Reason, hitherto intact, is about to yield to the influence of insanity; deserting the reins which she had so long held with a firm grasp, she is about to give way to error, whose caprices and decrees are omnipotent. In proportion as the one acted with prudence and circumspection, so will the other be obstinate and impetuous.

It must not, however, be supposed that this change always takes place without gradation. Sometimes the unhappy being, who is conscious for the first time of a hallucination, attempts to check it; and when he has long been tormented by it, and it still comes nearer and nearer, he uses every effort to conceal the struggle from those who surround him, keeps silence, and becomes sad and morose. Finally, when the evil has attacked his body, he still strives against it, convinced that he is the sport of an illusion. It may even happen that none of his actions are influenced by the hallucination. But it is most frequently the case that it carries with it a strong conviction to which the sufferers slavishly bow, blindly following all its dictates.

Hallucinations of hearing. - Sometimes the hallucinated hears a voice that whispers in his ear the strangest words, and issues the most extravagant orders. These voices almost always occur in the silence of night, at twilight, dawn, and in gloom and darkness. Do we not see, in this fact, a physiological phenomenon common to mankind? Is it not at such hours that he experiences those shades of restless anxiety and fear against which reason does not always keep guard? Hallucinations of hearing are the most common; they have been estimated as comprising two-thirds of the whole. Dr. Baillarger attributes the presence of hallucinations, at such times, to diminished watchfulness. The case of Blake does not support this opinion.

Case XXVIII

M. N., fifty-five years of age, was, in 1812, prefect in a large German town that rebelled against the French army in its retreat. The confusion arising from these events disorders the brain of the prefect. He imagines himself accused of high treason, and consequently dishonored. In this state, he cuts his throat with a razor; on recovering his senses, he hears voices accusing him. Cured of his wound, the same voices follow him; he is persuaded that he is surrounded with spies, and denounced to his enemies. These voices repeat to him day and night that he has betrayed his duty, is dishonored, and that nothing is left but to kill himself; they speak successively in all the European languages, with which the sufferer is familiar; one voice alone is less clear than the others, for it uses the Russian, with which Mr. N. is less conversant. In the midst of these conflicting voices, he hears that of a lady, who frequently bids him take courage, and have faith.

Frequently Mr. N. shuts himself up, that he may better hear and understand; he questions, he replies, he bids defiance, he grows angry, in addressing those whom he imagines speak to him; he is convinced that his enemies, by various methods, can divine his most intimate thoughts, and convey to him reproaches, menaces, and overwhelm him with the most sinister advice. On other points, he reasons perfectly well, and all his intellectual faculties are perfectly sound.

Returning to his country, Mr. N. passes the summer of 1812 in his chateau, where he receives much company. When conversation interests him, he hears no voices; if it languishes, he hears them imperfectly, and then withdraws, the better to listen to these treacherous voices; he becomes more restless and suspicious. The following autumn he comes to Paris; the same symptoms beset him during the journey, and provoke him on his arrival. The voices repeat: "Kill yourself; you cannot survive your dishonor!" "No, no," replies the sufferer, "I will not die till I am justified; I will not bequeath a dishonored memory to my daughter." He visits the minister of police (Real), who receives him very graciously, and endeavors to reassure him; but scarcely is he in the street before the voices again harass him.

Confided to my care, the patient keeps his room, and does not betray his secret. After two months, he appears to wish that I shall prolong my visits. I take a notion to call these voices gabblers; the word succeeds, and, in future, he makes use of it to express their horrible importunity. I venture to speak of his disorder, and of the causes of its continuance; he details to me what he has long endured, and yields a little more attention to my arguments; disputes my objections; refutes my opinion on the causes of the voices, and recalls to my memory an invisible woman in Paris, who, on being spoken to, gave answers from a distance. Physics, he said, had made such progress that, by aid of machinery, voices could be conveyed very far. "You travelled post one hundred leagues; doubtless the noise of the carriage would prevent your gabblers from being heard?" "Certainly; but with their contrivances I heard them distinctly." The present state of politics, the approach of foreign armies to Paris, strike him as fables, invented to ensnare his opinions. Some time after, the siege of Paris takes place; the patient insists that it is not a battle, but a field-day; that the journals are printed for him. On the 15th of April, "Shall we go out?" he asks suddenly. We go instantly to the Jardin des Plantes, where there are a number of soldiers wearing the uniform of all nations. We had scarcely gone a hundred paces, when Mr. N. seizes me by the arm: "You have not deceived me," says he; "let us return; I have seen enough; I was sick; I am cured."

From that moment the gabblers are quiet, or are only heard in the morning on rising. My convalescent can get rid of them by the briefest conversation, reading, or by walking. But then he looks on this symptom as I myself do; he considers it a nervous phenomenon, and expresses his astonishment that he was so long duped by it. He agrees to the application of leeches, foot-baths, and purgative mineral water. In the month of May, he resided in the country, enjoying perfect health, notwithstanding he had had the misfortune to lose his only daughter, and had other afflictions. Mr. N. returned to his country in 1815, where he was called to the ministry.

This instance is the most simple case of hallucination of hearing that I have gathered. The hallucination characterized the cerebral affection of the patient; his inquietude, his mistrust, his fears, were only the results of the phenomenon, which lasted during two months, although he had perfectly recovered the exercise of his understanding. Was custom the cause of this pertinacity?*