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When one considers that even with the greatest care the nutrition of tube-fed patients is bound to be poor, it would be only natural to suppose that this malnutrition would cause such a disturbance in the œstrous cycle and was evidenced objectively by a failure to menstruate. Even in patients who are not tube-fed, under-nutrition is to be expected and, as a matter of fact, is usually observed.
She claimed that she had previously forgotten about her marriage and thought she was still merely keeping company with Mr. F. She claimed not to remember coming to the hospital, did not know what ward she came to, who the doctor and nurses were, in fact claimed that it was about a year before she knew where she was. But she remembered having been tube-fed. She could not say why she did not speak.
She had to be tube-fed, was usually very resistive to any passive motions; quite often she retained her urine, but she did not hold her saliva. Yet there was some quick responses at least in the beginning.
As a rule she was quite stiff, offering passive resistance towards any interference. She had to be tube-fed at first. Later she was spoon-fed, and then would swallow, in spite of the fact that during the interval between her feeding she would let saliva collect in her mouth. For a time she had a tendency to hold one leg out of bed, and when it was put back would stick the other out.
For about ten days she was somewhat different. She became quieter and at first lay muttering unintelligibly, saying some things about being killed, but speaking little, often restlessly tossing about and tremulous. She had to be tube-fed.
The conflict was frankly stated in the words, “I love my father but don’t want to die.” Then for two weeks she had some fever, was tube-fed, muttered about being killed or showed some elation, there being apparently interrupted stuporous, manic and, possibly, anxiety episodes. Finally she settled down to a year of deep stupor.
For a time she refused food consistently, lost flesh and had to be tube-fed. For the most part she said very little and, when one accosted her, she was apt to turn away. A few times, when further urged, she swore at the examiner.
She did not recall, or at any rate denied, speaking of the young man suing her. She was then taken to a private sanatorium, where she was for two months preceding her admission to this hospital. There she was described as quiet, mute, tube-fed, resistive.
She usually lay or sat motionless, sometimes with mouth partly open, letting the flies crawl over her face, gazing in one direction, soiling, wetting, resisting moderately or markedly any interference, and had to be tube-fed. But this was not the invariable state. The most constant feature was her mutism, but even that was a few times interrupted.
She lay for the most part motionless, changing her position but rarely; her expression was stolid; she retained and drooled saliva, wet and soiled herself. She never answered any questions; showed no interest whatever. At times she was quite stiff and very resistive but never cataleptic. Her extremities were cold and cyanotic. She had to be tube-fed throughout. During this time she lost much hair.
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