Case XXXI

M. N., forty years of age, was suffering much domestic affliction. Like many others, he sought to drown his sorrows in wine. Several months before his disease, he became restless and strange. On the 30th of April, 184-, without more excess than common, he was taken with a febrile delirium, for which he was bled. Thirty leeches were placed behind his ears; which bled for twenty-four hours. By means of this and other suitable remedies, he enjoyed a brief respite; but the symptoms of excitement recurred; he uttered menaces and cries of terror, and demanded his knife, to kill the intruders. In one of these crises he was brought to my establishment.

On his entrance, I was struck with the wildness of his countenance; his looks expressed fear and rage; he was violently agitated, uttered menaces and cries, convinced that persons were hidden in his room, and under his bed; every instant he exclaimed, "Where are they?" The next day he was put in the bath, where, according to the plan followed for many years in my establishment, he remained for eight hours, receiving the douche irrigation as in the treatment of fractures.* He incessantly inquired what it all meant, calling on the commissioner and the king's attorney, and demanding his liberty.

Finding that the sight of the persons in attendance excited him greatly, I left him in complete solitude. During six days* he was bathed, purged, vomited, and received but little nourishment. At the end of that time, he appeared calmer, and begged to see me in private.

On being brought before me, he thus expressed himself: "Sir, you did right in conducting me into your establishment; I was then highly exasperated; I said and did the most foolish things; my language against my wife was entirely senseless. I acknowledge that her conduct is excellent, and that I have nothing to reproach her with; but if my brain was turned, it is no less true that it was caused by the scene I witnessed, and which I will describe to you: -

"I was in the bath which was prescribed by the doctor, on account of my feverish excitement, when I saw, as plainly as I now see you, a man enter my apartment, entirely dressed in black. He looked attentively at me, then made grimaces in order to provoke me. Indignant at such conduct, I showed him, by my countenance, how much displeased I was;. he then approached the stove-pipe, seized it, and springing up disappeared by the opening. I was quite astounded at this singular scene, when I saw three men come from under the bed; they advanced towards me, making the same gestures and grimaces as the first. I was furious, and loudly called for my knife, to kill them; they mounted the pipe in the same way, and disappeared through the hole. I had never seen them before, but their faces are so engraven on my mind that I should recognize them anywhere. Before they went, they filled my sheets and counterpane with dirty vermin of all kinds.* I certainly was excited for a time, but I will stake my existence on the reality of these facts."

* De l'emploie des bains prolongees et des irrigations continues dans le traitement des formes aigues de la Folie, et en particulier de la Manie, par A. Brierre de Boismont. Memoire de l'Academie de M6decine, t. xiii. 1848.

The calm and cool manner in which Mr. N. recited this history was at least as surprising as the circumstances. I made no observation on it, because in the course of events his cure was not far off, and I knew by experience that I should in vain have tried to disabuse him, and on the contrary might have irritated him.

Some days afterwards, the conversation was renewed, and I thought it time to speak candidly to him on his hallucination. "Well," said he, "admitting that it is but a notion, am I not well enough to be allowed to return home, where I am really wanted?" For four days previously, I had given him ten centigrammes of opium in a dose; the only effect was to cause an abundant perspiration.

By the end of the month, Mr. M. was completely restored to reason. He acknowledged that he had been duped by an error, promising to avoid the causes that had led to his malady. He begged to remain another month, in order to go at once into the country. I saw him two years afterwards; he was effectually cured.

Hallucinations of sight may be infinitely varied, for, being most generally but a highly colored reflection of habitual thoughts, they take as many forms as there are individualities.