PSYCHONEUROSIS, PSYCHASTHENIA


She described the knee-chest position, and a dose of Medorrhinum, 10M, not only brought the fever down, and cleared all of the symptoms in the lung, but also brought out a rash like measles. He made a perfect recovery. It was not measles because he didnt have the other symptoms, and he had had the measles not so very long before. That, I think, is correct procedure.


Mrs. Mary I.P– is thirty-six years of age, fully developed, well nourished, white, married female. She has brown eyes and hair and her weight it 135 pounds, height 5 feet 32 inches. By appearance she was in the best of health physically. Thorough physical examination clinically and by laboratory findings substantiated this observation. Only the cold sweat of the palms and soles were suggestive of some psychic or nerve disorder.

In two points the family relationship is pertinent to our case. Three aunts, as school teachers, were distressingly orthodox puritanically. The father was a harsh disciplinarian. Our patient in her own words said that her father told her when she was four years of age into the hayfield to tramp down the hay on the wagon. This was only a small beginning of her girlhood life hardened into farm duties equal to those of a hired man.

She was the first born and, as her two brothers and a sister came along, here was added responsibility in the fact that the mother was sickly. Her father would box her ears when he thought her dumb in the study of her lessons or about the work on the farm. The fathers sole ambition was to pay off the mortgage on the farm. The aunts idea was that every member of the family must aspire to higher education. To top it all off, the children were to wear the religious straight-jacket.

Thus our patient was embarked on a rugged course. Was she to weather the storm unharmed?.

She naturally was affectionate, possessed of a worthy ambition, and a friendly disposition, and, much to her credit, she had an unfaltering faith. Her intelligence would possibly rate above the average.

She did not mind so much the dictum by the aunts that she should have four years of Latin and mathematics for a high rating to a college. Her choice was a course in home economics and then a business course.

Eventually, not having sufficient funds to enter the college approved by her dictatorial aunts, she earned enough money by working in an A & O store to complete a business course.

Again, twice her aunts intervened in what would in her own right be the womans supreme right of choice. They objected to her marriage when nineteen years of age because she was too young. The second time, when she was twenty-one years, they did not like the physician who was her fiance.

Thus far there was not untoward personality reaction.

Her mother died after had nursed her for several months. Now at the age of twenty-six, and three months after the death of her mother, she married a foreman in a pottery. It was a decision made as a matter of convenience to escape her keeping house for her tyrannical father. Although he was “mothers pet”. he was an honest. industrious and a quiet sort of a fellow. There were flashes of humor when he was serene.

The marriage life from the start proved embarrassing. The first week the husband, seeing the minister who had tied the knot make his entrance to their home, ran and hid himself. Shocking as this was to our patient, she entertained the minister. During the following thirteen years Mary, our patient, heroically carried on. She kept faithfully her religious vows, was active socially. While her husband remained at home when no working, he was unsympathetic to her interests to the extent of heckling her and belittling her attainments. This incompatibility naturally led to neglected of marital duties.

However, at the end of thirteen months, when starting on their stormy voyage, a baby girl came to lend some pleasure. Understand, the husband was a good provider and helpful in the house. This in a way compensated for his shortcomings, but in the patients own words. “He was not my souls companion, his life was not like mine.”.

On March 19, 1945, during an argument over finances in her Sunday School class meeting, she being the class President, she said she felt as though something hit her in the back of the head and neck. Then the thought came to her, “If only Ross (her husband) were here.” Things began to look queer and small to her. “I felt I was in a daze. A feeling like vibrations went down my back. Then all the happenings in my past life and since then were like a dream-unreal. At once I began to ask myself, Why plan? Why build? Why be ambitious? why even be here? We just exist, die and decay.” Then she experienced numbness all over her with vertigo. Now objects and people appeared smaller than ever.

Consulting a physician, her systolic pressure was 90. A nerve tonic and liver capsules were prescribed followed by indifferent results.

On September 15, 1945 she was admitted to a private sanitarium. She was given five electric shock treatment during a fourteen day period. After the fifth treatment patient remarked, “I dont need any further treatment. I am all well.” The physician in charge stated that she had claimed that there was no feeling of unreality. Previously there was mild depressions, now all symptoms of it disappeared.

Symptoms were sensation of numbness, misery in the pit of the stomach, depressed, retarded, feelings of unreality, indifference, unworthiness and guilt. There were some imaginations. viz., she thought someone was going to blow up the schoolhouse. Once she experienced hearing a voice predicting that something would happen and sure enough Roosevelt died. “I don;t believe in fortune telling, though,” she remarked.

The patient, in giving her experience at the sanitarium, said that the electric shock treatments brought her out of her dazed condition, so that for one week she did not remember or think about the “burden of death,” as she termed it. then the idea of death returned stronger than ever.

Refusing to take more electric shock treatments, she was advised to consult an experienced psychiatrist. So in October, 1945, he prescribed Benzidine Sulphate, one tablet to be taken twice daily. This was faithfully done during the following three months. The husband stated that during the last few weeks in this period she was in bed most of the time being greatly depressed, crying, and had lost interest in everything. In the last week she threatened suicide. Persistently she said she had the means of carrying out this threat.

It was at this critical stage she was committed January 12, 1946 to a State Hospital. In addition to the picture of the mental disorder as narrated, she had lost affections toward her daughter and others. Immediately on admission in a few days she became mentally keen regarding her situation.

She asked persistently that something be done to restore to her the sense of reality. The fact of her inability to think and act normally was distressingly evident to her.

THERAPY.

Confession my bewilderment where and how I should come to grips therapeutically with this case, I prescribed Platina 1M. Later I discovered there was a physical angle to consider.

In the meantime a clergyman gave her religion-psychotherapeutic talks. Effort was made to help her in re-establishing a rational pattern of life. She had lost all concern for her daughter, Kathleen, now fourteen years old. She was told that Kathleen required motherly advice and guidance now through her first critical period of life, so immediately it was constantly on he mind to devise plans whereby she could obtain money. At one time she said she would be a singing evangelist. Then it was something else she purposed to do to obtain money. Her ideas were so absurd and visionary that time was spent disabusing her mind of them.

The husband received his course of correction. It was for me to jar him loose from his self-sufficiency. He was sternly told that he must change his attitude, if he wished the respect and love of his wife. He must manifest interest in the things she will be interested in. He was instructed in what constituted normal marital relationship. Surprisingly, the response was most immediate.

On Easter Sunday the husband, unquestionably in all sincerity, endeavored to make it a day to be long remembered. He took her to church. This he had never done. After church was over, on sitting down to the dinner table, the wife made the remark of Kathleen, the daughter, “I dont see why I brought you into the world.” The husband, in relating this, said he could have slapped her face. Later, the husband took her alone for a ride, thinking possibly he could reason with her. No; she at once accused him of having her committed to the State Hospital and that she had a notion to kill him and Kathleen for it Naturally, the husband and daughter discontinued their visits.

No desirable progress was being accomplished, so closer investigation revealed that at the age of 7 she had had double pneumonia with whooping cough. Her life was threatened, followed by slow recovery.

She was bothered every winter with throat trouble. At the age of 25 rheumatic fever lasted from Christmas to the following April. This started on the inner side of the left ankle with pain and swelling, extending upward into the left leg and arm; then it passed over into the right side where the rheumatic condition was less severe. Tonsillectomy was performed subsequent to the rheumatic attack. Dating from this operation, she said she experiences, prior to every menstrual period, a prickling, tingling sensation with extreme soreness under both clavicles. This completely disappears as soon as the flow starts.

V. T. Carr