Nervous and mental diseases . me depres-sion, or of fear and terror. The patient with the delusion of sin orpoverty, for example, presents motor inhibition. He sits in one placewith head bowed down, unmindful of what goes on about him, indiffer-ent or apathetic to all questions put to him, resisting every attempt togive him food or medicine, or to dress and undress him, or to give himexercise. He is lost in the contemplation of his misery. Anotherpatient, with these or similar depressed ideas more accentuated, or withmarked hallucinations, will wring his hands, tear his hair, walk or runup and
Nervous and mental diseases . me depres-sion, or of fear and terror. The patient with the delusion of sin orpoverty, for example, presents motor inhibition. He sits in one placewith head bowed down, unmindful of what goes on about him, indiffer-ent or apathetic to all questions put to him, resisting every attempt togive him food or medicine, or to dress and undress him, or to give himexercise. He is lost in the contemplation of his misery. Anotherpatient, with these or similar depressed ideas more accentuated, or withmarked hallucinations, will wring his hands, tear his hair, walk or runup and down, bewailing his misfortunes, or seeking to escape the MELANCHOLIA. 795 dreadful fate in store for him. In the first case the motor inhibitionmay be so complete as to make the patient perfectly immobile, so thatnot a single voluntary movement is made ; even micturition and defeca-tion are involuntary. Such immobility is generally of flaccid character,but sometimes it assumes the phase of rigidity, a waxy flexibility, or a. Fig. 306.—Catatonic symptoms in various psychoses (melancholia, general paresis, circular insanity,primary dementia, etc.) (photograph loaned by Dr. At wood, of Bloomingdale). spasmodic resisting rigidity (catatonic rigidity). Catatonic symptomshave been noted in other forms of psychoses, but the disorder describedby Kahlbaum under the name catatonia is really a form of tendencies are observed in every type of melancholia, but es-pecially in those with precordial distress and agitation. In the milder 796 MENTAL DISEASES. degrees, an attempt at suicide is often the first intimation to friends ofthe actual existence of insanity, since in these cases, outside of the sor-rowful mood of the patient, the intellectual processes may go on asbefore. Cases of melancholia attonita (with marked motor inhibition)also often make attempts at suicide, unexpected explosive attempts, theresult of the sudden letting up of mental and bodily tension. Th
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