Case LXXL

M. L. was attacked ten years since with a melancholy monomania, in which he believed himself exposed to the persecutions of bitter enemies. He frequently heard them make impure observations, and could not sleep on account of the conversations they held near to him. This patient had been subject from infancy to epileptic fits at irregular intervals, preceded by a hallucination that came like a flash. In the instant that preceded the loss of consciousness, he saw a diabolical figure approach him like the shade of a phantasmagoria; he cried out: "Here is the devil!" and fell to the ground.

Sometimes fantastic figures speak to the epileptic, abusing him, or commanding him to do something. It is almost certain that many crimes committed by these unfortunate beings, and for which they have been severely punished, have been the result simply of hallucinations of sight and hearing.

Case LXXII

"Jacques Mounin," says Berne, "was subject to epileptic fits, after which he evinced great excitement. After one of these attacks, he rushed like a madman into the open country, and killed three men in succession. He was followed by the inhabitants, seized, and bound, and, being interrogated, said he very well recollected having killed three men, and especially a relative, whose loss he deeply regretted; also, that, during his epileptic seizures, he saw flames all around him, and that the color of blood gave him pleasure." *

* Paterson, op. cit.

Several of our insane patients have described themselves as dazzled by a large red light, that shone like lightning, before the fit. In the greater number of cases that we have collected, the hallucination took place prior to their fall. M. Billod† has given the case of a young man who, two or three days before the attack, in a vision, saw and heard his mother and sister, with whom he conversed.

"The paroxysms of epilepsy," says Conolly, "are often preceded by the appearance of phantoms and spectres. As a similar state of the brain, peculiar to this hallucination, may exist in other cases not followed by paroxysms, we can comprehend how a belief in supernatural visions may be the result. Amongst my patients is a gentleman who, on the point of losing consciousness, always saw the most beautiful landscapes.

"Some years ago, I received into my establishment a countryman of athletic form, who came to be treated for epileptic fits that attacked him every month. He told me that, in one of the paroxysms he had before he came to my house, he was in the country harvesting; he seized a scythe, and, driven on by a voice, rushed through the fields, cutting right and left at everything in his path, until, exhausted with fatigue, he lay down under a wall and slept. What would have prevented him from committing a crime?"

M. Brachet, who has given a good description of epileptic convulsions in children, notices, as the forerunner to the fits, the frightful dreams which awaken the children with a start, give an expression of terror to their countenances, and make them utter screams of fear.

In the epileptic convulsions that occur towards the close of pregnancy, during confinement, and after delivery, hallucinations and illusions are very frequent.

* Brierre de Boiemont, Observations Medico-legales sur la Monomanie Homicide, p. 24, Paris, 1827.

† Considerations sur la Symptomatologie de l'Epilepsie, Annal. M6d.-Psych., Nov. 1843, p. 384.

3. Of Hallucinations in Hysteria. - " When moral disorders," says Cabanis, "are excited by nervous affections of the generative organs, that is to say, by hysteric affections, they are accompanied by extraordinary phenomena, which appeared, in times of ignorance, to be the intervention of some supernatural being; catalepsies, ecstasies, and all the paroxysms of excitement, which are characterized by ideas and an eloquence above the education and the habits of the individual, arise most frequently from spasms in the organs of generation."*

It is singular to hear Diderot exclaim, " No conditions are more closely correlated than ecstasies, visions, prophecies, revelations, passionate poetry, and hystericism"†

In fact, there is no nervous state which presents a greater variety of phenomena than hysteria. A practitioner, M. Honore, whose clinicals we have long had the honor to follow, observed to us, in pointing out his female ward, "Almost all these patients have hysteria."

In listening to the soliloquies of the hysteric patients, in the midst of incoherent phrases drawn forth by spasms, we frequently hear them address or reply to beings whom they imagine they see, or who appear to converse with them, or we hear them complain of the fetid air they breathe, or the detestable taste they have in their mouths.

The hallucinations of hysteria may be divided into two categories, according to whether they are manifested in a state of sanity, or whether they are combined with mental alienation.