CATALEPSY.—From Gr., xaTd2,n_ seizure.
is not a dis tinct disease, but a symptom of a disor dered condition of the highest nerve centres: the cerebral cortex. During the attacks, which are intermittent, the nervous system, especially the lower, is in an excitable state; the higher centres have lost control over the lower; the face at times is as passive and expression less as that of a marble statue, while in some cases the face seems to indicate mental agitation; there is impairment, or apparent loss, of consciousness, vo lition, and sensation; the patient lies, sits, or stands with muscles in a state of tonic or rigid immobility, and if the head or limbs are placed by an attendant in awkward, or what are usually uncomfort able, positions, they may remain so for an indefinite period, minutes or hours, without any apparent voluntary effort or evidence of fatigue on the part of the patient.
All these manifestations represent but a series of nervous phenomena in dicating a deranged condition of the nor mal functioning power of the general nervous system; we are therefore pre pared to learn that in a few cases it may be the only obtrusive evidence of disease; that it may occur associated with hys teria, or that it probably may be one of the manifestations of this affection; that it may be an epiphenomenon of certain organic diseases of the brain, such as abscess, tumor, softening, meningitis, haemorrhage, etc.; that it may be found in epilepsy, insanity, chorea, or, in fact, in almost any condition of the nervous system in which the inhibitory or con trolling power of the higher nerve-cen tres over the lower is greatly impaired or lost during the attacks.
Varieties.—As to the varying condi tions under which the phenomena may he manifested, with modifications of the symptoms in different cases, those who have regarded catalepsy as a distinct dis ease, sui generis, have spoken of "true" and "false" catalepsy: catalepsia vera and catalepsia spuria. With most of these writers there is but one form of catalepsy: that in which the limbs or any flexible portions of the body present a condition likened to a figure of soft or easily-molded wax (so-called llexibilitas cerea), in which the parts, without any apparent voluntary effort on the part of the patient, remain for an indefinite time in the positions in which they may be placed.
My individual impression is that cata lepsy, unassociated with organic disease, denotes an hysterical condition, and is then one of the numerous manifestations of hysteria or an affection closely allied to it. In some cases the cataleptic phe nomena may be the only evidence of dis ease, but this is so rare that some observ ers have never met with an example.
It may probably be placed between epilepsy and hysteria in the scale of maladies, but nearer the latter than the former, and, as regards the nature of its chief feature, it may be regarded as essentially one of the motor. But there is also distinct interference with the in tellectual processes, and interruption of the connection between the will and the motor centres. W. R. Cowers ("Quain's Die. of Med.," vol. i, p. 2S5).
[It is no more surprising that catalepsy should occur from organic disease of the brain than that hysteria should manifest itself under similar circumstances, and, in some instances, become so prominent as to lead the unwary observer to mis take a tumor or some other lesion for the functional disturbance. Indeed, it seems to me that this is another reason for regarding catalepsy as one of the manifestations of hysteria or its twin sister. In Colorado hysteria in its ex aggerated forms is almost unknown. During a residence of fourteen years in this State I have not met with a single case of catalepsy in which the cataleptic phenomena were prominent or consti tuted the sole evidence of the nervous disturbance. During my residence here my practice has been almost entirely limited to the diseases of the nervous system (mental and physical), and I