eive of these explanations being variations of one theme,
namely, that of death. In the last chapter it has been shown that a
delusion of dying, being dead, or having been dead is extremely frequent
in the stupor group. It would seem only natural then to regard the
inactivity, in so far as it may be specifically determined, as an
expression of some such delusion.

Psychiatrists are more or less aware of there being typical ideational
contents in the different manic-depressive psychoses. For instance,
every one is familiar with ideas of wickedness and inadequacy in
depression, ideas of violence in anxiety, or expansive and erotic
fancies in manic states. Quite similarly we have seen that death is a
dominant topic in a stupor. Now in addition to these typical ideas we
often hear expressed what we might term non-specific delusions, ideas
that seem to have nothing to do with a peculiar type of reaction which
the patient presents. It is therefore not surprising to find that
inactivity is not consistently ascribed to death or a related delusion.

For instance, Henrietta B. had much talk of higher powers that were
controlling her, also said that it was fear which kept her quiet.
Josephine G. said retrospectively that she had thought she would injure
people if she moved and that if she opened her eyes she would murder the
people around her. Johanna B. was afraid to talk because she fancied she
was in prison. Laura A.: During her stupor was more vague, saying, "I
can't move, they won't let me be," without betraying any suggestion of
whom "they" might be. Finally Mary C. (Case 7) was still more
indefinite, ascribing her immobility merely to fear. When one considers,
however, that these five were the only ones who gave any atypical
explanation of their inactivity among the thirty-seven cases, the
preponderance of the death idea becomes striking.

2. NEGATIVISM. The next of the cardinal symptoms to be considered is
negativism. This term, which is often loosely used, we would define as
perversity of behavior which seems to express antagonism to the
environment or to the wishes of those about the patient. Naturally it is
only in the minor stupors that we see it in well-developed form as
active opposition and cantankerousness. For example, Harriett C., who
stood about until her feet became edematous, would spit out food when it
was placed in her mouth but would eat if she were left alone with the
food. Josephine G., in a milder stat