delusions that they are
out of the world, that their brains are split, that they are talked
about, or that something is going on in the lower part of the body. The
affect is indefinite except for a certain bewilderment about their
thoughts and an anxious uncertainty towards external interference.
Intellectual processes suffer. They are disoriented and do not seem to
understand the questions put to them. An answer "That is too
complicated" may be made to some simple command. Kraepelin thinks that
the disorder is sometimes more in the realm of the will than of
thinking, for one patient could do a complicated calculation in the same
time as a simple addition. After recovery the memory for the period of
the psychosis is poor and quite gone for parts of it. Occasionally there
may be bursts of excitement, when they leave the bed; they may scold in
a confused way or sing a popular song.

His manic stupor is a "mixed condition," a combination of retardation
with elated mood. The condition is different from the depressive stupor
in that activity is more frequent, either in constant fumbling with the
bed clothes or in spasmodic scolding, joking, playing of pranks,
assaultiveness, erotic behavior or decoration. The affect is usually
apparent in surly expression or happy, or erotic, demeanor. They are
usually fairly clear and oriented and often with good memory for the
attack but with evasive explanations for their symptoms. One cannot make
any classification of the ideas he quotes, but it is apparent from all
his description that the minds of these "manic stupors" are not a blank
but rather that there is a fairly full mental content.

Wernicke, unhampered by classifications of catatonia and
manic-depressive insanity with inelastic boundaries, calls all stupor
reactions akinetic psychoses with varying prognosis. He does not make
Kraepelin's mistake of confusing the apathy of stupor with the
retardation of depression, stating distinctly that the processes are
different.

Bleuler also has grasped this discrimination. He points out that the
thinking disorder in what he terms "Benommenheit" (dullness)
differentiates such conditions from affectful depression with
retardation. He writes, of course, mainly of dementia praecox,[28] but
makes some remarks germane to our problem. In the first place he denies
the existence of stupor as a clinical entity, except perhaps as the
quintessence of "Benommenheit", it is the result of total block