This frightful disorder is not properly insanity, although it is somewhat allied to that most horrible of maladies, and may, in many constitutions, be the means of bringing it on, and although such hallucinations are proper to both. The difference I conceive to be that, in cases of insanity, the mind of the patient is principally affected, while the senses, or organic system, offer in vain to the lunatic their decided testimony against the fantasy of a deranged imagination. Perhaps the nature of this collision—between a disturbed imagination and organs of sense possessed of their usual accuracy—cannot be better described than in the embarrassment expressed by an insane patient confined in the Infirmary of Edinburgh. The poor man’s malady had taken a gay turn. The house, in his idea, was his own, and he contrived to account for all that seemed inconsistent with his imaginary right of property—there were many patients in it, but that was owing to the benevolence of his nature, which made him love to see the relief of distress. He went little, or rather never abroad—but then his habits were of a domestic and rather sedentary character. He did not see much company—but he daily received visits from the first characters in the renowned medical school of this city, and he could not therefore be much in want of society. With so many supposed comforts around him—with so many visions of wealth and splendour—one thing alone disturbed the peace of the poor optimist, and would indeed have confounded most bons vivants. “He was curious,” he said, “in his table, choice in his selection of cooks, had every day a dinner of three regular courses and a dessert; and yet, somehow or other, everything he eat tasted of porridge.” This dilemma could be no great wonder to the friend to whom the poor patient communicated it, who knew the lunatic eat nothing but this simple aliment at any of his meals. The case was obvious. The disease lay in the extreme vivacity of the patient’s imagination, deluded in other instances, yet not absolutely powerful enough to contend with the honest evidence of his stomach and palate, which, like Lord Peter’s brethren in “The Tale of a Tub,” were indignant at the attempt to impose boiled oatmeal upon them, instead of such a banquet as Ude would have displayed when peers were to partake of it. Here, therefore, is one instance of actual insanity, in which the sense of taste controlled and attempted to restrain the ideal hypothesis adopted by a deranged imagination. But the disorder to which I previously alluded is entirely of a bodily character, and consists principally in a disease of the visual organs, which present to the patient a set of spectres or appearances which have no actual existence. It is a disease of the same nature which renders many men incapable of distinguishing colours; only the patients go a step further, and pervert the external form of objects. In their case, therefore, contrary to that of the maniac, it is not the mind, or rather the imagination, which imposes upon and overpowers the evidence of the senses, but the sense of seeing (or hearing) which betrays its duty and conveys false ideas to a sane intellect.
More than one learned physician, who have given their attestations to the existence of this most distressing complaint, have agreed that it actually occurs, and is occasioned by different causes. The most frequent source of the malady is in the dissipated and intemperate habits of those who, by a continued series of intoxication, become subject to what is popularly called the Blue Devils, instances of which mental disorder may be known to most who have lived for any period of their lives in society where hard drinking was a common vice. The joyous visions suggested by intoxication when the habit is first acquired, in time disappear, and are supplied by frightful impressions and scenes, which destroy the tranquillity of the unhappy debauchee. Apparitions of the most unpleasant appearance are his companions in solitude, and intrude even upon his hours of society: and when by an alteration of habits, the mind is cleared of these frightful ideas, it requires but the slightest renewal of the association to bring back the full tide of misery upon the repentant libertine.
Of this the following instance was told to the author by a gentleman connected with the sufferer. A young man of fortune, who had led what is called so gay a life as considerably to injure both his health and fortune, was at length obliged to consult the physician upon the means of restoring, at least, the former. One of his principal complaints was the frequent presence of a set of apparitions, resembling a band of figures dressed in green, who performed in his drawing-room a singular dance, to which he was compelled to bear witness, though he knew, to his great annoyance, that the whole corps de ballet existed only in his own imagination. His physician immediately informed him that he had lived upon town too long and too fast not to require an exchange to a more healthy and natural course of life. He therefore prescribed a gentle course of medicine, but earnestly recommended to his patient to retire to his own house in the country, observe a temperate diet and early hours, practising regular exercise, on the same principle avoiding fatigue, and assured him that by doing so he might bid adieu to black spirits and white, blue, green, and grey, with all their trumpery. The patient observed the advice, and prospered. His physician, after the interval of a month, received a grateful letter from him, acknowledging the success of his regimen. The greens goblins had disappeared, and with them the unpleasant train of emotions to which their visits had given rise, and the patient had ordered his town-house to be disfurnished and sold, while the furniture was to be sent down to his residence in the country, where he was determined in future to spend his life, without exposing himself to the temptations of town. One would have supposed this a well-devised scheme for health. But, alas! no sooner had the furniture of the London drawing-room been placed in order in the gallery of the old manor-house, than the former delusion returned in full force: the green figurantés, whom the patient’s depraved imagination had so long associated with these moveables, came capering and frisking to accompany them, exclaiming with great glee, as if the sufferer should have been rejoiced to see them, “Here we all are—here we all are!” The visionary, if I recollect right, was so much shocked at their appearance, that he retired abroad, in despair that any part of Britain could shelter him from the daily persecution of this domestic ballet.
There is reason to believe that such cases are numerous, and that they may perhaps arise not only from the debility of stomach brought on by excess in wine or spirits, which derangement often sensibly affects the eyes and sense of sight, but also because the mind becomes habitually predominated over by a train of fantastic visions, the consequence of frequent intoxication; and is thus, like a dislocated joint, apt again to go wrong, even when a different cause occasions the derangement.
It is easy to be supposed that habitual excitement by means of any other intoxicating drug, as opium, or its various substitutes, must expose those who practise the dangerous custom to the same inconvenience. Very frequent use of the nitrous oxide which affects the senses so strongly, and produces a short but singular state of ecstasy, would probably be found to occasion this species of disorder. But there are many other causes which medical men find attended with the same symptom, of embodying before the eyes of a patient imaginary illusions which are visible to no one else. This persecution of spectral deceptions is also found to exist when no excesses of the patient can be alleged as the cause, owing, doubtless, to a deranged state of the blood or nervous system.
The learned and acute Dr. Ferriar of Manchester was the first who brought before the English public the leading case, as it may be called, in this department, namely, that of Mons. Nicolai, the celebrated bookseller of Berlin. This gentleman was not a man merely of books, but of letters, and had the moral courage to lay before the Philosophical Society of Berlin an account of his own sufferings, from having been, by disease, subjected to a series of spectral illusions. The leading circumstances of this case may be stated very shortly, as it has been repeatedly before the public, and is insisted on by Dr. Ferriar, Dr. Hibbert, and others who have assumed Demonology as a subject. Nicolai traces his illness remotely to a series of disagreeable incidents which