athic states, and moreover we find
occasionally some evidence in the behavior of the patient to
substantiate this view. For example, at one stage of the stupor of Annie
G. (Case 1), her arm could be moved without resistance. Then the elbow
would catch and at this moment the position would be maintained. Such
observation is highly suggestive of the resistance being signal for the
catalepsy. In Isabella M. the catalepsy appeared when resistance to
passive movements also developed. On the other hand, when the resistance
became extreme, the catalepsy was reduced, and vice versa. This makes
one think of two tendencies: suggestibility on the one hand, and
opposition on the other. We might presume that when both are present and
equally strong, stiffness with passive movements results as a kind of
compromise, but when there is a greater development of one, the other is
inhibited.
Such speculations remind one strongly of the psychology of conversion
hysteria and of hypnotism. In some cases of stupor hysterical symptoms
are quite definitely present. For instance, Celia G. began her psychosis
with hysterical convulsions which would terminate with short periods of
stupor. Later the stupor became persistent and during this stage she had
catalepsy (and restiveness as well) in her left arm only. On recovery
from her stupor she complained of stiffness in her hands, which
examination proved to be a purely hysterical difficulty.
This whole subject is without question obscure and many more and very
careful observations are needed before really satisfactory explanations
can be given for these phenomena. That it is a reaction which is related
to the primitiveness of the mental content and the intellectual deficit
in stupor would seem to be a reasonable view, inasmuch as quite similar
phenomena have been observed in a large number of animals, even among
crustaceans. As a result of our own observations the only thing we feel
at liberty to state with real confidence is that catalepsy is presumably
a phenomenon mental in origin rather than somatic, because it always
occurs in conditions which show other evidence of mentation.
Whatever may be the origin of the idea of the posture assumed, there can
be little doubt that its indefinite maintenance is a phenomenon of
perseveration. The conception of the position being in the patient's
mind, it is easier to hold it than elaborate another idea. This, of
course, is part of the intellectual disord
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