Case LXIX

- M., twenty-seven years of age, short and stoat, of a lymphatic temperament, had contracted, under the influence of his trade, the habit of drinking a considerable quantity of brandy. Three days before he was received into my house, his parents perceived that he stammered and trembled all over. On the day of his entrance he was under great excitement; the walls, he thought, were hung with skeletons, phantoms, and devils, who climbed up and then disappeared. At times, this phenomenon occurred on a space no larger than a sheet of paper. The objects before him were transformed in the strangest manner. Thus he brought to his doctor a cup and a hat, which he said had taken the forms of extraordinary personages. In his frenzy, he saw his wife committing the most furious outrages. This illusion exasperated him; he uttered deadly threats, which decided his medical attendant to transfer him to my establishment. When I interrogated him, he related, in a trembling voice, all the visions that distressed him; he said that his wife denied it, but that it was mere dissimulation on her part. He pointed them out to me with his finger, saying: "Do you not see them?" At night, he was constantly stooping down to seize every object, no matter of what kind, that came out from the floor. Now he uttered exclamations of terror at the aspect of frightful figures; now he made signs to other visions to approach, that he might talk with them. I have noticed elsewhere the frequency of this symptom, which is chiefly characterized by figures of animals, reptiles, and insects.* Two baths, of eight hours each, with cold water irrigation, cured this man, on whom twenty-five drops of opium had not taken effect.

Case LXX

"I was called," says Dr. Alderson, "sometime since, to M., who, at that time, kept a wine store. As I was in the habit of attending him, and knew him very well, I was struck, on my entrance, at the strange expression of his and fell into the street, having gone through the window. I found him bewildered by his fall; he still thought he saw the phantom, and only replied confusedly to my questions. Some days of quiet and abstinence restored him to reason.

* Brierre de Boismont, De l'hydropisie chez les alienes buveurs, et de sa guerison par l'usage modere du vin et de l'eau de vie (Gazette des Hopitaux, 8 Aout, 1844).

Authors, who have written on this disease, have described a number of cases of these disorders of the sensibilities. They conceive, in fact, that from hence may arise an infinite combination of hallucinations. This may show itself at the beginning of the disease, a circumstance which it is highly important to remark, for, if one of our patients could throw himself from a window in pursuing a fantastic figure, it is easily understood that another could strike a person down whose figure may appear to him to be that of a monster, an enemy, etc.

Dr. Delasiauve, who has published a good work on the Differential Diagnosis of Delirium Tremens,* recognizes these hallucinations, but thinks that this fact has been too much generalized. According to him, the terror which the greater part of the sufferers feel, proceeds from the dangers and menaces from which they attempt to escape, and in consequence of which, finding no relief, they sink into a real stupor.

It will doubtless be asked, why we have not combined hallucinations occasioned by fermented liquors with those which arise from poisonous substances? Our reply is this: -

The delirium of drunkards is a very common malady, which shows itself with the train of symptoms of insanity, and of which the original cause, the abuse of fermented liquors, may be itself the symptom of a mental malady. The hallucinations arising from poisonous substances are transient; they are very rare in our country, and many of them require study. Moreover, their action on the animal economy is quite different from that of fermented liquors; and their symptoms are not really those of insanity. We therefore think that these hallucinations ought to be comprised in a special chapter.

Recapitulation. - The delirium of drunkards is almost always combined with hallucinations and illusions, which may exhibit themselves under the most singular forms, and give rise to some of the disturbances of sight described in the treatises ex professo.

The hallucinations of delirium tremens merit a special chapter, for they are almost always of a distressing character, and give rise to a long train of singular, fantastic, reprehensible, and dangerous actions.

* Revue Medicale et Annal. Medic-psycho., Oct., 1851.

We must not lose sight of the fact that hallucinations are not exclusively produced by delirium tremens, and that many mental affections comprised under that name, but which differ in their symptoms, although having the same origin, may also be combined with hallucinations.

and fell into the street, having gone through the window. I found him bewildered by his fall; he still thought he saw the phantom, and only replied confusedly to my questions. Some days of quiet and abstinence restored him to reason.

Authors, who have written on this disease, have described a number of cases of these disorders of the sensibilities. They conceive, in fact, that from hence may arise an infinite combination of hallucinations. This may show itself at the beginning of the disease, a circumstance which it is highly important to remark, for, if one of our patients could throw himself from a window in pursuing a fantastic figure, it is easily understood that another could strike a person down whose figure may appear to him to be that of a monster, an enemy, etc.

Dr. Delasiauve, who has published a good work on the Differential Diagnosis of Delirium Tremens,* recognizes these hallucinations, but thinks that this fact has been too much generalized. According to him, the terror which the greater part of the sufferers feel, proceeds from the dangers and menaces from which they attempt to escape, and in consequence of which, finding no relief, they sink into a real stupor.

It will doubtless be asked, why we have not combined hallucinations occasioned by fermented liquors with those which arise from poisonous substances? Our reply is this: -

The delirium of drunkards is a very common malady, which shows itself with the train of symptoms of insanity, and of which the original cause, the abuse of fermented liquors, may be itself the symptom of a mental malady. The hallucinations arising from poisonous substances are transient; they are very rare in our country, and many of them require study. Moreover, their action on the animal economy is quite different from that of fermented liquors; and their symptoms are not really those of insanity. We therefore think that these hallucinations ought to be comprised in a special chapter.

Recapitulation. - The delirium of drunkards is almost always combined with hallucinations and illusions, which may exhibit themselves under the most singular forms, and give rise to some of the disturbances of sight described in the treatises ex professo.

The hallucinations of delirium tremens merit a special chapter, for they are almost always of a distressing character, and give rise to a long train of singular, fantastic, reprehensible, and dangerous actions.

* Revue Medicale et Annal. Medic-psycho., Oct., 1851.

We must not lose sight of the fact that hallucinations are not exclusively produced by delirium tremens, and that many mental affections comprised under that name, but which differ in their, symptoms, although having the same origin, may also be combined with hallucinations.