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It occurred in thirteen of thirty-seven cases, although it was present only as a tendency in three of these. If we define it as the maintenance of position in which a part of the body is placed regardless of comfort, we can see that sometimes it is difficult to differentiate from the phenomenon of resistiveness with its rigidity.
In the partial stupors it is seen as active opposition and cantankerousness. In the more profound conditions it is represented by muscular resistiveness or rigidity, or refusal to swallow food when placed in the mouth. Occasionally, too, the patient may even in a deep stupor retain urine so long that catheterization is necessary.
These impulsive attempts at self-injury lessened only towards the end of the period. Her laughter, which had been such a prominent trait, disappeared almost entirely during this entire phase. With all this, the general resistiveness, as has been stated, remained towards feeding or any other interference. It was only in the beginning associated with laughter as in the previous stage.
The unconsciousness of trauma or apoplexy is accompanied by focal neurological signs. The eyes roll independently, the pupils fail to react to light. On the other hand, there are definite symptoms characteristic of the functional state. Mental activity is evidenced by a muscular resistiveness or retention of urine.
There seems to be some correlation between inaccessibility and muscular resistiveness. The resistiveness would invariably return when the inaccessibility reappeared.
In only one of our cases was catalepsy definitely present without resistiveness, and in one other a “tendency to catalepsy” was noted without muscular rigidity being observed. In this latter case, when the catalepsy became unquestionable, resistiveness also appeared. It is one thing to note this coexistence and another to explain it adequately.
The commonest evidence of some form of consciousness persisting is probably to be seen in blinking when the eye is threatened or the sclera or cornea actually touched. A very large number of patients, when otherwise quite inactive, showed considerable response in their muscular resistiveness, the phenomena of which will be discussed shortly.
Henceforth this bewilderment ceased, and for 16 or 17 days she was essentially inactive for the most part, for a short time with a tendency to catalepsy and some resistiveness, and at that time lying with eyes partly closed. As a rule she said nothing spontaneously, but replied to some questions, usually with marked retardation, again more promptly.
When, on one occasion, asked how she felt, she, as before, said, “I feel better.” Then, with the exception of a day at the end of the month, when the more stuporous state was again in evidence, she returned to her former condition without catalepsy or resistiveness and without staring, but essentially with inactivity or slowness.
Speech then may also be slow and low, but usually shows no change except for the fact that it is diminished in amount. Sometimes awkward positions are assumed and retained, and there may be catalepsy. Negativism: A common symptom is perverse resistiveness.
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