Case CLIV

A medical doctor had hallucinations of sight and hearing. He entreated Esquirol to bleed him. The physician of Charenton long resisted, but vanquished finally by his importunities, complied with bis wishes. Scarcely had the assistant retired than he tore off the bandages, and filled several vessels with blood, when, feeling much weakened, he lay down on the bed, still bleeding profusely. On the return of the attendant, the patient was found in a state of exhaustion. He was, at length recovered, but remained quite blind. Notwithstanding the loss of blood, and the privation of sight, there was no modification in the delirium. The hallucinations preserved their energy, continuity, and character. We are acquainted with the sister of an esteemed artist, who, after too copious a bleeding, was confined to her bed for eighteen months, with a gradual diminution of sight; the same phenomenon was manifested in the muscular system, and the fine power of execution which she had previously had on the piano, was, by this means, greatly weakened.

Hallucinations have sometimes been cured by violent methods repulsive to humanity, but of which many examples are extant.

Case CLV

A carpenter, of Anvers, imagined during the night that he saw horrible spectres; the terror which he experienced was so great that he went mad. He was sent to the tomb of Saint Dympna, a virgin, who had the reputation of curing the bewitched. There he remained for one year, during which time he was subjected to all the treatment usually given to maniacs. But, as his board was no longer paid, he was sent home bound, in a cart. During the journey, having succeeded in breaking loose, he jumped out into a deep pond, which was by the roadside. The drivers succeeded, after awhile, in dragging him out, and replaced him half dead on the cart. He nevertheless recovered, and lived for eighteen years completely cured of his insanity.*

The case is interesting in connection with the spot, for Saint Dympna was revered in the village of Gheel, in Belgium, where there is still a large establishment for the insane, of some celebrity; it proves, besides, that, under some circumstances, an abrupt emotion, or energetic therapeutic method, has sufficed to restore reason suddenly.†

* Vanhelmont, Demons Idea, 49, oper. p. 175.

† Brierre de Boismont, Remarques sur quelques establissements d'alienes de la Belgique, de la Hollande, et de l'Angleterre, 1847, pp. 8 et 20.

An emetic, or a purgative, may sometimes cause the cessation of hallucinations. The use of baths, or of the douche, deserves special mention. Under Leuret's practice, the douche has more than once obliged the patient to recognize the fallacy of his ideas. Other practitioners have not been so fortunate. Sometimes even the patients have acknowledged all that was required of them, in order to escape what they called the punishment of the douche.

This means offers, however, useful resources, but it must be carefully regulated. If the hallucination be recent, and the character of the patient timid and fearful, the impression caused by a column of water may instantly change the current of his ideas. When persuasion, kindness, and raillery have failed in effecting this in a patient, whose position in life has accustomed him to the exercise of his own will, the douche, prescribed and executed with a great show of preparation, has, in some cases, succeeded. The probabilities would be fewer with a person of strong will and energy, especially if the hallucinations were of long standing. It would be the same in a case complicated with insanity, particularly if the monomania were of a gloomy character with a tendency to suicide. The hallucinations of mania, dementia, and general paralysis will rarely be alleviated by the douche. In one class of cases, the douche, far from ameliorating, would aggravate the symptoms.

For the douche, we have substituted continued irrigation. The water falls for hours together in a thin streamlet, or through small perforations, on to the head of the patient in the bath. The effect produced by this continual aspersion is, first, to keep up a constantly fresh temperament on the congested organ, without occasioning the symptoms caused by ice. And, secondly, it harasses the patient, who often asks to be released.

We have observed the same effects from continued irrigation that others have noticed from the douche. After some hours of this treatment, these patients have entreated to be taken from the bath, admitting that they had talked nonsense before, but were now entirely cured.