Her condition then remained essentially the same for some time. Then about six weeks after admission she became somewhat less resistive, was frequently seen sitting up in bed, moving her lips considerably (without speech) and regarding the surroundings with a bright interested expression and occasionally smiles. About this time she began exposing herself and chewing her finger nails. Four months after admission she was noted as being very resistive and negativistic, allowing saliva to accumulate in her mouth and making no attempt to keep the flies off her. At the same time she would keep in her mouth food that had been put there without chewing it. Two months later she seemed to laugh occasionally when other patients did so, but at the same time she showed a cataleptic tendency and was quite mute. Six months after admission she began to feed herself but rather sloppily. When one would speak to her, she would occasionally smile, but if shaken she would weep silently. About this time she began to do a little work in the ward, pushing a floor polisher. For the next couple of months her condition was about the same. She would stand around the ward, doing a little work if urged, might even dance if forced to. She was consistently mute. She was dirty but often decorated herself. Rarely she was assaultive. Then ten months after admission she one day suddenly became talkative, distractible and emotional, laughing and crying. There was with this, however, no open elation. Her talk was obscene, at times flighty, at times definitely scattered. All her habits were filthy. This pseudomanic episode lasted for a couple of months, and then she settled down to a fairly consistent deterioration with indifference, silly laughter, occasional assaultiveness, destructiveness and untidiness. Nearly two years after admission she had another period of excitement lasting about a couple of months. Shortly after this she began to fail physically, and in November, 1913, two years and five months after her admission, she died of pulmonary tuberculosis. In summary, then, we see that this patient exhibited symptoms of dementia præcox from the outset of her stupor, with scattering, genital sensations and incest ideas. The stupor symptoms gradually gave way to the typical indifference, negativism, obscenity, filthiness and inexplicable conduct of dementia præcox. At the beginning, however, the condition was superficially similar to that of a benign stupor, it being only on careful observation that other symptoms were noted. CASE 21.--_Rose S._ Age: 23. Admitted to the Psychiatric Institute April 5, 1905. _F. H._ The mother was living, the father dead. Otherwise no pertinent information was secured.