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After a prisoner is executed, the man's brother-in-law, Ollie Higgins, comes to claim the body from coroner William Chapin. In the autopsy room, William wonders why the inmate's spinal column has splintered in two and posits that the force of fear may have shattered his spine. When William wonders how many people actually die from fear, Ollie suggests that this unexplained phenomenon be called "the tingler." Ollie asks William for a ride into town, where he and his deaf-mute wife Martha run a silent movie theater. Upon arriving at the theater, Ollie invites William to join him and Martha for coffee. In the couple's apartment, which is located above the theater, William accidentally cuts his hand, terrifying Martha, who has an obsession with germs and a deadly fear of blood. Unable to scream because of her muteness, Martha faints instead, leading William to conclude that she fainted because she was unable to release her fear through screaming. When William returns home that night, he is greeted by his sister-in-law, Lucy Stevens, who is awaiting the arrival of her fiancé, David Morris, a pathologist working with William in his inquiry into the nature of fear. Before David arrives, Lucy and William discuss Isabel, Lucy's sister and William's wife, who is not only cheating on William, but has also refused to share her deceased parents' estate with Lucy. When David comes to pick up Lucy, William recounts Martha's psychosomatic blackout and suggests that the only way to isolate the physical mechanism of fear is to put someone into an extreme state of terror. Late that night, when Isabel returns home, William spots her embracing a man in their front yard and removes a pistol loaded with blanks from his desk drawer. As Isabel sneaks into the house, William greets her holding the gun and calmly states that unless she gives Lucy her rightful inheritance, thus allowing her to marry David, he will kill her. When Isabel sneers and tries to flee, William fires the gun at her, causing her to scream and faint in fear. Carrying her unconscious body to the examining table, William x-rays her spine, hoping to see the tingler at work. The x-rays show that fear energizes the tingler, allowing it to form a solid mass along the spinal column. Only by releasing tension through a scream can the victim dissipate the energy of the tingler. After Isabel awakens in a rage and storms out, William decides to create the tingler in a controlled experiment. The next day, he locks himself in his lab and injects himself with a hallucinatory drug. As William senses the walls closing in on him, he screams, then collapses. Upon regaining consciousness, William realizes that only mutes would be unable to release their fear by screaming. That night, William returns to the theater and, feigning concern about Martha, asks to examine her. After giving her an injection to "relax" her, William sends Ollie to the pharmacy to fill a prescription for sleeping pills. Alone in the apartment, Martha begins to hallucinate from the drug that William administered to her, and imagines a rotting corpse coming after her. Next, she sees blood pouring from the faucets of the bathroom sink and tub, which is brimming with blood. When a hand emerges from the gory ooze, Martha, unable to scream, dies from fright. Soon after William arrives home, a panicked Ollie knocks at his door, carrying Martha's dead body in his arms. After examining the corpse, William asks to perform an autopsy. As Isabel eavesdrops outside the lab, William extracts a spiny creature from Martha's spine which then encircles William's arm in a vise-like grip. Pulling the creature off his arm, William locks it away in a case. Once the autopsy is completed, Ollie asks if he can deliver Martha's body to the funeral parlor and leaves. Isabel then apologizes to William for her earlier behavior and suggests that they have a drink to celebrate his success. Isabel drugs William's drink, thus when Ollie phones to report that he had delivered Martha's body to the funeral parlor, William passes out while talking to him. Ollie has lied to William, however, and instead has taken Martha's body home, where, after draping it across the bed, retrieves the corpse mask and bloody hand that he used to frighten his wife to death. While William lies passed out on the couch, Isabel brings the case carrying the tingler into the room and unlocks it. As the creature locks its claws around William's neck, Lucy enters the house and screams, temporarily neutralizing the creature. The next day, William tells Dave that the only way to destroy the tingler is to reinsert it into Martha's body. When William calls the funeral parlor, however, he learns that the body is not there. Realizing that Ollie was responsible for Martha's death, William goes to his apartment, where he finds the mask and hand stuffed in a suitcase. As William talks to Ollie, the tingler breaks out of its case and slithers into the theater where the audience is raptly watching Tol'able David . When the tingler attacks a woman's leg, causing her to scream in fear, William cuts off the lights, throwing the theater into darkness, and announces that there is no cause for alarm. As the movie continues, the tingler crawls into the projection booth and in front of the projector, casting its shadow across the screen. William then switches the lights off and instructs the audience to scream for their lives. After the screams temporarily incapacitate the creature, William stuffs it into a film can then takes it back to Ollie's, where he grafts it into Martha's body. Once William leaves, Martha's body bolts upright, zombie-like, and Ollie, so frightened that he cannot vent his fear by screaming, dies.