CONSCIOUSNESS, DISTURBANCES OF.—Consciousness is the term applied to the conception entertained by an individual, not only regarding his own personality, but also concerning time and space. A person can fulfil the duties of his daily life in a proper manner only when his conscious ness is unrestricted and his will has free play. Disturbances of this faculty may result from Various diseased conditions, and may vary considerably as to degree of severity.
Delirium is a state of confusion in which the patient's conception of time and space is very obscure. He is uncertain of his whereabouts, becomes erratic, does not recognise his usual surroundings, and is annoyed by various sensory disturbances. Not uncommonly he looks upon him self as a stranger, and refers to himself in the third person ; or he believes himself a new individual, because he has entirely forgotten everything that took place before his illness. When recovery takes place he may remain totally ignorant of the events which occurred during his sickness, so that, as a matter of fact, he leads a true double life. On the other hand, after having been visited by a number of attacks, the patient frequently is able to remem ber what occurred during previous ones. These conditions, which lead to
a sort of " divided personality," have been largely made use of in fiction. They are often observed in that form of epilepsy in which the characteristic feature is a clouding of the intellect ; and they are associated also with hysteria, somnambulism, and with the hypnotic state. Compare the article on SLEEP.
Where the loss of consciousness advances to such a degree that the patient is unaware of certain natural processes in the system, the condition may be referred to as stupor, or stupefaction. Urine and farces are voided involun tarily ; the act of swallowing is disturbed ; and the sensitiveness of the skin is diminished. As the result of lying constantly in one position, ulcers of various sizes may develop, especially at points of the skin where pressure occurs. The manner in Nvhich these may be avoided is described under SICK, NURSING OF. This condition of stupor is developed in the course of diseases which are accompanied by protracted, high fever, such as typhoid, and it may occur also in cerebral and mental affections. For complete loss of consciousness, see UNCONSCIOUSNESS.