by the physician with immobile expression, slow motions and mute.
2. For about ten days, i.e., from January 27 to February 8, her condition was of a more pronounced character. For the most part she lay in bed with often quite immobile face and with eyes closed, or she looked about in a bewildered manner. She was very inactive, presented a marked resistance in her arms and jaw when passive motions were attempted, or, again, exhibited decided catalepsy. She had to be tube-fed. Once on the 27th of January, when the nurse tried to feed her, she pushed her away and said, "I am dead—I am not home." Sometimes she turned her hands about with slow tremulous movements, looking at them in a bewildered manner.
She usually was mute, except on the few occasions to be mentioned later, as well as on February 3, when she was generally a little more responsive. At that time she could be made to open her eyes, and then replied to a few questions slowly and in a low tone; others were left unanswered. (To the questions where she was and how long she had been here, she replied with "I don't know," but to questions about who the physician and the nurse were, by saying "You are a doctor," and "she is a nurse.")
In the general setting just described there occurred at various times changes in behavior which were as follows: On the evening of the 27th of January she got out of bed and walked about with slow restlessness, saying: "They say I am going to be cut up." On February 1, she was seen for a time making peculiar slow swimming motions with her hands. Again on the 3d of February she got out of bed, walked about slowly, with peculiar steps, as though avoiding stepping on something. Next day (the 4th) she sat up in bed—again made at times her peculiar slow swimming motions. She presented at the same time a peculiar dazed bewildered uneasiness and, when questioned what was the matter, said: "I am—I am—at the bottom of the deep—deep water—oh—oh—the deep—deep—dark water." And when further urged she added with the same manner, "I can't swim—I don't know—but the place"—She did not finish but later again muttered "the deep—deep—dark water." (Do you really think you are in the water?) "I don't know—my head is so bad."
For the following five days this behavior was repeated from
time to time, when she would sit up and with bewildered uneasiness make slow swimming motions and mutter when questioned, "I am in the deep, dark water."
Some other emotional responses in reaction to external events must still be mentioned. They were rare. On February 1 the patient's daughter came while she was lying motionless in bed. She slowly extended her hands, tried to speak, and then her eyes filled with tears. Again, at the end of the interview of February 3, after she had made a few replies, she settled down to her usual inactivity and, when further urged to answer, her eyes filled with tears.
3. From about February 9 to February 24 the condition again presented a different aspect, inasmuch as while there was still a marked reduction of activity, she showed this to a decidedly lesser degree. Moreover, there was no bewilderment at any time. No resistance, but cataleptic tendencies were still seen occasionally. There was at no time the peculiar dazed uneasiness and slow restlessness associated with the idea of being in the deep, dark water.
She now dressed herself very slowly, ate slowly but of her own accord, and spoke, though her voice was consistently slow, in a low tone and her words were few.
At the beginning of this period on February 9, when asked how she was, she said "I—I am sick." To the questions as to where she was, how long she had been here and how she had been taken sick, she replied by saying "I don't know." But she knew she was in a hospital, had been here before "many times." (Correct.) She was then again asked for the name of the hospital, but replied "I don't know." So the physician pointed out of the window and asked her what it was that she could see there (the East River). She replied, "It is the dark water. Sometimes I go there and don't come back again—and—something throws me up and I come back." (What has been the matter with you?) "I have been sick all this time." Again, "I can't tell—I am not a good woman—I am very sick." (Why do you say you are not a good woman?) "Oh, I did not do things right."