until finally they manifest a well-marked
persecutory delirium, or may fall into a semi-delirious stuporous state,
show numerous catatonic symptoms, become destructive and untidy, and in
general present a picture very similar to true catatonia.

Removal to the hospital ward frequently serves to put a stop to the
process at once, and often before reaching the hospital for the insane
they show no traces of the acute mental disorder.

The foregoing are types of degenerative psychoses met with in
imprisonment, and there can be no question that the prison milieu is the
etiologic factor here.

To speak here of a progressive disorder to which imprisonment only gives
a characteristic coloring is entirely erroneous. A psychosis which is
definitely brought on by a certain environment and which is corrected as
soon as the environment is changed, must be looked upon as the product
of that environment. That the degenerative soil which permits of the
development of these disorders cannot be looked upon as a basic
disorder, something like dementia praecox, is likewise unquestionable.
These individuals have always shown the same traits of character; it is
these very same anomalies which brought them in their childhood days in
conflict with the school authorities, which later made them inmates of
reformatories, and which finally were at the bottom of their habitual
criminality. Finally, the total absence of progression to more or less
definite end-results excludes the possibility of an organically
determined progressive disorder. A psychosis which develops in
imprisonment and progresses irrespective of the change of milieu is not
a prison psychosis in the sense that this term is here used. The
following cases are illustrative of the type under discussion.

CASE I.--A. F., aged 31 years; admitted to the Government Hospital for
the Insane April 7, 1911. Father alcoholic; died of cancer of liver
and stomach. Mother died of tuberculosis. One brother has been
confined in the Gowanda State Hospital for the Insane for past five or
six years; has always been an excessive alcoholic. One sister, aged
42, has tuberculosis. One of her children died of tuberculosis of the
bones. Another sister is hyper-religious and eccentric.

Patient was born at Olean, New York, in 1871. He knows of nothing
unusual attending his birth or childhood. He entered school at the age
of six, and attended irregularly for six or seven years. He was