ere is a complete cessation or more or less marked
diminution of all spontaneous or reactive movements. This includes such
voluntary muscle reflexes as contain a psychic component. For instance,
there is, often, an interference with swallowing (letting saliva collect
and drooling), winking, and even with the inhibitory processes used in
holding urine and feces (soiling and wetting). Often there is no
reaction to pin pricks or feinting motions. The inactivity also often
interferes with the taking of food so that spoon-feeding or tube-feeding
has to be resorted to. The patient may keep his eyes covered or stare
vacantly, the face often presenting a remarkably immobile wooden, or
stolid, expression. Complete mutism is the rule. When activity is not
totally interfered with, those movements which are present may be slow.
The patient may have to be pushed around and be able to take a few
steps, but soon relapses. More often they are of normal rapidity. Speech
then may also be slow and low, but usually shows no change except for
the fact that it is diminished in amount. Sometimes awkward positions
are assumed and retained, and there may be catalepsy.

_Negativism:_ A common symptom is perverse resistiveness. It may consist
in a marked stiffening of the body which is assumed spontaneously or
appears only when attempts at interference are made, or there may be a
more active turning away or even a direct warding off, sometimes with
scowling or anger or even swearing and striking. Retention of urine,
which is seen at times, should, perhaps, be mentioned here. Now and then
we find that a patient is put on the toilet and cannot be induced to
urinate or defecate, while soiling and wetting occur at once on
returning to bed.

_The intellectual processes:_ Little is known about the intellectual
processes from direct observation in these more pronounced cases, except
for the fact that in Case 5 questions or obtrusive occurrences sometimes
produced a somewhat puzzled facial expression. Moreover, the patient
retrospectively stated that she was unable to understand the questions,
which points to marked difficulty in apprehension. We also find that
occasionally there is evidence of an interference with the intellectual
processes which showed itself in what may be called "paragraphic"
writing when the patient could be induced to write. Above all, we see
that retrospectively very little is remembered of what took place during
the stupor, even