Case LXVIII

- M. B., paralytic and insane for four years, had apparently lost the power of speech. From time to time, he would utter hoarse cries and inarticulate sounds; then would keep silent for fifteen days or a month. At certain periods, he would recover his speech and pronounce several sentences,, which proved him to be under the influence of some frightful hallucination. In fact, he saw a shark at his side ready to devour him. His efforts to scare and drive away the monster were terrible. He uttered yells, which resounded afar off, and beat against the partition of his chamber. His features were distorted; his eyes started from their sockets; he was bathed in perspiration. Nothing could pacify him; we could only remain spectators of a strife that painfully affected all who witnessed it.

This hallucination was followed by very serious results. One day, believing that his sister, who was tenderly ministering to his wants, was the shark, he rushed upon her with a razor. Happily, she escaped the weapon, but a cousin who was present at this distressing scene, was so affected by it that she expired in five days.

Lately, another paralytic subject, who could scarcely make himself intelligible, commenced shrieking aloud, calling for help against a murderer. He then broke all the panes of glass in the window, probably to escape by the lightest passage, which he took for the door. We came in all haste. He told us that assassins had come in, had moved his bed, and wanted to kill him. Nothing could soothe him. After this hallucination, he refused food and quickly sank. He died in a few days.

Recapitulation. - Dementia, with general paralysis, may be combined with hallucinations.

Presenting, as simple dementia does, some of the symptoms of monomania and mania, the existence of hallucinations is easily explained.

It is more difficult to comprehend how hallucinations can be produced when all the faculties are destroyed.

It is probable that, in this state, some portion of the brain remains uninjured; so that when an influence, unknown to us, is felt, the hallucination may occur for a few moments. 11

At the commencement of general paralysis, the mind being only slightly affected, numerous and varied hallucinations may easily occur.