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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    weight of a few pounds is suspended to the limb, or passive motion is exerted to overcome the tension of the muscles that hold the limb in its position, the mem¬ ber gradually descends, without any ex¬ tra effort being exerted to keep it from falling. Consciousness is always im¬ paired, and sometimes apparently com¬ pletely lost, from the first. The degree of disturbed consciousness varies in dif¬ ferent cases. In some cases it seems to be completely abolished. [I think Dr. C. K. Mills is right in cautioning against haste in believing that unconsciousness is complete in a given case. J. T. Eskridge.] In a few cases in which the cataleptic condition of the muscles is well marked the patient makes no attempt to answer questions or to move when the skin is irritated, because volition is in abeyance; but the patient may know everything that goes on around her. The pulse, temperature and respiration are slightly changed. The pulse is slow or normal; the temperature is usually a little sub¬ normal; sometimes it is one or several degrees below the normal; respiration is quiet, shallow, and sometimes almost im¬ perceptible. The face is pale, the eyes wide open and looking horizontally for¬ ward. Sometimes the lids are partially or gently closed. The pupils are dilated, often react to light slowly, but in some cases they show no response. The fundi and optic nerves have been found anae¬ mic, according to W. A. Hammond. The features frequently present a blank or placid appearance, but in some cases they show evidences of mental agitation. The skin is often very cool and pale, especially if the paroxysm is prolonged; this with the almost imperceptible res¬ piration and expressionless features, open eyes, and dilated pupils—give the patient the appearance of death, for which catalepsy is said to have been mis¬ taken. Cutaneous sensibility is often abol¬ ished; in some cases it is only impaired; rarely a condition of liypersesthesia has been observed. The cornea, conjunctiva, and pharynx may present no evidence of sensation, or they may retain partial sen¬ sibility; so that the eyelids will close when the eyeball is touched, and the re¬ flex of the pharynx may be obtained. In some cases the power of deglutition is said to have been lost, but, more com¬ monly, when the food is placed on the posterior portion of the tongue it will be swallowed. The deep reflexes are usually lessened; they are rarely increased, and in some cases absent. They may be present on one side and absent on the other, although the wax-like condition of the muscles is bilateral. The func¬ tions of the special senses seem to be im¬ paired or abolished, although in some cases it is possible to elicit a response from the patient by stimulating the or¬ gan of hearing, and occasionally that of sight. The electrical reactions of the muscles and nerves have been found normal, lessened, and in exceptional cases increased. The paroxysms, even if prolonged, do not remain at their height for a great length of time. They may last only a few minutes, hours, or in rare cases days. In the prolonged attacks there are usually intermissions or remissions, during which the patient completely or partially arouses for a few minutes and then relapses. Hammond says the par¬ oxysm generally disappears as abruptly as it began. “A few deep inspirations are taken, the eyes are opened, or lose their fixedness, the muscles relax, and consciousness is restored, but no knowl¬ edge of what has occurred is retained.” It is probable that in 'the majority of