gree with this, although command automatisms have
not been prominent either in our benign or malignant stupors.

Two writers have made special observations that should be confirmed and
amplified before their significance can be established. Whitwell[30]
thinks that in addition to a diminished activity of the heart there
exists a pathological tension. Ziehen says that he also has frequently
seen angiospastic pulse-curves in exhaustion stupor or acute dementia,
but that other pulse pictures may be seen as well. Any such studies
should be correlated rigorously with the clinical states before they can
have any meaning. Wetzel[31] tested the psychogalvanic reflex in stupors
and in normal persons who simulated stupors. He found them different.

Only one publication has come to our attention in which an attempt is
made at psychological interpretation of various symptoms in stupor.
Vogt[32] derives much from a restriction of the field of consciousness.
Only one idea is present at a time, hence there is no inhibition and
impulsiveness occurs. Similarly, if the idea appear from without, it,
too, is not inhibited, which produces the suggestibility that in turn
accounts for catalepsy. Stereotypy and perseveration are other evidences
of this narrowness of thought content. Negativism is a state, he says,
of perseverated muscular tension. [This would apply only to muscular
rigidity.] So far as it goes, this view seems sound. Of course it
leaves the problem at that interesting point, Why the restriction of
consciousness?

If stupor be a psychobiological reaction, it should occur, occasionally,
in organic conditions just as the deliria of typhoid fever may contain
many psychogenic elements. Gnauck[33] reports such a case. The patient,
a woman, was poisoned by carbon dioxide. At first there was
unconsciousness. Then, as she became clearer, it was apparent that she
was clouded and confused. She soiled. Neurological symptoms were
indefinite; enlargement of the left pupil, difficult gait and
exaggerated tendon reflexes. Months later she was still apathetic,
although her inactivity was sometimes interrupted by such silly acts as
cutting up her shoes. After five months she recovered with only
scattered memories of the early part of her psychosis. What seems like a
typical stupor content was recalled, however. She thought she was
standing in water and heard bells ringing.

Stupor-like reactions are not infrequent in connection with or follo