This young person was brought from the
country to the hospital of Le Havre at the age of 19 because she was considered
insane and the hope of seeing her cured had almost been given up. The facts
were that she had periods of convulsive attacks with delirium which lasted
for days. After a period of observation, it became clear that the sickness
consisted of periodical manifestations which occurred regularly at the
time of her menstruations, and of less severe manifestations which were
more prolonged and occurred at irregular times during the intervals.
Let us begin with the first ones. At
the time preceding her menstruations, Marie's character changed; she became
gloomy and violent, which was not in her habits, and suffered pains, nervous
spasms, and shivering in her entire body. However, things went on
almost regularly during the first day, but hardly 20 hours after the beginning,
the menstruation stopped suddenly and a great tremor seized the whole body;
then, a sharp pain ascended slowly from the abdomen to the throat, and
a great hysterical crisis ensued. The attacks, although they were very
violent, never lasted for a long time, and never had resembled epileptoid
tremors; instead, there was a very long and severe delirium. At times,
she would utter cries of terror, ceaselessly speaking of blood and fire,
fleeing in order to escape the flames; at other times she would play as
a child, speak to her mother, climb on the stove or on the furniture, and
create havoc in the ward. This delirium and the violent bodily contortions
alternated with short periods of rest during 48 hours. The attack ended
with vomiting blood several times, after which everything came back approximately
to normal. After one or two days of rest, Marie would quiet herself and
remembered nothing of the episode. During the intervals of those intense
monthly manifestations, she maintained limited contractures at the arms
or the intercostal muscles or various, changing anaesthesias, and above
all a complete and permanent blindness of the left eye [...] furthermore,
she occasionally had smaller crises without the great delirium, but which
were characterized predominantly by attitudes of terror. This sickness,
which was so obviously linked to the menstrual periods, seemed to be uniquely
a physical one, and of little interest for the psychologist. Therefore,
at the beginning, I dealt very little with this person. At most,
I performed on her a few hypnotic experiments and a few studies on her
anaesthesia, but I avoided anything which could have disturbed her at the
time when her major manifestations were approaching. She remained for seven
months at the hospital during which the various medications and hydrotherapy
had not brought forth the least modification. Moreover, therapeutic suggestions,
notably suggestions concerning her menstruation, had nothing but bad effects
and increased the delirium.
Around the end of the eighth month she
complained about her sad lot and said, with a kind of despair, that she
was well aware that her symptoms would continue to recur.
'Look here,' I told her out of
curiosity, 'explain to me now what happens when you are going to be sick.
'
'But, you know it...everything stops.
I have a big shivering, and I don't know what happens next.'
I wanted to get precise information
about the way her periods had been inaugurated and had been interrupted.
She did not give a clear answer, and seemed to have forgotten most of the
events about which I asked her. I then occurred to me to put her into a
deep somnambulic condition, a state where [as we have seen] it is
possible to bring back seemingly forgotten memories, and thus I was able
to find out the exact memory of an incident which had hitherto been only
been very incompletely known.
At the age of 13, she had had her first menstruation, but, as
a result of a childish idea or something she had heard and misunderstood,
she imagined that there was some shame in it, and she tried a means of
stopping the flow as soon as possible. About 20 hours after the beginning,
she went out secretly and plunged herself into a big bucket of cold water.
The success was complete' the menstruation was suddenly stopped, and in
spite of a violent shivering, she was able to come back home. She was sick
for a rather long time and had several days of delirium. However, everything
settled down, and the menstruation did not appear again until five years
later. When it reappeared it brought back the disturbances I observed.
Now, if one compares this sudden stopping, the shivering, the pains she
describes today in the waking state, with what she describes in a somnambulic
condition--which, incidentally, was confirmed from other sources--one comes
to this conclusion: Every month, the scene of the cold bath repeats itself,
brings forth the same stopping of the menstruation and a delirium which
is, it is true, much more sever than previously, until a supplementary
hemorrhage takes place through the stomach. But, in her normal state of
consciousness, she knows nothing about all this, not even that the shivering
is brought forth by the hallucination of cold. It is therefore probable
that this scene takes place below consciousness, and form it the other
disturbances erupt.
This assumption--true or false--being
made, and after consulting Dr Powilewicz, I tried to take away from somnambulic
consciousness this fixed and absurd idea that the menstruation was stopped
by a cold bath. At first, I could not manage to do it; the fixed idea persisted;
and the menstruation, which was due for two days later, occurred as usual.
But, since I now had more time at my disposal, I tried again: I was able
to succeed only thanks to a singular means. It was necessary to bring her
back, through suggestion, to the age of thirteen, put her back into
the initial circumstances of the delirium, convince her that the menstruation
had lasted for three days and was not interrupted through any regrettable
incident. Now, once this was done, the following menstruation came at the
due point, and lasted for three days, without any pain, convulsion or delirium.
After noticing this result, the other symptoms were to be investigated.
I omit the details of the psychological exploration, which was at times
difficult. The attacks of terror were the repetition of an emotion which
this young girl had felt when seeing, at the age of 16, an old woman killing
herself by falling down stairs; blood, of which she always spoke during
her crises, was memory from this scene; in regard to the picture of the
fire, it was probably an association of ideas, because it was not linked
with anything precise. Through the same procedure as before, through bringing
the subject back by suggestion to the moment of the accident, I succeeded,
not without difficulty, to show her that the old woman had only stumbled
but had not killed herself: the attacks of terror did not recur.
Finally, I wanted to study the
blindness of the left eye; but Marie was opposed to it and said that she
was like that from birth. It was easy to check by means of somnambulism
that she was mistaken; if one transforms her into a five year-old
child, by the well-known methods, she takes back the sensitivity she had
at that age and one observes that she sees well with both eyes. Therefore,
it was at the age of six years that the blindness had started. On what
occasion? Marie maintains, in waking state, that she does not know. During
somnambulism, I make her play the chief scenes of her life at that time,
and I see that the blindness starts at a certain point on the occasion
of a trifling incident. She had been compelled, in spite of her cries,
to sleep with a child of the same age who had impetigo on the entire left
side of her face. Some time later, Marie developed an almost identical
impetigo, in the same place. Then plagues appeared again several times
at about the same time of year and were finally cured; but no one noticed
that, hence forward, she had an anaesthesia of the left side of her face
and was blind in the left eye! Since that time the anaesthesia had persisted
or at least-- in order not to go beyond that which can be observed-- whatever
be the period into which I set her back through suggestion, this anaesthesia
remains constant although her various other anaesthesias would disappear
completely at times. Same attempt as previously at cure. i put her back
with the child who had so horrified her; I make her believe that the child
is very nice and does not have impetigo (she is half-convinced. After two
reenactments of this scene I get the best of it); she caresses without
fear the imaginary child. The sensitivity of the left eye reappears without
difficulty, and when I wake her up, Marie sees clearly with the left eye.
It is now five months since these experiments were performed.
Marie has never shown the slightest signs of hysteria, she is doing well
and above all is becoming stronger. Her physical aspect has changed thoroughly.
I do not attach to this cure more importance than it deserves, and
do not know how long it will last, but I found this story interesting as
showing the importance of fixed subconscious ideas and the role they play
in certain physical illnesses, as well as in emotional illnesses [Ellenberger,
1970,361-4; translation of Janet,
1889, 336-40].