A further argument for the central initiation of many hallucinations of the distinctly morbid sort may be drawn from the course which the morbid process takes. The first stage is often not a sensory hallucination at all; it is a mere delusion; the patient thinks that plots are being concocted against him. After a time his secret enemies begin to reveal themselves, and he hears their abusive and threatening language. We surely cannot ascribe the sensory experience here to a lesion of the ear which happens to occur independently, but regularly, at this particular stage; it follows, on the other hand, in the most natural way, if we regard it as imposed from within, as soon as the disease has gone far enough for the mind to clothe its imaginary fears in a more vivid form. Specially conclusive in this respect are the cases where voices begin to address the patient in the most internal way, without sound, and only after a time take on a distinctly audible character.1 But of all the cases in point the most interesting are those where one type of hallucination assails one side of the body and another the other.2They confirm what was said above - that the mere fact of a hallucination being unilateral, or peculiar to one side of the body, though suggesting a defect in the external organ, is by no means a proof of it.3 The double sensory experience follows with exactness the course of the delusions.

The patient first suffers from melancholy and discouragement; this develops into a belief that he is surrounded by enemies: and he then hears insulting voices on the right side. To this unhappy stage succeeds in due course one of exaltation and self-esteem; the patient believes himself to be some royal personage. And now encouraging and eulogistic voices present themselves on the left side. "The good and the evil genii form a sort of Manicheism which governs him." Here the imagination, as its operations become more complex and establish an opposition of character between its creatures, takes advantage (so to speak) of the fact that the body has two opposite sides; it locates friends and foes just as they might be located in a picture or a play which represented an impending contest. It will scarcely be maintained that by accident the left ear began to be locally affected just at the time when the development of the plot necessitated the entrance of the friendly power upon the scene. Another case involves the sense of touch.

A man, after praying for a year that his actions might be Divinely guided, heard a voice say, "I will save thy soul"; and from that time forward he felt his left or his right ear touched by an invisible attendant, according as he was doing right or wrong.1 Did the auditory hallucination coincide by chance with the commencement of local irritation in the pinna? Dr. Magnan adds three examples of alcoholism, where abuse and threats were heard on one side, praise and consolation on the other. In these cases there were crises of fury, in which hallucinations of all the senses took place, involving both sides alike, and masking the more ordinary condition. On the decline of these crises, the opposed auditory hallucinations recommenced. It seems impossible to resist Dr. Magnan's view, that the poison, distributed through the whole brain, provokes at times a general crisis; but that when this subsides, it localises its action at the weakest spot. Should this happen to be the auditory centre on one side, a single unilateral hallucination would be the result; but if both centres remain affected the projection may assume the complex two-sided form.

(London, 1689), p. 375; Sadducismus Debellatus (London, 1098), p. 3; Boulton, Complete History of Magick (London, 1715), vol. ii., p. 31; Durbin, A Narrative of Some Extraordinary Things (Bristol, 1800), p. 17; Zwei Hexenprocesse in Ballenstedt (Quedlinburg, 1863), p. 56.

1Griesinger, Op. cit., p. 91. The bearing of this fact on the theory of central origin has been noted by Mr. Sully, Illusions, p. 119.

2See Br. Magnan's account in the Archives de Neurologie, vol. vi., p. 336.

3Cf. Dr. A. Robertson in the Report of the International Medical Congress, 1881, vol. iii., pp. 632-3. A gentleman who writes to me from the Junior United Service Club, and who describes himself as "a military physician of long foreign service and not of superstitious tendencies," says that as a youth he was once transported with passion during an argument." There was a large knife lying on the table, and I distinctly heard a voice whisper into my right ear, 'Take up that knife and use it.' I glanced over my shoulder involuntarily for the speaker " - who of course was not visible. There was no question of lesion here, either of the sense-organ or of the brain; for my informant has never had any other hallucination in his life. That a whisper should thus be located in one ear is specially natural; since it corresponds with our usual way of receiving real whispers.

But perhaps the strongest cases of all in favour of a purely central initiation yet remain - the cases of hallucination voluntarily originated.2 Wigan's instance has often been quoted, of the painter who, after carefully studying a sitter's appearance, could project it visibly into space, and paint the portrait not from the original but from the phantasm.3 He ended by confounding the phantasmal figures with real ones, and became insane. Baillarger reports another painter, Martin, as having similarly projected pictures, which so interested him that he requested anyone who took up a position in front of them to move.4 I have received recently another instance; a lady who has had a scientific training tells me that one bright June day, two years ago - when lying ill in bed, but with her mind specially active - she saw the gradual formation, on the background of the blind, of a statuesque head, which then changed into another. "I tired myself calling the pictures up again during the afternoon. They seemed as clear as if real, but after the first flash I was conscious of a mental effort with regard to them.