in prisoners", and in which the catatonic symptoms exist in a still more
pronounced manner. The severe forms of this disorder, which may extend
over weeks and months, are liable to be confused with progressive
deteriorating processes, especially so because those symptoms which were
wont to be considered by many as positively unfavorable prognostically,
may be found here in very deceptive imitations. Thus the affected, silly
behavior, impulsive actions, temporary verbigeration, senseless word
salad, grimacing, stereotypy, attitudinizing, etc., which these patients
exhibit, may easily be mistaken for the typical catatonic picture of
dementia præcox. According to Raecke's view the hysterical stupor is
closely related to the Ganser twilight syndrome. Stuporous conditions
may introduce the latter, and, vice versa, Ganser complexes may creep
into the stupor. Raecke's stupor, like Ganser's twilight syndrome,
frequently develops in criminals immediately after arrest or as a result
of great physical or psychic exertion. Sometimes the stupor is preceded
by convulsions, at other times by a prodromal stage of general
nervousness. In still other cases, unpleasant delusions and elementary
hallucinations precede the stupor, which may follow immediately after
this prodromal state or may be again preceded by a short attack of mania
with clouded consciousness. In contrast to the genuine catatonia,
Raecke's stupor as well as Ganser's twilight state, are characterized by
_a high grade of impressionability to things in the environment, which
may at any time suddenly cause a complete transition from an apparently
deep stupor to normal manner and behavior_. Headaches, vertigo, and
various hysterical stigmata are common to both the hysterical stupor and
the Ganser twilight state. At times recovery takes place suddenly, but
as a rule it is gradual and remittent in character. The duration of the
disorder differs. It may last for hours or months, and there generally
remains a more or less pronounced amnesia for the entire period of
stupor.
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