be our ambition to make a positive diagnosis before failure to recover
in a reasonable time leads to a conclusion of chronicity.

It is probably safe to assume, on the basis of as large a series as
ours, that the symptoms of stupor _per se_ imply no bad prognosis.
Further, it has been noted that a relatively pure type of reaction is
seen, the symptoms appearing with tolerable consistency. In analyzing
the histories of dementia praecox patients, therefore, one looks for
inconsistencies among, or additions to, the stupor symptoms. We may say
at the outset that we have been able to find no case of malignant stupor
that showed what we regard as a typical benign stupor reaction, and it
is questionable whether partial stupor as we have described it, ever
occurs with a bad prognosis. Usually the discrepant symptoms in the
dementia praecox cases are sufficiently marked to enable one to make a
positive diagnosis quite soon after the case comes under observation.

The law of benign stupor is a limitation of energy, emotion and
ideational content. In dementia praecox we have a re-direction of
attention and interest to primitive fantastic thoughts and a consequent
perversion of energy and emotion. In many malignant stupors one can
detect evidence of this second type of reaction in symptoms that are
anomalous for stupor. For instance, one meets with frequent silly and
inexplicable giggling. Then, too, smiling, tears or outbursts of rage,
the occasions for which are not manifest, are much more frequent than in
typical stupor. Similarly, delusional ideas (not concerned with death at
all) may appear or the patient may indulge in speech that is quite
scattered, not merely fragmentary. Two cases may be cited briefly to
illustrate these dementia praecox symptoms superadded to those of stupor.

CASE 20.--_Winifred O'M._ Age: 19. Single. Admitted to the
Psychiatric Institute May 6, 1911.

_F. H._ The occurrence of other nervous or mental disease
in the family was denied.

_P. H._ The patient seems to have been rather shy and
goody-goody in disposition. According to her mother this
seclusiveness did not begin to be markedly noticeable until
the winter before her psychosis, when there was some
trouble about getting work. She had previously been to a
business school. Then she held a position as stenographer
temporarily. When this job was over she had a number of
po