Devereux] MOHAVE ETHNOPSYCHIATRY AND SUICIDE 113 



whicli you just mentioned describe my condition. (Q) I recognize your descrip- 

 tion of liot waves in the head, and the sensation that I am going to lose my 

 balance when I get up abruptly. I used to have these feelings before fainting. 

 (The description pertained to dizziness associated with postural cerebral anemia 

 caused by low blood pressure. ) 



(Q) The miscarried child was fathered by my husband. 



(Q) At present my health is not very good. There is nothing special, really, 

 but I just don't feel well sometimes. Perhaps it is some aftermath of my illness. 

 (Q) I had no further fainting spells since I left the hospital. (Q) I don't 

 think that I was even temporarily out of my mind, or yamomk (insane), while 

 at the hospital. 



(Q) I know Apen Ismalyk (Case 4). He is insane (yamomk). (Q) I don't 

 know anyone else whom I would consider insane. 



An interview with the reservation physician, James L. Troupin, M. D., disclosed 

 that O : otc, 27 years of age, was admitted to the hospital on June 2, 1938, with 

 the diagnosis of incomplete abortion and postabortal sepsis. 



On the day of her admission the patient stated that she had missed a period, 

 which was due a month ago. If she was pregnant, her embryo would have been 

 about eight to ten weeks old. About ten days before admission she began to 

 have a flow, accompanied by clots. She denied all instrumentation or other inter- 

 ference. At the time of her admission this flow was continuing, though in some- 

 what lesser amount. There were no symptoms other than a slight nausea. 



Except for the amputation of the right forearm, and for a few moist rales in both 

 lungs (upper respiratory infection), no physical abnormalities could be found. 



During the flrst 2V2 weeks of her hospitalization, she had temperatures up to 

 100 and 101. About the third day, her nausea became worse and all food by 

 mouth was stopped. On the eighth day she was able to take some food, and from 

 then on she improved steadily. Throughout her illness, she was treated with hot 

 douches, surgical interference being thought inadvisable. She passed small clots 

 from time to time, and stopped flowing after about 2 weeks in the hospital. 



The only symptoms suggestive of psychiatric complications were the refusal 

 to eat during the flrst week, and considerable moaning and groaning during the 

 flrst 2 days. There was no pain severe enough to cause the upset she displayed. 



She was discharged as recovered on June 26, 1938, and since her discharge from 

 the hospital had been perfectly well. 



Comment 



Tentative diagnosis: 



(o) Physical: Incomplete abortion with sepsis. Upper respiratory 



infection. 

 (6) Psychiatric: Headaches, fainting, nausea, over-reacting to minor 



pain, anorexia. The entire picture suggests a transitory, mild, 



reactive depression. 



Two aspects of this case deserve to be discussed in some detail : 

 (1) The "miscarriage" may actually be an abortion procured "accidentally 

 on purpose." It is hard to understand otherwise why O : otc felt impelled to 

 go riding horseback for the first time in her life at that precise moment, especially 

 since Mohave women do not ride nowadays. This type of behavior is in a class 

 with that of some occidental pregnant women, who suddenly decide to play, e. g., 

 tennis, and manage to take a severe fall on the tennis court. This interpretation 

 implies that some, or all, of her psychiatric symptoms were manifestations of a 

 depression, caused by unconscious guilt over her so-called miscarriage. Why 



