Etiology of hallucinations and illusions - It should be sought in the psychical and corporeal elements of man, and above all in ideas, in hallucinations of long standing, single and compatible with reason.

FIRST Division. - Moral causes; their influence on hallucination - Statistic - Epidemic hallucinations - Influence of dominant ideas - Demonology, sorcery, magic, lycantrophy, apparitions, vampirism, ecstasies - Influence of different civilizations - Influence of the passions, of fixed ideas, of preoccupations of the mind, and of bodily occupations.

Second Division. - Physical causes. - These may be subdivided into five heads: 1. The influence of inheritance, of the sexes, of age, etc. - 2. The influence of mechanical causes, of fermented liquors and narcotic and poisonous substances - 8. The influence of mental diseases - 4. The influence of nervous diseases other than insanity - 5. The influence of acute, chronic, and other diseases - Recapitulation.

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Before we trace the accessible sources of hallucinations, that is to say, the secondary causes, † we must remember that ideas are composed of two distinct elements - a sensible sign and a pure conception. Mysteriously united, like the soul and the body, they form a perfect emblem of the nature of man. Hallucination, that outward garment, that daguerreotype of an idea, being then only the corporeal portion, whilst pure conception is its psychical part, it is evident that in these two elements we must seek the cause of this singular phenomenon.

The observations we have made on fever doubtless prove that this state is favorable to the production of errors of the senses; but it mast not be considered as exclusive, because fever may exist for a long time without either delirium or hallucination. There are, besides, cases of hallucination occurring in persons in good health, gifted with remarkable sense and under no morbid influence, which can only be explained by a peculiar modification of the nervous system. Such is the following case: -

*The study of the causes of hallucinations has so many points of anion with that of illusions; or rather, the ties which unite them are so intimate, that we have judged it right not to separate them.

† The primary cause of this phenomenon will always remain hidden, like that of all facts which surround us. It is the difference which separates the finite from the infinite, towards which we are constantly tending, often against our will, and which our most ardent desire to know will never alter in this world.

Case CXXIII

Madame la Vicomtesse d'A., wife to the celebrated author of that name, whom I attended for many years, was conversing with me one day on the apparitions of Holy Writ, of which her piety never permitted her to entertain the least doubt. "I will relate," said she, "an event that occurred to me twelve years ago, and which is a fresh proof of the reality of those visions to which your science gives the name of hallucinations. I had received a letter from my son-in-law, Count d'O., informing me that my daughter, from whom I was separated several hundred leagues, was very ill, but the letter did not contain any expression which led me to fear a fatal termination to her sickness. On returning to my room (it was then nine in the morning), preoccupied with the idea of my child's suffering, I heard a heart-piercing voice pronounce these words: 'Lovest thou me?' I felt no surprise, and instantly replied, in a loud voice: ' Lord, thou knowest that I have placed all my trust in thee, and that I love thee with all my soul.' The voice added: 'Wilt thou yield her to me V A shudder of fear ran through me, but recovering myself, I again replied: 'Howsoever painful the sacrifice, thy holy will be done!' and I then fell into an arm-chair in a fainting state. On the following day, a second letter brought me intelligence of the death of my dear child."

All who were acquainted with the Viscountess, knew her as a sensible, well-informed, and strong-minded woman. Tried by severe moral afflictions, which spare neither rank nor age, religious principle had sustained her. The more misfortunes assailed her, the more she implored consolation from God. In a word, she was a fervent Catholic, without bigotry or fanaticism; one of those privileged natures formed to administer to the happiness of their fellow-creatures, and who, on quitting the world, give an example of those glorious, unostentatious deaths justly contrasted by Count de la Mark with the dramatic deaths vaunted to him by Mirabeau.*

We shall make only a few brief remarks on the hallucinations of Madame d'A. It took place in broad daylight, at a period when her health was excellent; at a time when her attention was concentrated on the illness of her daughter. Brought up in the Christian faith, from which she had never swerved, and having always had recourse to prayer in her sorrows, she experienced no astonishment at the words which she believed she heard. Twelve years had elapsed, when Madame d'A. related the anecdote to me; but her belief in its reality was as vivid as on the day of its occurrence. This example is to me a most convincing proof of the manner in which the apparitions of the Middle Ages may be explained, and of the falsity of that system that would always convert hallucinations into a system of insanity.

In a medical point of view, there is no doubt that the nervous and sanguine elements play a considerable part in hallucinations; but how do they act? Therein lies the difficulty. We are entirely ignorant of their modes of action in the normal combinations of thought. Pathological anatomy might perhaps inform us that certain cerebral changes are more suited to their manifestation, which is, however, far from being proved. We only know that several stimulants contribute to give more vivacity and animation to ideas, which after all signifies that a greater affluence of blood reaches the brain. It may then be given, as a general rule, that a greater excitation of the nervous system, and a greater afflux of blood, contribute to the development of hallucinations. But what is the agent of these excitations? how does it modify these elements? where does it make itself felt? These are questions, the solution of which is not more easy than a thousand others of the same nature

* Correspoiidance entre le Comto de Mirabeau et le Comte do la Mark, recueillee et publiee par M. de Bacourt, t. i. pp. 258, 259. Mirabeau, et la cour de Louis XVI. par M. St. Marc Girardin, Revue des Deux Mondes, 1st Oct. 1851. Some time after that conversation, the Comte de la Mark went to see Mirabeau, who was seriously ill in bed; he, desirous of giving a proof of the impression which his words had made on his mind, bade him approach, and pressing his hand, said, "My dear connoisseur in glorious deaths, are you satisfied?" which have remained unanswered. Must we not admit a predisposition, that unknown something which we everywhere encounter? Without this assumption, how can we explain apoplexy in some cases, cerebral inflammation in others; in one, softening of the brain, in another, mania; in one, stupor, and in another the absence of any morbid phenomena?

Thus, in fine, under the influence of a moral or physical force, a stronger stimulation of the nervous and sanguineous Systems may produce an hallucination, without the possibility of establishing an intimate relation between these two orders of facts.

Having thus touched on the organic element, we will return to the world of ideas, in which we must necessarily seek the causes of the singular phenomena of hallucinations. Such a study, by its immensity, would offer almost insurmountable difficulties if we did not establish some fixed points to serve as guides in the work. Thus, in a first chapter, we will consider the action of social and individual influences, and of moral and physical causes, on the production of hallucinations; and in a second chapter, we will endeavor to penetrate more deeply into their mode of formation, by examining them psychologically, historically, morally, and religiously.

The study of the causes of hallucinations offers great difficulties. This disorder of the senses having always been looked upon as an epiphenomenon of insanity, authors in general have agreed not to consider it as a special subject, or to class its etiology with that of mental diseases. Ferriar and Hibbert, who have published special works on hallucinations, anterior to those of Esquirol, have pursued this erroneous course.

It is worthy of notice that the greater number of insane persons have hallucinations, but it is no less certain that they may be manifested singly. Even in their complicated state, it is not always difficult to recognize their origin. Finally, we may draw useful information from those which are compatible with reason, or which accompany disease.