Case CXX

"A lady," says Abercrombie, "whom I attended some years since for an inflammation of the lungs, woke her husband one night, at the commencement of her disease, and begged him to rise instantly. She told him that she had distinctly seen a man enter the room, pass the foot of the bed, and go into the boudoir on the opposite side. She was quite awake, and so satisfied of the reality of the apparition, that although the room was thoroughly searched, it was impossible to convince her of her error." A number of similar facts are related.

Case CXXI

A celebrated physician communicated to me a fact analogous to this, but still more striking. It occurred to a near relative of his own, about fifty years of age. Returning one evening from a visit, she went into a dark room to hang up some clothing; she had scarcely entered before she saw a skeleton, with its arm raised, and a poniard in its hand. The spectre darted its arm toward her, and plunged the poniard in her left side. On the same night she was attacked with fever, with a pain in the left side, and inflammatory symptoms. Her illness was severe. The impression produced on her mind was so strong, that long after her recovery she could not cross the threshold of the door where the apparition had appeared without agitation, and the observation that it was there her illness was contracted.*

Many authors, amongst whom Hibbert must be mentioned, have proved, that in the last stages of hectic diseases, and many other chronic affections, it is not unusual for patients to have hallucinations of an agreeable nature. By this tendency of the organization are explained the numerous communications which pious persons on their death-beds believe they hold with spiritual beings. Perhaps this disposition may be attributed to the happiness the sick persons, especially consumptives, experience, at the moment of death, which makes them conceive the most varied and beautiful projects. It must not be lost sight of, that in speaking of hallucinations consistent with reason, we have noted swoonings, syncope, and asphyxia, as favorable to the production of this symptom.

* Abercrombie, p. 361.

"Nothing is more surprising," says Aretee, "than the reflections sometimes made by sick persons in the crisis of their disease, the projects they form, and the sights they witness. Amidst the facts of hallucination noticed in the last stage of sickness, is one which will forever be engraven on my memory.

Case CXXII

"On the 1st of June, 1842, I received from the President of the School of Medicine in Rouen, the sad intelligence that my mother, who had for many years kept her bed, from a disease of the uterus, had two days before had epileptiform attacks, with loss of consciousness, of so violent a character that her life was despaired of, and it was feared that if in her enfeebled state she had another fit, she would die before I could reach home. My friend added that these violent crises had, for the time, ceased, and were replaced by a tranquil delirium, in which she saw shadows and figures of all kinds, spoke of various objects entirely unconnected with her position, no longer recognized those who surrounded her, but imagined herself ill-treated by them, and endeavored to drive them away; even to my sister, who had never quitted her bedside, she became entirely indifferent. In the midst of her incoherent words, one idea seemed predominant; that she should never see me again. She called for me unceasingly. That night found me by her side. Penetrating into the apartment of my much-loved mother, towards one in the morning, a prey to anguish in which all can sympathize, I found her sitting up, with fixed eyes, pronouncing, in a low voice, those words of delirium that have so long rung sadly in my ears. She desired that the persons who had come into the room might be sent away, especially the wicked woman who so much tormented her. With her hand, even, she tried to drive them off: 'Pray send them away,' she repeated; 'do you not hear what a noise they make V Then followed a mournful silence. 'They hinder me from seeing my son. My poor son! he will not come; when he does come, I shall be dead.' This delirium lasted for twenty-four hours.

"At this sight, I burst into tears, and taking her hand, said, 'Calm yourself, my good mother, I am near you, I will not leave you;' and I pressed her to my heart. Scarcely had I said these words, than my mother was silent, as if endeavoring to collect herself; and recovering her senses, said to me: ' Tell me, is it indeed you, my son? Ah, I know your voice. Where are you? I do not see you.' Her attention becoming more and more concentrated, she distinguished objects, and finally perceived me. 'You are there,' added she, 'I shall die content!' Her delirium had ceased; the sound of my voice had sunk to the depths of her soul. A miraculous change had occurred; reason shone brightly on the altar of maternal love. During the remaining five days of her life, I had the extreme happiness of seeing her reason preserved. On the fifth, the day of her death, an artist was taking her portrait; it was eleven o'clock in the morning. The painter observing her grow pale, proposed to defer the sitting. 'Go on,' said she, 'it will soon be too late.' At three she expired."

For the completion of this chapter, it only remains to speak of hallucinations in nervous complaints, and in some morbid conditions to which we referred when we spoke of hallucinations compatible with reason, but it would be only to repeat what we have already said; it appears to us sufficient to have called attention again to this subject.

Recapitulation. - Hallucinations may be combined with all diseases.

The impressions produced on the imagination by fever, have been divided into three degrees; in one, reason is intact; in the second, it is overthrown; in the third, destroyed. Any one of these states may replace the other.

Hallucinations sometimes precede the disease, of which they are then the signal precursors.

The principal diseases in which hallucinations have been observed are: inflammatory fevers, congestions, inflammations, and diseases of the brain and its membranes,* inflammations of the lungs, lesions of the digestive organs, typhoid and intermittent fevers, gout, hectic diseases, etc.

* Durand Fardel, Trait6 da Ramollissement du Cerveau; a work to which a prize was awarded by the Royal Academy of Medicine, 1843, 1 vol. 8vo., pp. 235, 249, 328.

The special character of hallucinations in the last stage of hectic diseases, is probably linked to a sense of happiness which makes this class of sick persons form a multitude of projects.

The combination of hallucinations with nervous diseases, has been sufficiently established.

Convalescence, abstinence, and loss of consciousness, may cause hallucinations. They have also been occasioned by atmospheric influences.

It is probable that the production of hallucinations in disease is the result of a morbid action of the nervous and circulatory cerebral systems; but how they are produced remains undiscovered.

Hallucinations are then manifested like delirium; hitherto cerebral modification has escaped all our researches.