Insanity : its classification, diagnosis, and treatment; a manual for students and practitioners of medicine / by E. C. Spitzka.

  • Spitzka, E. C. (Edward Charles), 1852-1914.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Insanity : its classification, diagnosis, and treatment; a manual for students and practitioners of medicine / by E. C. Spitzka. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    brain itself. Hallucinations of this kind are common feat- ures of opium and alcoholic delirium, of the delirium of meningitis, of the visions of the paretic dement, and are in these two latter disorders of grave import. It is difficult to determine to what extent hallucinations in the insane are determined in their origin and recurrence by the faulty conceptions and reasoning of the patient. There are undoubtedly patients suffering from delusional insanity whose hallucinations are a sequel of their delu- sions. Just as some artists possess the power of almost hallucinating a face once seen, and faithfully transferring its lineaments to canvas, or as Goethe, absorbed in selfish reveries, suddenly saw himself before him on the road; so the delusional lunatic, intensely concentrating his morbid ideation in a religious, an erotic, an ambitious, a hypochon- driacal, or a persecutory notion, develops corresponding hallucinations. Inasmuch as the hallucination strengthens and confirms the delusion opinion out of which it grows, the grave signification of this complicating symptom in the chronic insane becomes evident. Again, there are cases where the hallucination determines the character of a subsequent delusion, just as there are a few—a very few—authentic instances where a dream has produced an insane delusion. Insanity of this character, as a rule, offers a better prospect than that where the delusion is a primary factor, and determines the development of, and becomes in turn confirmed and more firmly organized by the hallucinations it provokes. Hallucinations are found with most forms of insanity, but, being often of a more evanescent character than delu- sions, they are not as frequently noted; they are also less readily announced, either because the patient imagines that the visions and voices are of a sacred character, and that it would be therefore a sin to communicate them to the uninitiated, or because some unwise person, having previously ridiculed him, the patient, insane as he is, appre- hends that his tale will be treated as a fiction again. There is, however, one form of insanity in which hallucinations are so prominent and numerous that it has been termed hallucinatory confusion. Hallucinations are also char- acteristic of insanity developing in prisoners, and are here doubtless due to the favoring influence of darkness, solitude, and silence in producing hallucinatory phenomena. The same remark applies to the insanity of blind persons.