Gregor[22] tells of a stupor which is unusual in that it consisted only of symptoms connected with inactivity, which did not affect the intellectual processes. The patient was a rubber worker who suddenly developed a depression with self-accusation and convulsions. She was soon admitted to a clinic and then showed mutism and catalepsy. Later she became totally immobile with no apparent psychic reactions, and soiled. Gregor studied pulse, respiration and respiratory volume in their reflex manifestations and found nothing unusual. Next he tried to discover if there were voluntary alterations in respiration. He discovered that the respiratory curve could be changed by calling out words to her, by odors associated with suggestions, menaces, etc. [This is suggestive of the dissociation of affect, which we have discussed.] After two months she recovered, with complete recollection of the stupor period. It was then proven that the absence of reactions was not the same as the lack of perception of stimuli.
Froederström[23] reports a case that suggests hysteria, where the stupor lasted for 32 years. A girl at the age of 14 fell on the ice, had a headache, went to bed and stayed there for 32 years. She lay there
immobile, occasionally spoke briefly and took nourishment, when it was put at a definite place at the edge of the bed. At first (according to a late statement of her brothers) this consisted only of water but was soon changed to two glasses of milk a day. After being in this state for ten years she was placed in a hospital for two weeks, where she was mute, did not react to pin pricks and had to be fed. It seems that at home she secretly looked after herself, for she kept her hair and nails in condition. Sometimes she sat up and stared at the ceiling.
After attending to the patient for 30 years, her mother died. The patient cried for several days when told of it, and after this she took nourishment of her own accord. Two years later a brother died. Again she cried on hearing the news. Her father, who looked after her when the mother was dead, also died. Then a governess came into the home, who noticed that furniture was moved about when she was alone.
At the age of 46 she suddenly woke up and asked at once for her mother. She claimed total amnesia for the period of her stupor, including the stay at the hospital. She could summon memories of her childhood, however. Her brothers she did not recognize and said, "They must be small." She recalled the fall on the ice and coming home with headache, toothache and pain in the back. Her general knowledge was limited but she could read and write. Her expression and appearance was that of a young person, only her atrophic breasts and the
fat on her buttocks betraying her age. She had been well for four years at the time the report was made.
He thinks that a certain tendency to exaggeration and simulation speak for hysteria. We would be more inclined to view the fact that she looked after herself in spite of complete amnesia as evidence of hysteria.
Another protracted case suggestive of hysteria is that reported by Gadelius.[24] The patient was a tailor, 32 years old, who had always been rather taciturn and slow. A year before admission he began to have ideas of persecution and to shun people. Then he developed a stereotyped response, "It is nice weather," whenever he was addressed. A month before admission inactivity set in. He would sit immobile in his chair with closed eyes and relaxed face; he resisted when an attempt was made to put him to bed. His color was pale.
He was taken to hospital on November 1, 1882, where he was observed to be immobile and to have little reaction to pin pricks. When a limb was raised, it fell limply. However, he would leave bed to go to the toilet. Tube-feeding became necessary, but when the tube was inserted in his nose, he woke up. He then showed an amnesia not merely for his illness but for his whole life: he did not know his father, that he was married or that he had a mother. To
wards the end of November, he became limp again and answered, "I don't know" to most questions. In December, however, he improved again and for a few months these variations occurred. From April, 1883, to May, 1886, he was in deep stupor, almost absolutely immobile and close to being completely anesthetic even with strong Faradic currents. Towards the end of this period he walked about whenever he thought he was not watched. He was very cautious about this and became motionless any time he became aware of observation. (Gadelius thinks this was not simulation but the expression of an automatism on the basis of a vague fixed idea.)