Case XCIV

A foreign lady, aged forty, was several years ago brought to our establishment. All the information that we could gain relative to her, was limited to the fact that for twenty years she had been subject to intermittent attacks of insanity; but we could learn nothing of the circumstances that had produced them. One morning, another person suffering under hysteric monomania entered my room, and said: "I want to tell you something! My neighbor is the celebrated Louisa. All night she has been talking with a person of whom she implored pardon for having caused him to be taken before the tribunal, or else heaping abuse on him; her conversation was mingled with the words poniard, assassin, deserted child, hospital, etc. I questioned her on her awaking, but failed to gain any light on the subject."

In order to understand this history, we must relate that, one year before, a merchant had brought his wife to our establishment to have her treated for a mental affection. The lady, who was very proud, was attacked with a disputatious and wicked monomania, and had such a hatred of her husband, that she had made several attempts on his life. After passing some time in my house, she confided to the other boarders that her husband was a wretch who had shamefully ill treated her. "I could destroy him, if I chose," said she; "I need but relate his infamous conduct towards a young person, whom, in a fit of jealousy, and perhaps to rid himself of, he stabbed, twenty years since. Although he was saved then by the devotedness of his victim, who declared to the magistrate that she had attempted her own life, he had the baseness to desert her, with her child. The poor creature was in despair; had she been removed into an insane hospital, she would probably have died."

* Alexander Crichton, An Inquiry into the Nature and Origin of Mental Derangement, p. 45, London, 1798.

The Louise that we tell of was the heroine of one of those domestic dramas, much more fruitful in events than any that are represented in the theatre.

Leuret, in his Fragmens Psychologique*, has remarked that there are some deranged persons who reason, during the day, according to the ideas and perceptions of the night. They are very capable of appreciating justly what they see during their waking hours, and, provided they do not mingle in their conversation recollections of their dreams, they are perfectly sane.

The coincidence which sometimes exists between dreams and insanity has been sufficiently pointed out. Here is a case in support of this opinion: A maniac whom Dr. Gregory attended, and who was completely cured, had, in a week after his recovery, dreams, in which he was annoyed with the same hurried thoughts and violent passions which he had during his madness.

Nocturnal hallucinations have sometimes exhibited themselves in an epidemic form. We have spoken of Hungarians, who saw in their dreams the shades of their relatives recently interred come to them, and felt that they sucked their blood.

There are some hallucinations that commence in sleep, and, being reproduced during several consecutive nights, are finally accepted as realities. The widow Schoul heard a voice for several nights, which said to her: "Kill your daughter!" At first she resisted, and drove away the thought on awaking; but the idea soon became fixed; it no longer disappeared with her sleep, and, after some days, the unhappy woman destroyed her child.

Recapitulation. - The nightmare, presenting a strong analogy to madness, it is not surprising that it is combined with hallucinations.

The hallucinations of nightmare are observable in childhood. They are also noticed at different stages of life. 14

Hallucinations have often been observed in nightmare under an intermittent form.

In nightmare, as in madness, it sometimes happens that persons are conscious that the phenomena they experience are not real.

The hallucinations produced by nightmare usually cease on waking; but they may be continued during waking hours, and be taken for realities.

The hallucinations of nightmare are frequently observed in insanity.

The hallucinations of nightmare serve as a natural transition to those of sleep, which only differ from waking hallucinations by their intensity and by certain psychological conditions. Indeed, it was long ago remarked that an hallucinated person was only a waking dreamer.

During sleep the operations of the mind are no longer subjected to the control of the will, and all ideas that are then formed, are received as so many realities.

The hallucinations of dreams may be traced to bygone reminiscences, or the association of ideas.

Many authentic facts seem to prove that the hallucinations of dreams may communicate the knowledge of an event that is passing at a given time; in this case it is probable, however, that it is but a simple coincidence, or a reminiscence.

Presentiments are often naturally explained; but there are cases in which they may be attributed to unknown physical or moral influences, or to the real phenomena of somnambulism or magnetism.

If impressions are generally weakened in dreams, there are cases which prove that the operations of the mind may take place, as in a waking state, and even be exercised with remarkable precision, rapidity, and power.

In general, the hallucinations of dreams cease on waking; or, if they still retain a certain energy, they have no influence on the conduct. In insanity, on the contrary, they exhibit an extreme intensity, and great fixedness of character, and remain deeply engraven on the memory.

Popular belief and religious opinions have concurred in imparting great influence to the hallucinations of sleep. It is, therefore, not surprising that some persons, extremely impressed by their dreams, have succeeded in imparting their opinions to the mass of the people. It is also possible that in this case, the recollection of nocturnal hallucinations has been entirely lost, and the mind has accepted as reality that which was, in fact, but a dream.

Some authors think that the cases of second sight are only hallucinations of sleep.

Dreams in neuroses and insanity may furnish many valuable indications of the malady.

Many insane persons reason during the day in conformity with the ideas and perceptions of the night.

The disorders that have occurred during mental alienation may be reproduced during sleep, after a cure has been effected.

Nocturnal hallucinations have sometimes exhibited themselves in an epidemic form.

Hallucinations, after being repeated for several nights periodically, may become permanent during the day.