Page:Popular Science Monthly Volume 86.djvu/90

86 or he hears a voice calling him evil names, and in the presence of such hallucinations, a delusion may suddenly arise. Other delusions of apparently sudden origin probably arise from other causes, some of them being the end result of a number of experiences, hallucinatory it may be, no one of which by itself has been sufficiently powerful to beget a delusion.

The somatopsychic delusions, Southard has well shown, may arise because of, or be concomitant with, stimuli resulting in particular kinds of sensation in particular parts of the body. Thus, he describes the case of a woman who expressed the belief that she had been shot in the breast with a “seven-shooter.” The patient could not show any signs of a wound, nor were there any external signs visible. There were noted pleuritic friction sounds and the autopsy revealed a fibrous pleurisy at the point at which she believed she had been shot. Whether or not the form of the delusion, namely, the belief in being shot, was due to other experiences, can not be determined. In this case the conclusion that there is a relation of the particular pathological condition of the pleura and the definite ideational localization of the point of the shot with the somatopsychic delusion is not only suggested, but almost forced upon us. The ideational selection of the particular weapon (a seven-shooter) may be indicative of other causes which acted in conjunction with the abnormal sensations.

Other cases which Southard has reported have equally suggestive histories indicating that the abnormal sensations from different parts of the body may give rise to delusions of a somatopsychic character. Thus, he has recorded the case of a man who complained of torpidity of the bowels. This patient almost constantly kneaded his right chest and abdomen because of this supposed condition. At the autopsy a number of pathological states were found in the region to which he referred his delusion, and one of these, namely, the right lung was adherent to the pleura, is sufficient to mention. Another patient complained that his stomach was always full and that he could not eat, and this belief was found to be associated with the pathological finding of intestinal obstruction from cancer. In this case probably the passage of food stuffs from the stomach into and through the intestines was retarded, and it is not difficult to conclude that the belief that the stomach was full had, partially at least, its origin in, or was built upon the foundation of, the abnormal sensations which accompanied the morbid modes of gastric and intestinal activity. The accumulation of cerumen in the ear of another patient was accompanied by the belief that bugs or buzzing flies were present.

Two other cases in which no peripheral lesions were found to correspond with the delusions are cases in which cerebral lesions were found to accompany the beliefs, (1) that the insides were gone and,