Lecture 32

Abstract

The patient who you see looks feeble, pale, and exhausted. In fact, for 4 weeks she has been in a severe state of arousal, in which she has produced an excess of movements, which probably explains why all her energy has been quite used up. To our great surprise, a turn-around occurred from yesterday, after she had been in constant motion the day before, mostly with histrionic-melodramatic expressive movements, and had been singing virtually without ever stopping. The way she carried out her singing was certainly surprising: It was accompanied by a fine tremor of her lower lip and the whole of her lower jaw, a movement akin to that of chattering teeth, but without the teeth ever occluding. Her voice thus attained a regular, tremulous character, reminiscent of many barrel organ performances, the more so as she sung only the notes, without accompanying words—evidently a wholly invented, sustained hymn, almost always at very high pitch—with steady, quiet ‘conducting’ [Ed] movements.