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Her psychosis lasted but a little more than three months under observation and was characterized by the following symptoms: She was usually in bed, staring blankly or appearing otherwise quite indifferent and apathetic, but not infrequently, especially during the first few weeks, she was quite restless, resistive, whined and suddenly appeared startled or distressed with no occasion for this reaction in the environment.
Of these 28 cases the incidence of the fever was as follows: 8 showed it only on admission; in 7 it was highest on admission but continued at a low rate throughout the rest of the psychosis; in 5 it extended without much variation throughout the psychosis; in 4 it appeared intermittently, while in 2 it was accentuated during periods when the mental symptoms were most pronounced.
In fact Bleuler states categorically that "up to the present no correlation has been discovered between the symptoms of onset and the gravity of the outcome." Kraepelin has split off from dementia praecox a separate psychosis Paraphrenia systematica which he timidly defends as a clinical entity apparently because the course is a long one and the deterioration less marked than in dementia praecox.
In studying the ideas which we obtained from the patients by retrospective account after the psychosis or from a retrospective account during freer intervals, it is, of course, difficult, especially in the former case, to say whether they have persisted for any length of time.
The last can be studied better than in the deep stupors because these partial cases are more or less accessible to examination. There is a tendency for the patient to think much of death either in the onset or during the psychosis. Negativism seems much less prominent than in the deep stupors. A natural criticism is that these cases merely had retarded depressions.
On the other hand, most women in stupor fail to menstruate during the bulk of the psychosis at a time when we believe emotions to be absent or greatly reduced in their intensity. The recent work of Papanicolaou and Stockard offers a simple explanation for this phenomenon.
Mental conditions are also triggered by low blood sugar levels, frequently contributing to or causing a cycle of acting out behavior accompanied by destruction of property and interpersonal violence, as well as psychosis and bouts of depression. It is not possible to easily deal with the resulting behavior problems unless the hypoglycemia is controlled.
Whether this neurosis is accompanied by such psychosis as ours, it is impossible to say; but those who deny that the nervous changes, which, in the dog, correspond with those which underlie thought in a man, are accompanied by consciousness, are equally bound to maintain that those nervous changes in the dog, which correspond with those which underlie sensation in a man, are also unaccompanied by consciousness.
In 1882, Leo Pinsker, a Jewish physician of Odessa, disturbed by the pogroms of 1881, made a keen analysis of the position of the Jews, declared that anti-Semitism was a psychosis and incurable, that the cause of it was the abnormal condition of Jewish life, and that the only remedy for it was the removal of the cause through self-help and self-liberation.
When she got to the dining-table she put her hand in the soup and then looked at it. So far there is nothing in this case atypical of what we would call a partial stupor. The cardinal symptoms of apathy, inactivity, with a thinking disorder, are all present and dominate the clinical picture. There is, further, the history of a delusion of death during the onset of the psychosis.
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