Catalepsy, (from to seize, or interrupt). It is also called catoche, cato-chus congelatio; and by Hippocrates, aphonia; by An-tigencs, anaudia; by Coelius Aurelianus, apprehensio, oppressio; also apoplexia cataleptica, detentio, encata-lejisis, comprehensio.
The word catalepsis hath many significations, as perception, or the knowledge of a thing; the retention of the breath, as when a person strains at stool; a retention of any humour which ought to be evacuated; an interruption of the blood in the vessels by a bandage, and the disease which is the subject of this article. The catoche is sometimes supposed to be the coma vigil; but most writers mean by it the catalepsy.
This disorder, with the carus, may be ranked among the species of apoplexy. Dr. Cullen considers it as such, and adds the following remark: ' I never saw any catalepsy but what was counterfeited; and the same has been seen by others. Therefore from the disease being seldom seen, differently described, and often altogether feigned, I know not in what place to fix it with certainty; but, as I am persuaded in general it does not differ from apoplexy, I have therefore placed it under that head,' viz. apoplexia cataleptica, when the muscles are contracted upon being moved by external force. Its seat seems to be in the back part of the brain, from the symptoms of the disease, and the observations made on dissecting those who die of it. Indeed its subjects, and, perhaps, the symptoms, do not essentially differ from chorea, since the tonic and clonic spasms originate from the same or similar causes; and chorea we shall find to be truly apoplectic.
The immediate cause of this and other spasmodic diseases, is an irregular distribution of the vital influence from debility. The predisposing cause is an irritable system; and the exciting suppressed perspiration, or a disordered stomach: noxious vapours, and bad smells, have been accused, but, we suspect, without sufficient foundation.
This disorder rarely occurs: the fits generally seize the patient at intervals, and last usually a few minutes* though sometimes they continue for some hours or days. It is rarely preceded by any signs that indicate its approach; in a few instances a stiffness in the neck, or a dull pain in the head, has ushered in the fit. In the disorder the patient is without sense or motion, continuing in the posture in which the fit attacked him, until a recovery from it: the limbs are moveable by another person; but, however they are disposed, the patient never alters their position until the paroxysm is at an end. He neither sees, hears, nor feels, whatever methods may be used to excite the sensations. He swallows greedily all that is given him; the countenance becomes florid; the eyes are open, seemingly fixed upon some object; at the close of the fit he fetches a deep sigh, and then recovers. Other symptoms attend different patients, or the same at different times, such as tears dropping from the eyes, grinding of the teeth, etc. but the above are the most general.
Care must be taken not to confound a catalepsy with a tetanus: the latter begins with a stiffness of the neck, which gradually extends to every muscle, and every limb is immoveably rigid.
If this disease proceeds from passions, the danger is not so great as when suppressed accustomed evacuations, or a foul stomach, are the causes: from suppressed evacuations it is mostly fatal. In general the cure will be similar to that of the apoplexy. The indication in the fit is, to relax the spasmodic stricture; and, out of the fit, to remove the material or secondary causes, which contribute to the production of the constriction.
In the fit, pungent acid spirits, such as the acetic acid, or the strongest wine vinegar, may be applied to the nose. Forestus strongly recommends antispasmodic oils to be rubbed on the nape of the neck, and on the back part of the head after shaving it. Strong stimulating clysters may be injected, if the anus is not too much constricted to admit them.
Bleeding is commended, if the face is very red and turgid; but, the heat and strength of the patient will best determine the propriety of this operation. Blisters, though recommended, seem not so eligible an application as sinapisms to the feet. Two or three spoonfuls of the following mixture may be given at proper intervals, either during the fit, or in its absence.
Gum ass. foetid. 3 ij. aq. puleg. iv. sp. ammoniac foetid. and tinct. valer. vol.āā ss. m. The fit is generally transitory, and never fatal.
In the absence of the fit, the remedies will be indicated by the remote causes. The bowels should, in every instance, be kept regularly and freely open. If, however, fears or other passions of the mind are the causes, medicines cannot be expected effectually to relieve; but, in such cases, a change of air, travelling, diverting company, etc. are to be insisted on. Electricity has been recommended, and cures from its employment have been recorded. The metallic tonics have also been recommended, particularly the copper and the zinc, though seemingly from no real trials.
The catalepsy sometimes ends in a melancholy, epilepsy, or fatal apoplexy.
See Coelius Aurelianus, Acut. ii. x. Hoffman. British Magazine for March, 1800, and the following numbers. Journal des Savans, Jan. 1776. Histoire de lacademie des Sciences, 1738; and Memoires pour 1742.