ne patient a type rather than an individual. Hence the gap in the
descriptive literature of stupor.

The necessity of establishing the possibility of some stupors having a
good prognosis has arisen from Kraepelin's work. He can rightly be
viewed as the father of modern psychiatry because he introduced a
classification based on syndromes and taught us to recognize these
disease groups in their early stages. Inevitably with such an ambitious
scheme as the pigeon-holing of all psychotic phenomena some mistakes
were made. Most of these appear in the border zone between dementia
praecox and manic-depressive insanity. The latter group being narrowly
defined, the former had to be a waste basket containing whatever did not
seem to be a purely emotional reaction. Clinical experience soon proved
that many cases which, according to Kraepelin's formulae, were in the
dementia praecox group, recovered. Adolf Meyer was one of the first to
protest and offered categories of "Allied to Manic-Depressive Insanity"
or "Allied to Dementia Praecox," as tentative diagnostic classifications
to include the doubtful cases.

Difficulties with stupor furnish an excellent example of the confusion
which results from the adoption of rigid terminology. The earlier
psychiatrists were free to regard a patient in stupor as capable of
recovery as well as deterioration. When Kahlbaum included stupor with
"Catatonia," the situation was not changed, for he did not claim a
hopeless prognosis for this group. But when Kraepelin made catatonia a
subdivision of dementia praecox, all stupors (except obvious phases of
manic-depressive insanity) had to be hysterical or malignant. Faced with
this dilemma psychiatrists have either called recoveries "remissions"
or, like E. Meyer, claimed that one-fifth or one-fourth of catatonics
really get well.

As a matter of fact it seems clear that stupor is a psychobiological
reaction that can occur in settings of quite varied clinical conditions.
It is not necessary to detail publications describing stupors in
hysteria, epilepsy, dementia praecox or in the organic psychoses. It may
be of interest, however, to cite some examples of acute, benign stupors
and the discussion of them which appear in the literature of recent
years.

An important group is that of stupors occurring as prison psychoses.
Stern[16] mentions that acute stupors are found in this group.
Wilmanns[17] examined the records for five years in a prison and
dis