ity is present in all gradations from outbursts of anger with
blows and vituperation to sullen, or even emotionless, muscular
rigidity. This last occurs most often when the patient is approached but
may be seen when observations are made at a distance. Frequently
_wetting_ and _soiling_ are due to negativism, when the patient has been
led to the toilet but relaxes the sphincters so soon as he leaves it. A
constant feature is a _thinking disorder_. On recovery memory is largely
a blank even for striking experiences during the psychosis and, when
accessible during the stupor to any questioning, a failure of
intellectual functions is apparent. An _ideational content_ may be
gathered while the stupor is incubating, during interruptions, or from
the recollections of recovered patients. Its peculiarity is a
preoccupation with the theme of death, which is not merely a dominant
topic but, often, an exclusive interest. Probably to be related to this
is a tendency, present in some cases, to sudden suicidal impulses, that
are as apparently planless and unexpected as the conduct of many
catatonics. Finally the disease is prone to exhibit certain _physical_
peculiarities. A low fever is common and so are skin and circulatory
anomalies. A loss of weight is the rule, and menstruation is almost
always suppressed.

As to the frequency of stupor no figures are available, for the simple
reason that the diagnosis in large clinics has not been made with
sufficient accuracy to justify any statistics. Most of these cases are
usually called catatonia, depression, allied to manic-depressive
insanity or allied to dementia praecox. The majority of the stupors
reported in this book were in women, but this is merely the result of
chance, since it has been easier in the Psychiatric Institute to study
functional psychoses in the female division, while the male ward has
been reserved largely for organic psychoses. The majority of the
patients seem to be between 15 and 25 years of age, so that it is,
presumably, a reaction of youthful years. In our experience most cases
occur among the lower classes, which agrees with the opinion of Wilmanns
who found this tendency among prisoners.

This gives a brief description of the deep stupor. But even our typical
cases did not present this picture during the entire psychosis. They
showed phases when, superficially viewed, they were not in stupor but
suffered from the above symptoms as tendencies rather than sta