he 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. Had her condition remained like this, there
would be no difficulty in classifying the case, but other
symptoms appeared.

Five days after admission she was restless, somewhat
distressed, and announced that she wanted to talk to the
physician. When examined, the distress, with some
whimpering, continued. She asked the doctor not to be harsh
to her, frequently said there was something wrong and began
to cry. A normal interest appeared only once, when she
spontaneously said she wanted to see her relatives. A most
interesting feature, however, was a certain perplexity that
now appeared. She spoke of this directly: "I do not know
what it is all about. I know you are a doctor, that is all.
I don't know whether I passed out and came back again or
what--I don't know what to make of it." She also felt
confused about her marriage--"There is where all the mixup
is. I was married when I was 16." She was reminded that she
had said she was single, and replied "I am single." Then
where is your husband? she was asked. "He must be dead."
She recalled the examination on admission and remembered
some of the questions that she was asked then, also knew
that she had been at the Observation Pavilion and that she
had reached this hospital by boat. On the other hand she
still claimed that the year was 1917, and in connection
with the delusion of having died was quite unclear as to
the time. She said that it seemed as if she had died many
years ago and that she had come to the hospital years ago.
She also spoke of having died at a summer resort the year
before. When asked for her age, she said that she must be
very old, but on the other hand claimed that she was
supposed to die and to come to the hospital when she was 26
(two years more than her actual age).

Her psychosis continued from then on for about ten weeks.
She soon began to feed herself, but otherwise for most of
this period remained quietly in bed, looking about a good
deal, although showing no particular mood reaction until
questioned,