A treatise on the theory and practice of medicine / by John Syer Bristowe.

Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the theory and practice of medicine / by John Syer Bristowe. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    exaggerated ; and generally wlien convalescence is in progress the patient suffers from depression, fatigue, and other symptoms which satisfy him that he is ill. Anaesthesia and analgesia are often observed in melancholia and dementia, but above all in general paralysis ; and these conditions may be general or limited to certain parts. But, in most lunatics, sensation remains unaltered. There may even be hyperasstliesia. The most interesting sensory disorders, however, are those which are known as illusions and hallucinations—the former term signifying the false perception of impressions made upon the organs of sense, the latter term signifying subjective sensory perceptions which ‘ are projected outwards, and thereby become, apparently, objects and realities.’ It is clear that there is a real difference between hallucinations and illusions, and yet it is often difficult or impossible to distinguish between them. Thus, in de- lirium tremens, when the attendants, articles of furniture, and even shadows, are taken for fiends or wild beasts, or muscse volitantes due to disturbance of the retinal circulation are transformed into beetles, butter- flies, or gold and silver coins, the patient is the victim of illusions ; but when he perceives similar things while nothing in the world around or in his organs of sense furnishes, so to speak, his mind with an excuse for seeing them, he suffers from hallucinations. Both illusions and halluci- nations may involve any or all of the senses. In the following paragraph, we shall speak of them as if they were identical. Hallucinations of sight are probably more common than those of any of-the other senses. They are seen, in different cases, by night by twi- light or by day ; they may be vivid or shadowy; they may be of short duration or persistent, or may come and go ; and they necessarily vary in character—in some instances animals, in some human beings, in some friends long dead, in some devils, in some angels, and in some panoramas crowded with life rising before the patient; and they are shocking, terri- fying, or agreeable, according to circumstances. Hallucinations of hearing are rather less common, and on the whole of graver augury, than those of sight. They are especially common in melancholia and chronic mania. The patient generally hears voices, to which he listens, with which he converses, which he quarrels with or obeys. These voices sometimes talk nonsense, frequently they upbraid or insult, or utter profane or obscene language, or revile the sufferer’s friends or relations, or tempt or command him to evil deeds. They often seem as distinct as the real voices which are uttered around him, and appear sometimes to come from articles of furniture or particular spots, sometimes to reach him from a far distance, and maybe by telephonic agency, and sometimes to be internal voices or voices without sound. Occasionally the patient hears discordant inarticulate noises, or strains of music. Hallucinations of smell, taste, and common sensation, are not unfrequent. As regards smell and taste the impressions on the perceptive centres are almost always of a disagree- able or offensive kind. Hallucinations of common sensation lead to the belief that animals are crawling over the skin, or that galvanism is being applied, or that frogs, snakes, birds, or the arch-fiend himself is present