3. Same work, A. A. Brill trans., "The Interpretation of Dreams," 1914; The Macmillan Company, New York.
4. Jung, C. G., "Studies in Psychoanalysis," Psychoanalytic Review and Monograph, 1914; Journal of Nervous and Mental Diseases Company, New York.
5. Internationale Zeitschrift fur Aerztliche Psychoanalyse, Officielles Organ der Internat. Psychoanalitischen Vereinigung; first number, 1913; Heller pub., Leipzig und Wien.
6. Jung, C. G., "Psychoanalysis," An address before the Psycho-Medical Society of London, 1913, August; Transactions of the Society.
7. Prince, M., "The Mechanism and Interpretation of Dreams"-A Reply to Dr. Jones; Journal of Abnormal Psychology, 1910; See especially pp. 248 et seq.
8. Jung, C. G., "Morton Prince, M. D.: 'The Mechanism. etc.,'-A Critical Treatment;" Jahrbuch fur Psychoanalytischen Forshungen, 1910-11.
9. Freud; See (3) page 81, on symbolical method.
10. Freud, "Ueber den Traum;" translator M. E. Eder, "On Dreams," 1914, Rebman Co., New York; compare views in (6) with Chapter XII, esp. page 105. cf. p. 106, "unconscious thinking."
11. Emerson, R. W., "The Poet," Complete Works, Vol. III pp. 34-5.
12. Freud, "Interpretation of Dreams," p. 243.
13. Russell, Bertrand: Lowell Lectures, 1914; Cf. Lect. VIII, pp. 219, sec. 2, 222, sec. 2; Title, "Scientific Method in Philosophy," Open Court Publishing Company, Chicago, London.
14. James, William, "Principles ... .," I, 270; Algebra-analogy; see also "Fringe," p. 258.
15. Hobbes, Thomas, "Leviathan," Chapt. III.
16. Sidgwick, Alfred, "The Application of Logic," 1910; The Macmillan Co.; especially pp. 93-94.
17. Delage, Ives, "Une Theorie de Reves," Revue Scientifique, II, July, 1891.
18. Prince, "The Unconscious," 1914; The Macmillan Co.; (a) "The Meaning of Ideas as Determined by Unconscious Settings;" (b) Role of same in phobia: especially p. 389, footnotes pp. 392-3, 408. Also, Journ. Ab. Psychology; (a) Oct.-Nov., 1912; (b) Oct.-Nov., 1913.
19. Ebbinghaus, "Abriss der Psychologie;" Max Meyer's version, Cf. pp. 94-5; "Ebbinghaus's Psychology," 1908; D. C. Heath & Co., Boston.
20. "Inventorial Record Forms of Use in the Analysis of Dreams," Jour. Ab. Psychology, Feb.-Mar., 1914.
21. Descartes, Rene, "Discours de la Methode pour bien conduire sa raison et chercher la verite dans les sciences;" Leyde, 1637.
22. Spencer, Herbert, "The Physiology of Laughter," 1860; in Essays.
23. Fontenelle, B. le B. de, "Entretiens sur la Pluralite des Mondes," 1686.
24. Freud, "Interpretation of Dreams," pp. 237-9.
25. Freud, "Drei Abhandlungen ... ," trans.: "Three Contributions to the Sexual Theory," Monograph, Journ. Nerv. and Mental Dis. Co., New York, 1909.
26. Jones, Ernest, "Papers on Psycho-Analysis," Chapter XX; W. Wood & Co., 1913.
27. Prince, "The Unconscious;" doctrine of secondary images.
28. Galton, Francis, "Inquiries into Human Faculty," 1883; Macmillan; see essays on association, doctrine of blends.
29. James, William, "Principles ... ;" The Mental Cue, II, 497, 518; for phrase, "Talks to Teachers," p. ix-118, 1900; Henry Holt & Co., New York.
30. Sherrington, C. S., "Integrative Action of the Nervous System," 1906; Scribners, New York.
31. Bechterew, W. von, "Objective Psychologie oder Psychoreflexologie," 1913; from the Russian, B. G. Teubner, Leipzig and Berlin.
Pavlow, "Study of the Higher Mental Functions," British Medical Journal, October, 1913.
32. Ladd & Woodworth, "Elements of Physiological Psychology," 1911; p. 594; Charles Scribner's Sons, New York.
33. Woodworth, R. S., "A Revision of Imageless Thought," in Psychological Review, January, 1915; Presidential Address, American Psychological Association, Philadelphia, 1914, December. See esp. pp. 26-27.
34. Hobbes, "Leviathan," Chapter II; cf. Compound imagination.
35. Freud, "Selected Papers on Hysteria and other Psychoneuroses;" trans. A. A. Brill, Monograph, Journ. Nerv. and Ment. Dis. Co., 1909, New York; pp. 5, and 177.
36. Spencer's conception of the escapement of nervous excitation is fundamental in connection with the dream theory here sketched: see the essays on Laughter and on Music, also many passages in the Synthetic Philosophy (Biology, Psychology). This conception is not to be confused with Janet's idea of "derivation," as stated in "Obsessions et Psychasthenie." The present formulation of the meaning of "apperceptive delay" in dreaming is based on the neurographic hypothesis, ("The Unconscious," Chapt. V.), and may be more precisely stated as follows:-
In the given instance, the original or primary neurogram possessed a certain passive inertia in responding to the stimulus, and it took a relatively long time for the excitation to raise the neurogic tonus of this primary neurogram so as to attain the level requisite for conscious imagination. But it was otherwise with the secondary or sequential neurograms, whose inertia had already been overcome by the facilitation (Bahnung) of the recent conversation about scratch-reflexes. For these neurograms to flash their imaged (conscious) equivalents into the dream-thought, it was enough that there should be a slight spill-over of excitation from the original neurogram.
Many examples could be cited from dreams, drowsy states and lapses of thought, showing the ways in which sequential neurograms produce trial apperceptions, pending the final revelation, through consciousness, of the original neurogram. The phenomenon of mental groping, here alluded to, is familiar in certain aspects; but, as an explanation of cryptic dreams, has not received the recognition that it deserves. Hence, the trial-and-error theory of dreams.
37. "Perplex," neologism of the writer; used to indicate a phenomenon frequent in both normal and psychopathic subjects; to wit, a group of delimitable stimulus-ideas, persisting as such, and unadjusted-a complex of persisting and unadjusted stimulus-ideas, demanding resolution; not the same as "complex" in Psycho-analysis. Cf. Prince's definitions of the varieties of complexes ("The Unconscious").
A CASE OF POSSESSION
BY DONALD FRASER, M. D., GLASGOW
THE Demonaic possession of the middle ages and of times nearer to our own was largely hysterical in character, and generally occurred in Epidemics.
It was associated with the more superstitious and emotional side of religious beliefs, where a real Hell fire and a personal Devil with attendant Angels or Demons were believed in, and feared, much more intensely and widely than they are today even amongst the ignorant and superstitious, while suggestion and contagion played a large part in its spread, as it did in that other and more hateful form of it known as witchcraft.
Esquirol who wrote clearly about it in his "Maladies Mentales" under the heading of "Demonomania,"[1] spoke of it as being propagated "by contagion, and by the force of imitation." This was illustrated in the Epidemic of Loudun, amongst others referred to by him. This epidemic spread to neighbouring towns menaced all the high Languedoc, but was arrested by the wisdom of a Bishop, who did this by depriving the movement of its marvellous elements. In this epidemic form it was in its bodily and mental manifestations really hysteria with characteristic stigmata and convulsions. An excellent example of this religious hysteria was presented as recently as 1857 in an epidemic at Morzines in upper Savoy. It began with two little girls, pious and precocious, who had convulsive attacks. It spread to other children and then to adults. Amongst the younger of those affected, ecstasy, catalepsy, and somnambulism were seen, and later, convulsions only; convulsive attacks returned several times a day. An attack usually began with yawning, restless movements, the aspects of fear passing into fury with violent and impulsive movements, with vociferations and cries that they were lost souls in hell, the mouth-piece of the devil, etc. These attacks would last from ten minutes to half an hour. A feature of this epidemic was the absence of coarse and erotic speech or gestures. Between the convulsions the victims were restless, idle and inattentive, being altered in character for the worse. In our day such epidemics are represented, though in tamer fashion, by Revivalism in its more noisy and extravagant eruptions. At all times, even when such manifestations are not much if at all out of harmony with ordinary religious feeling and action, there is a tendency to pathological conditions. Often its subjects, in the words of Professor James[2] "carry away a feeling of its being a miracle rather than a natural process, voices are often heard, lights seen, or visions witnessed; automatic motor phenomena occur; and it always seems after the surrender of the personal will as if an extraneous higher power had flooded in and taken possession." These are some of the more striking phenomena of mysticism, and are also largely pathological being amongst the major symptoms of hysteria. The history and course of our case illustrated very well this mixed condition. It has been pointed out that the ecstasies, trances, etc., of the mystic, while essentially pathological, have the evil effects of such morbid manifestations modified or largely neutralized by the idealism behind them, by that measure of true religious faith and feeling which dominates the whole process in the case at least of the higher mystics. The ore may be rough and very mixed, but the precious metal is there also, as it was in our patient, though the divine influence for which she craved was perverted into that of the "Evil one." In the individual cases described by Esquirol we recognize a more profound mental disturbance than is shown in the epidemic or hysterical variety. We indeed see many similar cases in our asylums though we generally speak of them as Religious Melancholics rather than as Demonomaniacs. In such cases recovery is slow or may not occur, the patient passing into a state of chronic mania, or of Dementia. There are other cases where the religious emotions and ideals are completely subordinated to or become identified with feelings of fear or remorse, the result of fixed ideas of a shameful, distressing or frightsome character. A good example of this condition though essentially hysterical in its nature, is detailed by Pierre Janet.[3] The patient, a neurotic, respectable business man thirty-three years of age, a good husband and father, on his return from a business journey of some weeks' duration is found to have become depressed and taciturn, and as the days pass his melancholy deepens. At first he would not speak, but soon when he wished to speak could not, making vain attempts at articulation. Under the influence of medical ideas suggested to him his symptoms simulate first Diabetes next Heart disease and his prostration becomes profound. By and bye he passes into a state only to be described as acute Demonomania marked by maniacal outbreaks in which he cried out and blasphemed, lamenting in quieter intervals his powerlessness to resist the Devil who was, he believed, actually not figuratively within him, who spoke and blasphemed through him, prevented him sleeping, etc. After some months he was sent to the Salpetriere where he came under the observation of Charcot and Pierre Janet. He was cured by means of suggestion by the latter, who also ascertained by his methods that the illness was the result of remorse for an offence committed during the business journey which preceded the outbreak.
[1] For a detailed account of it see the "Dictionary of Psychological Medicine" under the heading "Demonomania."
[2] The Varieties of Religious Experience; William James p. 228.
[3] "Nevroses et Idees Fixes" Vol. I, p. 377.
In many ways our case differs from cases of this type. An important difference was in the intermittent character of the symptoms. For a period of two years the patient alternated between a condition of acute misery from the delusion that the evil one had entered into her body, and one of apparent sanity. At the end of two years she was dismissed cured, and has remained well for several years. She differed also in the absence of blasphemous, extravagant or obscene speech or action. The Devil never at any time used her as the mouthpiece for devilish words or thoughts. He was there, and as she insisted, in bodily form within her, making her intensely miserable by his presence, and with the feeling that she was cast away from "grace" and the privileges of the religious life. Nor were there, as in the case above referred to shameful or remorseful complexes at the root of her mental condition. In presenting the facts of the case, names and special marks of identification have been altered.
Mrs. A., a widow, aged fifty-two years, was admitted to the Paisley District Asylum in 1910 with a history of having suffered for a month previously from mental depression said to be due to distressing delusions of a religious character such as that she was lost, was past forgiveness and dominating and originating all such thoughts was the belief that she was possessed by Satan or an evil spirit, who was in bodily form within her. This delusion caused her acute misery, and so absorbed her thoughts that she had ceased to take any interest in her household affairs, and had even talked of suicide.
Her condition on admission and for two years subsequently was that of recurring states of this acute mental distress, when she would rock to and fro, moaning and crying out, often with tears over her lost and dreadful state, and the presence in her inside of Satan or the "Evil one" whom she said she felt within her, and who made her "repulsive." This condition was varied with intervals of usually from one to three days of apparently complete sanity, when though quiet and somewhat reserved in manner, she was quite cheerful. When questioned at such times as to her delusion, she would admit its absurdity, but refer to an uneasy sensation in the region of the left hypochondrium, which, as she put it, surely meant that there was something wrong there. She would be occasionally normal in this way for a week or more, and on more than one occasion was so well as to be allowed out on parole, but had often to be brought back next day as depressed and delusive as ever. She was always worse in the mornings, and often improved as the day went on. She was a stout, pleasant featured and intelligent woman, somewhat anaemic, and with a slight bluish tinge of lips, though beyond a lack of tone in sounds, the heart was normal. Her anaemic condition was accounted for by her having suffered from menorrhagia for the greater part of two years, which only stopped a few months before her admission to the Asylum. It had during its continuance brought on breathlessness on exertion, and what she called spasms or "grippings at the heart," no doubt the basis of her uneasy feelings in left hypochondrium. There was a slight enlargement of the thyroid gland, but no symptoms referable to it. None of these physical conditions beyond the "grippings at the heart" it maybe, appeared to have any appreciable influence on her mental condition, which as has been noted above was normal until a month before her admission. An interesting feature of the case was the relation between her blood pressure and her varying mental states. Her blood pressure was taken with a Riva Rocci Sphygmomanometer morning and evening, sometimes oftener, during the greater part of 1912-13, and it was noted that her depressed or delusional states were marked by a low pressure, while a high or relatively high pressure marked her sane and cheerful states, contrary to what is usually observed in melancholia, though similar to what is seen in agitated melancholia and mania.[4] Thus at a pressure of 130" HGs, she was generally very well; at or about 120" HGs she was often well; at 110" HGs or 100" HGs she was always ill. When recovering, and few weeks before dismissal there was a fairly steady pressure of 118" HGs to 120" HGs day after day. It had been also noted throughout, that during a continuous period of depression, or of well-being, the pressure kept steadily high or low day after day according to the mental condition. There was obviously then a constant and close relationship between her blood pressure and her mental states. At first sight it looked as though those states were directly affected by the varying pressure as it may have influenced the nutrition and therefore the functions of the brain, and on physiological grounds it is difficult to exclude such an influence altogether, even though we come to the conclusion as we did that the variations followed the emotional conditions, and did not precede or cause them. The broad general statement has been made that "each pleasurable emotion raises the general blood pressure and increases the blood flow through the brain and each painful emotion: brings about the opposite result."[5] It cannot be said, however, that increased blood pressure will give pleasurable emotion. The splanchnic area can be acted on so as to raise the blood pressure without influencing the emotions. We know also that when it is raised in melancholia the increased pressure is associated with the reverse of pleasurable emotion. Still on therapeutical as well as on other grounds it appeared to us important to determine what, if any, influence the raising of her blood pressure by drugs or otherwise would have on her mental state. We did this by baths, by abdominal pressure by means of a large sand-bag laid over the abdomen, and by such drugs as adrenalin and pituitrin. The results were disappointing so far as therapy was concerned though of interest otherwise. The pressure was raised by all these measures without any improvement following such as occurred when it rose naturally. The rise by abdominal pressure was marked and occurred quickly, but without any apparent effect on her mental condition. When it was raised to 140"HGs under the influence of pituitrin there was marked depression as is shown in the chart for July, 1912. Pituitrin given in m. v. hypodermically three times a day, and after some days in larger doses by the mouth, kept the pressure between 125" HGs and 130" HGs, but with no corresponding mental improvement. For some days after the pituitrin was stopped its influence seemed to persist as the pressure kept high while the mental condition was low. One of her longest spells of continuous mental depression which lasted for twenty-seven days, occurred while her pressure was high under the influence of adrenalin. Digitalis, by the way, had no influence in any way on either her blood pressure or her mental condition. The only drug we found of any value was tinctopii in moderate doses three times a day, but it gradually ceased to do any good.
[4] Maurice Craig, Lancet June 25, 1898.
[5] Leonard Hill, "Cerebral Circulation" p. 74.