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paresis of the muscles of the front of the neck,
so that finally the patient could only move her head by pressing it
backwards between her raised shoulders and moving her whole back;
contracture and anaesthesia of the right upper, and, after a time,
of the right lower extremity. The latter was fully extended,
adducted and rotated inwards. Later the same symptom appeared in
the left lower extremity and finally in the left arm, of which,
however, the fingers to some extent retained the power of movement.
So, too, there was no complete rigidity in the shoulder-joints. The
contracture reached its maximum in the muscles of the upper arms.
In the same way, the region of the elbows turned out to be the most
affected by anaesthesia when, at a later stage, it became possible
to make a more careful test of this. At the beginning of the
illness the anaesthesia could not be efficiently tested, owing to
the patient’s resistance arising from feelings of
anxiety.
     
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    Studies On Hysteria
    24
     
       It was while the patient was in
this condition that I under took her treatment, and I at once
recognized the seriousness of the psychical disturbance with which
I had to deal. Two entirely distinct states of consciousness were
present which alternated very frequently and without warning and
which became more and more differentiated in the course of the
illness. In one of these states she recognized her surroundings;
she was melancholy and anxious, but relatively normal. In the other
state she hallucinated and was ‘naughty’ - that is to
say, she was abusive, used to throw the cushions at people, so far
as the contractures at various times allowed, tore buttons off her
bed clothes and linen with those of her fingers which she could
move, and so on. At this stage of her illness if something had been
moved in the room or someone had entered or left it she would
complain of having ‘lost’ some time and would remark
upon the gap in her train of conscious thoughts. Since those about
her tried to deny this and to soothe her when she complained that
she was going mad, she would, after throwing the pillows about,
accuse people of doing things to her and leaving her in a muddle,
etc.
       These
‘ absences ’ had already been observed before she
took to her bed; she used then to stop in the middle of a sentence,
repeat her last words and after a short pause go on talking. These
interruptions gradually increased till they reached the dimensions
that have just been described; and during the climax of the
illness, when the contractures had extended to the left side of her
body, it was only for a short time during the day that she was to
any degree normal. But the disturbances invaded even her moments of
relatively clear consciousness. There were extremely rapid changes
of mood leading to excessive but quite temporary high spirits, and
at other times severe anxiety, stubborn opposition to every
therapeutic effort and frightening hallucinations of black snakes,
which was how she saw her hair, ribbons and similar things. At the
same time she kept on telling herself not to be so silly: what she
was seeing was really only her hair, etc. At moments when her mind
was quite clear she would complain of the profound darkness in her
head, of not being able to think, of becoming blind and deaf, of
having two selves, a real one and an evil one which forced her to
behave badly, and so on.
     
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    Studies On Hysteria
    25
     
       In the afternoons she would fall
into a somnolent state which lasted till about an hour after
sunset. She would then wake up and complain that something was
tormenting her - or rather, she would keep repeating in the
impersonal form ‘tormenting, tormenting’. For alongside
of the development of the contractures there appeared a deep-going
functional disorganization of her speech. It first became
noticeable that she was at a loss to find words, and this
difficulty gradually increased. Later she lost her command of
grammar and