ntinued to do her housework. About six months
after this illness she left her home, but returned in a
week. She had vague ideas thereafter that the priests were
saying things against the family, and she often quarreled
with the tenants. For a year she had done no work but sat
about. Ten days before admission she stopped eating.

_Under Observation:_ The patient was mute, stolid, gazing
straight ahead, sometimes cataleptic. She had to be
tube-fed, was usually very resistive to any passive
motions; quite often she retained her urine, but she did
not hold her saliva. Yet there was some quick responses at
least in the beginning. At such times it was found that she
was oriented, but nothing could ever be obtained about her
feelings, etc., except that she once said, when asked
whether she was worried, that she "felt weak," had "nothing
to worry about." Occasionally she was seen to cry silently;
at times she would breathe faster when questioned, or
flush; once she took hold of the doctor's hand when he
questioned her, and cried, but made no reply. On another
occasion she was affectionate to her son, kissed him,
although she paid no attention to her daughter who
accompanied the son. Later she said to the nurses, "He is
the best son that ever lived." But more and more she became
disinterested, totally inaccessible, resistive, had to be
tube-fed. In this condition she remained for five and a
half years. At the end of that time she died of tubercular
pneumonia.

CHAPTER XII

DIAGNOSIS OF STUPOR

In any functional psychosis an offhand diagnosis is dangerous. When one
deals with such a condition as stupor, however, the problem is exacting,
for, although "stupor" may be seen at a glance, what is seen is really
only a symptom or a few symptoms. "Stupor," then, is more of a
descriptive than a diagnostic term. The real problem is to determine the
psychiatric group into which the case should be placed. This is a
difficult task, for the differential diagnosis rests on the observation
and utilization of minute and unobtrusive details. A correct
interpretation can be only reached by obtaining a complete history of
the onset and observing the behavior and speech of the patient for a
long period, usually of weeks, sometimes of months. With these
precautionary words in mind,