in would
wake the sleeper. His view is that pains tend to preserve the mutism and
amnesia, so that there are "inhibitory processes" causing the stupor,
which prevent the patient from further suffering. He does not find
either in theory or experience reason to believe that these conditions
are the result of either suggestion or "fixed ideas." He thinks it
natural that the last symptom of the stupor to disappear should be
mutism, as speech and vision are the prime factors in communicating with
environment. [As has been noted frequently in this book, mutism is a
common residual symptom of the benign stupor.] Myers believes that in
nearly every instance mutism follows stupor and is merely an attenuation
of the latter process. When deafness is associated with mutism, he
thinks it is often due merely to the inattention of the stuporous state.

In this connection we should mention that Gucci[27] points out that
stupor patients with mutism of long duration may, when requested, read
fluently and then relapse again into complete unreactiveness towards
auditory impressions. This, we would say, is probably an example of a
more or less automatic intellectual operation occurring when the patient
is sufficiently stimulated, although he cannot be raised to the point of
spontaneous verbal productivity.

As these scattered reports about benign stupors are so unsatisfactory,
one naturally turns to text-books. Little more appears in them.
Kraepelin treats stupors occurring in manic-depressive insanity as
falling into two groups, the depressive and manic. The former seems to
be nearer to our cases, judging by the statements in his rather sketchy
account. He regards stupor as being the most extreme degree of
depressive retardation. [This possibility has been discussed in the
chapter on Affect.] His description seems perhaps to include cases which
we would regard as perplexity states or absorbed manias. Activity is
reduced, they lie in bed mute, do not answer, may retract shyly at any
approach, but on the other hand may not ward off pin pricks. Sometimes
there is catalepsy and lack of will, again there may be aimless
resistance to external interference. They hold anything put into their
hands, turning it slowly as if ignorant of how to get rid of it. They
may sit helpless before food or may allow spoon-feeding. Not rarely they
are unclean. As to the mental content, he says they sometimes utter a
few words, which give an insight into confused