o
the rebirth motif, but formulated as dangerous situations. Associated
with this there was not a typical anxiety with the relative freedom of
activity belonging to this state, but an anxiety or distress or
uneasiness with traits of stupor reaction, namely, slow movements, lack
of contact with the environment, and a dazed facial expression. It would
seem that these facts could scarcely be accidental but that they must
have a deeper significance. As a discussion of this belongs, however,
more into the psychological part of this study, we shall defer it for
the present, and be satisfied with pointing out here the clinical facts
of observation.

In brief, then, our findings as to the ideational content of the benign
stupor are as follows: From the utterances during the incubation period
of the psychosis, from the ideas expressed in interruptions of the deep
stupor, as well as from the memories of recovered patients, we find an
extraordinary paucity and uniformity of autistic thoughts. They are
concerned with death, often as a plain delusion of being no longer
alive, or with the closely related fancy of rebirth. The rule is a
setting of apathy for these ideas, but when they are formulated so as to
connect them with the real life and problems of the patient, or when
rebirth is represented as a dangerous situation, some affect, usually
one of distress, may appear.

FOOTNOTES:

[6] Kirby, _loc. cit._, pointed out that stupor showed resemblance to
feigned death in animals, that the reaction suggested a shrinking from
life and that ideas of death were common.

[A] We may mention that since this study was made we risked a prediction
of stupor, which events justified, in the case of a patient who showed
expectation of death without affect. Such opportunities are rare,
however, since we usually do not see these cases till the stupor
symptoms are manifest. It would be unsafe to dogmatize on the basis of
such meager material.

CHAPTER VI

AFFECT

The most constant and significant symptom in the stupor reaction is the
change in affect. This extends from mere quietness in the mildest phases
of the disease through the stage of indifference where apathy replaces
the normal reactions of the personality, to the final condition of
complete inactivity in the vegetative stupor where all mental life seems
to have ceased. It seems as though there were, as a pathognomonic sign
of the morbid process, a lack of energy and loss