e, would turn her back on people.
When more inactive once rolled out of bed and lay on the floor. At this
time also she tried to keep people out of her room. Rarely, patients may
have angry outbursts, as did Annie K. (Case 5) who would strike at the
nurses.

Very often the failure to swallow and anomalous habits of excretion seem
to be negativistic in their nature. One thinks at once of the necessity
for tube-feeding, which is so common even when patients seem otherwise
fairly active. Naturally this form of treatment is necessary only when
the patient refuses to swallow. Quite frequently a refusal to urinate is
met with so that catheterization is necessary, or a patient may never
use the toilet when led to it, but will defecate or urinate so soon as
he leaves it. These latter, like some other perversities, suggest
reactions of a petulant, spoiled child.

By far the commonest manifestation is muscular resistiveness, often
spoken of as "resistiveness." It was present in thirty-two out of
thirty-seven of our cases. Usually it takes the form of a contraction of
the whole system of voluntary muscles when the patient is touched or the
bed approached. Often it appears only when any passive movement of the
limb is attempted. All muscles of the limb then stiffen, making the
member rigid. Sometimes the negativism is expressed by quite isolated
symptoms, such as stiffness in the jaw muscles alone. One patient showed
no opposition except by holding her urine for two days. Another kept her
eyes constantly directed to the floor. The reaction of another showed
no irregularity except for stiffness in the neck and arms and wetting
herself once after she had been taken to the toilet. One displayed
merely a slight stiffness in her arms. An interesting case was that of
Annie G. (Case 1) who kept one leg sticking out of bed. If this were
pushed in, she would protrude the other. Mary F. (Case 3) sometimes
expressed her antagonism to the environment by slapping other patients.
She spoke only twice in a year and a half, and each time it was when
interfered with. By far the commonest cause of muscular movement in
these inactive cases is resistiveness, and as a rule the inactivity is
interrupted only by negativistic symptoms.

If we look for some explanation or correlation of these symptoms, we
find that chance references to conduct seem to point in the same
direction, namely, to the desire to be left alone. This resentment
against interferen