covered that there were two forms of psychotic reaction, a paranoid
and a stupor type. It is interesting psychologically that the former
appeared largely among prisoners in solitary confinement, while the
stupors developed preponderantly among those who were not isolated. The
stupors recovered more quickly. He describes the psychosis thus: The
prisoner becomes rather suddenly excited, destructive and assaultive;
then soon passes into an inactive state, where he lies in bed, mute,
with open expressionless eyes. He is clean, however; eats spontaneously
and attends to his own hygienic needs. Some cases are roused by
transport from the jail to the hospital but sink into lethargy again
when they reach their beds. Physically, they show disturbances of
sensation which vary from analgesia to hypesthesia. There are a rapid
pulse, positive Romberg sign, exaggerated reflexes, fibrillary twitching
of the tongue and tremor of the hands. Recovery takes place gradually.
They begin to react to physical stimuli and to answer questions,
although still inhibited, until consciousness is quite clear. When
speech begins, it is found that they are usually disoriented for place
and time as the result of an amnesia which sets in sharply with the
excitement. This memory defect gradually improves _pari passu_ with the
other symptoms.

Two attacks in the same prisoner of what seem to have been typical
stupor are reported by Kutner[18] and Chotzen.[19] The patient was a
recidivist of unstable mental make-up. At the age of 34 he was sent to
prison for three years. Shortly after confinement began, he became
stuporous, being mute and negativistic, soiling, refusing food and
showing stereotypy. On being shifted to another institution he appeared
suddenly much better, although he remained apathetic and dull for some
months. A striking feature was a complete amnesia, not merely for the
stupor but also for his trial and entrance to the prison. At the age of
42, he was again incarcerated. A practically identical picture again
developed, with recovery when his environment was changed, and with a
similar amnesia. Recovery seemed to be complete and there were no
hysterical stigmata. The interesting features of this case are that a
typical stupor seems to have been precipitated by imprisonment, while
the retroactive amnesia covering a painful period of the patient's life
reminds one of hysteria.

A case which is more difficult to interpret is reported briefly