[Thus, a young man of fair education, and who was in all respects an excellent clerk, fancied he heard his employer re flect upon his honesty. He complained to the employer of the supposed injustice and was informed that he was entirely mistaken and that, on the contrary, his services were very satisfactory. This quieted him for a time, when the voices returned. He then resigned his position and spent his time at his home brooding over his troubles. In the meantime the hallucinations continuing, he purchased a revolver and spoke to some members of his family of the persecutions to which he was subjected to by his former em ployer. Finally, one day he went to the latter's house, and calling him to the door, fired at him, fortunately without doing any injury. Being arrested, his references to his hallucinations and de lusions resulted in his being committed as insane. For months his conduct in the institution was extremely precise; he was quiet and well behaved, and in conversation refused to acknowledge the presence of hallucinations and delusions. In his correspondence with members of his family, however, the persistence of both was manifest. In another case, boys followed the patient in the street, shouting opprobrious epithets. He also had hallucinations of smell and taste, with delusions of poisoning. In another case, a woman (spinster), hallucinations of hearing were combined with those of smell and sight. A sexual tendency was manifest in the hallucinations, although the behavior of the patient was unex ceptionable. Male attendants in the hospital, and sometimes visitors, would shout obscene remarks at her during the night. These were usually attributed to the most circumspect persons. On one occasion a high ecclesiastical dignitary visited the hospital, and a few days later the patient complained that she had been compelled to endure his presence and em braces during the previous night. Simi lar complaints, with no more reason, were made against some of the attend ants. She imagined a machine by which obscene pictures were thrown on the walls of her room during the night which she was compelled to look at. These frequently kept her awake, she averred, during the greater part of the night. At table some of the attendants delighted in throwing a stream of putrid sewage from a hose between her plate and her mouth, so that she was prevented from eating. The latter behavior, which she regarded as particularly atrocious, was generally attributed to the women nurses in her ward. hi other respects she was an extremely well conducted patient, an exceptionally good and industrious seam stress, and painfully neat and clean about her person, clothing, and room. GEORGE H. RonE.] Hallucinations of vision are often of a pleasurable character. The visions, so graphically described by Du Manlier in the novel before mentioned are examples. On the other hand, the visions may be disturbing or terrifying and aid in the genesis of delusions of suspicion or perse cution.
—Delusions are usually evolved out of hallucinations, although they may originate independently of these. In paranoia the characteristic de lusions are those of persecution, bined with delusions of grandeur. There are also delusions of personality, where the subject fancies himself another per son,—usually one belonging to a higher 1 social caste. Among the delusions coming rather frequent at the present time are those of electrical and hypnotic influence and of thought reading. The electrical delusions are sometimes very complicated. The patient is controlled by a dynamo, or some modification of the telephone, which is in the office of the chief of police of the city. Through this the patient is annoyed by the police, the detectives, or corrupt politicians, whose names are mentioned by the patient with great freedom. When the patient wants
to bring his complaints before the proper authority, the persecutor brings the machine into play and confuses the pa tient's mind or words to the extent that he cannot make an intelligent verbal complaint. He usually gives his com plaint very extensively and often nectedly in writing. The electrical or hypnotic apparatus is also used to deprive the patient of sexual power, or to compel him to masturbation, which he regards as an attack upon his self-respect. If one does not believe his words it is easy to prove it absolutely by a galvanometer which if attached to his head will show the presence of an electric current. A similar machine,—the description givenE is usually very vague,—is used to detect the patient's thoughts, and so get him into trouble.
[One patient, a woman, who was very much disturbed by the use of such a machine by the writer, invented one to counteract the influence of the first. Of course, the machine was never actually constructed; it existed only in the pa tient's mind. GEORGE Ii. ROHE.] the influence of delusions of persecution, the patients themselves come persecutors: the persecuteurs secutes of French authors. To this class belonged Guiteau and Prendergast, the assassins of President Garfield and Mayor Carter Harrison, whose history is so re cent that no detailed reference is here needed.
The delusions of grandeur may be present with or without hallucinations. They are usually combined with delu sions of persecution, although these may be in temporary abeyance. Thus, the asylum princes, saints, great generals, or even deities, while protesting their high estate, lament the fact that through the villany of others they are deprived of their just rights. These persons are also dangerous, because they sometimes seek to obtain by force the honors of which the world has robbed them.
In the early stages of paranoiac dis ease the delusions relate to some en croachments upon the life, health, honor, or property of the patient. Such pa tients are usually self-centered, and from childhood have been reserved, suspicious, and often hypochondriacal. They are generally badly developed, and have the more common stigmata of degeneracy: as a want of symmetry of both sides of the face, a lack of development of facial bones, giving rise to the protruding chin and "whopper" jaw so characteristic of the descendants of the Emperor Charles V, or asymmetrical palpebral fissures. They are generally unduly responsive to all external disturbing influences, and the development of morbid characteris tics may follow comparatively slight dis turbing causes. Paranoia develops as an unmistakable disease when hallucina tions of the special senses give rise to actual delusions. The delusions are at first, and often for many years, those of persecution, and their character is deter mined by their habits of life, system of beliefs, and above all by their antecedent mental development or education. They believe the world to be generally un friendly to them and seclude themselves from their fellows.
Sooner or later, however, they are forced by vividness of their hallucina tions to defy their enemies, and then de velop dangerous tendencies. Most of the crimes committed by the paranoiacs are done at this stage of their disease. The terminal state of paranoia is what has been happily termed by one writer the stage of transformation by which through a further elaboration of his de lusions the patient finally believes he has solved the terrible secret which has hitherto clouded his whole life. He be gins to believe that he is persecuted be cause he is a superior being, and delu sions of grandeur, power, and impor tance replace those of persecution; so that, though he may suffer, still he re joices more than he suffers.