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Updated: June 19, 2025
Two attacks in the same prisoner of what seem to have been typical stupor are reported by Kutner and Chotzen. The patient was a recidivist of unstable mental make-up. At the age of 34 he was sent to prison for three years. Shortly after confinement began, he became stuporous, being mute and negativistic, soiling, refusing food and showing stereotypy.
Even during the more stuporous state she could, a few times, be made to write a little. Then she either wrote very slowly and not more than a letter, or if she wrote more, it was remarkably mixed up. As to her orientation, nothing could be made out as a rule. At first, however, a few weeks after admission, she spoke correctly of the month as January and spoke of the Island.
The next stage is reached where the stuporous case can be stood upon his feet but cannot be induced to walk. The next degree is that of walking only when pushed or commanded. Finally spontaneous movement is observed in which the inactivity is evidenced merely by a great slowness. No correlation can be established between restrictions of speech and motion other than that present in the extremes.
In dealing with cases of benign stupor the first duty of physician and nurse is naturally the physical hygiene of the patient. More is needed to be done in the bodily care of these persons than for most of the inmates of our hospitals for the insane. It is perhaps no exaggeration to claim that a deeply stuporous patient needs as much attention as a suckling babe.
For him, apparently, patients who are markedly inaccessible to examination from whatever cause are “stuporous.” He closes with excellent remarks on physical and psychic treatment. As to prognosis he has nothing to say beyond the opinion that most of the cases recover.
The commonest introductory psychosis, he claims, is depression, but from his brief case reports it would seem that most of his patients were not stuporous, in the narrow sense of the term, but severely retarded depressions.
When it was renewed, blood again appeared in the sputa. Taussig mentions a curious mistake, in which an ounce of quinin sulphate was administered to a patient at one dose; the only symptoms noticed were a stuporous condition and complete deafness. No antidote was given, and the patient perfectly recovered in a week.
She lay in bed gazing, moving very little, not even when her meals were brought. She answered but little and consistently wet and soiled. This state lasted from about the middle of February until the beginning of April. From this stuporous state she emerged during the next four weeks, the awakening being associated with persistent efforts to arouse her.
So far as this case is concerned, therefore, we do find a distinct tendency for the ideas which refer to the more stuporous condition to differ from those which refer to the actual situation in the freer intervals, a difference which we may formulate by saying that, though primitive ideas are expressed, the tendency seems to be to connect them more with actual life, or that the primitive character is lost and the ideas take on a more depressive character with a depressive affect.
The stuporous face is empty, that of the other lined with melancholy. The intellectual defect, too, is different. In retarded depression the patient is morbidly aware of difficulty and slowness, but on urging often performs tests surprisingly well. In the stupor, however, one is faced with an unquestionable defect, a sheer intellectual incapacity. Here again the affect is a point of contrast.
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