Whether the protopathic excitation, then, be regularly or irregularly engendered, all goes on in the brain auto matically and, to some extent, unconsciously, by the individual force of the organs traversed by the process in evolution ; as though we had to do with a simple reflex operation in process of development in the grey tissue of the medulla ; as though we had to do with a foreign body, or a poisonous substance accidentally introduced into the stomach, and inevitably passing on its way through the successive regions of the intestinal canal.
We can thus comprehend how the third phase of the process (which is but the ultimate expression of the period of apparition and exteriorization of the human personality, which manifests its peculiar emotivity) ex presses, in a corresponding manner, the different vices of organization that have accompanied the first moments of its genesis.
In fact, if we study the concatenation of ideas and arguments in the case of the most rational lunatics, in those who, with persuasive logic, express, in correct terms, and often in a winning and convincing manner, all their emotions and all their extravagant conceptions ; if we follow out with care the natural sequence of wanderings, we shall always find that the first origin of their arguments and recriminations, their ideas of those persecutions of which they accuse those who surround them, their family, society in general, or persons un defined, have for their primary point of departure, an init ;al disturbance occurring in the method of sen sorial perception, and in the initiatory phase of a pro cess of judgment.
It is always a sensorial illusion, an hallucination, that is at the bottom of the morbid act, and directs its inevitable course.
Thus, we sometimes find an energetic and intelligent patient affected with reasoning mania, who bitterly complains of the soiled linen that is given him. He violently attacks those in his service, and complains the tricks of which he is the victim ; then shows the linen objected to, and, lo ! it is perfectly clean. We have caught the sensorial illusion causing the extrava gant judgment in the moment of its genesis. The patient imagined that he saw a spot of dirt, where there was none ; his senses used him badly ; and hence a series of extravagances constantly renewed in the same mind abused by its senses, and recurring by means of the same mechanism.
Or again, we may find another who, also suffering from peripheral disturbances in his nervous system— a special condition of his gustatory sensibility—con cludes that the food he is given is bad, that powders are put into it, that they wish to poison him, and that such and such a person is guilty. Another has scarcely risen from table, when he makes a great outcry, be cause, as he complains, they have given him no dinner. He is examined, and it is found that he suffers from a temporary anaesthesia of the pharyngeal mucous mem brane.
A laundress, whose case is reported by Charbeyron, and who had given up her business and become a sempstress on account of rheumatic pains, used to work late at night, and got ophthalmia. She, however, continued to work, and saw at the same time four hands, four needles, four seams. She had, in fact, double diplopia. She at first treated this as an halluci. nation ; but, at the end of some days, in consequence of weakness and prolonged mental anxiety, she imagined that she was really sewing four seams at once, and that God, touched by her misfortunes, had worked a miracle in her favour.* As we see here, also, there was a primary disturbance occurring in the first stage of the process (a sensorial illusion, diplopia) determining as its consequence the extravagance and error of judg ment.
In other circumstances, there are true hallucina tions, phenomena engendered on the spot by a species of erethism of the sensorial channels, which interpose and produce changes in the conscious personality. There are, in fact, almost always hallucinations of hearing, sight, and smell, which, either isolatedly or simultaneously, impinge upon the sensorium, and which are almost always found at the bottom of all forms of delirium. Sometimes there are voices heard subjectively, which incite the person under hallucination to avoid such or such a person, or to commit such or such an action ; that speak to him in a tone of menace and trouble him in his nightly rest. Sometimes there are various visions which keep him awake, painful per ceptions, either of taste or smell, which cause him to refuse food, etc.