to discover what had gone on in him during these five years, but could learn nothing. Another patient with a similar symptom, when asked why he had remained silent for years, maintained, “Because I wanted to spare the German language.”[1] These examples show that it is often impossible to lift the veil of the secret, for the patients themselves have neither interest nor pleasure in explaining their strange experiences, in which as a rule they realise nothing peculiar.
Occasionally the symptoms themselves are a sign-post to the understanding of the psychology of the disease.
We had a patient who was for thirty-five years an inmate at Burghölzli. For decades she lay in bed, she never spoke or reacted to anything, her head was always bowed, her back bent and the knees somewhat drawn up. She was always making peculiar rubbing movements with her hands, so as to give rise during the course of years to thick horny patches on her hands. She kept the thumb and index finger of her right hand together as in the movement of sewing. When she died I tried to discover what she had been formerly. Nobody in the asylum recalled ever having seen her out of bed. Only our chief attendant had a memory of having seen her sitting in the same attitude as that she afterwards took up in bed, at that time she was making rapid movements of extension of the arm across the right knee; it was said of her that she was sewing shoes, later that she was polishing shoes. As time went on the movements became more limited till finally there remained but a slight rubbing movement, and only the finger and thumb retained the sewing position. In vain I consulted our old attendant, she knew nothing about the patient’s previous history. When the seventy-year-old brother came to the funeral I asked him what had been the cause of his sister’s illness; he told me that she had had a love-affair, but for various reasons it had come to nothing. The girl had taken this so to heart that she became low-spirited. In answer to a query about her lover it was found that he was a shoemaker.
Unless you see here some strange play of accident, you
- ↑ I am indebted for this example to my colleague Dr. Abraham of Berlin.
