If one compares these data with those given in the chapter on Malignant Stupors, it is seen that in the main Newington has made the same discrimination as we have. He is certainly wrong in denying “negativism” to his anergic type. Probably, too, he attempts too fine a distinction between the physical symptoms of the two groups. His conclusions are interesting: that in the anergic cases there is an _absence_ of cerebration, while amongst the delusional there is an abnormal _presence_ of intense but perverted cerebration. This is not unlike our own view. He thinks the difference in memory is the most important differential point. Sex is important in determining the nature of the stupor, for he found the anergic type following mania in females only. He observed such an end to manic attacks in 6 out of 36 cases. All his cases were under 30 and he regards the prognosis as good on the whole. As to treatment he emphasizes the necessity for “moral pressure” as a stimulus and cites a case of rapid improvement after a change of scene. Since 1874 very little advance has been made by British psychiatrists, as seen by a perusal of Clouston’s[15] summary in 1904. He regards sex exhaustion as a highly frequent cause, although Dagonet had shown 32 years before that sex abuse does not produce a true stupor. He thinks stupor usually follows depression or mania and says that “the ‘Confusional Insanity’ of German and American authors is just a lesser degree of stupor.” Omitting his stupors in general paralysis and epilepsy he makes three clinical divisions: _melancholic or conscious stupor_, which is not a product of delusions, although delusions of death or great wickedness may be present, impulsiveness and fits may be observed; _anergic or unconscious stupor_, which corresponds roughly to our deep, benign stupor; and _secondary stupor_ after acute mental disease, which resembles our partial stupor. He warns against a rash diagnosis of dementia in this last group. His views on the importance of mental causation and the relation to manic-depressive insanity may be gathered from these sentences: “The condition of the mental portion of the convolutions in stupor is probably analogous to the stupidity of a nervous child when terrified or bullied.” “Stupor is frequently one of the stages of alternating insanity following the exalted condition. It is more apt to occur in those where the exalted period is acutely maniacal. The stupor is usually melancholic in form.” Since he claims that the anergic is a “very curable form of mental disease,” while only 50% of the melancholic cases recover, it seems clear that this division is not prognostically final. The “melancholic” is evidently Newington’s “delusional” without his more accurate discrimination of symptoms.