424: GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 

 CHAPTER VI. 



CATALEPSY. 



ETIOLOGY. Catalepsy belongs to the neuroses of stability (Sta~ 

 bilitats-neuroseri), according to the classification of Blazius. Dur- 

 ing a cataleptic fit, the limbs of a patient remain in the attitude in 

 which the patient voluntarily placed them prior to its commencement, 

 or in which they may be placed by a bystander during the seizure. 

 The limbs do not sink by reason of their weight, nor can the patient 

 of his own will bring them into any other position. The resistance to 

 gravitation opposed by the limbs proves that the muscles must be in 

 a state more or less of contraction. In all conditions in which the 

 muscles are fully relaxed, as in a swoon, or after death, the limbs fall 

 of their own weight as soon as support is withdrawn from them. It 

 would seem most natural to attribute the steady continuance of the 

 limbs in one attitude to a continued excitement of the nerves which 

 induce the muscular action requisite to produce such an attitude. This 

 explanation, however, is contradicted by the other phenomenon, for, 

 if we alter the position of the limbs of the patient, the new pos- 

 ture is retained, just as the former one was. It is contrary to all ex- 

 perience that a change of attitude in a limb, effected by foreign inter- 

 ference, should arrest the action of one nerve and induce action in 

 others. Cataleptic attacks are not sufficiently common to enable us 

 to decide these points positively ; but it is most likely that all the 

 motor nerves are in a state of medium excitement in this disease, and 

 hence that all the muscles of the body are in a state of contraction 

 sufficient to counteract the resistance afforded by the weight of the 

 limbs. The facility with which the posture of a limb may be changed 

 (flexibilitas cerea), and the fact that a limb remains bent, if we bend it, 

 or straight, if we straighten it, lead to the conclusion that the con- 

 traction of the antagonistic muscles fully preserves their equipoise. 

 The supposition that the medium state of irritability of the motor 

 nerves, which is the cause of this condition, proceeds from the spina] 

 marrow, is also the most satisfactory and general. The incapacity of 

 the patients to modify this excited condition of the motor nerves and 

 contractile state of the muscles by the force of their will indicates that 

 there is also a morbid state of the brain. In cases of catalepsy, where 

 consciousness is entirely suspended, no struggles occur; and, in cases 

 where consciousness is retained, the patients wish to move, but can- 

 not, because that particular part of the brain is thrown out of function, 



