908 and sent to the workhouse. She was again examined in 1913, and was found to be perfectly well, and she stated she had been well since the discharge.
These five cases will have to suffice for the present. They were given in full in spite of the fact that we shall leave out of our present considerations the history of the cases and certain of the stages, and confine ourselves to that stage of each case which is best qualified to give us a good general survey of the essential features of the stupor reaction.
These phases are: stage 1 of Case 1, lasting five months; stage 3 of Case 2, lasting one year; stage 2 of Case 3, lasting two years; stage 1 of Case 4, lasting three months; stage 1 of Case 5, lasting four months.
We gather from these descriptions that the essentials of the stupor reaction are (1) more or less marked interference with activity, often to the point of complete cessation of spontaneous and reactive motions and speech; (2) interference with the intellectual processes; (3) affectlessness; (4) negativism.