It is but a step from valueless life to death and the same tendency which makes the patient fancy he is dead, leads the tired man to sleep, the poet to sigh in verse for dissolution, and the myth maker to fabricate rebirth. The religions of the world are full of this yearning, which reaches its purest expression in the belief and philosophy of Nirvana. The ideational content of stupor has also its analogue in crime. The desire for perpetuation of relationships unprosperous in this world is not seen only in the delusion of mutual death. One can hardly pick up a newspaper without reading of some unhappy man or woman who has slain a disillusioned lover and then committed suicide.
Footnotes:
[12] Kirby, George H.: "The Catatonic Syndrome and Its Relation to Manic-Depressive Insanity." Jour. of Nervous and Mental Disease, Vol. XL, No. 11, 1913.
[CHAPTER XV]
THE LITERATURE OF STUPOR[C]
The cases of benign stupor which we report here are not clinical curiosities. Taking the symptoms as the products of a reaction type, the latter is really quite common. One, therefore, asks what other psychiatrists have done with this material. How have they described these stupors, how classified them? This chapter, essentially an appendix, attempts to give a brief answer to this inquiry. No attempt is made to catalogue all that has been written on or around this subject but only to mention typical reports and viewpoints.
The French, beginning with Pinel in the 18th Century, were the first to write extensively of stupor. An excellent paper by Dagonet[13] appeared in 1872, in which such literature as had appeared up to that time is discussed. He defines "Stupidity" as a form of insanity in which "delirious" ideas may or may not be present, which has for its characteristic symptoms a state of more or less manifest
stupor and a greater or less incapacity to coördinate ideas, to elaborate sensations experienced and accomplish voluntary acts necessary for adaptation. This would seem to include our "partial stupor," as well as the more marked cases.
He quotes an excellent definition from Louyer Villermay (Dict. des sc. méd. t. LIII, p. 67). "Stupor is a term applied to stupefaction of the brain. It is recognizable by the diminution or enfeeblement of internal sensation and by a greater difficulty in exercising memory, judgment and imagination. It is accompanied by a general numbness and a weakness of feeling and movement. The patient, then, has an indefinite and stupid expression, he understands questions put to him with difficulty, and answers them with effort or not at all. He seems overwhelmed with sleep, he forgets to withdraw his tongue after showing it to the doctor, he complains of no uncomfortable sensation, of no illness, he seems to take no interest in what goes on about him.... The stupor patient is a fool who does not speak, in this being more tolerable than the one who speaks [delightful naiveté!]. One who is dumbfounded by surprise or fright is also to be called stuporous."
Dagonet says stupor results from various causes, such as exhaustion, or emotional and intellectual factors. Clinically it varies in kind and degree according to the situation in which it develops. When it develops during normal mental health, it disappears when its cause does. In insanity it appears in the course of a psychosis of some duration, of