Case CXII

"Some months ago," says the author,"I attended M. R., who had been attacked, during a voyage from America, with violent headache. He was relieved by the formation of an abscess beneath the teguments of the skull; his breathing was somewhat affected by other tumors, which had formed in the throat. He complained of having fatiguing dreams, and even of dreaming when awake. A short time afterwards, he told me that, for the space of an hour or two, he thought he saw his wife and family, although convinced by his reason that they were in America. The impression on his mind was so strong, and the conversation he had held with his son so circumstantial and important, that he could not resist telling it in all its details to his friends on the following day. He also desired to be informed if his wife and family had not arrived from America, and whether they were not in the same house.

* Borden, Recherches theo. sur. les maladies chroniques, p. 326, et seq., edit. of the year IX.

† See the article Meningite Cerebro-Spinale, by M. Boudin in the Sup-plement of the Dictionnaire des Dictionnaires de Medecine, 1851, pp. 427 to 444.

‡ Histoire de l'Epid. de Mining. Cereb. Spinale,. Strasbourg, 1843.

"I was sent for a second time; he quickly perceived that he was considered deranged; when, turning towards me, he inquired if his disease could induce a belief in spectres, apparitions, and figures. 'Until now,' said he, 'I had no faith in all the stories of this character.' He knew that he was perfectly sane, and his friends also acknowledged him to be so, with a mind as strong as it had ever been.

"Having explained to him the nature and causes of his visions, and told him that they would cease with his bodily sufferings, both he and his friends grew composed. But the phantoms became more and more importunate, until he could not make up his mind to retire to rest, because he was immediately harassed by the souls of the dead, or visited by persons disagreeable to him. Having changed his room, the visions ceased for some time; but he soon perceived his friends of the new world pictured on a piece of polished metal.

"Designedly occupying myself with a book, I detected him mentally conversing with them, and at times evidently imagining that I also saw and heard them. When he looked away from the polished bar, he talked sensibly on religion, medicine, and politics. At length he changed his residence, when the purulent matter being discharged, his condition was ameliorated. He is now convalescent, and entirely relieved of his phantoms."*

Fever, by the sanguine cerebral afflux which it produces, or of which it is the result by the nervous diseases it occasions, plays an important part in the production of hallucinations. It is most generally accompanied by wakefulness. When it has lasted for some time, the patient, worn out, falls asleep, but he is soon wakened up, with horrible dreams that wear all the character of reality. The different effects of light and shadow, or the arrangement of the draperies, all unite to create in his disturbed imagination apparent forms, which, at first, are scarcely distinguishable; but which soon become to him realities, and are the preludes to an incoherent and continuous delirium.