20 Textbook of Practical Medicine, Felix von Niemeyer, American trans., 1876, vol. ii. p. 387.
21 Klinische Abhandlungen über psychische Krankheiten, 1 Heft, “Die Katatonie,” Berlin, 1874.
22 A Treatise on Insanity in its Medical Relations, by William A. Hammond, M.D., New York, 1883, p. 576.
Kiernan23 has written a valuable memoir on this affection. He has collected fifty cases, a few of which he gives in detail. Hammond and Spitzka discuss the disorder, giving new cases, in their treatises on insanity.
23 American Journal of Insanity, July, 1877, and Alienist and Neurologist, October, 1882.
Katatonia may begin in various ways, but it usually pursues a certain cycle. First appears stuporous melancholia, accompanied or followed by cataleptoid manifestations; then a period of mania with illusions, hallucinations, and delusions. Melancholia reappears in some form, with cataleptoid, waxy condition of the muscles, and a disposition to talk in a pompous or dramatic manner; convulsions or choreic movements may be present.24 Sometimes some phase of the cycle is absent.
24 Hammond.
In some cases in which the peculiar cycle and special phenomena which characterize katatonia are not present marked cataleptic or cataleptoid states may be observed among the insane, either as episodes or as long-continuing conditions.
As cases illustrating cataleptoid phenomena among the insane have not yet been published in large number, and are not well understood, I will record here, under the Symptomatology of Catalepsy, some illustrative cases which have either fallen under my own observation or have been supplied to me directly by medical friends.
M. A. Avery, assistant physician to the insane department of the Philadelphia Hospital, has kindly furnished notes of the following interesting case: