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Updated: May 31, 2025
His view is that pains tend to preserve the mutism and amnesia, so that there are “inhibitory processes” causing the stupor, which prevent the patient from further suffering. When deafness is associated with mutism, he thinks it is often due merely to the inattention of the stuporous state.
The author thinks that pain is a guardian protecting the patient from too distressing thoughts. An effort to speak would cause pain in the throat of a case of mutism and, sometimes, when a distressing memory was sought after under hypnosis, physical pain would wake the sleeper.
After recovery and during the interruptions the patient explained his mutism, refusal to swallow, his filthiness and general negativism as all occasioned by delusions. He was commanded by God to act thus, the attendants were devils, and so on. He spoke, too, of being under hypnotic influence. In addition there were other delusions such as that he had killed his brother.
The patient may keep his eyes covered or stare vacantly, the face often presenting a remarkably immobile wooden, or stolid, expression. Complete mutism is the rule. When activity is not totally interfered with, those movements which are present may be slow. The patient may have to be pushed around and be able to take a few steps, but soon relapses. More often they are of normal rapidity.
When asked how she came to Ward’s Island, she said “By ambulance.” The physical condition presented nothing of note, except for a certain sluggishness of the skin with marked comedones. By January, 1914, the picture changed somewhat and she then presented the following state for an entire year: The mutism persisted and indeed became even more absolute, and she began to wet and soil constantly.
However, she remembered worrying about being bad, about the fact that she could not “pay for the beds,” etc. Her mutism and refusal of food she was unable to account for. But she remembered having dreams at that time “of fire,” “of her dead father and of home.” In a survey of thirty-six consecutive cases of definite stupor, literal death ideas were found in all but one case.
Aurran, Bartholinus, Louis, Parsons, Tulpius, and others mention speech without the presence of a tongue. Philib reports a case in which mutism, almost simulating that of one congenitally deaf, was due to congenital adhesions of the tongue to the floor of the buccal cavity. Speech was established after removal of the abnormal adhesion.
Nov. 10. She is still fairly free. Nov. 11. Inactive, inaccessible, but for the most part not rigid. Nov. 14. Varies between mutism with resistance and more relaxed inactivity. To-day lies in a position repeatedly assumed by her, namely, on her stomach with head raised, resistive towards any interference, immobile face, totally inaccessible. Nov. 15. Freer. Nov. 17.
For the rest of the afternoon we stood about like Italian peasants after an earthquake, possessed of a sort of collective mutism, doing nothing, saying nothing, thinking nothing. Even my seven dead pullets, which had been battered to death by the hail, were left to lie where they had fallen. I noticed a canvas carrier for a binder which Whinnie had been mending. It was riddled like a sieve.
She was soon admitted to a clinic and then showed mutism and catalepsy. Later she became totally immobile with no apparent psychic reactions, and soiled. Gregor studied pulse, respiration and respiratory volume in their reflex manifestations and found nothing unusual. Next he tried to discover if there were voluntary alterations in respiration.
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