Case CXVI

A gentleman of Carlsruhe, in Silesia, forty years of age, sound in mind, of mature judgment, and entirely free from superstition, enjoyed habitual good health, excepting that he was subject to the colic and hemorrhoidal flux; a cataract had formed in one eye, and the sight of the other was much enfeebled. He was one day much alarmed by a fire which occurred in a house adjoining his own. On the evening of that day, his wife remarked that he was restless, and asked strange questions. Towards six o'clock, when the candles were lighted, he very seriously told her that his mother had entered the room, and had taken him by the hand, but retired when he was about rising to receive her. He farther said that she was accompanied by her husband and three persons whom he did not know. He then went to supper in a room above the one in which he usually sat, took his repast, and returned to the lower room, still accompanied by the vision. Covering his head with the bedclothes, he slept quietly. On the following day, a novel illusion took place; the walls of his room were all over black and white squares like a chess-board, and so powerful was the illusion that he spoiled several engravings that hung around his apartment After continuing thus for two days, his sight returned to its natural condition. He then complained a little of weakness and vertigo. His sleep, pulse, and appetite were good. Some laxatives, foot-baths, followed by tincture of quinia, brought a return of the hemorrhoids, and entirely cured him.*

* Patereon, op. cit.

The most diverse affections may, under circumstances impossible for us to appreciate, occasion hallucinations. From the following case, which we borrow from Dr. Alderston, it is evident that they may occur in gout.

Case CXVII

"I was called in," says that physician, "to

Mrs. ------, a lady eighty years of age, whom I had often attended for the gout. She complained of unusual deafness, with a great distension of the digestive organs, and was expecting an attack. Notwithstanding her great age, this lady enjoyed good health. She confided to me that for some time past she had been disturbed by visions. The first time that she noticed the occurrence, she believed that several uninvited friends visited her. Having recovered her first surprise, she evinced some regret at not being able to converse with them, and was about to give orders to have a card-table set. For this purpose she rang the bell. On the entrance of the servant, all the party disappeared. The lady expressed much surprise at their abrupt departure, and the servant had great difficulty in convincing her that no one had been in the room.

"She felt so ashamed of the illusion that for several days and nights she suffered, in silence, the appearance of a considerable number of phantoms, some of which represented long lost friends, and revived thoughts almost entirely effaced. The lady contented herself with ringing the bell, when the entrance of the servant rid her of their presence.

"It was some time before she could make up her mind to confide her sufferings to me. There was nothing either in her conversation or conduct to indicate a derangement of intellect, and she, as well as her friends, was convinced of her perfect sanity.

"The affection was relieved by plasters on the feet, and mild medicines, and was shortly afterwards entirely cured by a regular attack of gout. Since that time, both her reason and health have been good."†

* Archives Generates de Medecine, 1824, t. xix. p. 262, Hufeland's Journal, Sept. 1824, and Edinburgh Medical and Surgical Journal, April, 1828.

† Edinburgh Medical and Surgical Journal, vol. vi. p. 291.

All physicians have noted the state of restlessness, inquietude, melancholy, and terror, brought on by diseases of the heart. Persons thus affected, often wake up with a start, being pursued by frightful spectres, and hideous phantoms. This disposition of mind often occurs during the day. We have collected several cases of hallucinations coincident with an organic lesion of the heart.

M. Saucerotte has published several similar cases; amongst others, he mentions that of a subaltern officer, who being attacked with hypertrophy of the left ventricle, thought he saw white phantoms, of grotesque and indefinable forms, which stood before him in menacing attitudes. Ashamed of his fears, acknowledging himself the dupe of phantasmagoria, and dreading the ridicule of his brother officers, he dared not own with what a strange affection he was tormented.*

The pellagra, a cutaneous disorder observed in Lombardy, the Landes of Bordeaux, and in several parts of the south of France, is often accompanied by hallucinations and illusions. Some persons who are attacked believe themselves to be nuns or priests; others are convinced that Satan is pursuing them, and that they see the flames of eternal punishment. In Italy, the delirium is more especially of a religious character, and as the disease inclines the patient to mournful ideas, the disorder is more particularly characterized by the Bight of the devil, hell, etc.†

It is probable that the continuance of such sights creates the tendency to suicide so frequently observable amongst persons suffering with this malady; perhaps, also, the homicidal monomania, also spoken of, is no stranger to these hallucinations. The ideas taking a new direction, may substitute the forms of angels and paradise for those of demons, etc.

Women, under the influence of chloroses, are often a prey to profound melancholy. They seek solitude, shun activity, and delight in sombre ideas; many have symptoms of delirium; they are surrounded by grotesque forms, and see repulsive and hideous figures. If this state continues and increases, it may result in a fit of mental alienation, and make those objects permanent, which a very slight effort of reason might dispel.

* Saucerotte, De l'influence des maladies du coeur sur les facultes intel-lectuelles et morales de l'homme. - Annal. Med. Psych., t. iv. Sept. 1844, p. 177.

† Brierre de Boismont, De la pellagre et de la folie pellagreuse, Observations made in the Grand Hospital at Milan, 2d edit. Paris, 1832. Roussel, De la pellagre, 1845, 2 vols. in 8vo. Durand Fardel, Art. Pellagre, in the Supplement to the Dictionnaire des Dictionnaires de Medecine, 1851, p. 608.

Muratori reports a curious example of the state of visionary happiness which occurs in syncope, and in a semi-loss of consciousness. A young lady fell into a violent delirium at the close of a high fever. On the subsidence of the fever, she remained without motion or pulse; the temperature of the body was so low that she was considered dead. Her body was about to be arranged for burial, when she heaved a sigh. She was immediately rubbed with spirits, and warmed, when finally motion, consciousness, and speech returned, and she recovered entirely.

But, far from thanking those who had taken so much pains to restore her to life, she complained bitterly that they had recalled her soul, which had attained to an inexpressible state of tranquillity and happiness - a state not to be met with in this life, and compared to which its most refined and extreme pleasures were as nothing. She added that she had heard the lamentations and regrets of her father, and the directions for her funeral, but that nothing had disturbed her repose; that her soul was so profoundly steeped in the delights she enjoyed, that she had lost all idea of worldly things, and had even lost the wish to preserve her body.*

It cannot be denied that, in certain diseases, an over-excited sensibility is developed, which imparts a prodigious degree of delicacy and acuteness to the senses; some individuals, likewise, are sensible of odors, which come from considerable distances; others announce the arrival of persons, although no one else can detect any approaching sound.

"In some ecstatic and spasmodic diseases," says Gabanis, "the organs of sensation become sensitive to impressions unfelt in the ordinary state, or even receive unnatural impressions. I have frequently observed, in women of nervous temperament, the most singular effects result from the changes of which I speak.,,

* Muratori, Delia Forza della Fantasia, e. g.

It is probably for the same reason that we sometimes observe hallucinations daring the period of convalescence.