Case LXIII

M. B., a well-known artist, and one who has acquired a well-merited celebrity, has for fifteen years been subject to a maniacal delirium which has passed into dementia. Frequently set at liberty, his excitement becomes decided and even dangerous, whenever any great public event occurs. The intellectual disorder is then manifested by hallucinations of smell and taste; he imagines that he is obliged to inhale infectious odors; that some one is trying to injure and poison him. He becomes very suspicious, and shuts himself up in his room. He goes the rounds with his sabre, searches in the wardrobes, and under the beds, and threatens to kill twelve or fifteen hundred persons. He also believes that he is followed by strangers, who cause all the evils he suffers.

When tranquil, he speaks of his art, and it is then a real pleasure to listen to him, for his conversation, full of interest, is interspersed with curious anecdotes. His letters on the subject, although very long, exhibit no confusion of ideas. But when the paroxysm comes on, which occurs at indefinite periods, his conversation is incoherent. He is an elector, he must go and vote; he is a proprietor; they have no right to confine him. He is imprisoned because he quarrelled with a literary man, which he explained to the magistrates. Foreigners did all the harm; they were preferred to the French. He had written works which ought to insure the gratitude of the country. He then talks of the King of Prussia, and on many other subjects having no connection with his present state. His memory is weakened. During the paroxysm he sees individuals, and hears voices that threaten him; objects are transformed; he is terrified. By degrees these symptoms abate; he becomes rational; draws, paints, plays the violin, and talks well. For eleven years this state has continued. Latterly, he plays all night, and dances with the company. His hallucinations continue.

Case LXIV

- Madame Z., aged fifty, deranged for ten years, believes herself invested with the functions of inspector-general; her discourse is generally unconnected, especially when she talks long. This lady carries her head high, speaks senten-tiously, and in Italian. Sometimes she gets into a rage, because the telegraphs act in a manner tending to degrade her, and send her fumigations that she wishes to avoid. She complains that she is beaten, which adds to her anger, when fresh attempts at violence recall the old ones. By means of acoustics, her ears are assailed with filth and insults of all kinds. At times, Madame Z. dresses herself in a very absurd style; her manner is theatrical. She is intrusted with the highest functions; exerts an active surveillance; gives in reports of all she observes. If she sees anything blameworthy, she gets into a violent passion, and abases and threatens; her countenance expresses the excitement which transports her.

During the ten years that she has been under my charge, her maniacal acts are always the same; and she often explains them plausibly. In the middle of the night, and even in the day, her voice rings through the house; in a dogmatic tone she addresses discourses to beings with whom she is in the country, and speaks with them on the sciences. They are professors and learned men who reply to her.

One of her principal hallucinations is the belief that persons get into her chamber through the walls, the windows, and the doors, and talk and act obscenely. She insists that jugglers make use of physics and chemistry to torture her. She often entreats me to save her from the emmenagogues that the jugglers make her take. This lady has also illusions of the sight; figures and objects are transformed, or assume an unnatural aspect or color. The insanity has increased, but hallucinations and illusions still exist (October, 1851).

Dubuisson reports, in his work, the case of a demented person who, during sixteen years, at the vernal and autumnal equinox, and during the summer and winter solstice, shrieked night and day, tore his bedclothes, his sheets, and his mattress, because he imagined he was covered with serpents and vipers. These paroxysms lasted from fifteen to twenty days.*

In complete or entire dementia, when the memory is almost gone, when there remain no passions, no desires, and the patients obey their keepers like children, hallucinations are still produced.