Page:Popular Science Monthly Volume 17.djvu/175

Rh horrible drama. In reality, all is foreordained, regulated. The tumult goes on with the mathematical precision of a well-adjusted clock.

Fantastic as the delirium of the patients during their attack may appear, it always has a cause and occasion. The hallucinations of a demoniac resemble the real episodes of her life, particularly the one which has had the most influence in the development of her malady. It is true, as we have already said, that the principal cause of hysteria is hereditary predisposition; still, an accident is needed, an exterior provocation for the first nervous crisis, some event which may be grave or light, to determine the outbreak of a malady which has been brooding for a long time. This event is often a fright, a violent emotion, some grief, a disillusion. Then, in the attacks of delirium, the things and persons that were the occasion of the emotion—fright, grief—reappear as hallucinations. This influence of what has happened in the past establishes an important difference between the delirium of the insane and that of persons suffering from hysteria. The visions of the insane, whatever they may be, generally have no immediate relation to anterior events, while the form of delirium in hysteria is nearly always determined by an incident which has formerly played an important part in the life of the patient. The visions of beasts and monsters are common to all delirium. They appear whenever a fever has deranged the cerebral functions, and are the generally recognized marks of alcoholic delirium.

The period of delirium which indicates the ending of the attack is sometimes quite short. More often it is prolonged for several hours, and not rarely it persists for some days. The cerebral functions have been deeply troubled, and they return very slowly to their normal condition. It is, however, hardly proper to use this expression to describe the intelligence of the hysterical patients as it is observed during the intervals between their fits. Intelligence, it is true, is not extinguished; the memory, the keystone of the intellectual arch, is preserved; but the other faculties are singularly perverted. We can gain a good idea of their condition by studying the manners and the conversation of the demoniacs in the Salpêtrière. They pass the day in continual laughing at things that have nothing laughable in them—at the servant-maid who passes by, for example, at a badly made bed, at a bird that perches near the window, at a badly fastened bonnet. The same causes will as readily provoke tears. Interminable conversations are always going on, recriminations, with indignation drowned in a flood of words. With all this is combined an unceasing movement which has no real object and can not be explained. The woman must put flowers on the bolster of her bed, a ribbon in her hair, she must decorate herself with gewgaws; and the busy carefulness in these little matters contrasts with the negligence and disorder of the general keeping; a patient whose hat is adorned with ribbons will go out barefooted into the court. Odd ideas prevail, and absurd