In the six months during which the analysis has been in progress the patient has had no attacks in which she has had convulsions, frothed at the mouth, or bitten her tongue. She has had only three spells in which consciousness was lost and these were mild. The last one was described by the daughter. She said it was like a faint; that her mother was in it only a short time; that she had none of the symptoms she used to have; and was all right soon afterwards with no bad after-effects. She added that since her mother had been coming to the hospital she had improved so much they never thought of her now as being sick. The bad feelings have diminished so much in number and intensity as to be almost negligible. Family relations have so improved husband and wife are practically at one in their purposes. Social relations have also improved to such an extent that the patient has been able to prevent the wreck of the home of a friend, and in her church is an active worker on a number of committees. She is now doing her best to get her daughter started right in life. The patient regards herself as having practically recovered.
The next case I wish to present for your consideration is that of a young man twenty-six years old. He was brought into the accident-room of the hospital one night last Summer suffering from convulsions. He continued to have convulsions throughout the night, and as many as five interns were required to hold him quiet. These convulsions seemed to have enough purpose in them to warrant the diagnosis of hysteria, so the next morning he was referred to me.
"Last Wednesday night," he said, "I was having dinner with a customer at the Hotel Thorndike. I began to feel sick and went to the toilet and vomited. Then I went back and got my friend and started for a drug store in Park Square to get some quinine. But before I got very far I began to shiver and shake and I knew that it took quinine two or three hours to work so I started back to the hotel to get a room. No rooms were to be had, so I said 'get a taxi and take me to the hospital.' I lost the use of my legs on the steps and they had to carry me. In this attack I was more or less conscious all through it." What were you thinking of in the taxi, I asked. "I don't know. I felt as if I wanted to jump at something and grab something." Can you not remember what was in your mind, I continued. "Only what I've told you," he answered. Will you lie down and close your eyes and imagine yourself back in the taxi, I asked. Now tell me what you see. After a moment he said, "I see flames." What else do you see? "Nothing, only flames. I feel as if I wanted to jump into the fire." Did you see flames in the taxi, I asked. "Yes, that was what I wanted to jump at." At this moment the patient gave a start. What did you see then, I asked. "There is something in the flames, an object, I don't know what it is. It might be a thing or a person. I feel as if I wanted to grab the object." At this instant the patient gave a violent jump into the air and then sank back relaxed. What did you see, I asked. "This object. It seemed to be attracting me." Can't you tell what it is, I said. "No. But it seems almost like a person. It seems as if I could see an arm." What else do you see? "The arms seem beckoning me." It is a person then? Is it a man or a woman? "I don't know. I can't make out." Look. "It is a woman. I can see now." Is it anybody you know? "No, I can't see any face." What do you see? "Just a woman, standing in the flames, with outstretched arms, as if imploring me to come. I feel a yearning, as if I must jump and grab her." The patient stiffened slightly and gave a sort of spring up from the couch and then sank back, breathing a little heavier. What did you see, I asked. "I thought she beckoned me to come." Can you see who it is now? "No The face is blank." Look again and see if you can't tell who it is. What do you see? "I can't tell. I see several faces come and go." Do you recognize them? "Yes. The first is my little girl's; then I see a former sweetheart of mine; then I see my wife's face."
Gradually the following story was elicited from the patient. His mother died when he was seven and his father married again in less than a year. The former sweetheart was his step-mother's half-sister who came to live at their house because the schools were better. He became infatuated with this girl and his step-mother did everything she could to encourage his feeling as she thought it would be a good match. The vision of his sweetheart in the flames was based on an actual occurrence. She was sitting in front of a fireplace once when a log of burning wood fell out and he jumped to pull her away and held her close in his arms for a moment.
Finally, however, he broke off absolutely all relations with the girl. The reason seems quite adequate. Why didn't you marry, I asked. He answered, "we quarrelled and I left her. I didn't like her morals. She went with other men and had connection with them. I saw her go into the woods one night with another fellow, and once at Salisbury Beach I saw her go into a hotel with a man and register as his wife."
About a year after this the patient began going with another girl more in an attempt to crowd the image of his former first love out of his mind than because he had fallen in love again. A year later they married. From the first his married life was not entirely happy. More or less unconsciously he began to regret lost opportunities. He was a travelling man and soon after marriage his route was enlarged necessitating his being away from home a month at a time. On these trips he used to get exceedingly lonesome especially as he steadily refused going with other travelling men and making a night of it as they often did. One of his routes took him to Virginia and he said that he had returned from New York on the way there just for the sake of spending a night with his wife. Once, in New York, he was unfaithful to his wife and on that occasion contracted gonorrhea. This, however, was the only time he has ever had extra-marital sexual relations, he said.
Just before his attacks began, which was about four years ago, he was told by his wife's doctor that it would be impossible for her to have any more children as she was suffering from heart disease. To his mind this meant giving up coitus. Then, unconsciously, he began to dream of Anna, his first love. He regretted more than ever not taking advantage of his former opportunities, and unconsciously dallied with the thought of deserting his wife. Just at this time his attacks began.
As the analysis progressed his attacks diminished and shortly disappeared. Gradually the image of his wife took full possession of his mind and the image of Anna disappeared. Towards the end of the analysis as he was lying on the couch with his eyes shut, he saw Anna in the flames and felt the yearning but not so strongly as to lead to any impulsive movements. What do you think all this might mean, I asked. "I don't know," he answered, "it might mean I still cared for Anna and that if I let myself go it would break up my home." With his full realization of the meaning of this symbolization, it was assumed that he was cured.
Seven months later, in company with a colleague, I visited my former patient and he told me that he had not had a moment's illness since I last saw him. He told me that while occasionally the thought of Anna would come to his mind, it never disturbed him, and never distracted his attention from other things. He has prospered in his business, and I saw every evidence of a happy home.
This case merits consideration for a number of reasons. In the first place the attacks were cured by psychoanalysis. No one who saw the association of the symbolical imagery and the convulsive movements could fail to see that there was a causal connection between them. The subsidence in violence and frequency of the convulsive movements as the conscious grasp of the meaning of the mental symbolical imagery increased was also completely convincing of the therapeutic value of the analysis. The question of the permanence of the recovery is of course open, because seven months is far too short a time to carry complete conviction.