Catalepsy

“ In true apoplexy certain peculiar changes in pulse, respiration, and temperature can always be expected, and these differ from those noted in catalepsy. The stertorous breathing, the one-sided helplessness, the usually flushed face, the conjugate deviation of the eyes and head, the loss of control over bowels and bladder, are among the phenomena which can be looked for in most cases of apoplexy, and are not present in catalepsy.
It is hardly probable that a cataleptic will often be supposed to be drunk, or a man intoxicated to be a cataleptic ”

“ Perhaps, in these latter cases, the disunion is less complete. Dr. Werner relates of his somnambule, that it was after those attacks of catalepsy, in which her body had lain stiff and cold, that she used to say she had been wandering away through other spheres. Where the catalepsy is spontaneous and involuntary, and resembles death so nearly as not to be distinguished from it, we may naturally conclude, if we admit this hypothesis at all, that the seeing of the spirit would be clear in proportion to its disentanglement from the flesh. ”

“ The best thing to do is to let him waken himself, as he directed us to do in the telepathic message. He is, as he says, recuperating from his illness and should not be disturbed. You are, perhaps, unaware that catalepsy, although believed by many people to be a disease, is really no disease at all. ”

“ In some cases, indeed, a purple hue will suddenly suffuse the cataleptic body; the limbs are then extremely rigid, but become pliant when the healthy tint is restored.
The sensation in the brain of the cataleptic, as of those recovering from drowning, resembles the pricking of needles, the circulation soon becoming accelerated. Hunger is usually intense when the patient awakes. The usual duration of catalepsy is from twenty to forty hours. The return of volition is commonly marked by perspiration ”

“ The body indeed is, to the external world, dead; for although the cataleptic will often swallow food, while all the other muscles are in spasm, this may, I believe does, depend on mere irritability, by which, as I before told you, the brain is first excited, and then directs a movement without the mind’s feeling. Catalepsy is so peculiar to young females of extreme sensibility, that it may be considered an intense hysteria, depending on certain sympathies, or resulting from sudden or powerful influences on the passions. The form of catalepsy marked by hysteria is least dangerous ”

“ The right hand and forearm rise up and assume the primitive position of the left hand, which is now stretched out on the arm of the chair, with the waxen pliability that pertains to the cataleptic state.”
An interesting experiment may be tried by throwing a patient into lethargy on one side and catalepsy on the other. To induce what is called hemi-lethargy and hemi-catalepsy is not difficult. First, the lethargic stage is induced, then one eyelid is raised, and that side alone becomes cataleptic, and may be operated on in various interesting ways. ”

“ The aspect of the patient in the two conditions, moreover, offers striking differences, the sleep-like immobility of lethargy contrasting vividly with the petrified attitudes of catalepsy. In both conditions, however, there often is the same absolute insensibility even to the most painful stimuli. A most remarkable phenomenon may be observed in some instances: by merely opening one eye of the lethargic patient the corresponding side of the body is cataleptized. ”

“ The conclusions derivable from these premises are as important as they are obvious. The first and most vital is that when a patient is suffering from a disease which will induce catalepsy, and begins to enter that state, the usual remarks and conversation of those at the bedside must inevitably tend to deepen and prolong the lethargy. The patient appears to be dying. The friends, by word and action, are conveying the impression that death is at hand. ”

“ The last of the cardinal symptoms to be considered is catalepsy. It occurred in thirteen of thirty-seven cases, although it was present only as a tendency in three of these. If we define it as the maintenance of position in which a part of the body is placed regardless of comfort, we can see that sometimes it is difficult to differentiate from the phenomenon of resistiveness with its rigidity. It is most frequently observed in the hands and arms, perhaps because it is, as a rule, most convenient to demonstrate the retention of awkward positions in the upward extremities. ”

“ As a matter of fact, catalepsy, of such a nature as to be confounded with tota exitus, is extremely rare—so rare that we doubt if any practitioner with a large experience of nervous conditions has met with more than one or two instances. ”

“ In the first place, the loss of consciousness, although more complete and more absolute—or rather, strictly speaking, more profound—than in genuine catalepsy, is of much briefer duration. The vertigo or vertiginous phenomena which always accompany genuine petit mal are rarely if ever present in catalepsy. ”

“ Many other symptoms, supposed by their observers to be independent of mental expectation, are described, of which I only will mention the more interesting. Opening the eyes of a patient in lethargy causes her to pass into catalepsy. If one eye only be opened, the corresponding half of the body becomes cataleptic, whilst the other half remains in lethargy. Similarly, rubbing one side of the head may result in a patient becoming hemilethargic or hemicataleptic and hemisomnambulic. ”

“ The subjects of catalepsy are in most instances females of highly nervous temperament. The exciting cause of an attack is usually mental emotion operating either suddenly, as in the case of a fright, or more gradually in the way of prolonged depression. The symptoms presented vary in different cases, and even in the same individual in different attacks. Sometimes the typical features of the disease are exhibited in a state of complete insensibility, together with a statue-like appearance of the body which will retain any attitude it may be made to assume during the continuance of the attack. ”

“ The muscles can act in obedience to the will, and the trunk and limbs do not maintain the positions in which they are placed for any unusual time. In genuine catalepsy the consciousness is so suspended or altered that the period of the seizure afterward remains a blank in the memory of the patient. ”

“ The lowering of temperature, and particularly the presence of extreme coldness of the surface, with exceedingly weak pulse and respiration, have doubtless always been present in the cases—a few, at least, authentic—in which catalepsy has been supposed to be death. ”

“ I have done with minute pathology: as there are however two diseases, epilepsy and insanity, which may be the result of catalepsy, I may offer a precept on the point. The propensity to trance cannot suddenly be averted, but the state of the body and mind are important studies for our treatment. Melancholy and apathy are the features of the mind of the cataleptic, and languor and faulty secretions the symptoms of the body. ”

“ Insensibility is complete, and the patient, if some one does not wake her up, will remain for hours as if she were annihilated in a sleep without a dream. If the eyes are open, there is catalepsy—that is, the muscles will retain indefinitely the position that has been given them. If, for example, the arm has been lifted into the air and put into an unnatural position, it will continue raised in the attitude that has been imposed upon it. If, on the contrary, the eyes are closed, other phenomena will be brought out. ”

“ I shall narrate the facts which loom so large in the dawning light, very simply and briefly, as they are manifested in catalepsy.
An uninformed person being in the room with a cataleptic patient, would at first suppose her, putting aside the spasmodic affection of the body, to be simply awake in the ordinary way. By-and-by her new powers might or might not catch his observation. But a third point would certainly escape his notice. I refer to her mental state of waking trance, which gives, as it were, the local colouring to the whole performance. ”

“ Some doctors, however, place it between catalepsy and somnambulism. Each of these stages is marked by quite distinct phenomena. We give them as described by a pupil of Dr. Charcot.
LETHARGY.
This is a state of absolute inert sleep. If the method of Braid is used, and a bright object is held quite near the eyes, and the eyes are fixed upon it, the subject squints, the eyes become moist and bright, the look fixed, and the pupils dilated. This is the cataleptic stage. If the object is left before the eyes, lethargy is produced. ”

“ The researches in hypnotism during the present century, and particularly those of Heidenhain and of Charcot and Richer, have thrown new light on many cataleptic phenomena.
ETIOLOGY.—In catalepsy, as in hysteria, insanity, and many neuroses, inheritance frequently plays a predisposing part. Eulenburg places it in the large group of diseased conditions designated by Griesinger constitutional neuropathies. The cataleptic of one generation may be the descendant of the insane, the epileptic, the syphilitic, or the alcoholized of a former. ”

“ This disorder, a mystery as deep as that of sleep, was connected with the scheme of evidence which Lambert had set forth in his Treatise on the Will. And when Monsieur Lefebvre spoke to me of Louis' first attack, I suddenly remembered a conversation we had had on the subject after reading a medical book.
"Deep meditation and rapt ecstasy are perhaps the undeveloped germs of catalepsy," he said in conclusion. ”

“ This woman went to fetch her husband, and between them they got me to their poor hovel.
“It would seem that I must have again fallen into a catalepsy—allow me to use the word to describe a state of which I have no idea, but which, from the account given by my hosts, I suppose to have been the effect of that malady. I remained for six months between life and death; not speaking, or, if I spoke, talking in delirium. At last, my hosts got me admitted to the hospital at Heilsberg. ”

“ Carpentaria, there is only one absolutely reliable symptom of death, and that is—putrefaction. Death is imitated by various diseases. But there are not many that will imitate the coldness of death as catalepsy will. ”

“ The scepticism which lightly contradicts the Biblical narratives of the raising of the "dead" to life is seemingly ignorant of facts that go far to place these upon firm ground as historical occurrences. Catalepsy, [50] or the simulation of death by a trance, in which the body is sometimes cold and rigid, sensation gone, the heart still, is well known to medical men. [13] In early times such a condition would inevitably have been regarded and treated as actual death, without the least suspicion that it was not so. ”

“ The cessation of respiration and the absence of audible heart-beats are signs generally regarded as sufficient in themselves to determine the reality of death. But persons have been resuscitated from a state of asphyxia or have recovered from a state of catalepsy or lethargy in whom, to all appearances, the respiratory and circulatory processes have been arrested. ”

“ Such a condition is most frequently seen in cases of cholera, hysteria, catalepsy, hypnosis, excessive fatigue, prolonged exposure to cold or to high temperatures, concussion, severe hemorrhage, action of certain poisons, electrical currents and lightning stroke, strangulation, asphyxia, suffocation, drowning, etc. The condition of apparent death may last hours or even days, but as a rule it is one of very short duration. ”

“ According to his theory, currents of what he calls the galvanic-neururgic fluid, are capable of producing all the well-known symptoms and phenomena of thought from idiocy to genius, and from unconscious sleep to the highest excitement; the process by which these results can be obtained is a suspension of the vital equilibrium by disease, intoxication, abstinence, long-continued fasting and prayer and the like. If the marvelous fluid is unequally distributed through the system, catalepsy ensues. ”

“ The sight of an umbrella makes him shiver as if he were in a storm. Handing such a person a pen will not make him write, but if a letter is dictated to him out loud he will write in an irregular hand. The subject may also be made to sing, scream or speak different languages with which he is entirely unfamiliar. This is, however, a verging toward the somnambulistic stage, for in deep catalepsy the patient does not speak or hear. The state is produced by placing the hands on the head, the forehead, or nape of the neck. ”

“ As we have already seen, all that is necessary to produce catalepsy is to lift the arm or affirm the existence of rigidity. If the sleep be profound enough, the automatic movements which usually occur in somnambulism can be provoked by simple suggestion, and, if the sleep he not sufficiently deep, no amount of friction of the head unaided by suggestion will produce somnambulism. ”

“ Previous to the cataleptic acme girls are often maniacally violent, and will then suddenly regain their temper and their reason. They will sit and play with their fingers in a sullen mood, and the power of motion and speech and other acts of volition may be alternately impaired or lost. In some, the sleep has been preceded by fits of lethargy, by lassitude, and inaptitude to exertion, and perhaps a propensity to sleep-walking. The decided state of catalepsy has begun in an epileptic convulsion. In all, I think, I have seen combined with this disorder, irregular determination of blood ”