CATALEPSY. 425 



whose duty it is to conduct the impressions fi-om the central organs 

 of imagination and volition to the motor nerves. 



Catalepsy is quite common among the insane, especially among 

 persons suffering from melancholia attonita. It also sometimes pre- 

 cedes the convulsive attacks of hysteria. Cataleptic fits may also ac- 

 company St. Vitus's dance, the chorea Germanorum^ tarantism, and 

 other epidemic and endemic forms of convulsion of psychical origin, 

 and which Eomberg aptly terms psychical convulsions. It is very 

 rarely met with as an independent affection in persons whose health 

 .s otherwise good. Children and young persons seem to be most 

 '.iable to its attacks. Mental emotion is said to be its principal exciting 

 cause ; indeed, in healthy individuals, slight indications of this morbid 

 condition are sometimes observable as a result of such impressions. 

 It is a very common thing to see persons, under the influence of sudden 

 tear or horror, standing motionless, with outstretched hands, until the 

 emotion subsides. 



SYMPTOMS AND COURSE. In my description of the symptoms and 

 course of catalepsy, as an independent disease, I must rely entirely 

 upon the representations of others, since all the cases which I have 

 had an opportunity of observing personally have inspired me with the 

 suspicion that they were simulated. The precursors of a cataleptic 

 fit are said to be headache, dizziness, buzzing in the ears, broken 

 sleep, extreme irritability, and other symptoms of nervous derange- 

 ment. The paroxysm itself sets in suddenly. The patient remains 

 motionless as a statue in the attitude in which he may happen to 

 be at the moment of the attack. At first, some force is required 

 to move the limbs ; afterward, they can be moved with ease, 

 and it is possible to adjust them in any desired posture, and they will 

 retain that posture much longer than a healthy person would be able 

 to retain it of his own will. During the fit, consciousness and sensi- 

 bility to external impressions are either entirely suspended, or else, 

 though the senses may be retained, and though external impressions 

 are perceived, the patient is unable, either by word or act, to give any 

 sign of consciousness. The respiratory movements and the beat of 

 the heart and pulse are usually so feeble as scarcely to be perceptible. 

 The urinary and alvine evacuations usually are arrested. Deglutition 

 proceeds undisturbed, if the bolus be thrust far enough back into the 

 pharynx. Generally speaking, such a fit only lasts a few minutes ; 

 more rarely it continues for several hours or several days. When it 

 is over, the patients yawn and sigh like persons who have waked out 

 of a profound sleep. If the seizure be a very transient one, and be 

 accompanied by loss of consciousness, the patient often is quite unawaro 

 that any thing unusual has happened to him, and, after the fit is over 



