ing of
mental processes. Consequently, he says, one can observe the external
features of stupor in all akinetic catatonics, in marked depressive
retardation, when there is a lack of interest, affect or will, in
autism, with twilight states, as a result of negativism or, finally,
when numerous hallucinations distract the patient's attention into a
world of fancy. He notes that in all stupors (with the exception,
perhaps, of "Benommenheit") the symptoms may disappear with appropriate
psychic stimulation or that some reaction, no matter how larval, may be
observed. He speaks, for instance, of the visits of relatives waking the
patient up.

His only real group is "Benommenheit," which he separates out as a true
clinical entity. This seems to correspond roughly with our "Partial
Stupors." It is essentially an affectless, thinking disorder, usually
acute, sometimes chronic, occurring among schizophrenics. He believes
that it is the result of some organic process (intracranial pressure or
toxin). Activity is much reduced or absent; they have poor
understanding, answer slowly or confusedly; their actions are sometimes
as ridiculous as those of people in panic (e.g., throwing a watch out
of the window when the house is on fire); the defect is best seen in
writing, for large elisions are found in sentences. He was able to
analyze only one case and she retained her affect; it was even labile
and marked. One suspects that such a case might, perhaps, not really
find a place in the "Benommenheit" group even as Bleuler himself
describes it.

With the exception of Kirby, whose work has already been discussed in
the introduction, we have been able to find only one author who has
attempted any symptomatic discrimination of the recoverable and
malignant catatonic states. Raecke[29] made a statistical study and
found that 15.8% recovered, 10.8% improved, 54.4% remained in
institutions, while 30% died. With the etiology mainly exogenous 20%
recovered and 14.3% improved. A good outcome was seen in 30.2% of
hereditary cases, while only 22.7% did well in the non-hereditary group.
His most important contribution is in his formulation of good and bad
symptoms. He thinks that dull, apathetic behavior with uncleanliness and
loss of shame are not so unfavorable as has been thought. Malignant
symptoms are grimacing with prolonged negativism but without essential
affect anomaly, decided echopraxia and echolalia and protracted
catalepsy. We would a