Volume 1

Sajous's analytical cyclopædia of practical medicine / by Charles E. de M. Sajous and one hundred associate editors.

  • Charles E. de M. Sajous
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Sajous's analytical cyclopædia of practical medicine / by Charles E. de M. Sajous and one hundred associate editors. Source: Wellcome Collection.

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    have seen cases from nearly every por¬ tion of the State, and many from the adjoining States and territories. If other observers shall find that so-called true catalepsy is only found in places favorable for the development of hys¬ teria in its most pronounced type, it will show, at least, that the phenomena of the former are closely associated with those of the latter, if, indeed, they are not a part of them. Further, the course, duration, prognosis, and treatment of catalepsy are almost identical with those of hysteria. J. T. Eskridge.] I shall first endeavor to give a descrip¬ tion of the cataleptic phenomena in cases in which they occur as the principal or only symptoms of the nervous disorder, then as they are found associated with other, and often graver, nervous de¬ rangements. Symptoms.—The symptoms of cata¬ lepsy are not easily described, as the phenomena observed are seen under so many different conditions. In a very few cases the cataleptic phenomena are the only obtrusive evidences at the time of the attack of a disordered state of the nervous system; in a second class the symptoms of hysteria are so pronounced that it is difficult to determine which is the real affection; in a third the cata¬ leptic phenomena form a part of a graver disease, such as insanity, epilepsy, or organic trouble of the brain; in a fourth the nervous symptoms are the results of certain poisons or toxsemic states; and finally in a fifth the peculiar nervous disturbances are a part of the phenomena witnessed in a state of hypnosis which has been introduced by a method that greatly agitates and excites the higher nerve-centres. I shall first try to give a description of catalepsy as free from complications as possible, then will fol¬ low references to cataleptic phenomena as met with in association with other nervous disorders. Catalepsy is essentially a paroxysmal or intermittent affection. For its devel¬ opment in its typical form it probably always requires on the part of the sub¬ ject a certain predisposition, an unstable and excitable nervous condition, a tend¬ ency to hysterical manifestations, most prominent among which is hypersensi¬ tiveness of some of the special senses. The paroxysms vary greatly in their severity and duration. The pronounced symptoms usually come on suddenly, but these are often preceded by headache, slight hysterical manifestations, giddi¬ ness, gastric symptoms, or hiccough. The special symptoms are ushered in by all or part of the voluntary muscles sud¬ denly becoming rigid, the limbs remain¬ ing in the positions in which they were arrested by the onset of the attack. In some cases the arm stops in the act of carrying a cup to the mouth; the latter remains open and the whole body assumes a fixed position, as if petrified. At first the muscles are quite rigid and resist strong passive motion; but soon the rigidity is followed by a soft, wax¬ like state of the muscles. The limbs may then be placed in various positions by moderate passive motion, and in these they will remain for several minutes, or even for hours in some cases. If an arm or a leg is placed at a right angle with the body, with no support except that given by the muscles in a state of in¬ creased tension, it would be main¬ tained in this uncomfortable position for a considerable length of time; but after awhile the limb from force of gravity begins gradually to descend. Two important observations may be made at this stage of the attack that have considerable diagnostic value. One is that the patient’s features and respira¬ tion show no evidence of fatigue or vol¬ untary effort, and the other is that if a