ule, most convenient to demonstrate the retention of awkward positions
in the upward extremities. But any part or even the whole body may be
involved; for example, Charles O. retained standing positions even where
balance was difficult. This phenomenon is often accompanied by "waxy
flexibility," where the joints move stiffly but retain whatever bend is
given them, like a doll with stiff joints.

The significance of catalepsy is best studied by considering its
relationship to other symptoms and by noting remarks made by the
patients in reference to it. The most important observations which we
have made seem to indicate that it never occurs with that degree of deep
inactivity which suggests a complete lack of mentation on the part of
the patient. One is therefore forced to conclude that back of this
phenomenon there must be some purpose, some kind of an ideational
content, although this may be of a primitive order. This is demonstrably
true in some cases, at least such as that of Isabella M., who left her
arm sticking up in the air but took it down to scratch herself and then
put it back. Somewhat similarly, Charlotte W. (Case 12), when she was
shown during convalescence a photograph of herself in a cataleptic
state, said that that was when she was waiting to go to Heaven and was
afraid to move. Again she remarked, "I was mesmerized." Josephine G.,
who showed only a tendency to catalepsy, said that she feared the devil
would get control of those about her if she moved. Sometimes there is a
development of this symptom from others which seem to be ideational in
their origin. For instance, Charles O. began making flail-like
movements. These passed over into slow circular motions which finally
subsided into the maintenance of fixed position.

References to hypnotism are not infrequent, and in many cases there is
evidence of a delusion that the posture is desired by those in charge of
the patient. Annie G. (Case 1) said so directly. In retrospect she
explained the holding of her arms in the air by saying, "I thought you
wanted me to have them up." Henrietta B. at one examination kept her
arms raised in the position in which they had been put for a minute and
then dropped them, saying, "Stop mesmerizing me." But she then put them
up again of her own accord and now presented intense resistance to any
motion. Later she extended her arms in front of her and said, "I am all
right," in a theatrical manner. Some patients give evidenc