One of the observations of Richer was on the influence of light on catalepsy and hysterical lethargy. The patient was placed before a bright focus of light, as a Drummond or electric light, on which she was requested to fix her sight. In a short time, usually a few seconds or several minutes, sometimes instantaneously, she passed into the cataleptic state. She was as one fascinated—immobile, the wide-open eye fixed on the light, the conjunctiva injected and humid. Anæsthesia was complete. If the patient was hemianæsthetic, she became totally anæsthetic. She did not present contractures. Her limbs preserved the suppleness of the normal state or nearly this—sometimes being the seat of a certain stiffness; but they acquired the singular property of preserving the attitude which one gave them. One interesting peculiarity was the influence of gesture on physiognomy. The features reflected the expression of the gesture. A tragic attitude imprinted a severe air on the physiognomy; the brows contracted. If one brought the two hands to the mouth, as in the act of sending a kiss, a smile immediately appeared on the lips. It was an example of what Braid calls the phenomena of suggestion—of Heidenhain's imitation. The state of catalepsy endured as long as the agent which produced it—that is, as long as the light continued to impress the retina.
The characteristics of the two abnormal states—catalepsy and lethargy—into which hystero-epileptics may be thrown were summarized by Richer as follows: (1) Cataleptic state: The eyes wide open; total and absolute anæsthesia; aptitude of the limbs and different parts of the body to preserve the situation in which they are placed; little or no muscular rigidity; impossibility of causing muscular contraction by mechanical excitation. (2) Lethargic state: The eyes wide open or half closed; persistent trembling of the upper eyelids; convulsion of the eyeballs; total and absolute anæsthesia; muscular hyperexcitability; the limbs, in a condition of resolution, do not preserve the situation given to them, except the provoked contracture impressed upon them.
In the experiments at Salpêtrière the hystero-epileptics were sometimes plunged into the states of catalepsy and lethargy under the influence of sonorous vibrations instead of frights.
During the state of provoked hysterical catalepsy it was found that sight and hearing could be affected by various procedures. The eyes were fixed, and seemed not to see anything. If, however, an object was slightly oscillated in the axis of the visual rays at a little distance from the eyes, soon the gaze of the patient followed these movements. The eyes, and sometimes even the head, seemed to turn at the will of the operator. Hallucinations were produced. When the look was directed upward the expression became laughing; when downward, sombre. The cataleptic state might now cease completely. The patient walked, followed the object on which her gaze was fixed, and took attitudes in relation with the hallucination suggested. Music also caused her to assume positions related with the various sentiments suggested to her by the music. Sudden withdrawal of the object from before the eyes or of the sound from the range of hearing caused a return of the catalepsy. The cataleptic patient in whom the eye was in such a state as to perceive the movements of an experimenter placed in front of her reproduced these movements exactly. At the Philadelphia Hospital I have repeated most of the experiments of Heidenhain and of Charcot and Richer.
Unilateral Catalepsy.
Hemi-catalepsy or unilateral catalepsy is sometimes observed, and has been studied both in hypnotic investigations and as a special nervous affection. Charcot and Richer found that hemi-catalepsy or lethargy may be produced on a patient, and that they may both exist simultaneously in the same subject. When, for instance, a patient was plunged into the cataleptic state under the influence of a bright light, shutting with the hand one of the eyes, the patient at once became lethargic on the same side only; the other side remained cataleptic. Heidenhain and Gruetzner studied some remarkable phenomena, which they have recorded under the name of unilateral hypnosis, in which some surprising sensory disturbances occur. They also found, among other things, a striking disturbance in the process of accommodation and in the perception of colors in the eye of the cataleptic side. In a case of hystero-epilepsy upon which I performed numerous hypnotic experiments which have been reported15 the patient nearly always presented unilateral cataleptic phenomena. These were present on the left side, the patient being subject to convulsions which were more marked on the right side, this being also much wasted.
15 Philadelphia Med. Times, Nov. 19, 1881.
I witnessed some curious unilateral cataleptoid phenomena in the case of a medical friend, who has made a note of his experience.16 He says: “In the course of some experiments on table-tipping, which were conducted mainly to satisfy the curiosity of persons who had never seen anything of the kind, I became the subject of a very peculiar and marked hypnotic influence. The ordinary tricks of tipping, answering questions, guessing numbers, etc. had been performed with the table, during the greater part of which I had been one of the circle, when my right hand began to contract so as to form an arch, and was then lifted from the table. These movements were not volitional; I was unable to control them. While my hand was in this position one of the persons sitting at the table suddenly put his hand on my forehead, and I sank back in the chair, passing into a conscious but apparently powerless state, but only for a few moments. Later in the evening the hypnotic influence in the right hand was still more distinctly manifested. If allowed to remain a short time on the table, the fingers began to vibrate vertically and horizontally, the motion finally extending to the forearm and becoming so violent as to throw the hand about in a rapid and forcible manner. While thus affected I found it utterly impossible to sign my name. I would be able to form the first letter or so, and then most extraordinary gyrations would be made. In one instance I wrote very slowly, using all the muscular control at my command, and succeeded in writing the full name, but in a form wholly different from my ordinary signature.”
16 Polyclinic, Sept. 15, 1883.