Paula’s case is not unique.

Paula is simply the only seriously depressed patient who has had their baseline vital signs at rest measured. And Paula’s vital signs matched the vital signs of thousands of bipolar depressed insane patients studied by Dr Emile Kraepelin, over 100 years ago.

Why haven’t researchers tried to replicate Kraepelin’s results?

I think it is because most doctors are not as knowledgeable in physiology and/or in acid base of the blood as Kraepelin was. Not that it takes that much knowledge to deduce that abnormal breathing rate fixed too low or becoming irregular, as Kraepelin found to be the case in bipolar depression and mania respectively, suggests metabolic dysfunction wrecking havoc with the normal chemistry of the blood, affecting the brain and the mind and physical state. Kraepelin practiced during the European Golden Age of physiology and obviously knew a lot about physiology. He was heavily influenced by Wilhelm Wundt, who trained as a physiologist under Hermann Von Helmholtz . Kraepelin practiced during the time of Charles Scott Sherrington, Nobel prize winner, who theorized that the nervous system coordinates various parts of the body and that the reflexes are the simplest expressions of the interactive action of the nervous system, enabling the entire body to function toward a definite purpose.

I suggest to you that the main purpose of the “interactive action of the nervous system” is to ensure that acid base chemistry of the blood remains normal in order to allow cells, tissues, organs, to function properly. In my opinion, everything else in a bonus [higher executive function of the mind included].

And what did Kraepelin do? He measured respiratory rate, blood pressure, heart rate, heart signs, and body temperature in patients in the different stages of manic depressive insanity. The abnormal pattern of vital signs he found during the different stages of these [reversible] attacks clearly showed him that a pattern of respiratory failure occurred , that the abnormal respiratory rate showed this, along with the stereotyped physiolgical responses from the rest of the body that followed naturally. Kraepelin also gave these patients timed tests of arithmetic and reading to see if and how their mental capacities were affected. His methods were simple and direct and very effective in determining mental deterioration compared to one’s baseline performance.

Why are scientists, researchers and clinical doctors not following Kraepelin’s lead?

Why don’t they try to replicate his work [in unmedicated patients]?

Paula is not unique. We have no idea how many people have damage to the ventilatory system, due to injury to the peripheral nervous system and injury to muscle, cartilage, or bone of the body because why?

There is no good reason.

Counting baseline respiratory rate, tidal volume, minute ventilation is basic and non-invasive. Abnormalities and damage to the motor ventilatory system may be the cause of essential hypertension [the cause of which is presently unknown].

Knowing PaCO2 of the arterial blood, even if it is an invasive procedure, is sometimes necessary to avoid permanent illness and disability.

Supportive medical care may be necessary to treat major depression and altered mental status.

Outdated ideas and sloppy physical assessment in medicine and psychiatry are no excuse .

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