At the Observation Pavilion she was described as wandering about in a perplexed manner, restless, resistive, answering few questions and in a low tone. She said things were "changed," also that she was married to S.
Under Observation: 1. For about ten days the patient's condition may be described as follows: The most striking feature was a certain restlessness with insistence on going out, with complaints that this and that had been done to her and with senseless struggling when interfered with. But all the motions were slow, the whole restlessness aimless and impulsive. Although the facial expression was somewhat perplexed, it changed remarkably little, and whenever asked whether she felt worried or anxious she denied it, and, indeed, there was only a suggestion of perplexity in her face.
The ideas which she expressed during this time referred to a few topics only, namely, marriage, wealth, and State prison. The remarkable fact was that all the ideas about marriage and wealth were spoken of, often immediately, again after some interval, now in the positive and again in the negative sense. Thus she said she was "Mrs. S.," again "You kept me from marrying Mattie S.," or "I am not supposed to be here—I am a married person," but also "You kept me from getting married." Or, "Take off that black dress, I am a bride," again "You have taken my bridal crown off my head," "The steamboats (seen from the window) are mine—I own the ships, the oceans, the land and everything," or again, she said she owned a kingdom, was Sh.'s wife, a wealthy woman, had millions. Sometimes she connected the millions with Sh. "Sh. has millions." On the other hand, she said: "I owned all this before I came. I have nothing now," or "You have taken the regal crown from me," "You have made a pauper of me," "They did it again, they took my millions away," or "Let me out, they are taking my millions."
Other ideas throughout this period were that this was a State prison, that "bums" were around. On one occasion she said "You can't put down all these things and make me out a lunatic." At another time she pulled a patient's hair and then said without fun: "I fixed the leading lady of the dump—she knows a lot,
but she does not know enough to keep her soup cool." When questioned about this woman (who at the time while cleaning had moved the furniture), she said: "I don't know where I am at."
The orientation during these days was not markedly disordered, when one got down to it. Although she spoke of State prison, it was always found she knew the name and the location of the hospital, the names of people around her, even the date approximately, though she was apt to say it was February 19, 1492, or October 19, 1492, or when the year was not given as 1492 she said it was "1900 or 1901, or 1911 or 1912." Frequently, however, it was hard to hold her attention.
Finally, it should be mentioned that she very often wet herself in bed or when standing, even when standing in the examining room.
2. The period following and lasting for two months may be given in the form of abstracts of each note.
November 7: Yesterday quiet, though struggling. Says without change of expression, "I saw four people killed—my mother, my brother, a priest, and my dear sister—we were all killed." Again, "I don't know where I am," "I am an orphan, my people died" (without affect).
November 20: More quiet recently, says little, but tries to get out when brought to the examining room, but when not prevented walks slowly about as before, says she wants to go home. Looks peculiarly blank.