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Wernicke wisely refrained from attempting more than a loose descriptive grouping. He called all conditions with marked inactivity and apathy “akinetic psychoses” and said that some recovered, some did not. Taxonomic zeal began to blind vision when Kahlbaum formulated his “Catatonia” and included stupor in the symptom complex.
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.
As to the frequency of stupor no figures are available, for the simple reason that the diagnosis in large clinics has not been made with sufficient accuracy to justify any statistics. Most of these cases are usually called catatonia, depression, allied to manic-depressive insanity or allied to dementia præcox.
At first, the victim screamed and thrashed his limbs as the brain sent out message after message to the rest of the body, but since the brain had no way of knowing whether the messages had been received or acted upon, the victim soon went into a state comparable to that of catatonia and finally died. If it was not the ultimate in punishment, it was a damned close approach, MacMaine thought.
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.
The condition which we call stupor occurs in the course of many different types of mental disease. It is true that it is frequent in catatonia but is not exclusively there. Mongols have black hair and straight hair, but one cannot therefore say that any black and straight haired man is a Mongol. Fortunately Kahlbaum prevented serious error by leaving the prognosis of his catatonia open.
When they took him out of his suit he was apparently unconscious. He could not be roused. Freed, he drew his knees up to his chin in the position in which primitive peoples bury their dead. He seemed to sleep. Brent examined him carefully. "Catatonia," he said distastefully. "He spent his life thinking he was smarter than anybody else smarter, probably, than all the universe. He believed it.
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