The defect in thinking which still remained is very difficult to formulate. She was now entirely oriented, no longer with any hesitation about the correctness of her information. She subtracted 7 from 100 very quickly and could from memory write a long poem, but there was a certain vagueness about her which partly may have been due to a still existing indifference. This vagueness consisted chiefly in a difficulty of attention or in her
capacity to grasp fully what was wanted. It is best illustrated by a few examples: After she had been asked about the onset of her sickness and she had said that what was on her mind then were prayers for the salvation of her relatives, she was asked exactly when it was that she thought of this; she answered "Now?" (What period were we talking of, the present or past?) "The present." (What did I ask you?) "About this period of my sickness." (Which one?) "What sickness?" She said herself at this point, "I am rather stupid" (quite placidly). Or again she said she did not know why she pounded her head, but finally said, "To get better and go home." (Do you think if you pounded your head against the wall you would go home sooner?) "I don't know—maybe." (How would it help you?) "You mean to go to the city?" (Yes.) "I don't know." Again when asked how her mind worked, she said, "Pretty quickly sometimes—I don't know." (As good as it used to?) "No, I don't think so." (What is the difference?) This had to be repeated several times, at which she said, "There is no difference." (What did I ask you?) "The difference." (The difference between what?) "You did not say." Equally striking was the fact that when she was jokingly told "If it snows to-night, we shall have a black Christmas," she did not grasp the absurdity at once, but in a rather puzzled way asked, "Why?"
She was then discharged on parole, two years and one month after admission. Soon after discharge her menstruation, which had been absent throughout her psychosis, returned. On her discharge she had regained her normal weight, and during the two subsequent months gained fifteen pounds.
She then recovered completely, so that three months after discharge she made a very natural impression. She said, on looking back over her state with impulsive excitement, that she constantly had the idea that she wanted to punish herself, but that she did not know why, and did not think she was sad or worried.
Considering only the second phase of the psychosis, this deep stupor showed many interruptions, due not merely to her suicidal efforts but also to her resistiveness. The condition, too, was not so com
pletely affectless as one expects a deep stupor to be. In the first stage there was much sudden laughter, reminding one of dementia præcox (except for its never being shallow or silly) and this persisted into the first part of the second phase. The actual attempts at self-injury brought out emotion, for with them she scowled and frowned as well as showing considerable energy.
To these may be added the following case. It is not unlike the ordinary stupor in the fact that there was intense inactivity and mutism with great tenseness. The remarkable trait was, however, that for a whole day she forcibly held her breath until she got blue in the face. The case in detail is as follows:
Case 11.—Rosie K. Age: 18. Admitted to the Psychiatric Institute January 24, 1907.
F. H. Both parents were living. The father was a loafer. Nine brothers and sisters were said to be well, with the exceptions of one brother who had an irritable temper, and of a markedly inferior sister.
P. H. The patient was a Galician Hebrew, a shirtwaist operator. Not much was known about her make-up, but it is certain that she was a bright girl. The patient herself said after recovery that her father was nagging her constantly with complaints that she was not making enough money, although he himself did not work and she contributed much to the support of her family. She disliked him very much and claimed that all her relatives worried her, except her mother.