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The illusions present an almost endless variety. The transformation of persons and things is not uncommon. Miss D. regarded all the persons in the house as Irish: each played a distinct part in this general transformation. One was her enemy, another one of her friends; all had their particular character and standing, and each acted accordingly. This illusion lasted a long time. Mrs. M. believed she saw her brother, who had been dead for many years, in the person of several invalids. Sauvages, under the name of tentoin vertigineux, mentions a peculiar affection of the hearing which consists in the person hearing to the right of him the words which have been uttered to the left, and vice versâ.

Illusions of hearing are very frequent amongst the insane; a kind word addressed to another person, or a simple movement of the lips, is construed into jeers, curses, or blessings.

Illusions, like hallucinations, have often terminated in quarrels, duels, suicides, and murders.

Example 37. M. C., who had been deranged, returned to his family before he was completely recovered. The next day he went into the cellar, where his wife followed him; and his sister-in-law, finding they did not return, did the same. Their prolonged absence alarmed the servant, who went to ascertain the cause, and hastily returned, uttering cries of terror, and fled from the house. Her broken sentences and expression of alarm showed that some terrible catastrophe had occurred. The police, on going to the spot, found the two women dead upon the ground, and weltering in their blood. seated on a cask, and a razor covered with blood at his feet. On being questioned, all the reply he made was that he had seen the devil, and had defended himself against him. This man was again placed in confinement at Charenton, and in 1825 was removed

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to a private asylum, where I saw him for about a year. His reason having returned, he claimed his liberty, which he obtained, against the advice of MM. Esquirol and Marc. Some years after he attacked the female with whom he was living, taking her for a devil who reproached him with his crimes: she saved her life by jumping out of the window. Twelve days after, C. died in the asylum of M. Pressat, in a transport of rage, believing himself surrounded by phantoms and devils.*

Some invalids accumulate sand and small pebbles, believing them to be precious stones. M. V. passes the day in examining with his glass these pretended jewels. He returns home sinking beneath the weight of his riches. Illusions of the sense of touch will frequently lead the insane person to think he has been struck. Madame D. suffers from an eruption of the skin, which she regards as the marks of blows that have been given her during the night. It is certain that rheumatic, neuralgic, and internal pains give rise to illusions of touch in many of the insane. We associate with illusions all those false sensations which arise from disease of the internal organs, as the stomach, intestines, &c.; all those of the hypochondriac which have been spoken of as internal hallucinations.

Most of these illusions are associated with the previous occupations, ideas, habits, and passions of the invalid. A young lady told me that she was unable to rest, because all the persons around her wore masks, and she was in the midst of a perpetual carnival. This illusion, like many others, remained quite inexplicable, until she had been with me some time, when I learnt that it originated in a visit she had paid to a bal masqué at the opera.

* A. Brierre de Boismont: Observations médico-légales sur la Monomanie homocide. Paris, 1827.

Illusions of smell and taste are exceedingly common. We have hereafter related the case of a patient who licked the walls of his apartment, mistaking them for oranges. Nothing is more common, especially in monomania accompanied by melancholy, than to hear the person complain his food has a poisonous taste; an idea which leads him to attempt suicide by starvation.

Each sense may be the seat of an illusion, and all of them may be affected simultaneously.

Illusions may last for a long time. Guislain has related the case of a poor woman who became deranged when her son joined the army. One day an idiot, having been brought to the same asylum as the one she was in, she mistook him for the son she had so lamented. During many years she continued to bestow the most tender solicitude upon the idiot boy.

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CHAPTER V.

HALLUCINATIONS IN MONOMANIA, STUPIDITY, MANIA, DEMENTIA, AND GENERAL PARALYSIS.

ALTHOUGH hallucinations may exist by themselves without any complication, it is far more common to find them combined with some form of insanity. According to Esquirol, out of every hundred lunatics eighty are more or less affected by hallucinations. Recent observations have shown that this number is too high. "In 145 cases at the Bicêtre," says M. Baudry, " 56 had hallucinations."-Thèse, 1833, p. 14. In our own establishment, out of 66 lunatics, 38 had hallucinations.

Hallucinations are most frequent in monomania. This arises partly from the nature of the insanity itself, and partly from these phenomena being more easily observed in such cases. This is not, however, invariably the case; for in melancholia some individuals will maintain an obstinate silence for many years, and the secret hallucination is only revealed by chance. It may, however, be stated generally, that the more extravagant and singular the actions of the individuals, the more reason there is to suppose that they are the result of hallucinations or illusions.

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Example 38. I have seen," says Marc, "in the asylum of Dr. Pressat, a man advanced in years, and affected with melancholy from reverse of fortune. For many years he had never spoken a word. His sole occupation consisted in smelling and licking the walls of his apartment, and the sill of his door: he

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would continue this for hours together, without our being able to explain the reason of such a singular and laborious act, whose frequency and duration had made several deep impressions on the plaster of the room. During my visits I had often questioned him, but in vain, as to his motives for such conduct, when one day, pretending not to notice him, I asked the attendant how all these dirty spots had come upon the wall. To our great surprise, the invalid broke through his long silence, and said, 'Do you call those dirty spots and excavations; do you not perceive they are oranges from Japan? What delicious fruit they are; what a colour, what a perfume, what an excellent flavour they have!' And he continued to smell and lick them with increased eagerness. Thus, then, all was explained, and the poor hallucinated whom I had hitherto pitied as the most unfortunate of mankind, on the contrary, was happy, since the most agreeable hullucinations of the senses, of sight, of smell, and of taste provided him with perpetual pleasure."*

Esquirol has reported a case of melancholia where the individual passed the whole day perfectly motionless, and seemed lost to all that was around him. He was kept in this condition through fear of a voice, which threatened him with death if he made the slightest movement.

MM. Aubanel and Thore, in their statistics of the Bicêtre, state that in 87 cases of monomania which they had registered in one year, 45 had hallucinations.

Out of 18 cases of monomania in our establishment, 12 had hallucinations. Several had also illusions. Lypemania (melancholy) was the form which predominated; and all who were attacked by it had

* Marc: De la Folie dans ses Rapports, avec les Questions Medico-judiciaires. 2 vols. in-8. Vol. i. p. 191. Paris, 1840.

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