Case LXV

- M. C, sixty-three years of age, had always a weak intellect, but was often obstinate. His children were obliged to leave him. Having reached the last stage of dementia, no longer recognizing any one, he was brought to my establishment, because every night, at bedtime, he was seized with an extreme terror at the sight of murderers coming to kill him. During the existence of this idea, he called out incessantly to the assassin, to the police, for help, and fought as though to defend himself. This lasted for several months, and some days before his death, the same hallucination came to torment him.

* Des Vesanies, ou Maladies Mentales, p. 188, Paris, 1816.

For ten years we had a lady under our care, with whom it was impossible to hold any communication because she fell into a rage whenever she was approached, and talked wildly and incessantly. Every night she held disputes with persons who contradicted and insulted her; her quarrels were extremely violent, and lasted for hours. All the phases of the scene may be imagined.

Senile dementia, which is only a variety of this kind, is also sometimes accompanied by hallucinations. We knew an old lady, aged eighty-two, who, from time to time, was subject to a very singular false impression. This lady, whose chamber looked on to a large white wall, told us how agreeably she was occupied in seeing several thousand persons coming down the wall to attend a fete. These persons wore ball-dresses; they were men, women, and children. She uttered exclamations of joy and surprise at their number, the variety of their costumes, and the rapidity with which they went down to the third story below. By degrees the promenaders diminished; she only saw a few scattered groups; and at length all disappeared. We have since noticed similar cases in very aged women.

Recapitulation. - Dementia is frequently combined with hallucinations and illusions.

The nature of dementia would appear at first sight to render this combination less frequent; but on studying more attentively this form of derangement, we are convinced that it has different degrees of development, amongst which monomania and mania play an important part. The duration of these hallucinations may be prolonged for years, because there are varieties of dementia that remain stationary for a length of time.

Hallucinations may be exhibited in dementia, as in other forms of derangement, under a continuous, remittent, intermittent, and periodical type.

The existence of hallucinations in complete dementia excites no surprise, since the individual so attacked has lived out a common life, and we cannot ascertain whether all his recollections are extinct.