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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    The true signification of insane hallucinations and illu- sions, like that of the insane delusion, lies in the fact that the logical apparatus, instead of correcting the error of the perceptions by the inhibitory influence of collateral percep- tions and reasoning, incorporates them in an insane belief, or bases insane actions on them. In briefly enumerating the varieties of insane percep- tions, it is best to consider hallucinations and illusions to- gether. Visual hallucinations, or insane visions, may vary in in- tensity and distinctness from mere blurs, clouds, or haloes, to flashes of light, bright color perceptions and fac-similes of the reality. The perception of single faces and figures often engaged in some occupation, the details of dress and of the features being distinctly reproduced; or of noisome reptiles or dancing devils in larger numbers and lesser distinctness serve to characterize different varieties of insanity. Some- times the same hallucination continues for years. A patient may see the same person or animal following him wherever he goes. At others a fixed hallucination may become the basis for transitory ones. A patient sees himself in heaven or in hell continuously, but the other inhabitants of the hal- lucinated locality are continually changing. In their com- plexity and expansiveness such hallucinations sometimes approach the abstract visions of the poet. This variety is found in chronic insanity, and is less favorable in its prog- nostic indications than the more confused and evanescent hallucinations of some acute derangements. Illusions of sight generally relate to persons, and are like the corresponding hallucinations determined by pre-existing delusions. Either the patient refuses to recognize his rela- tives (generally one), and asserts that they are strangers, or ■—and this is a not uncommon occurrence in the asylum ward —greets and embraces others as his or her children, sisters, brothers, or parents. These combined illusions and delu- sions of identity are so powerful, that in one instance a patient who asserted that the writer was her son, though properly recognizing all her other surroundings, and very unmanageable generally, followed his directions and volun- tarily went to the asylum, because she could not believe her own son would advise her against her and his interests. Hallucinations of hearing are more frequent in chronic delusional insanity and in melancholia, than those of sight, and are particularly common in persecutory delirium. Not