e were a few occasions when an element of
elation cropped out. Thus on one occasion she laughed,
another time gripped the doctor's pad and tried to read it.
When the nurse laughed, she made a funny grimace at her and
said "Why do you laugh?" Again she once sang two songs, but
after the first verse got stuck and kept repeating one
word.

At the end of three months she improved rather rapidly and
was in a condition for discharge as "recovered" a month
later. Retrospectively she said that she recalled feeling
guilty, thinking that her mother was dead, having been
killed by the patient as a result of worrying over the
latter's failure in her examinations and refusal to eat.
She remembered, too, that at times she thought the building
was burning. Some things like "Chinatown Charlie" she
denied remembering, although she had a good recollection
for the external facts throughout the psychosis. Her
insight was superficially good, but she was reluctant to
discuss her psychosis, in fact claimed that she had been
made more of a lunatic by coming to the hospital than she
was on admission.

Some five years later she had another somewhat similar
attack, again following a quarrel, this time with a fellow
employee. In this second psychosis, however, manic elements
were much more prominent.

Here again, then, we have the symptoms of apparent apathy, inactivity,
and similar ideas of death, but the thinking disorder was possibly not
very profound, inasmuch as she had a good memory for external events.
Her ideas, too, are much more florid than those which we customarily
meet with in stupor cases, but the most marked peculiarity was that
this "stupor" was liable to constant interruption, either spontaneously
or as a result of questioning, which always produced a mood reaction.
She was apathetic only so long as she was left alone. In other words,
whenever an effort was made to test what seemed to be apathy, the
evidences of it disappeared.

The third case to be considered is somewhat like that of the first, Anna
L. (Case 16), in that with the inactivity and apathy there was a
coincident subjective perplexity. The apathy, however, was less marked
than in the case of Annie L.

CASE 18.--_Catherine M._ Age: 24. Admitted to the
Psychiatric Institute November 10, 1913.

_F. H.