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of people, who descended the wall for the purpose of going to a fête. They carried with them their dresses for the festival. The company consisted of men, women, and children. We have heard her cry out with delight at their number, the variety of their costumes, and the haste with which they descended. Gradually the number of the promenaders diminished: she only perceived a few solitary groups, and by degrees they all disappeared. We have since met with two similar cases in very old ladies.

SECT. II.-Hallucinations in Dementia with General Paralysis.-It may at first seem singular that the most severe form of insanity should be capable of being complicated with hallucinations. How, in fact, are we to believe that a man who cannot speak plain, whose memory is gone, who is blind, his mouth half open, his lips hanging down, his step tottering and uncertain, can be excited by anything? Nevertheless, experience shows that it does occur. we have said at page 135, regarding the different degrees and types of dementia, will also apply to cases of deranged intellect accompanied by paralysis. We speak here only of paralysis with insanity, and not of that of the disease, which has been described some years back under the title of progressive general paralysis without insanity.

What

Examples of hallucinations in this kind of insanity are far from numerous, but there can be no doubt that some insane persons, with paralysis and in a state of dementia, have hallucinations of sight and hearing. Out of eight lunatics, paralysed and in a state of dementia, whom we have had in our establishment, four have been so affected.

Example 50. Madame -, aged sixty-five, belonged to a literary family, and has herself been distinguished by her writings. At the present time her conversation is unconnected, her speech hesitating,

and her memory gone; but in the midst of this total wreck, the idea that she has been a poetess still survives. Every morning she tells me, in a voice full of emotion, that she has been visited by an angel clothed in white, who spoke to her. During the day she said to me, "My angel spoke to me, and engaged me to go out and visit my daughter." The angel is young, beautiful, and fair; it is a recollection of the past. At times she imagines she partakes of an excellent repast, and will describe to me all the dishes she has tasted. To hear her, you would suppose that she still assisted at the banquet. The meats on the table are exquisite; they give forth the most savoury smells, and the wines are of the most celebrated growths. Unless she is speaking of her poems and her writings, her conversation wanders perpetually.

In the following case the person had arrived at the very worst stage of the disease, when he suddenly emerged from his speechless condition, and uttered cries and howls which nothing could allay.

Example 51. M. B., who has been insane and paralytic for nearly four years, seems to have entirely lost the power of speech. From time to time he utters hoarse, inarticulate cries; this will last for fifteen days, and after that he will remain silent for a month. At times he recovers his speech, and utters a number of sentences, which all show that he is under the influence of a frightful hallucination. He believes there is a shark close at hand, and ready to devour him. His efforts to frighten the creature and drive it away are terrible to behold. He sends forth cries that may be heard a long way off, and dashes himself against the walls of his room; his features are distorted, his eyes are starting from their sockets, and the sweat pours from his body. It is impossible to afford him any relief, and one is com

pelled to remain a helpless spectator of a struggle which it is most distressing to witness.

This hallucination produced very serious results. One day he imagined that his sister, who anxiously attended upon him, was the shark; he rushed at her with a razor, and tried to wound her. Fortunately she was able to avoid his cuts; but one of his cousins, who was present at this frightful scene, was so affected by it, that she died five days after.

HALLUCINATIONS IN IMBECILITY, IDIOTISM, AND CRETINISM.

For the production of hallucinations it is necessary that certain faculties, amongst which the imagination holds an important place, should be able to perform their functions. But when the intellect is destroyed, as in the last stage of dementia, or where it has never existed, as in idiotism and cretinism, errors of the senses cannot take place.

A distinction must be made where the imbecile has some portion of intelligence-where, for instance, he has memory, is capable of being taught, or of observing; where he experiences fear and sometimes revenges himself. It seems to us beyond a doubt that reprehensible and criminal acts have been committed by imbeciles under the influence of hallucinations and illusions. The insane imbecile is unquestionably a credulous being, and this condition of his mind renders him a docile instrument in the hands of designing men; the examination of his mental faculties proves that he may be governed by hallucinations.

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CHAPTER VI.

HALLUCINATIONS IN DELIRIUM TREMENS.

THE effect of alcoholic liquors on man are too well known to render it necessary for us to dwell upon them here; we shall therefore confine ourselves to noticing some particulars concerning the insanity which they give rise to.

*

In those lunatic asylums which are devoted to the reception of the middle classes of society, one-tenth of the inmates, says M. Royer-Collard, become insane through the abuse of spirituous liquors or wine. At Charenton the number of men insane from this cause is four times that of the women. M. Bayle attributes to the same cause one-third of all the mental diseases which have come under his notice.† It is important to remember that in some individuals this propensity to drink does not show itself until after the appearance of the mental disease; thus in some females of most estimable character it makes its appearance at the change of life.

pauper lunatics Out of 1679 1808 to 1813,

In the houses for the reception of these proportions are still greater. insane admitted into the Bicêtre from M. Ramou-formerly house-surgeon to the hospital -considered that 126 of these were due to excessive drinking; while, according to M. Esquirol, out of 264 females at the Salpêtrière, 26 were to be attri

* H. Royer-Collard: De l'Usage et de l'Abus des Boissons fermentées et distillées.-Thèse de Concours. Paris, 1838.

Bayle: Traité des Maladies du Cerveau et de ses Membranes. Paris, 1826.

buted solely to the abuse of wine or spirits. The functional disorders which are produced in the insane from excessive drinking manifest themselves under many different forms; but those only will be noticed here which relate to sensation, and which show themselves by illusions and hallucinations of the senses. These patients see objects double; everything around them is in motion; they are haunted by shadows and spectres; they hear the sound of many voices, or of separate noises; they believe their food is poisoned, and they are annoyed by disagreeable odours.

M. Viardot, translator of the Nouvelles Russes of M. Gogol, says that the Zaporogh Cossacks, who indulge in the immoderate use of spirituous liquors, are often attacked with delirium tremens, and that they are then beset with demoniacal visions. He mentions the case of one man who saw enormous scorpions stretching out their claws, endeavouring to lay hold of him, and who died in convulsions on the third day, when he thought they had actually seized him. (Revue des Deux Mondes.)

The existence of these peculiar and distressing hallucinations has been commented on by the writers of every country. We read in the American Journal of Insanity, that all kinds of animals introduce themselves into the room of the sick man; they glide into his bed, or walk over the coverings, or threaten and torment him with hideous grimaces.*

From the numerous cases of this kind which are brought in the course of every year to my establishment, mostly from amongst publicans, I have selected. the following:

Example 52. M., aged twenty-seven, stout, small, and of a lymphatic temperament. In consequence of his occupation, he had been in the habit of drinking

* Annal. Med.-Psych. p. 466. Juillet, 1850.

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