Case CLI

An English navy officer having devoted himself ardently to telescopic observations, imagined he had made remarkable discoveries in the sun. Amongst other strange assertions, he solemnly declared that, at the time of Napoleon's abdication, in 1814, he had seen the figure of the Emperor in that planet; that on the following day he had again seen it, but transformed into a skeleton. On the third day, the figure was 30 no longer visible; but the united colors of the allies were alone distinctly seen. A copy of these apparitions was regularly entered on the ship's books, and it is said that several sailors bore witness to the truth of the observations. Notwithstanding this corroboration, very few persons put any faith in the discovery, and the officer had the mortification to find that the whole was regarded as a fallacy. There is no doubt that these illusions were perfectly inoffensive, that they did not interfere with the operations of his mind in the ordinary business of life, nor prevent the fulfilment of his duties.

Conolly, from whom we have borrowed this case, adds that individuals ought not to be confined because they hold particular or even eccentric ideas, on certain subjects, otherwise a new field would be open for arbitrary measures. A man may be accounted singular, even insane, for believing in the existence of two worlds, the one invisible, the other visible; that there is no such thing as solitude; that every secluded spot is filled with spirits; that there is no act, howsoever secret, but has numerous witnesses. Nevertheless, in avowing this, he says nothing but what has been taught him by religion; but if he goes one step farther, if he professes to communicate with these invisible beings, he runs the risk of being looked on as a madman, although many great men have believed in the reality of such things; he is, in fact, under the influence of hallucination; he has allowed his thoughts to assume a bodily form; comparison and judgment are disordered. But, although unreasonable on this point, if his conduct be correct, and his actions irreproachable, no one has a right to interfere in his affairs, to call him to account for his opinions, and still less to confine him.

Thus, whenever hallucination is inoffensive, isolation is unnecessary; but this is no longer the case if it be prejudicial to himself or to others; sequestration is then indispensable. Examples of mutilation, suicide, homicide, theft, and incendiarism are so common among the hallucinated, that it is needless to insist on them.

In regard to treatment, does not hallucination, even if inoffensive, require isolation when it has resisted the usual means employed in such cases?

It is not thus, when hallucination, howsoever transitory, may result in serious consequences.

Case CLII

We were consulted some years since by a young lady artist, whose husband had very short epileptic attacks, which were immediately followed by mental alienation. He believed himself surrounded by menacing figures, and flames, and said that he saw spirits. In one of these paroxysms, he seized his wife by the throat and would have strangled her, but she escaped. At another time, he asked for a poniard to destroy the enemies whom he believed surrounded him.

It is easy to conceive the alarm which these two attacks occasioned the young wife. "I can no longer endure," she said, "such a state of life. My sleep is disturbed by frightful dreams; every instant I seem to feel the shocks which precede those paroxysms. I study his slightest movements; it occupies my whole attention; my powers are paralyzed, my voice is weakened, I can no longer follow my profession. Come, sir, to my aid ! do not abandon me in so cruel a position; in the name of Heaven, have pity on my fate!" The agitation of the lady, the tone of her voice, and the expression of her eyes, spoke more than words could do.

On the other hand, the husband, having recovered himself, exhibited no sign of derangement in his faculties; his conversation was sensible; he knew that he had been deceived by illusions. "When I suffer thus," he added, "it appears as if my ideas are confused; my head becomes a chaos in which I can distinguish nothing."

Young, fond of his wife, and not considering his indisposition dangerous, he was placed in a difficult situation, and his medical adviser no less so.

It was evident that the kind of disease with which this young man was afflicted was most serious, for experience has but too often proved what catastrophes have arisen from mad and hallucinated epileptics. The moral condition of the woman required consideration; in fact, a few degrees farther would bring suicide or madness. Isolation, then, was indispensable; I advised it; but taking into consideration the brevity of his attacks, and his rapid return to reason, I did not think it necessary to recommend a private retreat. I engaged his friends to point out to him the necessity of a separation of some months from his wife, and to take an oath to that effect, which plan was carried out.

With our laws, sequestration was, in this case, impossible; and yet what reliance could be placed on the word of a man whose disease might at any moment derange his reason, and who was, moreover, much enamored of his wife?

Section first, - Physical Treatment - The intimate connection which unites the two constituent principles of man suffices to show that each in its turn may be influenced, and that thence it is necessary to have recourse to therapeutic means applicable to both. Let us take a few examples: A female yields to the immoderate use of fermented liquors; she has hallucinations; simple isolation is sometimes sufficient to effect a cure; but often we must resort to opium, bleeding, baths, etc. Another thinks she sees the devil; reasoning, raillery, and the douche may eradicate the false sensation. In general, it is necessary to use both methods, in consequence of the reciprocal action of the two principles. An individual suffers violent grief, which he attributes to one of his enemies; soon this particular person, or some other fantastic form takes entire possession of him; he no longer sleeps, his blood becoming heated, to use a common expression, secretions and excretions are deranged. In this case, should not physical remedies precede moral means? What reason teaches, experience demonstrates.

The academician, Nicolai, subject to sanguine congestions, which required the use of bleeding, neglected this precaution; phantoms of all kinds unceasingly beset him. He was bled, and restored to peace and quietness.