[10] Dr. Morton Prince and Dr. H. Linenthal coöperated with me in the study of the case published in full in the “Boston Medical and Surgical Journal.”
[11] See my works, “The Psychology of Suggestion,” “Multiple Personality,” and others.
[CHAPTER XXIII]
APHONIA, STAMMERING, AND CATALEPSY
S. R. Age 25. Russian Jewess; married; has four children. Patient was brought to me in a state of helplessness. She could not walk, and was unable to utter a word. When spoken to she replied in gestures. When challenged to walk, she made unsuccessful attempts. The step was awkward, the gait reeling, the body finally collapsing in a heap on the floor. When I shut her eyelids, the eyeballs began to roll upwards, the lids soon became cataleptic, and the patient was unable to open them. When I insisted that she should open the lids, she strained hard,—the muscles of the upper part of the body became painfully tense,—wrinkled her forehead, and contorted violently her face. After long insistence on her replying to my questions, and after long vain efforts to comply with my request, she at last succeeded in replying in a barely audible voice. When whispering she kept on making incoordinate movements with jaws and lips, began to shut her eyelids, rolled up the eye-balls, forced the tongue against the teeth, stammered badly on consonants, uttering them with great difficulty after long hesitation, the sound finally coming out with explosive force.
I insisted that she must stand up, she raised herself slowly and with effort, took a couple of steps, and sat down at once on the chair. During the period of effort there was marked tremor in her left arm. When she sat down, she threw her head backward, rolled up her eyeballs, and began gradually to close her eyelids. She remained in this position for a couple of minutes, and then began spasmodically to open and shut the eyelids. When taken to her room, the patient walked up, though with some difficulty, three flights of stairs without the nurse’s support.
The patient was greatly emaciated,—she lived in extreme poverty. She was married five years, and had given birth to four children. Patient was suffering from severe headaches which set in soon after the birth of the second child. At first the headaches came at intervals of a few weeks, and lasted about a day, then with the birth of the other children the headaches grew more severe and more frequent, and finally became continuous. From time to time the attacks were specially exacerbated in violence, she then complained of violent pains in the head, excruciating agony toward the vertex. The face was deadly pale, the hands and feet were ice-cold, the pulse weak and sluggish. During the attack the head had to be raised, since in any other position the pain was unbearable. The pain was originally unilateral, starting on the left side of the head. Of late the pain spread from left to right. The whole head felt sore, like a boil, the scalp was highly sensitive. The intense attacks, sweeping over the patient unawares, were accompanied by twitchings of the eyelids, rolling of the eyeballs, dizziness, sparks before the eyes, pains in the left side of the chest, and by numbness and hypoaesthesia of the face, arms and legs. The patellar reflex was markedly exaggerated, no clonus was present; the pupils reacted well to light and accommodation.
The patient was admitted to a local hospital, and was allowed to nurse her one year old baby. Three days after admission, while nursing her baby, she was seized with a violent attack of headache and pain in the left side. The arms felt numb and “gone.” The patient was seized with a panic that the child might fall; hugging the baby to her left breast she screamed for help in agony and terror. Immediately following this seizure the patient lost her voice, speech, and power of walking.
After staying in the hospital for two weeks, the patient was put under my care.