ts were slow and stiff. When
stimulated, however, he responded promptly and had no retardation.
Speech and writing showed nothing characteristic.

May 11:--Flexibilitas cerea more marked; mutism; retention of saliva;
eats food voluntarily; bowels require frequent attention.

May 20:--Requires spoon-feeding; sleeps well; remains always in bed in
stiff attitudes.

June 1:--For three or four days refused food, except for one or two
meals daily. At times suddenly surprises attendants by sensible
remarks, as: Another patient said, "That is G. W. W.," and patient
promptly replied, "No, it is Rip Van Winkle." Negativistic signs more
marked. Knows physician when eyes are pushed open. At times tries to
whistle.

June 13:--For past week has been noisy and excited. When he hears
dishes rattle, yells "Chow-chow" for a long time. Continued hot bath
for one hour always relieves this excitement. Physical signs negative;
Wassermann negative; blood and urinary analysis negative.

June 18:--Admitted to the Government Hospital for the Insane. The
Marshal who accompanied the patient from California to this
institution states that the patient was resistive and negativistic;
that he assumed various constrained attitudes; was untidy, mute, and
refused food. All these tendencies were markedly influenced, however,
by positive requests of the Marshal. When told that he would be
chastised if he did not give up his untidy habits, these disappeared,
etc. On admission to the Government Hospital for the Insane the
patient had to be carried into the ward, as he refused to walk. He was
mute, negativistic, and assumed various uncomfortable and constrained
attitudes. Every now and then he would snap at those who handled him,
and this would be accompanied by a growl. He was very resistive to the
taking of a bath, and suddenly snapped at the attendants who cared
for him. When reprimanded, however, by the Supervisor, and told that
he would have to take the bath, he quietly underwent the procedure.

Physical Examination:--Pupils widely dilated. Face somewhat distorted.
Pupillary reflexes normal; although limbs would remain in a fixed
attitude when so placed, he did not evidence the typical flexibilitas
cerea. It seems as though he anticipated the passive movements, and
there was present a certain amount of voluntary intent. All
superficial reflexes active; winced when pricked wit