VISIONS: A STUDY OF FALSE SIGHT (PSEUDOPIA.) BY EDWARD H. CLARKE, M. D. WITH AN INTRODUCTION AND MEMORIAL SKETCH BY OLIVER WENDELL HOLMES, M. D. BOSTON: HOUGHTON, OSGOOD AND COMPANY, (ft&e Ktoersfiie Press, ©amfcrttig'e. 1878. Copyright, 1878, By HOUGHTON, OSGOOD AND COMPANY. All rights reserved- RIVERSIDE, CAMBRIDGE! STEREOTYPED AND PRINTED BY H. 0. HOUGHTON AND COMPANY. “ The view of things by means of the eyes is full of decep- tion, as also is that through the ears and the other senses:. but that it is the brain which produces the perceptions of hear- ing, seeing, and smelling, and that from these come memory and opinion— Piledo of Plato. CONTENTS. PART I. PAGE Visions common to Human Experience. Definitions . 6-19 Cases and Comments 10-50 Apparatus of Vision, etc 50 Physiological Analysis of Vision .... 55 Functions of the Tubercula Quadrigemina ... 68 Visual Centre of the Hemispheres .... 104 The Frontal Lobes 125 Effects of Habit, Association, Emotion, Volition, ex- pectant Attention 138 Relations of the Blood with the Brain, Metamor- phosis of Tissue, Waste, etc 153 Effects of Drugs: Digitalis 166 Quinine 167 Strychnine 168 The Bromides 169 Opium 174 Indian Hemp (Hashish) 179 Alcohol 186 Ether 190 Influence of Disease 193 Influence of Volition 201 Remarkable Cases 206, 209 Visions peculiar to Children 212 Summary, with Illustrative Figure .... 218-223 VI CONTENTS. PART II. PAGE Explanation of Visions. Sight not a Function of the Eyes, but of this Brain 224 Explanation of Cases given in the First Part . 227 Case communicated by Dr. Weir Mitchell . . . 246 Spinoza’s Vision . . . . . . . . 254 Macbeth’s Vision of the Dagger . . . . . 256 Visions of the Dying 258 Case of Dr. 262 Case from the “ New Quarterly Review ” . . 266 Case of a Child . . . 274 Case of Mrs. 276 Visions of Sleep 279 Case of exposed Brain 282 Different Varieties of Dreams 303 Case of a Medical Student 305 Lord Brougham’s Vision 307 Case from the “ Psychological Journal ” . . 313 Case from Wundt 315 HsTTEODU CTIOH. By OLIVER WENDELL HOLMES, M. D. The unfinished essay here presented to the public has a singular and quite exceptional interest. When its author had read his death sentence, and knew that the malignant disease of which he‘was the subject would be slow in its work and involve great suffering, he felt that he must have something to occupy his mind and turn it away in some measure from dwelling only on the tortures of his body. He therefore took up the study of a question in which he had long been inter- ested and made it his daily occupation to write upon it. So long as his strength lasted sufficiently, he wrote with his own hand. After this he employed another to write at his dictation. This disease had already made deep inroads upon his constitution, and he was every day becoming more de- pendent on the ministrations of those about him, when his wife, who had been his nurse, his amanuensis, his patient and tender companion, was seized with sudden illness which after a few days ended in her death. It is not often that a human heart is tried at once with the pangs of bodily suffering and the agony of grief as his was at this distressing period. But he bore up VIII INTRODUCTION. against it all with a courage and serenity which it seemed as if nothing could subdue. After a time he returned to his work. His mind had lost nothing of its discriminating force, his language nothing of its clear- ness. Again I found him busy with his manuscripts when I entered his chamber at my frequent friendly visits. He became again interested in the trains of thought he had been following. He would hand me a page or two of his manuscript for criticism, or bring up some special point for my consideration. All this time the deadly internal disease was feeding on his life, and not an hour was free from suffering except when his pains were lulled into temporary quiet by the use of narcotics. At length the pen dropped from his hand, the mind ceased from its labors, he lingered a little longer in a state of being that was divided between anguish and stupor, and the end long wished for came at last. Throughout his long and wearing illness he had watched himself as he would have watched one of his patients. He knew what was almost certainly to be the issue of his disease, and had known it from a very early period. Yet he did not speak of himself as if he knew his case to be hopeless. It seemed to me some- times as if he felt that it was not courteous to his vis- itor to appear in the attitude of a condemned man, and that he spoke of the possibility that the disease might not prove malignant in its nature rather to make his guest feel more cheerfully about him than because he himself indulged in any vain illusion. The essay bears evidence of the philosophical state INTRODUCTION. IX of mind in which it was written. I have been sur- prised to find how little correction of any kind it re- quired. From the first page to the last it is clear, connected, without a trace of any disturbing. influence. A strange thought suggests itself, which is perhaps too fanciful to be mentioned in this connection. I can- not help being reminded of the Indian brave’s death- song, in which he calmly defies his tormentors. Socrates was about to die when he discoursed in those imperish- able words wdiich the Phsedo records for us, but he was not in bodily torture. This serene disquisition was writ- ten in hours of distress which were intervals of agony. No stoic of the woods, no philosopher of antiquity ever faced his doom with a more unshaken constancy and courage, with a nobler tranquillity, than the writer of this essay. Had it no other claim upon the reader, it would always have an interest as the mental legacy of one who was much honored and loved, and as a les- son of manhood too precious to be forgotten. Although the essay is left unfinished, it should not be called a fragment. It would not be difficult to com- plete it by the addition of a very moderate number of pages. It was left by Dr. Clarke to my decision what disposition should be made of the manuscript. I had heard many portions of it, and discussed many points involved in it with him. But I read it all over care- fully, and had no hesitation in deciding that, imperfect as it was, it should be given to the public. I did not look up the literature of the subject to see for myself just how far Dr. Clarke’s ideas had been anticipated, or how far they were in opposition to those of any other INTRODUCTION. X physiologist or psychologist. I made no changes of any importance, and no additions whatever. The man- uscript was singularly free from errors and corrections, both that portion of it written with his own hand, and the parts which were copied for him, and my work was hardly needed in addition to that of the corrector of the press. I have made out a table of contents which will per- haps be a sufficient guide to the general and the scien- tific reader, in looking after what specially interests them. But I will indicate a few of the pages which will be found more particularly attractive to most of those who take up the essay. As Dr. Clarke resolves so large a part of mental action into pure automatism, it is only fair to remem- ber these words of his, showing that he recognized something beyond this. He is speaking of the visions of the dying. “ Probably all such visions as these are automatic. But yet, who, believing in God and personal immortal- ity, as the writer rejoices in doing, will dare to say ab- solutely all ? Will dare to assert there is no possible exception?” (p. 272.) It must be borne in mind, too, that he recognized the “ ego ” as distinct from “ his engine,” the bodily mechanism (p. 168), and that he speaks of the will as a primum mobile, — an initial force, — a cause.” (p. 211.) Ingenious and interesting as are the speculative por- tions of the essay, the numerous hitherto unrecorded cases will perhaps be found its most permanently val- uable contribution to science. Physiological opinions, INTRODUCTION. xi and even commonly accepted results, may be rejected as unsatisfactory by another generation of experimenters and theorists; but well recorded cases, drawn up by trustworthy witnesses, do not lose their value with the lapse of time. Such are many of these which are pre- sented to the reader. I may venture to add that I my- self knew personally the subjects of the cases recorded on pages 39, 262, and 277, and have heard a minute and circumstantial account of each of these cases from the lips of Dr. Clarke himself. With reference to the last case, Dr. Clarke mentioned a circumstance to me not alluded to in the essay. At the very instant of disso- lution, it seemed to him, as he sat at the dying lady’s bedside, that there arose “ something ” — an undefined yet perfectly apprehended somewhat, to which he could give no name, but which was like a departing presence. I should have listened to this story less receptively, it may be, but for the fact that I had heard the very same experience, almost in the very same words, from the lips of one whose evidence is eminently to be relied upon. With the last breath of the parent she was watching, she had the consciousness that “ something ” arose, as if the “ spirit ” had made itself cognizable at the moment of quitting its mortal tenement. The co- incidence in every respect of these two experiences has seemed to me to justify their mention in this place. The facts relating to the frequency of visions in children, and their power of summoning them up by an exercise of will, p. 212, also deserve special attention. Whatever Dr. Clarke has to say concerning the ac- tion of drugs is peculiarly entitled to confidence, as he XII INTRODUCTION. was a most diligent student of their vai’ious modes of action, and had a great experience with them, more es- pecially in all that relates to the use and abuse of nar- cotics and stimulants. But there is one case recorded which I venture to say no human being who draws the breath of life can read without profound interest. It is that which may be found on page 262. It is a deep-sea sounding of the dark abyss where each of us all is to sink out of sight sooner or later. The wise physician is on friendly terms with death. It is as much a physiological ne- cessity as life, and though, like the visit of an officer of justice, its entrance must not be allowed without a proper warrant, yet that warrant is sure to be issued at last. The wonderful calmness of the observed and the observer, in this almost if not quite unique case, impart a perfectly scientific character to this observa- tion of an event which is commonly yielded passively to the empire of emotion. Many, who through fear of death have been all their life-time subject to bondage, will, I believe, find more consolation in this recital than in almost any other human record. I will only add a single remark for the scientific reader. The expressions “ cell-groups,” “ polarizing the cells,” and some other terms must be accepted, rather as a convenient form of signifying an unknown change of condition, than as intended to be taken lit- erally. And I may say in conclusion that the whole essay must be read not with an over-critical spirit, but in the constant recollection of the mental conflict going on during the long agony in the course of which it was written. INTRODUCTION. XIII I subjoin, at the request of his nearest relative, the obituary notice which was furnished by myself to the “ Boston Daily Advertiser.” A few very trifling al- terations only have been made, and the reader will, I trust, overlook any repetitions of what has been said in the preceding pages. EDWARD HAMMOND CLARKE. BORN, FEBRUARY 2, 1820 ; DIED, NOVEMBER 30, 1877. The death of Dr. Clarke has not fallen upon our community as a surprise. It has long been known that he was suffering from a disease so nearly hopeless, as to leave scarcely a possibility of its retracing its steady progress toward a fatal issue. For the last three years he has been unable, to practice his profession. A year ago he might be met occasionally walking languidly in the Public Garden ; for some months he has been con- fined to his chamber, and for the past few weeks to his bed. The internal disease which was wasting his life was full of anguish. He was never free from pain except when under the influence of anodynes, and from time to time was racked with agony. It is a great sor- row to lose him, but all who know what he has been enduring must be thankful that he is released from his bondage to suffering. The tributes which have been rendered to his memory might seem to render unneces- sary the words which can do little more than repeat what has been so well said already. I need only refer to the full and very interesting sketch of his life in the “ Evening Transcript,” and to the eloquent discourses XIV INTRODUCTION. delivered from the pulpit, by the Rev. Mr. Ware and the Rev. Dr. Bartol, which the public has had the priv- ilege of reading. But as one of the friends who have seen him often and intimately during the years of his mor'ttal illness, I cannot forbear to add my testimony to that of others, who have watched him through the course of that protracted martyrdom. The antecedents of a man so distinguished by his high qualities will always be looked at with interest. Almost invariably some elements of the mental and moral traits which marked him will be found in the line of ancestry from which he is descended. Dr. Clarke’s father, the Rev. Pitt Clarke, was one of those excellent New England clergymen, whose blood seems to carry the scholarly and personal virtues with it to their descendants, oftentimes for successive generations. From a brief account of his life, written by himself, and a sketch by his son, the late Manlius Stimson Clarke, it is easy to draw the portrait of the good pas- tor who, for forty-two years, ministered to the people of the pleasant village of Norton, Massachusetts. His simple, industrious habits, for he worked on his farm as well as preached to the farmers round him, his creed or “ Confession of Faith,” which he left as a legacy to his flock, a creed devout, humane, with a stronger flavor of Matthew’s gospel than of Paul’s epistles, but refer- ring all to the “ sacred volume ” as “ the sole rule of his faith, preaching and practice ” ; the love and confi- dence with which he was regarded in the community, — these would give the outline which the reverence and affection of his children filled up with their remem- brances. INTRODUCTION. XV We are apt to look, perhaps, with even more interest upon the mothers of those who have become justly distinguished and honored. Dr. Clarke’s mother, Mary Jones Stimson before marriage, second wife of his father, was one of those women who live and die known to but a few persons comparatively, but who are remembered by those few as more to be loved and admired than many whose names are familiar, and not undeservedly so, to the public. She was endowed with noble and attractive personal qualities, was very fond of literature, and left many poems, some of which are preserved in a small memorial volume and show a cul- tivate*! taste as well as warm affections. It is impos- sible to read the lines “ To a Son in College,” or “ A Prayer,” without feeling that such a mother was worthy to be rewarded with such children as God gave her. Edward Hammond Clarke, her fourth and youngest child, was born in Norton, February 2, 1820, graduated at Harvard College in 1841, took his medical degree at Philadelphia in 1846, travelled extensively in Europe with the eldest son of the late Mr. Abbott Lawrence, and established himself at length in Boston, where he acquired and maintained a leading position among his contemporaries. In 1855 he was chosen Professor of Materia Medica in the medical school of Harvard Uni- versity, succeeding to the very distinguished Dr. Jacob Bigelow. This office he resigned in 1872, and was at once chosen a member of the Board of Overseers of the University. He still continued in active practice until assailed by the disease which ended in his death on the 30th of November just past. XVI INTRODUCTION. Returning to his early history, we find that the state of his health obliged him to leave college before the second term of the senior year, so that he could not take any part at commencement, but that he stood first in his class at the time of leaving. He had intended studying divinity, but circumstances changed his course, and he adopted the profession in which he attained great eminence, as he would have- done in any other which he might have chosen. He would have been a very learned and acute theologian. Those who have heard him speak upon questions before legislative com- mittees cannot doubt that he would have been a pow- erful advocate. Calm in manner as in mind, clear in statement, looking at subjects in a broad way and from many sides, yet shrewd to see on which side lay the truth he was in search of, he would have probably found his way from the bar to the bench, and left the name of a wise, if not of a great, judge upon our records. No one ought to regret the choice which gave such a helper to lighten the burden of human infirmities. He had all the qualities which go to the making of a master in the art of healing ; “ science ” enough, but not so much in the shape of minute, unprofitable acqui- sition as to make him near-sighted; very great indus- try ; love of his profession and entire concentration of his faculties upon it, with those mental qualities already spoken of as fitting him for other duties, but which equally fitted him to form a judicial opinion in the silent court-room where nature is trying one of her dif- ficult cases. INTRODUCTION. XVII Such a man is pretty sure to find his place in any great centre of population. But to be recognized as standing at the head of the medical profession in a large city, or an extensive district, implies a previous long and arduous struggle, at least in one who comes unheralded and unknown. Every step of such a man’s ascent must be made, like an Alpine climber’s in the glacier, in the icy steep of indifference; fortunate for him if he does not slip or is not crushed before he reaches the summit, where there is hardly room for more than one at a time. It was in such a position that Dr. Clarke stood when he felt the first symptoms of the disease to which he was to fall a victim. He cannot have been suffering very long from it when he consulted one of our most skilful surgeons, and learned the too probably malig- nant nature of the affection. There was a chance, per- haps, that the symptoms might be interpreted otherwise than as a certain warrant of death. For the greater part of the time, while the writer was an habitual vis- itor to his sick chamber, he was in the habit, if he referred to his disease at all, of speaking as if he had a chance of recovery. It was only a few weeks before his death that he spoke of the end as rapidly approach- ing, and then said that the trial of parting with life had been long over, even from the time when he had first sought the surgeon’s opinion. One sleepless night, in which he walked his chamber alone with his fatal sentence; a letter preparing the one nearest to him for the inevitable approaching future; after that strug- gle he felt as if the darkest passage of the valley of the XVIII INTRODUCTION. shadow of death had been left behind him, and walked serenely forward from that day to the end. If all who knew him and leaned upon him as their cherished and trusted adviser; if all who valued him and loved him as a friend; if all who felt his impor- tance as an active and wise and public-spirited citizen; if all whom his well-weighed and soberly stated opin- ions on educational and hygienic subjects have influ- enced, both at home and abroad ; if all the pupils who have sought his guidance in the important branch which he invested with so much attraction, as well as made affluent with fresh instruction, — if all these were to record their praises and their regrets, the volume must be ample that would hold his eulogy. There is only space for a brief notice of some of his excellences in different directions. And first of all, as a physician. It may be asked, what are the points of superiority which make the great practitioner? It is not the power of making a minute diagnosis ; in other words, of naming and localizing a disease with the greatest nicety. It is not the power of displaying, dif- ferentiating, and describing the effects of disease as shown in the degenerated organs which once belonged to a patient. Skill in these two branches is often found in the same individuals, and is always justly and greatly to be valued ; but one may be a skilful interpreter of the signs of disease, and an expert with the scalpel and the microscope, and yet very inferior as a practitioner to another who is far less instructed than himself in both of these departments. Given a fair acquaintance with the meaning of the ordinary signs and symptoms of INTRODUCTION. XIX disease, and the alterations which give rise to them, the best practitioner is the one who seizes most readily and certainly the vital conditions and constitutional tenden- cies of the patient, and shows most sagacity, tact, and fertility of resources in dealing with the varying states of his mind and body, whether or not he has occasion to use special remedies for special purposes, as every routine practitioner is capable of doing. Here it was that Dr. Clarke showed his mastery. He read his patient’s mind as every man must who would control another; he took in the whole bodily condition and its changes by careful examinations, scrupulously recorded after his visits for the day were finished; and he knew, as very few practitioners really know, what remedies could and could not do, — but especially what they could do in the way of alleviating suffering and shorten- ing or arresting curable diseases. As an instructor Dr. Clarke was the admiration of his pupils. His plan of teaching therapeutics was his own, and he not only spoke with authority, but made a sub- ject commonly thought among the least interesting of a medical course a great centre of attraction to the students of the medical school. In the councils of the Faculty his opinion was always listened to with respect, as coming from one of its wisest and most fair-minded members. As a writer he published no voluminous work. He contributed various articles on the Materia Medica to the “ New American Cyclopaedia.” In conjunction with Dr. Robert Amory, he published, in 1872, a small volume on the physiological and therapeutical action of XX INTRODUCTION. the bromides of potassium and ammonium. In 1876 he published, under the title of “ Practical Medicine,” a brief and clear account of the progress of medical knowledge during the century just finished. But noth- ing that came from his pen has been so universally read as his essay entitled “ Sex in Education.” This publi- cation was like a trumpet-call to battle, and started a contest which is not yet over. Dr. Clarke received a great number of letters and printed communications confirming his views,.and was made the object of many attacks, which he bore with perfect equanimity, feeling that he had honestly given the results of his experience, having only the good of the community in view. A second essay, “ The Building of a Brain,” followed up the first, with various important propositions bearing on education, and was widely read, but provoked less sharp antagonism. He wrote a valuable letter on the park question, and on all subjects relating to public health his opinion was looked to as of very high authority. During the confinement of his last illness he occu- pied himself much with reading, and in the later part of the time, until his strength entirely failed him, with writing, chiefly on points of psychology which particu- larly interested him. He seemed to enjoy discussing nice and difficult questions with some of his visitors, and it was pleasant, following his lead, to see him for- get himself for a little while in the analysis of mental operations, in which he showed a power of steady and penetrating thought which would have given him a name in metaphysical speculation if he had concen- INTRODUCTION. XXI trated his efforts in that direction. He had the great advantage of having studied the working of the mind under various exceptional conditions, and had many strange things to tell from his own experience, all of which he was disposed to account for without invoking any of the vulgar machinery commonly called in to ex- plain such phenomena. His constitution was gradually yielding to his dis- ease. The end which he had long foreseen as probable was growing more and more certain, if possible, and, of course, coming nearer and nearer. What affection could do to help him bear his anguish was done for him tenderly and lovingly by his devoted wife and daughter, and the friends who were anxious to render their ser- vices. In this strait of a dependent, suffering, and fail- ing life, the wife, to whom he looked for daily care and solace, who was to watch his decline and be with him in the last hour of earthly companionship, was seized with sudden illness, and died after a few days, leaving the dying husband, who had thought to have gone long before her. Under this sudden and overwhelming grief, with pain as his constant companion, with death always in full view, he bore himself with a steadfastness, a perfect quiet of aspect and manner which showed at once lii-s self-command and his self-submission to the orderings of that Providence in which he trusted. His rule in this world had been duty; his faith in looking forward to the future was simple, untrammelled by mechanical forms or formulas, but having as its inmost principle the love which casteth out fear. XXII INTRODUCTION. How many families there are in this community that feel as if they could hardly live without the counsels of this good, skilful, wise physician, or die in peace with- out having had all his resources called upon to keep them breathing this sweet air of life a little longer! How many will feel that no one will ever read their conditions of mind and body as he did, or give himself up so unreservedly to the exactions of their too fre- quently selfish suffering, or bring into the sick chamber a look so tranquillizing and assuring ! Time will teach them that the art, which is long, does not perish with the fleeting life of its wisest practitioner; that others, many of them, perhaps, his own former pupils, will deserve and gain their confidence; that the affections, seeking new objects when the old are torn away, will surely find them ; but to many the best eulogy of the best physician who comes after him will be so long as they live, that he recalls to their memory the skill, the wisdom, the character of Doctor Edward Clarke. VISIONS. Visions have always held, and still hold, a place among the experiences of mankind. From the time that Abraham had a vision of angels in his tent, to the latest manifestation of modern spiritualism and spirit seeing; among all nations, savage, civilized, and enlightened; in all classes, whether cultivated or ignorant; and in every phase of human development, oriental and occi- dental, Pagan, Christian, and Mohammedan, there have been those who saw, or who pretended to see, visions. Visions have not only been recog- nized as a part of the mysterious phenomena of disease, but of the equally mysterious phenomena of health. The hearty and strong, as well as the morbid and ill, have been visited by them. Nec- romancers and charlatans, seers and prophets, en- thusiasts and sober minded people, those who have deluded, and those who have inspired, the race, have, with varying degrees of earnestness and success, supported their claims to reverence or obedience, by the assertion that they could see what was hidden from the eyes of others. 6 VISIONS. When we consider that such very different per- sonalities as Elijah and St. Paul, Buddha and Mo- hammed, St. Francis d’ Assisi and Swedenborg, Joan of Arc, Luther and Bunyan, Indian Med- icine Men and Oriental Hakems, Convulsionists of St. Medard, inmates of asylums for the insane, invalids, elevated by the ecstasies of hysteria, and persons sunk in articulo mortis, opium and hash- ish eaters, alcohol drinkers, and others, have all seen visions, it seems as if such phenomena must be among the commonest experiences of human- ity, and of a character which ought not to pro- duce amazement or incredulity. But such is not the case. Visions are regarded, and naturally regarded, not only by scientific and thoughtful people, but by the common sense portion of the community, very much like ghosts, as unrealities. A few exceptions may be made in the case of apostles and teachers, but the vast majority of visions are classed among the delusions, vagaries, and fancies of mankind, or among the inexplicable phenomena of disease. Yet it must be admitted, after acknowledging to their fullest extent the obscurity, mystery, and charlatanism which covers up and infects the matter we are considering, that the denial of a substantial and real foundation to the phenomena of visions must be accompanied with a certain reserve. Sometimes the incredu- lity of the most skeptical has been staggered by the statements of those, whose mental soundness and recognized honesty precluded the suspicion of VISIONS. 7 deception or insanity; but these exceptional in- stances have usually been summarily disposed of, by remanding them to the region of the myste- rious and unknowable. Now and then, some san- guine or philosophic hearer of such statements has returned a doubtful hope that science would yet penetrate the mystery that enveloped them, and arrive at an adequate solution of them, and per- haps has accompanied his hope with the vague as- sertion that — “ There are more things in heaven and earth, Horatio, Than are dreamt of in jour philosophy.” The persistence with which the truthfulness of visions has been affirmed, at all times, every- where, and by such a variety of individuals, is it- self a significant fact, and one that deserves con- sideration. It implies that below the nonsense, charlatanism, fanaticism, ignorance, and mystery, upon which visions are largely built up, there is somewhere a substratum of truth, if we could only get at it. Such a growth could never have appeared, nor would it continue to appear, if its roots did not draw their nutriment from some- thing more invigorating than fancy or deception. It must be admitted, moreover, that the question of the possible occurrence of visions is one of great interest and importance. Its interest lies in its intimate connection with the attractive and shadowy territory — the terra incognita, and de- batable ground — which stretches between the 8 VISIONS. body and mind, and which connects this world with the next. Its importance lies in the fact that its solution, if a solution is possible, would not only throw light upon some of the intricate and vexed problems of psychology, but would aid materially in dissipating many popular supersti- tions and widely spread delusions. That there have been, and are, many persons who solemnly assert that they have seen visions, as well as dreamed dreams, is acknowledged. The question which it is proposed to investigate here is not whether such assertions are made, but upon what they are founded. Are visions, whether occurring in the sound or unsound, ex- cluding, of course, necromancy and cheating, pure figments of the imagination, or are they facts, resting upon a physiological basis ; and if the lat- ter, what are the conditions, and what is the mechanism of their production ? If any satisfac- tory answer to these inquiries can be given, it must be obtained, not from psychology or theol- ogy, but from physiology and pathology; not from metaphysicians or priests, but from physi- cians and physiologists. Approaching the subject upon its physiological side, and supplementing physiological investigation by clinical observa- tion, it is possible to clear away some of the ob- scurity which covers it, and to pick out a few grains of wheat from the mass of surrounding chaff. Fortunately, recent discoveries in physiol- ogy are of a character to throw a partial, if not VISIONS. 9 a full, light upon these and similar problems, and to give reasonable assurance of a complete solu- tion at some future period. It is unnecessary and unwise to complicate our present inquiry with any discussion of the differ- ence or identity of mind and matter. Whether mind is a product of matter, and so material, or an entity distinct from matter, it is admitted by all that it is manifested, so far as we know it, or can know it, in this world, only by and through mat- ter. The materialist and immaterialist are so far agreed. Obviously, then, the rational method of studying psychological phenomena is a physiolog- ical one. The brain being an organ of the mind, knowledge of it is an indispensable prerequisite to a comprehension of the latter ;1 consequently, visions which are mental or subjective phenom- ena, must be conditioned, if they occur at all, as intellection is, by the brain through which they are displayed. They can appear only under def- inite modifications of the circulation, nutrition, and metamorphoses of the intracranial apparatus. The states of the brain, therefore, which permit, accompany, and modify visions, and not the re- ports of consciousness, should be investigated, in order to arrive at any intelligent notion of 1 Admitting that the conception of spirit or mind, as abso- lutely independent of matter, is unthinkable, I cannot regard them as identical. It is not from any unwillingness to affirm my belief in an ego, that there is an apparent doubt in these statements, but from a desire to avoid the introduction of side issues. 10 VISIONS. such singular occurrences. A knowledge of these states, that is, an acquaintance with the physiolog- ical conditions and mechanism of visions, would go a great way towards discovering the true char- acter of the latter. With the hope of contributing something to our knowledge of the natural history of visions, the following essay has been prepared. It is founded upon a series of cases, of which the ma- jority occurred under the writer’s observation. The subjects of these visions were all persons of more than ordinary intelligence and cultivation. It is possible, perhaps probable, that this fact had a more intimate connection than that of mere coincidence with the visions reported. The de- velopment of the nervous system, and especially of the cerebral portion of the nervous system, which attends cultivation and intellectual power, is more likely than the intellectual development, which is permitted by brains of coarser fibre and quality, to afford an opportunity for the dis- play of extraordinary nervous phenomena. It will also be noticed, that all the individuals, whose cases are here presented, were themselves con- scious of the subjective character of their visions. Indeed, all other cases were purposely excluded. The conditions of hallucination, illusion, and delu- sion can be more easily and satisfactorily studied in persons who recognize the unreality of what besets them, than in those who entertain an op- posite conviction. VISIONS. 11 Before going further, it is important to be sure that a definite and precise signification is attached to the principal terms we are to use, or at least to the one by which the subject we are to investigate is designated. Accuracy and clearness of state- ment ai-e essential to accuracy and clearness of ideas. Unfortunately, the terms which have just been mentioned, hallucination, illusion, and delu- sion, are vaguely employed, and often confounded with each other. They have not acquired definite and distinct significations; at least, not to such a degree that any one of them brings before the mind a peculiar and individual condition or no- tion, to the exclusion of the others. They are often used as if they were synonymous, and as if the conditions of the nervous system which they indicate were similar, or the same. This confu- sion undoubtedly arises from the uncertainty and inaccuracy which has existed, till recently, of our knowledge of their causes and character. Webster defines delusion, to be “false represen- tation .... illusion; ” illusion to be “ decep- tive appearance .... false show ; ” and hallu- cination to be “ delusion, faulty sense, erroneous imagination.” According to Worcester, delusion is “a false belief .... illusion;” illusion is “ deception, as of the sight, mind, or imagination .... delusion ; ” and hallucination is “ a mor- bid error in one or more of the senses .... de- lirium .... delusion.” Evidently, both of these lexicographers regard the above terms as nearly 12 VISIONS. synonymous. Their definitions would lead an inquirer to suppose that delusion, illusion, and hallucination, instead of being different and dis- tinct physiological conditions, were almost identi- cal affections. Dr. William A.'Hammond, who is aware of the existing confusion of ideas and language on this subject, has endeavored to get rid of it by careful definitions. He defines 1 Illu- sion to be “a false perception of a real sensorial impression. Thus a person, seeing a ball roll over the floor, and imagining it to be a mouse, has an illusion of the sense of sight.” Hallucina- tion he defines to be “ a false perception, without any material basis, and is centric in its origin. It is more, therefore, than an erroneous interpre- tation of a real object, for it is entirely formed by the mind.” Delusion, according to the same au- thor, is “ a false belief.” An individual,'who has an illusion or hallucination, and is sensible that they are not realities, is not deluded; one who accepts them as facts is deluded. These distinc- tions are just and important. They are founded on the existence of three distinct classes of false perceptions, which have been discovered by physi- ological and clinical observation : viz. one of sub- jective, or as Dr. Hammond designates them, centric perceptions, which are produced solely by cerebral action, and are recognized as false by the subjects of them ; a second class of objective, or 1 Diseases of the Nervous System, by William A. Hammond, M. D., 6th ed., pp. 320, 321. VISIONS. 13 eccentric false perceptions, which are recognized as false by the subjects of them, and are produced by external objects, acting on the visual appara- tus, ab-extra, that is, playing upon the individual from without, and hence the term illusion, from in and ludo, to play upon; and a third class of false perceptions, which may be subjective or objective, or both together, in the reality of which the in- dividual believes, and so is deluded by them ; hence delusion, from de and ludo, to be played upon from within, or mocked by the brain. Noth withstanding the justness of these distinc- tions, it is difficult to keep them well in mind, and use the old names. Hallucination, illusion, and delusion, as the above citations from Webster and Worcester show, are so closely allied, in their or- dinary acceptation, that one not only suggests the others, but is often confounded with them, or is substituted for them. It would avoid ambiguity of language, and confusion of thought, to discard them altogether, at least, from scientific treatises, and employ new ones, if such could be found, which would describe, more accurately than these, the conditions they are intended to designate, and with which no preconceived notions are as- sociated. With the hope of attaining this object, the fol- lowing terms are proposed, and will be used in the present essay. The normal process of vision may be appropriately called Orthopia, from 6p6o