Page:A case of double consciousness Albert Wilson 1904 MPD in a child.djvu/5

Rh not be prepared to find aberrations from the normal brain functions?

There is exaggerated ideation and motor explosion in cases of cortical hyperæmia or congestion. Such might be the case here during the maniacal attacks B 1. But where loss of memory occurs as in the B 2 sub-stage, is it not possible to conceive that the blood-supply may have been shut off in the Broca area, or part of it? The microscope reveals to us only some of the finer blood-vessels and capillaries of the cortex, but it has not yet shown us the most delicate system of channels which bathe the individual cells and fibres in lymph or serum. The spasm of one arteriole which we can see may curtail functions in a group or layer of cells or association fibres with very surprising results. Nor have we as yet traced the terminals of the sympathetic vaso-motor fibres in the cortex. Yet the same must exist; Nature would never leave her work imperfect. Therefore, while we must not dogmatise, yet we may speculate, and speculate with reason on an unknown physical condition which may have a vast influence on psychical phenomena.

B 3, or the third abnormal personality, was called "Old Nick," and was a very frequent and prolonged visitor. It first appeared on July 24th, 1895, two months after B 2 ("a thing") had occurred. B 3 ("Old Nick") stayed till August 8th and then disappeared for a year, returning July 12th, 1896, when it stayed for ten weeks. "Old Nick" had a very violent temper, but was always very sorry afterwards and said, "It is a naughty man that comes." "Old Nick" could as a rule walk, and could read and write from the first, so there was not the same amnesia for names and objects as in B 2. "Old Nick" also had the best health of any of the personalities, which perhaps throws a side-light on the etiology of neurasthenia.

The following incidents illustrate some of the special features of the case:—Whilst in this "Old Nick" state the patient's mother was ill in bed. The patient attended carefully to her mother, whom she styled "Mary Ann." One day she returned suddenly to the normal, and was both surprised and distressed to find her mother ill; and could not understand it, for her mental association was with the last normal period when her mother was up and in good health. The patient had several times been at the sea-side, but when taken in this B 3 stage to Maldon it all came as a new and surprising experience. She