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When Kraepelin included it in his large group of Dementia præcox, however, it implied that stupor could not be an acute, recoverable condition. He unquestionably advanced psychiatry greatly but his scheme was too ambitious to be accurate. Many observers saw patients, classified as dements according to Kraepelin’s formulæ, return, apparently normal, to normal life.
German psychiatry has tended to make the insane patient a type rather than an individual. Hence the gap in the descriptive literature of stupor. The necessity of establishing the possibility of some stupors having a good prognosis has arisen from Kraepelin’s work.
Finally Kirby published a series of cases which showed decisively that this classification was too rigid. Since his paper is the foundation for this present study, it should be reviewed carefully. He first points out that Kraepelin’s “Dementia præcox” includes much more than it should with its inevitably bad prognosis.
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.
The latter group being narrowly defined, the former had to be a waste basket containing whatever did not seem to be a purely emotional reaction. Clinical experience soon proved that many cases which, according to Kraepelin’s formulæ, were in the dementia præcox group, recovered.
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