Catalepsy may properly be divided into four classes, differing from one another only in the causes which induce the condition. The first is catalepsy from hypnotic suggestion; the second, epidemic catalepsy; the third, self-induced catalepsy; the fourth, catalepsy arising from disease or nervous exhaustion. Suggestion is the all-potent factor in the production of the catalepsy of the first three classes, as it is in the production of all other hypnotic phenomena. The suggestion may come, first, from an operator who purposely induces the condition as an experiment. Secondly, it may arise from the patient seeing other cataleptic subjects. In such cases, catalepsy may run through a whole school or a neighborhood, precisely as does epidemic insanity, St. Vitus's dance, and many other nervous troubles. "Imitation," or the disposition to imitate, has generally been assigned as the cause of such manifestations becoming epidemic among children. But this is a palpable error. It arises rather from the fear that each one feels - the mental suggestion that each one makes - that he or she may be the next victim.
Thirdly, self-induced catalepsy is illustrated in the experiments of the East Indian fakirs, and arises from auto-suggestion. In these cases the condition is purely hypnotic, and is self-induced by simple processes, well known to all who have made an intelligent study of hypnotism as practised in the Orient.
It is not, however, with these classes that we have to deal in this chapter, but rather with cases which arise from disease or nervous exhaustion. In such cases, suggestion can hardly be considered as an initial cause, although, as we shall see further on, it is a potent factor in deepening, prolonging, and terminating the condition.
I have said that catalepsy marks the crisis in certain diseases. It is, in fact, the supreme erTort of nature to give the exhausted nerves their needed rest. When this fact is once appreciated, and the patient is intelligently treated on its basis, much needless alarm will be saved, and many fatal errors will be avoided. The patient in that condition is enjoying absolute rest. All the vital processes are practically suspended. He is free from all pain, and is enjoying a refreshing sleep, - a sleep so profound that it may be truly likened to its "twin-brother, death." The depth and duration of the trance will depend upon the necessities of the case. That is to say, it will be proportioned to the severity of the patient's illness, and his consequent need of rest and recuperation.
The primary mistake which many physicians make in managing cataleptic patients consists in seeking, by heroic treatment, to hasten restoration to consciousness. No greater mistake is possible. If the attempt is successful, it causes a fearful shock to the nerves, and the effort is thwarted which nature is making to relieve the patient and give rest to his already overstrained nervous system. If it is unsuccessful, the patient is threatened with the danger of being buried alive, or of an autopsy. These dangers are ever present; and as long as physicians fail to recognize the pregnant fact that an advanced stage of decomposition is the only infallible test of death, just so long will the human race be menaced with the horrors of premature burial.
The most important branch, however, of the subject of catalepsy is that pertaining to its psychological features. I have said that catalepsy belongs to the domain of hypnotism. I mean by this, not only that the phenomenon is identical with the condition which can be produced by the ordinary hypnotic processes, but that the cataleptic patient is amenable to precisely the same psychological laws which govern the ordinary hypnotic subject.
The two fundamental propositions which bear upon this subject are the following:-
First, a patient in a case of suspended animation or catalepsy, induced by disease or nervous exhaustion, is amenable to control by suggestion precisely as he is in the ordinary hypnotic state.
Second, a patient in that condition is always conscious, subjectively, of all that happens around him. That is to say, no matter how profoundly the objective senses are locked in slumber, the subjective faculties are ever alert, and the subject recognizes, often with great acuteness, everything that goes on around him. This fact is not always recognized by hypnotists, and it is safe to say that ignorance of this one truth has been the source of more erroneous conclusions regarding the significance of hypnotic phenomena than all other causes combined. Hundreds of cases are reported where the patients noted all the preparations for burial and all that was said and done, and yet were unable to move or make the fact known that they were alive. This seems to be the universal testimony, although it is possible that the patient might not, in all cases, remember what he had experienced. In fact, it is common for hypnotic subjects to forget their experiences during the sleep; but that does not militate against the fact that they were subjectively conscious at that time.
The conclusions derivable from these premises are as important as they are obvious. The first and most vital is that when a patient is suffering from a disease which will induce catalepsy, and begins to enter, that state, the usual remarks and conversation of those at the bedside must inevitably tend to deepen and prolong the lethargy. The patient appears to be dying. The friends, by word and action, are conveying the impression that death is at hand. The physician feels the pulse, which grows fainter and fainter, until it is no longer perceptible. He examines the heart until its pulsations cease. Finally, he turns to the stricken friends, and in a solemn voice announces that all is over, - the patient is dead. Now, if it happens that it is merely a case of catalepsy, or suspended animation, the announcement by the physician that the patient is dead is an all-potent suggestion which is, and must inevitably be, seized upon by the subject and carried to its legitimate conclusion. A case of prolonged suspension of animation is the inevitable result, as the laws of hypnotism teach, if they teach anything. The patient actually believes that he is dead.
The statement of this proposition seems almost ridiculous; but when it is remembered that no suggestion seems absurd or incongruous to the hypnotic subject, the proposition is seen at once to be an absolute verity. Who has not dreamed of being dead ? Few, if any, have not had this experience; and yet the incongruity of the two ideas - of being dead and of calmly reflecting on the subject - never strikes the dreamer's subjective intelligence. Subjective impressions never seem absurd or incongruous to the subject. This principle runs through all subjective mental action, from the dreams of the healthy sleeper to the hallucinations of the monomaniac. Subjective intelligence, be it remembered, is capable of exercising but one form of reasoning, - the deductive. But it will reason deductively from any premise imparted to it, by any form of suggestion, with great acumen; and it never arrives at a conclusion inconsistent with the premise, - that is, the suggestion. All the facts known to the individual's objective experience which are inconsistent with that premise stand for nought in presence of the one ever-present idea.
That idea is the major premise, unquestioned and indisputable, of a syllogism which he will inevitably complete with logical accuracy.
It is easy to see from what has been said what an appalling, ever-present danger menaces the patient who, from any cause, becomes cataleptic, especially the one who has reached the crisis of a lingering illness, and is surrounded by physicians and friends who are ignorant of the psychological principles involved. The natural language of the emotions of the surviving friends, the wail of hopeless grief, the administration of the sacraments of the Church, and, finally, the authoritative announcement of the doctor that "He is dead!" all tend to the one result. When to these are added the ice-pack or the embalmer's fluid, it remains only for the performance of an autopsy to give the coup de grace.
I shall not attempt to apply the principles here laid down to particular cases. Those who are cognizant of the circumstances of any case, either recorded or within their own private experience, will easily recognize their significance. Nor shall I attempt to prescribe the specific course to be pursued where suspended animation is suspected, as that is the province of the physician in attendance on each particular case. My object will have been accomplished if what I have said shall be the means of directing the attention of the medical profession to the psychic aspects of catalepsy, and to a more careful study of the psychology of that science which has suffered so much at the hands of charlatanism on the one hand, and prejudice on the other, - hypnotism.
Nevertheless, a few general observations regarding the proper course to be pursued may not seem impertinent. It is obvious that when catalepsy is suspected, or is possible, all allusion to or suggestion of death should be avoided, especially by the physician in attendance. It should not for a moment be forgotten that, however profoundly the objective senses may be locked in insensibility, subjectively the patient is awake and is taking cognizance of all that occurs, and appreciates with wonderful acute-ness the significance of every word that is uttered. It should be remembered that since suggestion can induce catalepsy, it can also deepen and prolong the period of its duration. Conversely, it is the most potent means of restoration. Other restoratives should rarely, if ever, be resorted to. Violent means should never be employed. The essential thing is a cheerful, confident demeanor in all present at the bedside. Time should always be given for the conservative forces and recuperative powers of nature to do their legitimate work, and in due season the patient, who "is not dead, but sleepeth," will awake; or, in obedience to suggestion, will "arise and come forth," saved from the jaws of death, - rescued from the horrors of a living grave.