DEMENTIA PRAECOX, CATATONIC TYPE


Normally possessed of a very cheerful disposition and quick in her actions, intellectually keen, it was not her good fortune to have educational advantages. She was more sympathetic and affectionate than the average. Her social activities were limited to a few. She was treated with respect as to her standard of morals and right living, and her morals and habits were the very best.


Mrs. Nettie G-, age 34, is a white, married and undernourished female. She was committed December 12, 1932 to a State Hospital.

The patients mother was psychotic for four months in 1915. Her diagnosis was Manic Depressive, Manic type. Family history is otherwise essentially negative.

Normally possessed of a very cheerful disposition and quick in her actions, intellectually keen, it was not her good fortune to have educational advantages. She was more sympathetic and affectionate than the average. Her social activities were limited to a few. She was treated with respect as to her standard of morals and right living, and her morals and habits were the very best.

She was considered to be delicate as a child. Her first serious sickness was eleven years after her marriage at the age of 23 years. This was a severe attack of the “flu” beginning March, 1932, from which she did not recover. In July of the same year there was a period of two weeks when she had attacks of singing and praying, followed by several months of being retarded in her actions. Appetite was fair. insomnia was present, and she did not wish to leave her home.

On December 4, 1932 her husband, a World War I veteran, had a serious attack of pneumonia. The patient when normal was always much concerned about her husband and two children. Not recovering from the “flu” and caring for her sick husband, she went into a state of apprehension and mutism.

On admission to the Hospital in December of 1932 there was general muscular, rigidity with shyness and seclusiveness. In brief, her hospital course over the period of thirteen years was one of absolute mutism. When relatives visited she became agitated, would cry, wringing her hands. She, however, ate better and gained weight. More cooperative, she proved to be a good worker, kind and helpful to the patients. When not busy working or caring for patients she continued seclusive and uncommunicative.

THERAPY.

January 10, 1945. Phosphorus 200th was prescribed,not on any characteristic symptoms, but on the general aspect of the case. Patient was fair-skinned, blonde hair, sensitive nature with lively perceptions. Also she was a person with strong emotions plus psychotic symptoms as previously mentioned.

January 24, 1945. She wrote a letter for the first time while in the hospital. It was addressed to her husband and her sister, stating how much better she felt; that she was afraid to talk because she might say something wrong. She said it was a blessing that she was sent to the hospital because she refused to eat while at home.

On the evening after supper on this same day of her letter writing she was sitting on a cough with two patients, both on one side of her. On her other side a patient was standing near by in the door of her room. The patient was becoming furious because our patient and others were near her door. Nettie, our patient, could not stand for the verbal abuse,so she proceeded to accuse this angered patient of being inconsiderate of the patients and herself who were working to keep the ward clean, while she never did so much as to make her own bed.

The were the first words uttered by our patient during the thirteen years in the hospital. From then on she had attacks of excitement. She worried about her son in the Army. She would shout, sing and pray. During these attacks she gave her son over to Gods care and hoped he would be a good boy.

February 3,1945. she manifested the following symptoms; being so occupied with them she was unable even to care for her personal needs:.

She said electricity came into her room and shocked her. when her husband shaved electricity came to her. She admitted hearing voices when she was home, but could not elaborate on them. Anyone in her room drew blood from her abdomen. She says she is going to die. When she does she wants someone near her. She desired hot food and drinks, craved ice cream. Sensitive to the cold, she required much bed covering or would stand by the not air register.

Phosphorus 1M was given, followed in one week by disappearance of the symptoms and the patient went about her work as usual.

Nothing of note is to be recorded during the following ten months. As the case ceased to improve by return of symptoms, Phosphorus continued to be indicated. At the 50M potency reaction was less conspicuous, so we dropped to the 30th potency.

The last prescription of Phosphorus was December 13, 1945 of the 200th.

January 1, 194. Patient was having an Allium cepa type of rhinitis with lachrymation. The 200th fixed it. But February 4, 1940 the rhinitis returned in a more severe form. Now inflammation of the eyes with redness of the lids and the edges. The patient gave a past history of what appeared to be conjunctivitis (purulent) treated by Argyrol. Natrum mur. 10M was given. It required three ore prescription. After the 50M there was no recurrence of the eye trouble.

Only for minor ailments did the patient require treatment until on April 7, 1947 there appeared a severe attack of the “flu.” Only the symptoms common to this malicious malady were present. Then Influenzin Hispanica 10M was administered.

It is needless to say that this patient, 48 years of age, is now of sound mind after fourteen years. But her future may be a problem. About five years ago her husband took unto himself his housekeeper as common-law wife, illegally so, and he has a son by this woman, age three years. Our patient was told of this disgraceful affair a few months after she began to talk and to improve under the influence of Phosphorus.

It was surprising how sternly, with a minimum degree of emotion, she became reconciled to this event, and is satisfied to enjoy the affection of a son who is in training at West Point and a daughter, married and living in the old home town. ATHENS, OHIO.

 

DEMENTIA PRAECOX, PARANOID.

[ Read before Bureau of Clinical Medicine, I.H.A., June 26, 1947].

V.TABER CARR, M.D.

Frances P. S., Thirty-five years of age, white married female, was graduated from Ohio University in 1936. She taught Home Economics two years in a High School and has since been active and influential in several organizations.

She married at the age of 25 years and has two children aged seven and four years.

Personality: With a tendency to being quiet and reserved, she is congenial and deeply interested in her home.

History of Present Illness: While she was teaching school, at the age of 24 years, she became restless, more talkative than normal, with complaints of various things wrong with her. It is to be noted that she was afflicted with a severe frontal sinus trouble during this restless period. Following the above experiences and appendectomy was performed. The appendix was found normal.

Five year ago there was intolerance for iodine. It induced stomach acidity, nausea and emesis. During the spring of 1945 there was an attack of sinus trouble with a profuse, yellow, post nasal discharge. This condition was alleviated, but returned the following spring, 1946. Treatment during April proved successful in stopping the discharge. Almost simultaneous with disappearance of the discharge the patient suffered intense pain, shooting in character, in the forehead. With the lessening of the pain the patient began to imagine she had various ailments. The most disturbing was cancer. This prompted her to visit several doctors; naturally she derived no satisfaction.

She continued her normal activities in her church and Parent- Teachers Organization until she had a fainting attack. Then she said her eyes pained, and she complained of pains all over her body, more so in her hands and arms. Rubbing caused the pains to be bearable. It was then that she began to lose interest in her normal pursuits and wrote many pages on cancer. She in tended to publish this matter in book form.

Her husband, thinking a change would do her good, sent her from their home in Portland, Oregon to Athens, Ohio. She traveled with the two children as far as Omaha, Nebraska. Here she was taken off the train because of disturbing the passengers and the train crew.

A brother soon brought her and the two children to their destination. Admitted to the Hospital, September 20, 1946, the patent for the most part was cooperative but required close supervision. There were times when she was noisy, singing or shouting. One day she spent the day saluting the nurses as they passed by her door and she kept repeating, “1-2-3-4, Heil Hitler.” At first she was manic-like in her expressions and manner, viz., she came to the ward office saying. “Im (speaking her name) of the F.B.I. what can I do for you? What is this worth to you?” She then emptied the contents of her purse. Then she called attention to every piece of clothing she had on and told where it came from. From here on she rambled from one thing to another. However, every sentence indicated a delusion.

These delusions were many, fantastic, unsystematized and utterly illogical, the longer she remained in the hospital, viz., “The Navy took a shot at me once. They can kill my baby for Im the atomic energy. I belong to the F.B.I. My husband is in the Navy. I am full of electricity and atomic energy. I asked Dr. Dixon why he said I was the most brilliant woman who ever came in this office when I got a D in psychology.”.

In mood there was consistently a trend of indifference. On a few occasions she wished to see her children. She had apparently forgotten her husband. She doubted that there was anything wrong with her mind.

THERAPY.

Between September 27, 1946 and January 23, 1947 electric shock treatment were given in four short periods with two to five shocks to a period. Only temporary improvement resulted.

The following symptoms were considered on February 12, 1947, after a personal interview with the husband:.

1. She always was sensitive to cold.

2. Craved company. Never like to be alone. This was even manifested during her psychosis.

3. She imagined she was sick with cancer, etc.

4. There was misidentification of persons and things, her husband was someone else, a pencil belonged to the President of the United States.

5. Many grandiose ideas.

6. She is very affectionate.

7. Suppression of nasal discharge.

8. Rubbing alleviated pain.

Phosphorus 1M was given January 13, 1947. Unknowingly, it was given before her menstrual period by two days. Because the flow was so profuse with cramping pains she was obliged to remain in bed. There was also present a foul odor.

During the first ten days she experienced sharp pains in her forehead. Immediately this aggravation she became mentally normal.

Six weeks after receiving the Phosphorus she went to her mothers home, caring for her children. On May 31, 1947 she and her children returned do their home in Oregon.

In a letter dated October 9, 1947 the patient writes. “I am feeling better than I ever did. I weigh now 151 lbs., 15 pounds more than I ever did weigh. My two little children keep me busy.” ATHENS, OHIO.

V. T. Carr