COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX00064491 RECAP THE DISEASES OF PERSONALITY, irv xii. RieoT. S^v,.. -'5 THE DISEASES OF PERSONALITY TH. RIBOT, PKOFKSSOR OF COMPARATIVE AND EXPERIMENTAL PSYCHOLOGY AT THE COLLEGE DE FRANCE AND EDITOR OF THE "REVUE PHILOSOPHIQUE. " AUTHORISED TRANSLATION. CHICAGO: The Open Court Publishing Company l8qi. TABLE OF CONTENTS. PAGE. INTRODUCTORY. Division of the subject i The nature of consciousness : two hypotheses 3 It is only a perfectionment : facts in support 6 Importance of the psychic factor 17 CHAPTER I. ORGANIC DISORDERS. The sense of the body, its importance and its complexity. ... 19 Slight variations of the personality in the normal state 30 More serious cases o-? j^ Cases of double personality 34 Personality of double monsters 38 Personality of twins 45 CHAPTER II. EMOTIONAL DISORDERS. Emotional manifestations in general 55 Depressions and exaltations of the personality 57 Their alternation in cyclic insanity 60 Complete metamorphosis of the personality 62 Sexual characters : eunuchs, hermaphrodites, opposite sex- uality ' 56 Complete transformation of character 72 Foundation of the personality : personal unity and identity are the psychic expression of the unity and identity of the organism g^ CHAPTER III. DISORDERS OF THE INTELLECT. PAGE Alterations arising from parsesthesis and dyssesthesis, and from hallucinations 92 Cerebral dualism and double personality: discussion 100 Role of the memory T14 Ideas, transformations proceeding from above ; their super- ficial character : madmen, hypnotised subjects 118 Disappearance of the personality in mystics . 125 CHAPTER IV. DISSOLUTION OF PERSONALITY. The insane : cases of real double personality ; periods of the dissolution 117 Attempt at classification of the diseases of personality ; three principal types: alienation, alternation, substitution 135 CONCLUSION. Zoological individuality and its ascending evolution 139 Colonial consciousness 141 Physical synthesis and psychical synthesis of personality in man 146 The ego is a co-ordination 151 ERRATA. Page 6, line 12 from top ; for by read/or. Page 12, line 15 from top ; for actually read in the present instance. Page 16, line 7 from bottom ; for relation read revelation. Page 17, line 8 from top ; for dictum read datu7n. Page 24, foot-note, first line ; for TJie Senses and Intelligence read The Senses and the Intellect. Page 24, foot-note, last line ; for Pathology of Spirit read Pathology of Mind. Page 27, lines 10, 9, and 8 from bottom ; for all consciousness, whether clear or obsure, acttial or reproduced by some external circtimstance read all con- sciousness whether clear or obscure, abtual or reproduced, of any extraneous thing. Page 29, line 14 from bottom ; for exerts read exhibits. Page 44, line 18 from top ; delete the comma after Siamese. Page 49, line 7 from top ; read attended for attented. Page 53, line 5 from bottom ; physical personality : the original also reads "physical personality"; perhaps /.ycAzra/. Page 84, line 3 from bottom ; delete by way of. Page 106, line 10 from top ; delete that it looks quite obvious. Page no, line 2 from top ; for inancinis7n read Manicheisfn. Page 120, lines 11 and 12 from bottom ; for Hypertrophied and atrophied read Hypertrophy and atrophy. Page 124, line 10 from top ; for hynotising read hypnotising. Page 124, last line of large type ; iox purpose read investigation. DISEASES OF PERSON A LITY. INTRODUCTION. In psychological language by '^ person " we gen- erally understand the individual as clearly conscious of itself, and acting accordingly. It is the highest form of individuality. In order to explain this attri- bute, which metaphysical psychology exclusively re- serves for man, the latter science is satisfied with the hypothesis of an ego ; that is a perfect unity, simple and identical. Unfortunately, however, this is only a de- ceptive clearness and the semblance of a solution. Unless we attribute to this ego a supernatural origin^ it will be necessary to explain how it is born, and from what lower form it proceeds. Experimental psychology does not propose the problem in the same manner, or treat it according to the same methods. Experimental psychology learns from natural scientists that in many instances it is difficult to determine the characteristics of individual- ity, even of those creatures that are by far less com- plex than human persons. Hence it mistrusts any purely simple solution, and, far from regarding the question as settled, as it were, at the first onset, it sees the problem at the close of its researches, as rather the result of long and laborious investigations. There- fore, it is but natural that the representatives of the 2 DISEASES OE PERSONALITY. old school, after once having lost their true bearings, should groundlessly accuse the adepts of the new school of actually purloining their ego. But on either side both language and methods have now become so different, that all mutual understanding henceforth will be impossible. It will be necessary, even at the risk of increasing the alread}^ extant confusion, to investigate what teratical, morbid, or simply rare, cases can teach us concerning the formation and disorganization of per- sonality, yet without assuming to treat the subject in its totality. Personality being the highest form of psychic in- dividuality, there arises the preliminary question : What is the individual? There are few problems that in our time have been more discussed among natural scientists, or remain more obscure in regard to the lower degrees of animal existence. This is not the right moment to speak of it in detail. At the close of this work, after studying the constitutive elements of personality, we shall consider it in its totality. Then will occur the time, to compare it with the lower forms, through which nature has essa5^ed to produce it, and to show, that the psychic individual is the expression of an organism ; in conformity with the latter, it is either low, simple, incoherent, or complex and unified. Descending the whole series of animated beings, we see how the psychic individual is always formed through the more or less complete fusion of more sim- ple individuals. ^' A colonial consciousness" is created through the cooperation of local consciousnesses. The discoveries of modern naturalists, in this respect, are of the utmost importance to psychology, because they completely transform the problem of personality. The INTR on UCTION. 3 latter henceforth must be studied from below— from the lowest step of the ladder. Thus we are prompted to ask, whether the human person itself is not also, im tout de coalition—?, whole by coalition— the extreme complexity of which veils from us its origin, and whose origin would remain im- penetrable, if the existence of elementary forms did not throw a certain light upon the mechanism of this fus- ion. In fact, the human personality is an aggregated whole, a complex. In order to know it, we must analyze it ; but the analysis here is fatally artificial, because it disjoins groups of phenomena, which do not merely stand in juxtaposition, but are really coordinate, their relation being not of simple simultaneousness, but of reciprocal dependence. And yet, this work of analysis is altogether indispensable and we must severally un- dertake to investigate the organic, emotional, and /«/^/- /^^/?/^/ conditions of personality^, at the same time lay- mg due stress on occurring anomalies and disorders. Our final study of the subject will allow us to group together anew these several disjoined elements. II. Before entering into the exposition and interpre- tation of facts, it is first useful, even for reasons of clearness and good faith, to understand the true nature of consciousness. It is not here the question of a monograph embracing, as it were, the entire science of psychology ; it will suffice, simply, to present the problem in a precise form. Leaving aside details, we are confronted by two hypotheses; the one, a very old hypothesis, which re- gards consciousness as the basic property of '' soul " 4 DISEASES OF PERSONALITY. or of '^ mind," constituting its essence ; the other, a very recent theory, which regards it as a simple phe- nomenon, superadded to the activity of the brain — as an event having its own conditions of existence, and which appears or disappears according to circum- stances. The former hypothesis has for so many centuries reigned supreme, that it has become an easy matter to appreciate its respective merits and deficiencies. I have not to pass sentence on this the- ory ; I shall limit myself to showing its radical incom- petency to explain the unconscious life of the mind. At first, during a long time, this hypothesis did not even mention this unconscious life. The precise and profound views of Leibnitz upon this point remain forgotten or, at least, without any application ; and in the present century, even, the most renowned psy- chologists (with only a few exceptions) yet remain ensconced within their theory of conscious life. When finally the problem thrust itself forward, and it be- came evident to all, that to reduce psychic life to the sole data of consciousness, is such a poor and sterile conception, that practically it becomes useless — then, indeed, there arose a very great confusion. Then, so-called "unconscious states" were admitted, — an ambiguous and half-contradictory term, which has rap- idly spread, and has its equivalent in all languages, but by its very nature betrays the period of confusion, in which it was born. In fact, what are these uncon- scious states ? Prudent writers posit their existence, without attempting to explain them. The more ven- turesome speak of latent ideas, of unconscious con- sciousness, both of which are expressions so vague and so full of inconsequences that many authors have been compelled to admit their shortcomings. In fact. INTRODUCTION. • 5 when the soul is conceived in its quahty of a thinking substance, whose states of consciousness are modifi- cations, in such case it will be impossible without a manifest contradiction to refer to it the unconscious states ; subterfuges of language or dialectic subtleties will be of no avail ; and as we can not deny the high importance of these unconscious states as factors of psychic life, there would be no exit from this inextric- able situation. The latter hypothesis rids itself of all this conflict- ing logomachy ; it does away with the factitious prob- lems that crop up in the former (for example, whether consciousness is a general or particular faculty, etc.), and without hesitation we may claim for it the benefit of a lex parcimonice. It is simpler, clearer, more con- sistent. By way of contrast to the other, we may characterize it by saying, that it expresses the uncon- scious in physiological terms (as states of the nervous system), and not in psychological terms (as latent ideas, non-felt sensations, etc.). But, this is only a particular side of an hypothesis, which must be con- sidered in its entirety. Like all general terms, consciousness must be resolved into, concrete data. Will, in general, does not exist, but volitions \ and in a like manner there is no consciousness in general, but only states of con- sciousness. The latter are the reality. It would be idle to define consciousness as : "the fact of being conscious," for this is merely a datum of observation, a final fact. Physiology teaches that its production is always associated with some activity of the nervous system, particularly of the brain. The reverse, however, does not take place. All psychic activity cer- tainly implies nervous activity; still, all nervous activity 6 . DISEASES OE PERSONALITY. does by no means imply psychic activity — nervous activity being far more extended than psychic ac- tivity. Consciousness, accordingly, is something su- peradded. In other terms, we have to bear in mind, that every state of consciousness is a complex event, conditioned by a particular state of the nervous system. This ner- vous process is not an accessory but an essential part of the event, and, moreover, is its basis and funda- mental condition. As soon as produced, the event exists in itself; as soon as consciousness is added to it, the event exists by itself. Consciousness completes and perfects the event, but does not constitute the same. This hypothesis easily explains how all manifesta- tions of psychic life, sensations, desires, feelings, vo- litions, memories, reasonings, inventions, etc., may al- ternately be conscious and unconscious. There is noth- ing mysterious in these alternations, since in all cases the essential conditions, /. e., the physiological condi- tions, ever remain the same, and consciousness is but a perfectionment. Yet, why is this perfectionment sometimes super- added, and at other times lacking? If in the physiological phenomenon itself there was not something more when consciousness is present than when it is absent, we should indirectly adjudge victory to the adverse hypothesis. Could it be proved that every time certain physiological conditions exist, consciousness will appear; that whenever they disap- pear, the former disappears ; and whenever they vary, consciousness also varies— this would no longer be an hypothesis, but actually a scientific truth. We are still very far from this point. At all events, we may be sure that consciousness INrKODUCTION. j itself will not furnish these revelations. As Maudsley justly observes, consciousness at the same moment cannot be effect and cause, — cannot be itself and its molecular antecedents. It lives but for a moment, and cannot through a direct intuition return backward as far as its ov^n immediate physiological antecedents; and moreover, to go back to its material antecedents, would be to lay hold of, not itself, but its own cause. At the present moment it would be chimerical to attempt even a broad determination of the necessary and sufficient conditions of the appearance of con- sciousness. We know, indeed, that cerebral circula- tion, in the double relationship of the quantity and quality of the blood, is a matter of great importance. A striking proof of this is furnished by experiments performed upon the heads of recently beheaded ani- mals. Psychometric researches demonstrate every day that the more complex a state of consciousness is the greater length of time it requires, and that, on the contrary, automatic acts — whether primitive or ac- quired, and the rapidity of which is extreme — do not enter into consciousness. We may, moreover, admit that the appearance of consciousness is con- nected with the period of disassimilation of the nerv- ous tissue, as Herzen distinctly has shown.* All these results, however, are only partial conquests ; but, the scientific knowledge of the genesis of a phenom- enon supposes the determination of all its essential conditions. The near future, perhaps, will furnish these. In the meantime, in order to corroborate our hypoth- esis, it will be more profitable to prove, that it alone * Rrvnc Philoso/>h/que, Vol. VII, p. 353, and La Condizione fisica della Cos- cienza. Rome, 1879. 8 DISEASES OE PERSONALITY. explains a principal characteristic (not a condition) of consciousness, namely, its intei-mission. In order from the outset to avoid all equivocation, I may ob- serve that here it is not the question of the discontin- uity of the states of consciousness among themselves. Each state of consciousness has its limits which, while allowing it to associate with the others, at the same time will protect their respective individualities. Here it is not the question of this, but simply of the well- known fact that consciousness has its interruptions, or as is said in, popular parlance : " Man does not al- ways think." It is true that this assertion has been contradicted by the majority of metaphysicians. As a matter of fact they never have furnished any proof for the Support of their thesis, and as all appearances are against it, the onus p7-obatidi would legitimately seem to be incumbent on the former. Their whole argu- mentation reduces itself to maintaining that since the soul is essentially a thinking subject, it is impossible that consciousness should not exist in some certain degree, even when there remains no trace of it in the memory. But this is simply begging the question, since the hy- pothesis maintained by us contests precisely their ma- jor premise. Their alleged proof is definitively but a deduction drawn from a contested hypothesis. Leaving aside all a piHori solutions let us examine the question in itself. Let us leave aside the cases of syncope, pro- voked anaesthesia, epileptic vertigo, coma, etc., and abide by what is more common, more frequent, to wit : the psychic state during sleep. It has been maintained that there is no sleep without dreams ; but this is a purely theoretic assertion, and a consequence of the above-mentioned principle, that INTRODUCTION. g the soul always thinks. The sole argument of fact that they can plead, is to the effect, that sometimes the sleeper, addressed or questioned, may answer in a suf- ficiently pertinent manner, yet upon waking will have no recollection of the matter. Still, this fact alone does not justify any general conclusion and to the theory of the metaphysicians physiology opposes an- other. Physiology lays stress on the fact that the life of every organ comprises two periods : the one of rel- ative rest or assimilation, the other of activity or dis- assimilation ; that the brain makes no exception to this law and that experience shows, how the duration of sleep at different times and in the different circum- stances of life stands in direct ratio to the craving of assimilation. The cause is the necessity of repairing the losses sustained ; of making nutritive circulation follow upon functional circulation. During the state of being awake the brain consumes more material than the blood furnishes, so that oxidation soon di- minishes and along with it the excitability of the ner- vous tissue. The experiments of Preyer prove that sleep then will overtake the subject, when through prolongated activity the substance of the brain, like that of a fatigued muscle, is encumbered with a quan- tity of acid waste material {deti-itus).'^ Even the pres- ence of these products at a given moment will stop the activity of the brain, and the latter does not reappear before rest has allowed the complete elimination of these waste products. It must be admitted, that complete, absolute sleep, without dreams, is the exception ; but that it actually occurs, and not unfrequently, suffices to establish the intermittent character of consciousness. * Through the absorption of a certain quantity of lactate of soda, as a type of the products of disassimilation in the brain, Preyer has produced yawn- ings, somnolence, and even sleep. lo DISEASES OF PERSONALITY. The physiological thesis has a much stronger de- monstrative value than the metaphysical thesis. Let us further remark — and this is an important point — that all those who have investigated whether there ex- ists perfect cerebral sleep, have been cultured and active minds (psychologists, physicians, men of letters,) in whom the brain is ever upon the alert, like a delicate instrument vibrating to the touch of the slightest exci- tation, and endowed, as it were, with a constant habit of consciousness. Thus, it happens that the very men who propound the problem : "Do we always dream ? " in reality are the least competent to solve it negatively. But the same does not happen with people engaged in the manual trades. A peasant living far from all intellectual agitation, limited to the same occupations and same routine, generally speaking, does not dream. I know several, who regard dreams as a rare incident in their nocturnal life. "The most convincing proof, that the mind can be completely inactive during sleep, that its existence can be momentarily interrupted or suspended, would incontestably be furnished, if the mind should join end to end, as it were, the instant in which a man falls asleep with that in which he awakes, and when this space of time appears to him, as if it had never existed. Philosophers, who do not believe in complete sleep, themselves have pointed out this kind of proof, at the same time denying that it had ever occurred. I, myself, nevertheless, have been a witness to this fact under the following cir- cumstances : I was called at two o'clock in the morn- ing to lend my assistance to a person in the neighbor- hood, attacked by cholera. At the moment of going out my wife made some admonitory remarks about the candle that I held in my hand, and immediately fell INTR OD ucrroN. 1 1 asleep again. I returned home in about half an hour. The noise, caused by the key in opening the door, sud- denly awoke my wife. '' Her sleep had been so deep, and she had so closely joined the instant at which she fell asleep with the instant at which she awoke, that she believed she had not slept at all, and imagined that the noise made by the key on my return actually was the noise made at the moment of my departure. Beholding my return, she thought I had merely stepped round, and asked me the reason why ; and she was greatly astonished to hear, that I had been absent during half an hour."* I do not see what objections can be made to facts of this kind, unless, indeed, we revert to the unavoid- able hypothesis of states of consciousness that left no trace in the memory; but, I repeat, this is merely a gratuitous hypothesis, destitute of probabihty. Those who are subject to fits of fainting, with loss of con- sciousness well know, that pending their duration they might fall down, hurt a limb, upset a chair, and on re- covering their senses, not have the faintest idea of what had taken place. If these sufficiently serious in- cidents had been attended with consciousness, is it likely that they would not have left any persistent re- collection at least for a few seconds ? We do not for a moment deny that in certain circumstances, normal or morbid (for example in hypnotized subjects), states of consciousness will leave no apparent traces on awaking, and can later be revived again ; we shall even limit to any desired extent the actual instances cf com- *Despine, Natural Psychology, Vol. I. p. 522. Alienists have mentioned cases in which a pathologic state suddenly happens to suppress consciousness, and the patient after a more or less long interval resumes his speech at the very word where he h?d stopped. See other facts of this kind in Winslow, " On Obscure Diseases," etc., p. 322, and following. 12 DISEASES OE PERSONALITY. plete interruption of consciousness ; it suffices that there be a single one, in order to raise insurmountable difficulties to the hypothesis of the soul as a. think- ing substance. In the contrary hypothesis, everything is easily explained. Since consciousness is an event depending upon determined conditions, it is not at all a matter of surprise that at times it should fail. If this were the occasion to treat exhaustively the problem of consciousness, it also would be possible to prove, that in our hypothesis there is nothing wavering or contradictory in the relation of the conscious to the unconscious. The term unconscious can always be para- phrased as follows: a physiological state, which some- times and even most frequently being accompanied by consciousness, or at its origin having been so, actually is not so accompanied. This characteristic, although neg- ative as psychology, is positive as physiology. It af- firms that in every psychic event the basic and active element is the nervous process, the other is only a con- comitant. As a consequence of this, there will no longer be any difficulty in understanding the proposi- tion, that all manifestations of psychic life by turns can be either unconscious or conscious. To effect the former instance it is sufficient that there be produced a determined nervous process, that is, the putting into play of a determined number of nervous elements, forming a determined association, to the exclusion of all other nervous elements, and of all other possible associations. In the latter instance, it is necessary and sufficient that there be added certain supplementary conditions, whatever they may be, without changing anything in the nature of the phenomenon, except making it conscious. We further understand, how unconscious cerebration is able to perform such a heavy INTRODUCTION. 13 piece of work noiselessly and, presently, after a very long incubation, will reveal itself through unexpected resiilts. Every state of consciousness represents only a very inconsiderable portion of our psychic life, be- cause every instant it is supported and, as it were, im- pelled by unconscious states. Each volition, for ex- ample, dives to the very depths of our being; the mo- tives that accompany and apparently explain it, are never but a feeble part of its true cause. The same takes place in a great number of our sympathies, and this fact is to such a degree manifest that even minds completely destitute of observation, will often wonder at being unable to explain to themselves their aver- sions or sympathies. It would be irksome and beyond our purpose to continue the present demonstration. If the reader wishes, he may turn in Hartmann's Philosophy of the Unconscious, to the part bearing the title "Phenome- nology." Here he will find classed all manifestations of the unconscious life of the mind, and he will see that in this classification there is not a single fact which may not be explained through the hypothesis that has here been sustained. A last point still remains to be explained : the theory that regards consciousness as a phenomenon. It is the upshot (as could be easily proved, if this di- gression were opportune) of this fundamental principle in physiology: '^ reflex action is the type of nervous action and the basis of all psychic activity." To many over-cautious persons this theory has seemed para- doxical and irreverent. It seems to them that it de- prives psychology of all solidity and dignity. They are unwilling to admit, that the shghtest manifestations of nature should be unstable, transient, superadded, and 14 DISEASES OE PERSONALITY. subordinate as to their conditions of existence. Yet this is simply a prejudice. Consciousness, whatever be its origin and nature, loses nothing of its genuine value : "consciousness must be appreciated in itself; and to him who places himself at the point of view of evolution, the origin does not matter the most, but rather the height that has been attained. Experience, moreover, shows that the higher we reascend the series, the more complex and unstable become the na- tural compounds. If stability really afforded the true standard of dignity, in such case, the minerals would play the most prominent part. This purely sentimen- tal objection, accordingly, is not tenable. As to the difficulty of explaining, through this hypothesis, the unity and continuity of the conscious subject, at present it would be premature even to moot this subject. In due time this problem, in its turn, will also appear. There is, however, one weak point in the hypothesis of consciousness- phenomenon. Its most convinced partisans have defended it in a form that has caused them to be called the theorists of pure automatism. According to their favorite comparison, consciousness is like the sparks from a steam-engine, lighting it up at intervals, but having no effect upon its speed. Con- sciousness, thus, does not produce action any more than the shadow that accompanies the steps of the traveler. We have no objection to these metaphors, viewed purely as vivid illustrations of the doctrine in question ; but taken in a strict sense they are exag- gerated and inexact. Consciousness in itself and through itself is really a new factor, and in this there is nothing either mystical or supernatural, as will presently be seen. In the first place, from the hypothesis itself (the INTRODUCTION. 15 state of consciousness supposing physiological condi- tions more numerous, or at least other ones, than the same state when unconscious), it results that two in- dividuals, — the one being in the former state, the other in the latter, — all other things being equal, are strictly- speaking, not comparable to each other. It is possible to allege even stronger reasons, — not logical deductions, but facts. When a physiological state has become a state of consciousness, through this very fact it has acquired a particular character. In- stead of occurring in space, that is, instead of being conceived as the setting into activity of a certain num- ber of nervous elements, occupying a determined sur- face, it assumes a position in time ; it has been pro- duced after this, and before that other thing, while in the unconsciousness state there was neither a before nor an after. The physiological state becomes suscep- tible of being recollected, /. e., of being recognized as having occupied a precise position among other states of consciousness. It has, accordingly, become a new factor in the psychic life of the individual — a result that can serve as a starting-point to some new (either conscious or unconscious) work ; and it is so far from being the product of a supernatural operation, that it reduces itself to the organic registering which is the basis of all memory. In order to be more precise, let us take a few ex- amples. Volition is always a state of consciousness the affirmation that a thing must either be done or pre- vented ; it is the final and clear result of a great num- ber of conscious, sub-conscious, and unconscious states; but once affirmed, it becomes a new factor in the life of the individual, and, in the assumed position, it marks a series, /. e., the possibility of being recommenced i6 DISEASES OF PERSONALITY. (begun over again), modified, prevented. Nothing similar exists in regard to automatic acts that are not accompanied by consciousness. NoveHsts and poets, who usually are good observers of human nature, have frequently described that well-known situation, in which a passion — whether love or hatred — long brooded over, unconscious, ignorant of itself, at last bursting forth, recognizes, affirms itself, becomes con- scious. Then its character changes ; it either redoubles in intensity or is crossed by antagonistic motives. Here, likewise, consciousness is a new factor, which has modified the psychological situation. One may by instinct, that is, through unconscious cerebration, solve a problem, but it is very possible that some other day, at another moment, one will fail in regard to an anal- ogous problem. If, on the contrary, the solution of any problem is attained through conscious reasoning, a failure will scarcely occur in a second instance ; be- cause every step in advance marks a gained position, and from that moment we no longer grope our way blindly. This, however, does not in the least dimin- ish the part played by unconscious work in all human discoveries. These examples taken at hazard may suffice to show, that the above-mentioned metaphors are true of each state of consciousness taken i7i itself. In itself, indeed, it is but a light without efficacy, merely the sim- ple relation of an unconscious work ; but in relation to the future development of the individual it is a factor of the first order. What is true of the individual is also true of the species, and of the succession of species. From the sole point of view of the survival of the fittest, and ir- respective of all psychological considerations, the ap- INTRODUCTION. 17 pearance of consciousness upon earth was a fact of the greatest magnitude. Through it experience, that is, an adaptation of a higher order, became possible to the organic animal. We have not to investigate its origin. In this respect, very clever hypotheses have been made, which all enter the domain of metaphysics, and which experimental psychology has not to discuss, because it accepts consciousness as a dictum. It is probable that consciousness has been pro- duced like any other vital manifestation, at first in a rudimentary form, and apparently without great effi- cacy. But from the moment it was able to leave be- hind a vestige, to constitute in the animal a memory for the psychic sense, utilizing its past for the profits of its future, from that moment a new chance of sur- vival was created. To unconscious adaptation, blind, incidental, dependent upon circumstances, there was added a conscious adaptation, uniform, dependent upon the animal, surer and more rapid than the other; and the latter has shortened the work of selection. Thus, the parts played by consciousness in the development of psychic life are manifest. I have dwelt rather long upon this point, because the advo- cates of the hypothesis, above set forth, have only considered it in its present form, without concerning themselves about that which results from its ap- pearance. They certainly had stated, that consciousness en- lightens ; but they had not shown, that consciousness also adds. To repeat once again our former state- ment : consciousness itself is but a phenomenon, only an accompaniment. If there exist animals, in which it should appear and disappear at each instant, with- out leaving any traces, it would be strictly correct tq 1 8 DISEASES OE PERSONALITY. call such animals spiritual automatons ; but if the state of consciousness leaves a vestige, a registration in the organism, in such case it does not act merely as an indicator, but as condenser. The metaphor of an auto- maton is no longer acceptable. This being admitted, many objections to the theory of a consciousness-phe- nomenon fall to the ground of themselves. The theory is completed, without having been weakened. 19 CHAPTER I. ORGANIC DISORDERS. I SHALL now dwell more at length upon the organic conditions of personality ; inasmuch as everything de- pends upon these and they explain all the rest. Met- aphysical psychology, with logical consistency, has paid no attention whatever to these conditions ; for it de- rives its ego from above, and not from below. On the contrary, we shall maintain that the elements of per- sonality must be sought for in the most elementary phenomena of life ; the latter, in fact, stamp it with its own distinctive mark and character. In every animal the basis of its psychic individu- ality is the organic sense — the sense of the body, usuall}^ vague and obscure, but at times very clear in all of us.* This organic sense is that ''principle of individu- ation" so eagerly sought for by scholastic doctors, for the reason that everything — either directly or indi- rectly — rests upon it. We may regard as highly prob- able, that according as we descend toward the lower animals this organic sense of body will more and more preponderate, down to the point where it actually be- * Incidentally, I may observe that a great metaphysician, Spinoza, plainly maintains the same thesis, although in difterent terms: "The object of the idea that constitutes the human soul is body.... and nothing else." "The idea that constitutes the formal existence of the human soul is not simple, but composed of several ideas." (^Ethics, part IL propositiojis 13 and 15. See also Scholia of prop. 17.) 20 DISEASES OF PERSONALITY. comes the entire psychic individuality. But, in man and with the higher animals, the turbulent world of desires, passions, perceptions, images, and ideas covers up this silent back-ground. Except at given intervals, it is forgotten, from the fact that it is not known. Here the same takes place as in the order of social facts. The millions of human beings, making up a large na- tion, as regards itself and others, are reduced to a few thousand men, who constitute its clear consciousness, and who represent its social activity in all its aspects, its politics, its industry, its commerce, and its intel- lectual culture. And yet these millions of unknown human beings, — limited as to manner and place of ex- istence, quietly living and quietly passing away — make up all the rest; without them there would be nothing. They constitute that inexhaustible reservatory, from out of which, through a rapid or sudden selection, a few individuals rise to the surface ; but these favorites of talent, power, or wealth themselves enjoy but an ephemeral existence. Degeneracy — always fatally in- herent in that which rises — will again lower their race and themselves, while the silent work of the ignored millions will continue to produce other ones, and to impress upon them a distinctive character. Metaphysical psychology only keeps in view the lofty heights ; but purely internal observation cannot tell us much about what takes place within the body, and, as a matter of course, from the very outset, the study of general sensibility has been mainly the work of physiologists. Henle (1840) defined general sensibility or ''coen- aesthesis" as: '^the tonus of the sensible nerves, or the perception of the state of average activity in which these nerves are constantly engaged, even during the ORGANIC DISORDERS. 21 moments when they are not excited by any external impression." And elsewhere: ''General sensibility is the sum total, or the not yet unravelled chaos, of sensa- tions that from every point of the body are being in- cessantly transmitted to the sensorium. "* By the above- mentioned term E. H. Weber even more precisely un- derstands : an internal sensibility, an inward touch that imparts information to the sensorium concerning the mechanical and chemico-organic state of the skin, the mucous and serous membranes, the viscera, the mus- cles, and the articulated parts. In France, Louis Peisse, a physician-philosopher, was the first to react against the doctrine of Jouffroy^ who maintained that we do not know our own body except in an objective manner, as an extended, sohd mass, similar to other bodies in the universe, situated beyond the ego, and foreign to the perceiving subject. Peisse proved, though in somewhat cautious terms, that the knowledge of our body, above all, is entirely subjective. His description of this organic conscious- ness seems by far too correct, not to be quoted entire. ''Is it certain," he says, "that we have absolutely no consciousness of the activity of the organic functions? If it be the question of a clear, distinct, and locally de- terminable consciousness, like that of external im- pressions, it is clear that we lack it ; but we might pos- sibly possess a kind of silent consciousness, obscure, and latent, as it were, the analogue, for example, of that of sensations which provoke and accompany the respiratory movements— sensations, which, although incessantly repeated, pass by unperceived. In fact, might we not -regard that remarkable feeling which * Pathologische Untersuchungen, 1848, p. 114. Allgemeine Anatomie 1841, p. 728. 22 DISEASES OE PERSONALITY, ceaselessly and without intermission, warns us of the presence and actual existence of our own body, as a dis- tant, faint, and confused echo of the universal vital ac- tivity ? Almost always, and wrongly, we confuse this feeling with the accidental and local impressions that in waking hours arouse, stimulate, and maintain the play of sensibility. These sensations, though inces- sant, make but a fugitive and transient appearance on the stage of consciousness, while the feeling in ques- tion lasts and persists, even beneath this ever mobile theatrical display. '^Condillac very appropriately called it the basic feeling of existence; Maine de Biran termed it, the feeling of sensitive existence. Through this feeling, the body incessantly appears to the ego as its ow?t, and through it the spiritual subject feels and per- ceives itself to exist, locally, as it were, within the limited extent of its organism. Like a constant, un- failing admonisher, it renders the state of the body in cessantly present to consciousness, and thus, in the most intimate manner, displays the indissoluble bond subsisting between psychic and physiological life. In the usual state of equilibrium, which constitutes the state of perfect health, this feeling, as I said, is con- tinuous, uniform, and is always equal, which prevents it from reaching the ego and attaining the state of dis- tinct, special, and local sensation. In order to be dis- tinctly remarked, it must acquire a certain intensity. This organic feeling is then expressed by a vague im- pression of well-being, Or of general distemper ; the former denoting a simple exaltation of vital physio- logical action ; the latter its pathologic perversion. But in such case it does not fail to localize itself under the form of particular sensations, connected with some ORGAN J C DISORDERS. 23 certain region of the body. It often reveals itself in a more indirect, yet far more evident, manner, when it chances to fail in any given point of the organism ; for example, in a limb struck by paralysis. Such a limb still naturally clings to the living aggregate, but it is no longer included in the sphere of the organic ego — if vi^e may use this expression. The affected limb ceases to be perceived by the ego as its own, and the fact of this only negative separation is expressed by a particular, positive sensation, known to all, who have experienced a complete numbness of any member caused by cold or a compression of the nerves. The sensation is nothing more than the expression of the break or loss which the universal feeling of physical life suffers ; it proves that the vital state of the limb in question really existed, though obscurely felt, and that it constituted one of the partial elements of the gen- eral feeling of life of the organic whole. In this man- ner any continuous, monotonous noise — as that of a carriage in which we happen to be riding — ceases to be perceived, although continuing all the time to be heard ; for if it suddenly stops, its cessation will be instantly remarked. " This analogy helps us to understand the nature and mode of existence of the basic feeling of organic life, which in this hypothesis simply would be a resultant '^171 confuso'^ of the impressions produced upon the living points by the internal movement of the func- tions carried to the brain, whether directly by the cer- ebro-spinal nerves, or mediately by the nerves of the ganglionic system."* Since the time when this passage was published *Note to his edition of the "Rapports du physique et dn moral," by Cabanis, pp. io8, 109. 24 DISEASES OF PERSONALITY. (1844) psychologists and physiologists have been at work studying the elements of this organic or general sense of the body. They have determined what each vital function contributes as its own share ; they have shown how complex this confused feeling of life is, which, by means of incessant repetition has become ourselves ; and that searching after it would be equiv- alent to seeking for ourselves. Consequently we know it only through the variations that raise it above, or lower it beneath the normal tone. The reader in va- rious special works'^ will find the detailed study of these vital functions and their general physical contributions. It is not our purpose here to enter upon a special in- vestigation of these topics, and therefore a condensed recapitulation will be sufficient. In the first place, we have the organic sensations attached to respiration: the feeling of comfort produced by pure air ; of suffocation from close air ; those arising from the alimentary canal, and others, still more gen- eral, connected with the state of nutrition. Hunger and thirst, for example, despite appearances, have no precise localization ; they simply result from a discom- fort of the whole organism. They are the loud plead- ings of a too impoverished blood. As regards thirst especially, the experiments of CI. Bernard have shown that it arises from lack of water in the organism, and not from dryness of the pharynx. Of all the functions, general and local circulation exerts, perhaps, the great- est psychological influence, and its variations import the most from individual to individual, and according to the different moments, within the same individual. Let us further recall to mind the organic sensations * See particularly Bain : The Senses and Intelligence. Part I. Ch. II. and Maudsley : Pathology of the Spirit. ORGANJC DISORDERS. 25 that arise from the state of the muscles : the feeling of fatigue, exhaustion, or its reverse ; finally the group of muscular sensations which, associated to the external sensations of sight and touch, play such a prominent part in the creation of our knowledge. Even reduced to itself alone, in its purely subjiective form, muscular sensibility will reveal the degree of contraction or re- laxation of the muscles, the position of our limbs, etc. I purposely omit the organic sensations of the genital apparatus ; I shall revert to it when studying the emo- tional bases of personality. If the reader will conceive for a moment the mul- titude and diversity of the vital actions just cited in a general way, he will be able to form a certain idea of what must be understood by the expression : physical bases of personality. Constantly active, they make up by their continuity for their weakness as psychic ele- ments. Hence, as soon as the higher forms of mental life disappear, they pass to the front rank. A clear example of this exists in dreams (whether pleasant or painful) aroused by organic sensations; as night-mares, erotic dreams, etc. In these dreams, even with a cer- tain degree of precision, we may assign to each organ the part that belongs to it ; the sensation of weight seems mainly attached to the digestive and respira- tory organs ; the feeling of struggle and combat to af- fections of the heart. In more rare instances patho- logical sensations, unperceived during waking hours, will re-echo during sleep like premonitory symptoms. Armand de Villeneuve dreams that he is bitten in the leg by a dog ; and a few days later that same leg is at- tacked by a cancerous ulcer. Gessner in his sleep fancies that he is bitten in the left side by a serpent ; a little later on the very spot there developed an anthrax 26 DISEASES OF PERSONALITY. of which he died. Macario dreams that he has a very sore throat ; he rises in normal health ; but a few hours later is attacked by an intense amygdalitis. A man sees in a dream an epileptic ; a short time after- wards he himself becomes one. A woman dreams that she speaks to a man who cannot reply to her, because he is dumb ; at her waking she herself has lost the power of speech. In all these cases we take for facts those obscure incitations which, from the depths of the organism, reach the nervous centres, and which, amid all its turmoil and perpetual mobility, conscious life hides from us instead of revealing. It is clear that the exclusive faith which psychology has so long accorded the mere data of consciousness, would throw into the shade the organic elements of personality ; but, on the contrary, in a professional way, physicians, as a matter of course, were expected to cling to it. The doctrine of the temperaments, old as medical science itself, ever criticized and ever re- molded,* is only a vague and fleeting expression of the principal types of the physical personality, such as furnished by observation, and with the main psychical traits that flow hence. The few psychologists, accordingly, who have stu- died the problem of the different types of character, have sought their ground of support in this doctrine. Kant did so more than a century ago. If the determina- *Henle has attempted recently (Anthropological Lectures, 1877, p. 103- 130), to attach the temperaments to the different degrees of the activity, or tonus, of the sensitive and motor nerves. When this degree is at its lowest, we obtain the phlegmatic temperament. At a high degree, with a rapid ex- haustion of nerves, we have the sanguine temperament. The choleric also supposes a high tonus, but with persistence in the nervous action. The mel- ancholic temperament cannot be defined by the simple quantity of the nervous action ; it supposes a high tonus, with the tendency to emotions rather than to voluntary activity. ORGANIC DISORDERS. 27 tion of the temperaments at any time could become scientific, the question of personality would be greatly simplified. Until this takes place, the most relevant point will be, to rid ourselves of the purely preconceived notion, that personality is a mysterious attribute, dropped down from the skies, and without antecedents in na- ture. If we simply cast a glance at the animals that surround us, we shall have no difiiculty in admitting, that the difference between horses and mules, between geese and ducks, their ''principle of individuation," can onl}^ be derived from a difference of organization and of adaptation to environment, with the ps3xhical consequences that thence result ; and that in the same species the differences of one individual from another cannot originally be owing to any other cause. In the natural order of things there is no reason for making an exception of man; apart from the fact that in man the excessive development of intellectual and emo- tional faculties causes illusion, and hides the primitive origin. Does physical personality exist in nature ? Under- standing by physical personality the mere sense of a state of organized being ; a mode of being where, by supposition, all consciousness, whether clear or ob- sure, actual or reproduced by some external circum- stance, would be absent? Evidently not as regards the higher animals ; phy- sical personality, in the sense explained, can be pos- ited only as a very artificial abstraction. It is prob- able, that this form of psychic individuality, consisting simply in the consciousness which the animal has of its own body, exists m very low species, yet not in the lowest. 28 DISEASES OF PERSONALITY. In the latter, — e. g., in multicellular individuals composed of cells entirely similar among them- selves, — the constitution of the organism is to such a degree homogeneous, that each element lives apart by itself, and each cell has its own particular action and reaction. But their entirety no more represents an individual than six horses, drawing a carriage in the same direction, constitute one single horse. Here there is neither coordination nor consensus, but simply juxtaposition in space. If, with certain authors, we attribute to each cell the analogue of consciousness (which only would be the psychic expression of their irritability), we should obtain consciousness in a state of complete diffusion. From one element to the other there would exist a degree of impenetrability, that would leave the entire mass in the condition of living matter, without even an external unity. In a higher order, however, for example in Hydras, observation is able to prove a certain consensus in the actions and reactions, and a certain division of work. Yet the individual is very precarious. Trembly, by aid of his scissors, out of a single individual was able to make fifty. Inversely, of any two Hydras we can make one ; it is sufficient to reverse the smaller, before introducing it into the larger specimen, in a manner that the two endoderms touch and merge into each other. If allowed to venture an opinion on this obscure matter, I should say that this kind of adapta- tion of movements might denote a certain, tem- porary, unstable unity, subject to circumstances, yet, perhaps, not entirely destitute of a certain obscure consciousness on the part of the organism. If we find that we are still too low, we may re- ascend the series (for every determination of this kind ORGANIC DISORDERS. ' 29 is arbitrary), in order to fix the point at which the animal has only the consciousness of its organism, of what it undergoes and produces — or, has but one organic consciousness. This form of consciousness, in the pure state, perhaps, does not even exist ; for, as soon as any rudiments of the special senses appear, the animal transcends the level of general sensibility. But, on the other hand, does general sensibility alone suffice to constitute a consciousness? It is known, that the human foetus makes efforts to extricate itself from any inconvenient position, to escape the impression of cold or of painful irritation ; yet, are all these merely unconscious reflexes ? I hasten away from all conjectures of this kind. One thing, at least, is incontestable ; viz., that organic consciousness — (the consciousness which the animal has of its body and only of its body) — in the greater part of animal existence exerts an enormous pre- ponderance; that it stands in inverse ratio to the higher, psychic development ; and that, everywhere and always, this consciousness of the organism is the basis upon which all individuality rests. Through it all is ; without it there is nothing. Indeed, it would be impossible to imagine the contrary; for, do not external impressions — that first matter of all mental life — enter through the organism, and — what is still more important — are not instincts, feelings, aptitudes, proper to each species, to each individual, stamped and fixed by heredity in the organism — we know not how, but as proved by facts — with an unalterable soHd- ity? 30 DISEASES OF PERSONALITY. II. If, accordingly, we admit that the organic sen- sations proceeding from all the tissues, organs, and movements produced— in a word, from all the states of the body — are in some degree and form represented in the sensorium ; and if the ph57sical personality be only their sum total, it follows that personality must vary as the}^ vary, and that these variations admit of all possible degrees, from simple distemper to the total metamorphosis of the individual. Instances of ' ' double personality " about which there has been great discussion, (we shall later speak of it,) are but an ex- treme case. By dint of patience and careful in- vestigations we should find in mental pathology enough observations to establish a progression, or rather a continuous regression from the most transient change, to the most complete alteration of the ego. It is an incontestable fact, that the ego exists only on the condition of continually changing. As regards its identity this is only a question of quantity. Its identity will persist as long as the sum of the states that remain relatively fixed is greater than the sum of the states that are added to or detached from this stable group. For the present we have onty to stud}^ the irregu- larities of personality that are immediately connected with organic sensations. Since, by itself, general sen- sibility has only a very feeble psychic value, it pro- duces only partial disorders, except in cases where the alteration is total or sudden. By way of a beginning, we shall here notice a state which can hardly be called a morbjd state, yet pro- ORGANIC DISORDERS. 31 bably is well-known to all, and consists in an alternate feeling of exuberant vitality or of depression, without apparent cause. In these states the usual tone of life changes, rises, or falls. In the normal state there is a positive ''euphory"; neither comfort nor discomfort arise from the body. Often, on the other hand, the vital functions become exalted ; activity superabounds and seeks to expend itself; everything seems easy and profitable. This state of weU-being, at first entirely physical, is propagated to the whole nervous organi- sation, and arouses a multitude of pleasant feelings, to the exclusion of contrary ones. Everything looks bright. At other times the reverse will happen, as in states of disease, despondency, listlessness, impotence and — as consequences of grief — in fear, in painful and depressing feelings. At such times everything looks black. In either instance, however, there is no news, no event, in fact, nothing external to us, to justify this sudden joy or sadness. Surely, in an absolute sense, it cannot be here said, that personality has been transformed. Relatively it has been so. The individual man has been changed, is not the same as before to himself, or better still, to those who know him. This, when translated into the language of analytic psyshology, simply means, that this personality is constituted by elements, some re- latively fixed, but others variable ; that the variabiHty having by far exceeded its average value, the stable portion has been affected, yet has not disappeared. Now, if instead of disappearing merely to return after a brief delay to the normal state, we suppose that this change persists (a supposition that is daily real- ized; ; in other words, if the physical causes that induce this change are permanent, instead of being 32 DISEASES OE PERSONALITY. transitor}^, in such instance there is formed a new physical and mental habitude, and the centre of gravity of the individual shows then a tendency to displace- ment. This first change may then give rise to others so that the transformation is constantly on the increase. For the present I shall not discuss this subject at length. I simply wished to prove that from a normal state we may by imperceptible stages descend to the state of complete metamorphosis ; or that it is purely a question of degree. In studying the disorders of personality, it is im- possible strictly to determine those that have their immediate cause in the perturbations of general sen- sibility, because these latter by a secondary action excite psychic states of a higher order (hallucinations, feelings, and morbid ideas). I shall limit myself to instances in which they appear to preponderate. We shall find in the ^'- Annales medico-psycholo- giqiies^^ "^ five observations, which the author has grouped under the title: "^^An aberration of the physical personality." Without caviling about the title, which, perhaps, conveys somewhat more than it ought, we are shown in the examples quoted how an unknown organic state, an alteration of the coenaes- thesis, /. e. of the organic sense, without any external cause, may produce a feeling of corporeal annihilation. "In the fullness of health, and in the possession of exuberant vitality and strength the person experiences an ever increasing sensation of weakness, to such a point, that every moment he has the fear of falling into syncope, and of ceasing to exist." Otherwise the sensibility remains intact; the patient eats with ap- * §ept. 1878. 56 Serie, tome XX, pp. 191-223. ORGANIC DISORDERS. ■^2> petite, and if we attempt to oppose his will, he will react with the utmost energy; still- he will keep re- peating that he feels like one dying ; that he is slowly passing away ; that there are left to him only a few hours to live. Very naturally, upon this purely phys- ical foundation at the same time there are grafted any number of delirious conceptions : one subject be- lieves himself to be poisoned, another maintains that some demon has entered into his system, and is actually ''sucking away his life," etc. Let us, however, confine our attention to the im- mediate consequences of the physical state. We here encounter that state of despondency, already described, and known to everybody, yet here in a much more serious and stable form. The mental distemper in- creases in proportion and systematizes itself. The in- dividual tends to be no longer the same. This forms a new stage toward the dissolution of the ego, al- though as yet far from having been reached. This beginning of transformation, due to exclu- sively physical causes, is also met with in persons who maintain that they are enveloped in a veil or cloud, cut off from the external world, insensible. Others enjoy with delight the hghtness of their bodies ; will feel as if suspended in mid-air ; believe they are able to fly j or have a feeling of heaviness either in the whole body, in certain hmbs, or in a sin- gle limb that seems stout and heavy — all of which phenomena are naturally explained from disorders of the muscular sensibility. ''A young epileptic at times felt his body so abnormally heavy, that he scarcely was able to support it. At other times he felt so light that he believed he did not touch the ground. Sometimes it seemed to him, that his body had assumed such 34 DISEASES OE PERSONALITY. huge dimensions that it would be impossible to pass through a certain door-way."* In the case of the latter illusion, which relates to the dimensions of the body, the patient feels himself much smaller or much larger than in reality he is. The local perversions of general sensibility — al- though by nature limited — are not of less psychologic importance. Some subjects will assert, that they no longer have teeth, mouth, stomach, intestines, brain : which can only be explained through a suppression or alteration of the internal sensations that exist in the normal state and contribute to constitute the notion of the physical ego. To the same cause, at times aggravated by cutaneous anaesthesia, we must refer certain cases in which the patient believes, that one of his limbs or even his whole body is of wood, glass, stone, butter, etc. After a while, he will say, that he has no body at all, that he is dead. Instances of this kind are really encountered. Esquirol speaks of a woman who be- lieved that the devil had carried off her body ; the sur- face of her skin was completely insensible. The phy- sician Baudelocque, during the last period of his life, had lost all consciousness of the existence of his body : he maintained that he no longer possessed head, arms, etc. Finally, there is a widely known instance related by Foville. "A soldier believed himself to be dead ever since the battle of Austerlitz, at which he had been seriously wounded, f When asked about his con- dition, he would answer : ' You wish to know how fares old Lambert ? He is no more ; he was carried off by a cannon-ball. What you see there is not him- * Griesinger : Traite des jnaladies mentales, trans. Doumic, p. 92. t Michea, Annales inedico-psychologiques , 1856, p. 249 et seqq. ORGANIC DISORDERS. 35 self, but only a wretched machine that has been made like him ; you ought to ask them to make another one.' In speaking of himself, he never said 'I,' but 'that thing.' His skin was insensible, and often he would fall into a state of complete insensibility and immobility, lasting several days." In the case just mentioned, we enter into the realm of serious perturbations ; meeting for the first time with an instance of double personality, or more strictly speaking, a discontinuity, a lack of fusion between two periods of psychic life. The present case might * be explained as follows. Before his accident, this sol- dier, like everybody else, had his organic conscious- ness, the sense, the feeling of his own body, of his physical personality. After the accident an internal change was brought about in his nervous organization. Concerning the nature of this change, unfortunately, we can only form hypotheses, the effects alone being known. Whatever it may have been, it resulted in giving birth to another organic consciousness — that of a "wretched machine." No kind of amalgamation had been effected between the latter and the older consciousness — the recollection of which had tena- ciously remained with the patient. The feeling of identity, accordingly, is lacking ; because in the or- ganic states as well as in others, this feeling can only result from a slow, progressive, and continuous assi- milation of the new states. Here, the new states did not enter the old ego as an integral part. Hence, that odd situation in which the old personality appears to itself as having been, and as being no more, and in which the present state appears as an external, strange thing, and as not existing. It may be re- marked, in fine, that in a state where the surface of . ^6 DISEASES OF PERSONALITY. the body no longer yields sensations and where those that do arrive from the organs are equivalent almost to none at all ; where both superficial and deep sen- sibilit}^ is extinguished — that in such a state the or- ganism no longer excites those feelings, images, and ideas that connect it with higher psychical life. The organism is simply reduced to the automatic acts that constitute the habitude or routine of life, or properly speaking, it becomes ''a. machine." Strictly viewed, we are, indeed, allowed to as- sume, that the only personality in this example is the personality which recollects ; we must nevertheless acknowledge, that it is of a very extraordinary nature, existing only in the past ; and that, instead of calling it a person, it would be more correct to call it a memor3^ What distinguishes the above-mentioned instance from those of which we shall speak elsewhere, is pre- cisely this, that here the aberration is altogether phy- sical, springs solely from body and bears solely upon the body. The old soldier did not believe himself to be another (Napoleon, for example, although the lat- ter also had been at Austerlitz). The present case is as free as possible of intellectual elements. The illusion of patients or convalescents, who be- lieve themselves double, must also be referred to per- turbations of general sensibility. At times there is pure and simple illusion without doubling, where the morbid state is projected outward, and the individual alienates a part of his physical personality. Such, are the cases of the patients, of whom Bouillaud speaks, who having lost the sensibility of half of the body, imagine to have beside them in bed an other person, ^or even a corpse. But when the group of organic ORGANIC DISORDERS. 37 sensations of a morbid nature, instead of thus being alienated, clings to the normal, organic ego and for some time coexists with it, without fusion, then and for just this space of time the patient believes that he has two bodies. '^ A certain convalescent from a fever believed himself to consist of two individuals, of which one was in bed, while the other was walking about. Although without appetite, he ate a great deal ; having, as he said, two bodies to feed." * ''Pariset, in his early youth having been affected by typhus during an epidemic, remained several days in an extremely low state, verging on death. One morning there suddenly awoke a more distinct feeling of himself. He began to think, and seemed to ex- perience a genuine resurrection ; but, strange to say, at the same instant he had, or believed to have, two bodies ; and these bodies seemed to him to be resting in two different beds. In so far as his soul was present in one of these bodies, he felt recovered, and enjoyed delightful repose. In the other body his soul suffered, and he argued with himself : Why am I so well in this bed and so ill and oppressed in the other ? This thought preoccupied him for a long while. Pariset himself — a man most subtle in psychological analysis — has many times told me the detailed his- tory of the impressions which at that time he ex- perienced, "f In the above we possess two instances of double physical personality. Although as yet we are not far advanced in our study, the reader, at all events, is able to see, how the two cases referred to, when closely examined, are really unlike. The current term * Leuret, Fragiitents psychologiqiies sur la/blie, p. 95. t Gratiolet, Anatomze coviparec du systhne nerveux. Vol. II, p. 548. 38 DISEASES OF PERSONALITY. "double personality" is but an abstraction. As soon as we translate it into concrete facts, into authen- tic observations, we shall only find diversity. Each case, as it were, asks for a particular interpretation ; and a priori we certainly might expect one. Per- sonality — as we maintain, and as we shall further attempt to prove — being a very compound complex, it clearly follows that its perturbations likewise must be multiform. Each case shows it as differently decom- posed. Disease becomes a subtle instrument of an- alysis, and furnishes us experiences that are inacces- sible by any other method. The difficulty is to inter- pret them satisfactorily ; but even errors will only be transitory, since the facts which the future has in store will serve either to verif}^ or rectify them. III. The part sustained by the physical personality as an element in the make-up of the complete person- ality is so important and has been so much neglected, often indeed intentionally, that too much light cannot be shed upon it. In this connection we may derive much profit from the consideration of a number of rare cases which psychology has overlooked, but which bring to the support of our thesis the supple- mental evidence of facts which, although they are not more convincing, are at least more striking. I refer to cases of double monsters. We must admit that the available data in such cases are very meagre. Nature does not multiply monsters, and among the seventy or eighty species pointed out by teratologists, the majority have no in- terest for us. Of double monsters, moreover, many ORGANIC DISORDERS. 39 do not reach the adult age. The anatomist and phys- iologist, consequently, may learn much from such prodigies ; but this, it will be seen, is not the case with the psychologist. And, furthermore, really trust- worthy observations on this subject seldom reach back further than a century. In everything beyond that date the marvellousness and vagueness of the de- scriptions recorded nullifies any value they might pos- sess. The ego, it has been repeatedly affirmed, is im- penetrable ; it forms in itself a complete, a perfectly circumscribed whole, the which is a proof of its essen- tial unity. This assertion, as a matter of fact, is in- contestable ; but that impenetrability is merely the subjective expression of the impenetrability of the or- ganism. One ego cannot be another ego, for the reason that one determinate organism cannot at the same time be a different organism. But if, through a concurrence of causes which we need not here enu- merate, two human beings, whose condition dates back to the foetal stage, be united at some, part of their bodies, while both their heads, the essential or- gans of human individuality, remain perfectly separate, the following condition of affairs will be presented : namely, each organism will no longer be completely limited in space, and distinct from every other organ- ism ; there will be a joint and undivided part common to both ; and if, as we maintain, the unity and com- plexity of the ego are but the subjective expression of the unity and complexity of the organism, there will be of necessity, in the case now presented, a partial penetration of the one ego by the other, and there must exist a determinate element of psychic life that is held in common, and that cannot be said to belong 40 DISEASES OF PERSONALITY. to an I, but must belong to a We. Each indivi- dual is thus a little less than an individual. And this has been fully corroborated by experience. '' From an anatomical point of view a double monster is always more than a unitary individual, and less than two ; yet at times it approaches closer to unity, and again closer to duality. In the same way, from a physiological point of view, a double monster is always endowed with something more than unitary life, and with something less than two lives : but its double life may incline in the one case more to unity, or in the other more to duality. '* Regarding merely the phenomena of sensibility and of will, a monster composed of two almost com- plete individuals, united simply at a given part of their body, will be double, morally as well as phys- icalty. Each individual will have a sensibility and a will of his own, the effects of which will extend to his own body, and to his alone. It may even happen that the twins, while widely different in facial outlines, stature, and physical constitution, will be no less so in point of character and degree of intelligence. At the same instant the one will be merry, and the other sad ; one will be awake, while the other will be asleep ; one will want to walk while the other wishes to rest ; and from this conflict of two wills, animating two bodies indissolubly bound together, certain movements may arise that are wholly without results, that will be neither resting nor walking. These two human halves may quarrel, or even come to blows. . . . And thus their moral duality, the consequence of their physical duality, may be demonstrated by a hundred proofs. At the same time, however, since there exists a point of junction in the double body, situated at the line of ORGANIC DISORDERS. 41 division of the two component individuals, and com- mon to both, other phenomena, less numerous though they be, show in them a beginning of unity. *' Impressions made upon the region of union, es- pecially if made at its central point, are perceived at the same time by both brains, and both are able to react upon the impressions in the same manner. . . . Let us add, that although peace may often be ruptured between the twins, still there nearly always prevails between them a harmony of feelings and desires, sym- pathy and reciprocal attachment, the full extent of which it is impossible to comprehend without having read the entire evidence .... ''The same, and also different, phenomena are present where, by a still more intimate union, we find two heads upon one body, and with but a single pair of legs. Anatomical examination proves that in such beings each individual possesses for himself one side of the common body, and one of the two legs. The ob- servation of physiological and psychological phenom- ena fully corroborates this singular result. Impres- sions made at any point along the axis of union, will be perceived at the same time by both the heads ; be- yond and at a distance from the axis impressions are perceived by but one head ; and what is true of the sensations is true of the will. The right brain is the seat of perception for the right leg alone, and it alone will act upon the right leg; and so the left brain alone acts upon the left leg, so that the act of walking will result from movements executed by two limbs belong- ing to two different individuals, and co-ordinated by two distinct wills. ''Finally, in parasitic monsters, where the organ- ization almost becomes unitary, all vital acts, sensa- 42 DISEASES OE PERSONALITY. tions, and manifestations of will are performed almost exactly as they are in normal beings. The smaller of the two individuals, having become an accessory and inert portion of the larger, exerts but a feeble influence upon it, limited to a very small number of functions.'"*" To these general traits we shall add a few details borrowed from the most remarkable instances. We possess numerous records concerning Helen and Judith, a twin female monster, born at Szony (Hungary) in 1701, died at Presbourg at the age of twenty-two years. The bodies were placed almost back to back, united in the sacro-pelvic region and part of the loins. The sexual organs were double ex- ternally, but with a single vulva hidden between the four thighs ; there were two intestines terminating in a single anus. The two aortas and two inferior venae cavae were united by their extremities, and thus formed two large and direct communications between the two hearts, and hence a semi-communion of life and func- tions. '^ The two sisters had neither the same temper- ament nor the same character. Helen was taller, prettier, more agile, more intelligent, and of a sweeter disposition. Judith, at the age of six years was at- tacked by paralysis, which retarded her growth and development ; her temperament was consequently more sluggish. She was slightly malformed, and had a somewhat difficult utterance. Nevertheless, like her sister, she spoke Hungarian, German, French, and even a little English and Italian. Each seemed to feel a tender affection for the other, although in their infancy they sometimes had quarrelled, and even come *I. Geoffroy Saint-Hilaire, Histoire des Anomalies, Vol. Ill, p. 373. The monster called " Home's epicome " (a monstrosity in which a second head grew from the first) had a parasitic head that only presented a very imperfect delifieation of the normal life. ORGANIC DISORDERS. 43 to blows. The needs of nature were felt simultaneously except in the case of urination. They had simultane- ously been afflicted with measles and small-pox ; and if other maladies attacked either one, the sister would experience at the same time internal discomfort and keen anxiety. Finally Judith was attacked by a dis- ease of the brain and lungs. Helen, after suffering for several days from a low fever, suddenly lost her strength, yet preserving the clearness of her mind and the faculty of speech. After a brief illness she suc- cumbed a victim, not to her own, but to her sister's maladies. Both expired at the same moment." The Siamese twins, Chang-Eng, born in 181 1 in the kingdom of Siam, were united from the navel to the xiphoid appendix. After a description of their external peculiarities, I. Geoffroy Saint-Hilaire adds : ^'The two brothers, also in their other functions [other than respiration and arterial pulsation], evince a re- markable concordance, though not absolutely constant, as people have been pleased to maintain, and as Chang and Eng themselves have stated to persons who were satisfied with addressing them a few vague questions. There is, doubtless, nothing stranger than the contrast of an almost complete physical duality and an absolute moral unity \ but,at the same time,nothing is more con- trary to sound theory. I have made careful observa- tions, and gathered together every information that could enlighten me concerning the value of the above too frequently repeated assertion ; and I have found, that in the conflict between the disregarded principles of theory, and all the psychological assertions of which the unity of the Siamese twins has formed the inex- haustible topic, the facts — ^_as was to be expected — have •declared themselves in favor of the former. Twins 44 DISEASES OF PERSONALITY. formed according to two almost identical types; in- evitably submitted during their life to the influence of the same physical and moral circumstances ; similar in point of organisation and education — the Siamese brothers became two beings whose functions, actions, words and even thoughts, are almost always con- cordant, conceived and produced parallel to each other. . . . Their joys and griefs are common. In these twin-souls the same desires are manifested at the same instant; a phrase, begun by the. one is often finished by the other. But all these concordances only prove parity, not unity. Other twins in the nor- mal state present analogies of this kind, and, doubt- less would reveal even more remarkable ones, if dur- ing their whole life they had always seen the same ob- jects, felt the same sensations, enjoyed the same pleas- ures, and suffered the same griefs. . . .'"*' As regards the Siamese, twins I may add that with advancing age and through the effect of circumstances their differences of character became more marked, and that one of the latest observers described one of the two brothers as morose and taciturn, the other as gay and cheerful. The subject of the present work, however, is not the psychology of double monsters, since they only figure as examples of the deviations of physical per- sonality. I shall, accordingly, only recall to mind the recent case of Milie and Christine, in whom the sensi- bility of the inferior limbs is common. The two spinal cords must in consequence form a genuine commissure at the level of the point of union. The civil and ecclesiastical laws, which are inter- ested in this problem under several heads, (questions * As regards further details, see the above-quoted work Vol. Ill, p. 90,. and following. ORGANIC DISORDERS. 45 of civil condition, marriage, right of succession, bap- tism, etc.,) have not hesitated to acknowledge two persons where two distinct heads existed, and justly so, although practically certain perplexing instances might be met with. The head in man being the true seat of personality — the locality in which the synthesis of the latter takes place — it may upon the whole be said to represent the individual. Later on we shall see in descending the scale of animal existence that this point is more doubtful. But, if the question is discussed scientifically, it is impossible in double mon- sters to consider each individual as complete. I shall not weary the reader with entirely useless comments, since the facts speak for themselves. If the reader carefully examines the preceding passages, he will convince himself that, even where the per- sonalities are the most distinct, there exists a com- plication of organs and functions to such an extent that each cannot be itself except on condition of being more or less the other, and itself being conscious of the fact. The ego, accordingly, is not an entity acting where it chooses or as it pleases ; controlling the organs in its own way, and limiting its domain according to its own wish. On the contrary, it is a resultant, even to such a degree that its domain is strictly determined by the anatomical connections with the brain, and that at one time it represents an entire body, less an undi- vided part, and at another time the half of a body, and in parasitic monsters such a limited domain, that it does not suffice to support life, and accordingly is expelled prematurely. 46 DISEASES OF PERSONALITY. IV. In order to prove once more and in another man- ner that the principle of individuation is the organism ;: that it is such without restriction, immediately through the organic sensations, but mediately through the emotional and intellectual states, of which we shall speak later \ let us examine what takes place in cases of twins. Psychology has not concerned itself about the latter, any more than about cases of double mon- sters, while at the same time modern biologists furnish a number of very curious data. In the first place, we must recall to mind that twins represent on the average of births about i in 70. The- cases of triplets or quadruplets are very rare^ not more than I in 5000, and i in 150,000 respectively; ta mention instances of these would uselessly complicate our researches. Let us further remember, that twins are of two species. Either each of them is germinated from a distinct ovule, in which case they may be either of the same or of a different sex ; or they may have issued from two germinative spots in the same ovule, and then they are enveloped within the same membrane and are invariably of the same sex. The latter instance alone yields two personalities that are strictly speaking legitimately comparable. Leaving aside animals, we shall abide by man and take the problem in all its complexity. It is evident, that since the physical and moral state of the parents is the same for both of the twin individuals, a cause of difference has thus been removed at the very mo- ment of procreation. As their development has for a starting-point the materials of the same fecundated ORGANIC DISORDERS. 47 ovule, there will exist a great probability of extra- ordinary likeness in the physical constitution, and consequently, according to our thesis, in their mental constitution also. Let us now glance at the facts that are in our favor ; and afterwards consider objec- tions and exceptions. The perfect resemblance of twins is a matter of common observation. Since remote antiquity this topic has furnished subject-matter to the humorous poets, and later it has more than once been used by modern novelists. But writers have generally limited themselves to external resemblances, resulting from stature, form, face, voice, etc. But, there are other much deeper resemblances. Even long ago physi- cians had observed that most twins also present ex- traordinary agreement of tastes, aptitudes, faculties,, even of fates. Recently Mr. Galton has made an inquiry on this subject, issuing lists of questions,, to which about eighty answers were returned, thirty- five with the addition of minute details. Mr. Galton's- aim, however, was totally different from our own. Through his researches upon heredity, he wished to determine by a new method the respective parts played by natur-e and education ; but among his material is much that is of profit to us.* Mr. Galton reports a number of anecdotes similar to those which have been long current : a sister tak- ing two music-lessons daily, in order to leave her twin- sister at liberty ; the perplexities of a certain col- lege-janitor, who, when a twin came to see his brother,. did not know which of the two he ought to allow to * They will be found under the title '-History of Twins " in his book Inquiries into Hujnan Faculty and its Development (pp. 216-242), London: Macmiilan, 1883. 48 DISEASES OF PERSONALITY. depart, etc. Others evince a persistent resemblance under circumstances scarcely favorable to preserve it. *'A. was again coming home from India, on leave ; the ship did not arrive for some days after it was due; the twin brother B. had come up from his quarters to receive A., and their old mother was very nervous. One morning A. rushed in saying, ' O mother, how are you ? ' Her answer was, ' No, B., it's a bad joke ; you know how anxious I am ! ' and it was a little time before A. could persuade her that he. was the real man." (p. 224.) But that which relates to mental organisation has a still greater interest to us. '' One point which shows the highest degree of resemblance between twins," says Galton, ''is the similarity in the association of their ideas. No less than eleven out of the thirty-five cases testify to this. They on the same occasion make the same remarks, begin singing the same song at the same moment, and so on : or one would commence a sentence, and the other would finish it. An observant friend graphically described to me the effect produced on hef by two such twins whom she had met casually. She said : 'Their teeth grew alike, they spoke alike, and together, and said the same things, and seemed just like one person.' One of the most curious anec- dotes that I have received concerning this similarity of ideas, was that one twin. A, who happened to be at a town in Scotland, bought a set of champagne glasses which caught his attention, as a surprise for his brother B ; while at the same time B, being in Eng- land, bought a similar set of precisely the same pat- tern, as a surprise for A. Other anecdotes of a like kind have reached me about these twins." {^Loc. cit. p. 231.) ORGANIC DISORDERS. 49 The nature and evolution of physical and men- tal maladies will also furnish very convincing facts. The latter only may interest psychology, but the former reveal a similarity in the innermost constitution of the two organisms which sight cannot discover in the form of external resemblances. '*! have attented professionally," says Trousseau, "a case of twin- brothers so marvellously like each other, that I was unable to distinguish between them unless I saw them side by side. This physical resemblance extended still further ; they had an even still more remarkable pathological resemblance. One of them, whom I saw in Paris, when he happened to be suffering from rheumatic ophthalmia, said to me : *At this very moment my brother must be suffering like me.' And as I strongly protested against such an idea, a few days later he showed me a letter that he had just received from his brother, then at Vienna, and who wrote : ' I have got my ophthalmia, you must have yours.' However strange this may appear, the fact nevertheless remains incontestable. It was not a circumstance related to me, but an actual fact that came within my own experience, and during my prac- tice I have witnessed other remarkable cases of this kind. "* Galton furnishes several examples of which we will cite only the following: ''Two twin-brothers, quite alike, warmly attached to each other, and having identical tastes, had both obtained government clerk- ships. They kept house together ; one of them sick- ened of Bright's disease and died of it; the other sick- ened of the same disease and died seven months later " (p. 226). We might fill whole pages with analogous instances. *Trousseau, Clinique Medicate, Vol. I, p. 253. " Leron sur I'asthme." 50 DISEASES OF PERSONALITY. In the case of mental diseases the same sympathy is observed ; a few examples of which will suffice. Moreau (de Tours) records a case of twins, physical^ alike, who were attacked by insanity. In both patients ''the predominant ideas are absolutely the same. Both be- lieve themselves to be the objects of imaginary per- secutions. The same enemies have sworn their ruin, and employ the same means to accomplish their ends. Both are subject to hallucinations of hearing. They never address a word to any one whatever, and with difficulty return an answer to questions. They always keep aloof from each other, and do not even com- municate between themselves. An extremely curious fact that has frequently been verified by the attendants of the ward and also by ourselves is the following : from time to time, at irregular intervals, of two, three, or several months, without apparent cause and through an entirely spontaneous caprice of their malad}^, there occurs a very marked change in the condition of the two brothers. Both, at the same time, often on the very same day, emerge from their state of stupor and habitual prostration; they make the same complaints and appeal to the physician to immediately restore them to freedom. I have seen this rather strange fact reproduce itself even when they were separated from each other by a distance of several miles; the one be- ing at the Bicetre, the other living on the farm Sainte- Anne."* T\\^ Journal of Mental Science \ has more recently published a case of insanity in twins, where we see * Psychologie morbide, p. 172. We also find an extraordinarily curious case in the Annales medico-psychologiques , 1863, Vol. I, p. 312. On the ques- tion of twins may be consulted the special work of Kleinwaechter : Die Lekrc von den Zwillingen, Prague, 1871. t April 1883, and Ball, De la folie gemellaire, in D Encephale . ORGANIC DISORDERS. 51 two sisters, resembling each other very closely in features, manners, language, and intellectual disposi- tion, '^to such a point that it would be very easy to mistake one for the other," and who, placed in dif- ferent wards of the same asylum, with no possibility of seeing each other, presented exactly the same symp- toms of mental alienation. We must nevertheless anticipate certain objec- tions. There are twins of the same sex, who are dis- similar, and although statistics do not tell us in what proportion true twins (issues of the same ovule) pre- sent these differences, it is sufficient if it takes place only in a single case to be worthy of a particular dis- cussion. Elsewhere * we have enumerated the nu- merous causes that in every individual tend from conception until death to produce variations, that is, certain marks peculiar to an individual, and differen- tiating it from every other. Here, as we have said, a certain category of causes must be eliminated : those which proceed immediately from the parents. But the impregnated ovule also represents ancestral in- fluences, — 4, 12, 28 possible influences according as we ascend to grandparents, great- grandparents, great- great-grandparents, etc. We can know only through experience which of them prevail j and to what ex- tent. As a fact, in this case it is the same ovule which serves to produce two individuals ; but nothing proves that everywhere and always there was made a rigorously equivalent division between both in re- gard to the quantity and quality of the materials. The eggs of all animals not only possess the same anatom- ical composition, but chemical analysis can only re- veal in them a few infinitesimal inequalities ; still, the * L'heredite psyckologique, 2nd edition, part II, ch. IV. 52 DISEASES OF PERSONALITY. one produces a sponge, the other a man. This ap- parent resemblance, accordingly, must hide profound differences, although it escapes our most subtle means of investigation. Do they arise from the nature of the molecular movements, as certain authors think ? We may suppose anything we please, on condition that we perfectly understand that the egg itself is al- ready a complex thing, and that any two individuals emerging from it, strictly speaking, cannot be similar. Our perplexity only arises from our ignorance of the processes according to which the primitive elements group themselves in order to constitute each indi- vidual, and in consequence, of the physical and psy- chic differences which thence result. Some of Gal- ton's correspondents have reported the curious fact of certain twins who were '' complementary to each other." ''There is," writes the mother of the twins, ^'a sort of reciprocal interchangeable likeness in ex- pression that often gave to each the effect of being more like his brother than himself." — ''A fact struck all our school contemporaries (writes a senior wrangler of Cambridge) that my brother and I were complement- ary, so to speak, in point of ability and disposition. He was contemplative, poetical and literary to a re- markable degree. I was practical, mathematical, and linguistic. Between us we should have made a very decent sort of a man." (pp. 224 and 240.) The phys- ical and mental capital seems to have been divided .between them not by equality but by equivalence. If the reader carefully considers how complex the psychic organization is in man ; how improbable it is, by the very reason of this complexity, that two persons should be the repetition of each other, although twins approach it to an astonishing degree, the reader, as I ORGANIC DISORDERS. 53 maintain, will irresistibly be induced to think, that a single perfectly verified fact of this kind proves more than even ten exceptions, and that the moral resem- blance is but the correlative of the physical resem- blance. If by an impossible hypothesis any two men were created in such a manner that their respective organisms were identical as to constitution ; that their hereditary influences were rigorously alike ; if, by a still greater impossibility, both received the same physical and moral impressions at the same moment, there would not be any other difference between them than that of their position in space. In closing this chapter, I feel somewhat ashamed of having accumulated so many data and proofs to establish a truth so evident to my eyes as the proposi- tion : As the organism, so the personality. I should have hesitated greatly to do it, if it had not been too easy to show, that this truth has been forgotten and disregarded rather than denied ; and that writers have almost always been contented to mention it under the vague law of the influence of the physical over the moral nature. The facts that up to this point have been studied cannot alone lead to a conclusion : they only pave the way for it. They have shown that, reduced to its last elements, physical personality presupposes the properties of living matter, and their co-ordination ; that, in the same manner as the body is only the or- ganized and co-ordinated sum of all the elements that constitute it, so also the physical personality is only the organized and co-ordinated sum of the same ele- ments as psychic factors. They express their nature and agencies, but nothing more. The normal state, the teratological cases, the resemblance of twins have 54 DISEASES OF PERSONALITY. proved it. The aberrations of the physical person- ality, or as M. Bertrand ingeniously calls them,* ''the hallucinations of the sense of the body" contribute an additional amount of evidence. But there are devia- tions of the human person, arising from other causes, and produced by a more complicated mechanism, which we will now proceed to investigate. * De V aperception du corps huntain par la conscience, p. 269 et seqq. CHAPTER II. EMOTIONAL DISORDERS. Before proceeding farther let us remind the rea- der once for all, (and this also applies to the intellectual derangements,) that we are still continuing our study of organic conditions, but under a different aspect. The desires, feelings, passions that impart to character its fundamental tone, have their roots in the organism and are predetermined by it. The same applies to even the highest intellectual manifestations. Still, as the psychic states here play a preponderating part, we shall treat them as the immediate causes of the changes of personality, without forgetting, however, that these causes are in their turn effects. Without presuming to give a rigorous classifica- tion of the emotional manifestations, which we have not to follow up in detail, we will reduce them to three groups of which the psychological complexity goes on increasing, while the physiological import- ance decreases. They are : (i) the tendencies con- nected with the preservation of the individual (nutri- tion, self-defense) ; (2) those relating to the preserva- tion of the species ; (3) the highest of all, those which presuppose the development of intelligence (moral, religious, aesthetic, and scientific manifesta- tions, ambition in all its forms, etc.) If we consider the development of the individual, we shall find that 56 DISEASES OF PERSONALITY. it is in this chronological order the sentiments appear. We see it in a marked degree in the evolution of the human species. Inferior human races — with whom education does not correct nature by furnishing the accumulated result of the work of centuries — never pass beyond the preservation of the individual and of the species, or at most exhibit only a slight trace of the sentiments belonging to the third group. The emotional states connected with nutrition con- stitute with the child in its early infancy the only ele- ments, as it were, of its nascent personality. Thence arise comfort and peevishness, desires and aversions. It constitutes that sense of the body about which we have spoken so much, arrived at its highest psychic expression. As natural causes, too manifest to need further explanation, cause nutrition almost exclusively to predominate with the child, it follows that the child has, and can only have, a personality. almost entirely nutritive, that is, the most indefinite aud lowest form of personality. The ego, for him who does not re- gard it as an entity, can here only be a compound of extreme simplicity. As we grow up from infancy the preponderating role of nutrition will diminish ; still, it will never completely lose its rights, because among all the prop- erties of the living being it alone remains fundamental. Thus it happens that important alterations of person- ality are associated with its variations. When nutri- tion is diminished, the individual feels himself de- pressed, weakened, contracted ; when it is increased, he feels himself excited, strengthened, expanded. Among all the functions whose harmony constitutes this basic property of life, the circulation seems to be that one of which the sudden variations have the EMOTIONAL DISORDERS. 57 greatest influence upon the emotional states and dis- play themselves by an immediate counter-stroke ; but let us leave aside detailed conjectures, in order to in- vestigate the facts. In the states known under the names of hypochon- dria, lypemania, melancholia (in all its forms), we find alterations of personality that imply all possible degrees, including complete metamorphosis. Among these different morbid states physicians have marked certain clinical distinctions, but these are not very important here. We can include them within a com- mon description. In such morbid states there is a feeling of fatigue, of oppression, anxiety, depression, sadness, absence of desires, permanent lassitude. In the most serious cases, the very source of the emo- tions is completely dried up : ''The patients have be- come insensible to everything. They have no longer any affection for parents or children, and even the death of persons that were dear to them, would leave them perfectly cold and indifferent. They cannot weep, and nothing moves them except their own suf- ferings."* As regards activity, there is torpor, loss of power to govern the actions or even the will, over- powering inaction for many hours, in one word, that "aboulia" (lack of will) of which we studied all the forms in treating of the diseases of the will. As re- gards the external world, the patient, without being under an hallucination, finds that all his relations to it are changed. It seems as if his habitual sensa- tions had lost their usual character. ''All that sur- rounds me," said one of them, "is still as formerly, and yet a change must have been effected ; things still have their old forms, I can see them perfectly well, * Falret, Archives generates de medecine, December, 1878. i8 DISEASES OF PERSONALITY. and yet they have also changed a great deal." One of Esquirol's patients complains that his existence is incomplete. "Each of my senses, each part of myself is, as it were, separated from me, and can no longer give me any sensation ; it seems to me that I never actually reach the objects that I touch." This morbid state, due sometimes to cutaneous anaesthesia, may increase to such an extent '^that it seems to the pa- tient that the real world has completely vanished out of sight, or is dead, and that there only remains an imaginary world, in which he is afraid of dwelling."* To this picture we may add the physical phenomena ; such as disturbances of the circulation, of the respira- tion, and of the secretions. The emaciation of the sub- jects may become considerable, and the weight of the body very rapidly diminish during the period of de- pression. The respiratory function is impaired, the circulation reduced, and the temperature of the body is lowered. By degrees these morbid states take form, organize themselves, concentrate themselves in some wrong conception, which — having been excited by the psy- cho-physiological mechanism of association — in its turn becomes a centre of attraction toward which everything converges. One patient will say that his heart has become petrified, another that his nerves are like burning coals, etc. These aberrations have innumerable forms, and vary according to individuals. In extreme cases the individual will doubt his own ex- istence, or deny it. A young man, while maintaining that he had been dead for two years, expressed his perplexity in the following words : "I exist, but out- * Griesinger, Traite des maladies mentales. Fr. trans, p. 265. V Ence- J>hale. June, 1882. EMOTIONAL DISORDERS. 59 side of real material life and despite myself, for noth- ing has really killed me. Everything in me is mechan- ical, and takes place unconsciously." Is not this con- tradictory situation, in which the subject claims to be alive and dead at the same time, the logical and nat- ural expression of a state in which the old ego and the new, vitality and annihilation seem to keep in equili- brium ? Still, the psychological interpretation of all these cases is not doubtful. They are organic disturbances, the first result of which is to depress the faculty of feeling in general, and the second effect is to pervert it. In this manner there is formed a group of organic and psychic conditions that tend profoundly to mod- ify the constitution of the ego in its inmost nature, because they do not act after the manner of sudden emotions, the effect of which is violent and superficial, but by slow, silent actions of unconquerable tenacity. At first this new mode of being seems strange or ex- traneous to the individual and outside of his ego. By slow degrees, however, and through habit, this new feeling insinuates itself into and becomes an integral part of the ego, changes its constitution, and when of an overpowering nature, entirely transforms it. In perceiving how the ego is dissolved, we under- stand also how it is made. In most instances, doubtless, the alteration is only partial. The individual, while seeming to become another to himself, and to those who know him, still preserves a fundamental feeling of himself. In fact, complete transformation can only be a very rare occurrence ; and we may besides ob- serve, that whenever a patient maintains that he is changed or transformed, he is actually right, notwith- standing the denials or hilarity of his friends. He 6o DISEASES OE PERSONALITY. really cannot feel otherwise, because his consciousness is but the expression of his organic state. Subjec- tively he is not the sport of any illusion ; he is merely what he ought to be. On the contrary it is the un- conscious unacknowledged hypothesis of an independ- ent ego, — existing by itself as an unalterable entity, — which instinctively urges him to believe, that this, change is only an external event, a strange or ridicu- lous garb in which his personality has been wrapped,, while in reality the change is internal, and implies, certain losses and acquisitions in the substance of the ego itself. * * * The counterpart of these partial alterations is met with in cases where the ego is exalted and elated, and ascends extremely far above its normal tone- Instances of this are found at the beginning of general paralysis, in certain cases of mania, during the excited period of so-called "cyclic" insanity. It forms alto- gether the inverse of the previous picture. Here we have a feeling of physical and moral well-being, superabun- dant strength, exuberant activity, which vents itself with reckless prodigality in speeches, projects, enter- prises, and incessant, fruitless journeys. To this super- excitation of the ps5^chic life corresponds an over- activity of all the organic functions. Nutrition in- creases — often at an exaggerated rate — respiration and circulation are quickened, the genital function is aroused ; and notwithstanding a great expenditure of force the individual does not feel any fatigue. After- wards these several states group themselves, become unified and finally to a considerable extent transform the ego. One individual may feel a herculean strength, and be able to lift prodigious weights, procreate thou- EMOTIONAL DISORDERS. 6i sands of children, race with a railway-train, etc. An- other subject is an inexhaustible mine of learning, imagines himself a great poet, artist, or inventor. At times the transformation approaches still nearer to complete metamorphosis ; and then the subject, en- tirely engrossed with the ^ feeHng of his matchless power, proclaims himself pope, emperor, god. "The patient," as Griesinger justly observes, "feeling proud, bold, cheerful; discovering in himself an unwonted freedom in all his decisions; and moreover, feeing the super-abundance of his thoughts, is naturally prone to ideas of grandeur, rank, riches, or some great moral or intellectual power, which alone can have the same degree of freedom, of thought, and will. This exag- gerated idea of force and of freedom must neverthe- less have a motive ; there must exist in the ego some- thing that corresponds to it; the ego must momentarily have become entirely another; and the patient knows no other way of expressing this change, than by pro- claiming himself a Napoleon, a Messiah, or some other exalted being." * It would be a mere waste of time to endeavor to show, that this transformation of the ego, whether partial or complete, momentary or permanent, is of the same nature as in the preceding instances, and that it assumes the same mechanism, with this sole difference that here the ego is dissolved in the inverse sense, not through defect but through excess. These alterations of personality into more or less, ■this metamorphosis of the ego, which either raises or lowers it, would be even more remarkable if in the same individual they followed at regular intervals. As a matter of fact, an instance of this very frequently * Op. cit., p. 333. 62 DISEASES OF PERSONALITY. happens in so-called '^ cyclic " madness, or insanity in. double form, essentially characterized by successive periods of depression and excitement, following each other at regular intervals, and in some patients with oc- casional intermissions of lucidity. And then the fol- lowing strange fact may be witnessed. Upon what might be called the primitive and fundamental per- sonality, of which there still remain a few greatly altered fragments, are grafted by turns two new^ personalities — not only quite distinct, but which wholly exclude each other. Here it is indispensable to give a summary of certain observations on the sub- ject.* A woman, observed by Morel, had been abandoned by her mother to a life of vice from the age of fourteen years. ''Later in her career, a prey to every pang of shame and wretchedness, she had no other resource than to enter a house of ill-fame. A year afterwards she was rescued from it and placed in the convent of the Good Shepherd, at Metz. There she remained for two years, and the too intense reaction in her feelings which occurred resulted in the outburst of a religious mania, which was followed by a period of profound stupidity." It is then, while under the treatment of the physician, she passes through alternate periods during which she imagines herself by turns a prosti- tute and a nun. On coming out of the period of stu- pidity, ''she resumes her work with regularity, speaks with becoming propriety ; but at the same time ar- ranges her toilet with a certain coquetry. The latter tendency thereupon increases, her eyes become spark- ling, her glances lascivious, she dances and sings. * They will be found in extenso in Ritti, Traite clinique de lafolie h double forme. Paris, 1883, observations XVII, XIX, XXX, and XXXI. EMOTIONAL DISORDERS. 63 Finally the obscenity of her utterances And her erotic solicitations necessitate her solitary confinement. She gives herself the name of Mme. Poulmaire, and fur- nishes the most cynical details of her former state of prostitution." Then again after a period of depres- sion ''she becomes meek and timid; and evinces the most scrupulous decency in her demeanor. She ar- ranges her toilet with extreme severity. The intona- tion of her voice is peculiar. She speaks of the con- vent of the Good Shepherd at Metz and of her desire to return there ; she now calls herself Sister Martha of the Five Wounds, Theresa of Jesus, Sister Mary of the Resurrection. She refrains from speaking in the first person : says to the sisters, Take our dress, this is our pocket-handkerchief. Nothing now belongs to her personally (according to the rule of Catholic con- vents.) . . . She sees angels who smile upon her, and has moments of ecstacy. " In another instance reported by Krafft-Ebing, a neuropathic patient of insane parentage, ''was during the period of depression disgusted with the world, preoccupied with the thought of approaching death, and of eternity, and then thought of becoming a priest. During the maniacal periods he is turbulent, studies furiously, will not hear a word more about theology, and only thinks of practicing medicine." An insane woman of Charenton, of a .very distin- guished and highly gifted mind, would change "from day to day in person, condition, and even in sex. At one time she would be a princess of royal blood, be- trothed to an emperor ; at another time a woman of the people and democratic ; to-day married and en- ceinte ; to-morrow once more a maiden. She would even at times believe herself to be a man ; and one 64 DISEASES OF PERSONALITY. day she imagined herself a political prisoner of im- portance, and composed verses upon the subject." Finally in the following case we find the complete formation of a second personality. ''A lunatic, an in- mate of the asylum at Vanves, " says Billod,* ^' about every eighteen months would let his beard grow and introduce himself to the whole house, quite changed in dress and manners, as a lieutenant of artillery, named Nabon, recently arrived from Africa, to become a sub- stitute for his own brother. He would say, that be- fore leaving his brother had imparted to him infor- mation respecting everyone ; and at his arrival he would ask and obtain the honor of being introduced to each person present. The patient thereafter for several months remained in a state of marked exalta- tion, adapting his whole conduct to his new individu- ality. At the expiration of a certain time, he would announce the return of his brother, who, as he said, was in the village and would come to replace him. Then one day he would have his beard shaved off, change his dress and manner, and resume his real name. But then he would exhibit a marked expression of melancholy, walking along slowly, silent, and soli- tary, usually reading the Imitation of Jesus Christ, and the Fathers of the Church. In this mental state — a lucid one perhaps, but one that I am far from con- sidering as normal — he would remain until the return of the imaginary Lieutenant Nabon." The two first of the above-mentioned cases con- clusively show an exaggeration, a considerable aug- mentation of what takes place in the normal state. The ego of all of us is made up of contradictory ten- dencies, such as virtues and vices, modesty and pride, * Annates fnedico-psychologiques ^ 1858, according to Ritti op. cit., p. 156. EMOTIONAL DISORDERS. 65 avarice and prodigality, desire for rest and craving for action, and many others. In the ordinary state these opposite tendencies are balanced, or, at least, that which prevails is not without a counterpoise. But here, through very well determined organic condi- tions, there is not only an impossibility of equilibrium, but a group of tendencies is hypertrophied at the ex- pense of the antagonist group, which is atrophied ; then a reaction takes place in an inverse sense, so that the personality, instead of consisting of those average oscillations of which each represents one side of hu- man nature, passes constantly from one excess to the other. Incidentally we may observe that these diseases of personality consist in a reduction to a more simple condition. But this is not the place to insist on this point. II. Nutrition being less a function than the basic prop- erty of all that lives, it follows that the tendencies and feelings that are connected with it have a very general character. The same does not apply to the preservation of the species. This function, connected with a determinate part of the organism, reveals itself hy feelings of a very precise character. Accordingly it is highly adapted to the purpose of verifying our thesis. For if personality is a compound, varying ac- cording to its constituent elements, a change in the sexual instincts will change it, a perversion will per- vert it, an inversion will invert it; and this is just what occurs. In the first place, let us call to mind certain facts which are .well known, although the conclusions which they would seem to impose are not generally drawn 66 DISEASES OF PERSONALITY. from them. At the period of puberty, a new group of sensations, and in consequence new feelings and ideas are developed. This afflux of unaccustomed psychic states — stable, because their cause is stable, co-ordinate among themselves because their source is the same — tends profoundly to modify the constitution of the ego. It feels itself undecided, tortured by a vague, latent distemper, the cause of which is not understood j by degrees these new elements of the moral life are as- similated by the old ego, enter into it, become a part of it, but at the same time make it a different one. The ego is changed ; a partial alteration of the per- sonality has been accomplished, the result of which has been to constitute a new type of character — the sexual character. This development of an organ and its functions with their train of instincts, images, sen- timents, and ideas, has produced in the neutral per- sonality of the child a differentiation, has made of it a male or a female, in the complete sense. Until this period there had existed only the foundation of it, by virtue of which, however, the change could be effected without a sudden shock, without a break between the past and the present, and without a complete change of personality. If now we pass from the normal development to exceptional and morbid cases, we find certain varia- tions or transformations of personality connected with the state of the genital organs. The effect of castration upon animals is well known. It is not less marked upon man. Leaving aside a few exceptions (some of which are recorded in history), eunuchs represent a deviation from the psychic type. According to Maudsley, they are selfish, cunning, de- ^ceitful, liars, destitute of moral sentiment, and fur- EMOTIONAL DISORDERS. 67 thermore exhibit marked impairment of intellectual vigor. '^^ Whether this moral degradation directly results from castration, as certain authors maintain, or in- directly from an equivocal social position, matters little, for our thesis : whether directly or indirectly, the cause remains the same. With hermaphrodites experience corroborates what might have been predicted a priori. With the ap- pearances of one sex they present some of the charac- teristics of the other ; but far from combining both functions they only exhibit incomplete organs usually destitute of sexual function. Their moral character is sometimes neutral, sometimes masculine, and at other times feminine. Abundant instances of this are found in writers who have studied the question. f ^'Sometimes the hermaphrodite, after showing a lively inclination for women, manifests through the sudden descent of the testicles completely opposite instincts." In a recent case observed by Dr. Magitot, an hermaph- rodite woman evinced alternately very pronounced feminine and masculine tastes. ''In general the emo- tional faculties and the moral dispositions experience the counter-effect of the defective conformation of the organs." Still, as Tardieu observes, ''it is only fair that we should make a large allowance for the influence of the habits and occupations that the mistake made as to their real sex has forced upon the individuals. Some males who from the first had been dressed, edu- cated, employed, and sometimes married as females, retained the thoughts, habits, and manners of women. Such was the case of Maria Arsano, who died at * Pathology of Mind, p. 454. + As regards the facts, see Isid. Geoffroy Saint-Hilaire : Histoire des ano- malies, t. II. p. 65 and following. Tardieu and Laugier, Dictionnaire de medi- cine, art. " Hermaphrodisme," etc. 68 DISEASES OF PERSONALITY. eighty years of age, and who in reaHty was a man, but whose character had been rendered effeminate by habits." It is not my intention to review the perversions or aberrations of the sexual instinct,* each of which stamps its mark upon personality, affects it more or less either transiently or permanently. As a culminat- ing point of these partial alterations we have the total transformation, the change of sex. There are numer- ous instances of this, and the following may serve as a type. Lallemant relates "the fact of a patient, who believed himself to be a woman, and used to write letters to an imaginary lover. At the autopsy it was discovered that hypertrophy with induration of the prostate gland had taken place, and impairment of the ejaculatory ducts. " It is probable that in many cases of this kind perversion or abolition of the sex- ual sensations has occurred. I must, however, point out a few exceptions. Sev- eral detailed observations, (which may be found in Leuret, Frag77ients psych, p. 114 and following,) show us individuals, who assume the carriage, the habits, the voice, and when they are able, the dress of the sex they imagine themselves to belong to, yet without ex- hibiting any anatomical or physiological anomaly of the sexual organs. In cases of this kind the starting- point of the metamorphosis must have its seat else- where. And this can only be in the cerebro-spinal organ. In fact, we may observe, that whatever has been said of the sexual organ as constituting or modi- fying personality must not be understood simply of * For the complete exposition of this question see the article of Dr. Gley "Sur les aberrations de I'instinct sexuel," in the Revue philosophiqtie for January, 1884. EMOTIONAL DISORDERS. 69 the organ itself as defined by its anatomic conforma- tion ; it applies also to its connection with the brain, where it is represented. Physiologists place the genito-spinal reflex centre in the lumbar region of the cord. From this centre to the brain nothing with regard to the activity and the seat of the function is known ; for the hypothesis of Gall, who made the cerebellum the seat of physical love, notwithstanding a few favorable observations of Budge and of Lussana, has not been widely accepted. Whatever may be our ignorance upon this point, it is evident that the sexual impressions must reach the brain, since they are felt, and because there are centres from whence the psychic incitations are transmitted to the sexual or- gans, in order to arouse them into action. These nerve-elements, whatever be their nature, number, or seat, whether they are localized or diffused, must be the cerebral, and consequently the psychic, represen- tatives of the sexual organs ; and as in creating a par- ticular state of consciousness, others are usually ex- cited, there must needs exist an association between this group of psycho-physiological states and a cer- tain number of other groups. From the above-men- tioned cases, we must, accordingly, infer that there is produced a cerebral disturbance of unknown nature, (a woman believing herself a man, a man believing himself a woman,) the result of which is a fixed and erroneous state of consciousness. This fixed, exclu- sively predominant state thereupon produces a num- ber of almost automatic natural associations, which are, as it were, its radiations (feelings, carriage, lan- guage, dress of the imaginary sex): it tends to com- plete itself. It is a metamorphosis which proceeds from above, and not from below. Here we have an 70 DISEASES OE PERSONALITY. instance of what is called the influence of the moral over the physical nature ; and we shall try to show later on that the ego discussed by the majority' of psychologists, (it is not here the question of the real ego?) is formed according to an analogous process. These cases, however, belong to the intellectual devia- tions of personality, of which we shall speak in the next chapter. Before taking leave of this subject, I should not like to leave unnoticed a few matters of fact which are difficult to explain, yet which cannot be seriously ad- vanced against us. I allude to the singular phenom- enon called '^ opposite sexuality" {sexualite co7ttraire~), which has been quite frequently discussed of late, and which it will suffice to mention in a few words. Certain patients observed by Westphal, Krafft Ebing, Charcot and Magnan, Servaes, Gock,* etc., dis- play a congenital inversion of the sexual instinct, whence there results, notwithstanding a normal phys- ical constitution, an instinctive and violent attraction for a person of the same sex, with a marked aversion for the opposite sex; briefly, ''a woman is physically a woman, and psychically a man, a man is physically a man and psychically a woman." Such facts are in complete disaccord with all that logic and experience teach us. The physical and moral contradict each other. Strictly speaking, those who maintain the en- tity of the ego, might avail themselves of these anom- alies, and assert that they prove its independence, its autonomous existence. This, however, would be a great mistake, for their entire reasoning would rest upon two very weak foundations, upon facts which are very un- * Charcot and Magnan, Archives de Neurologie, 1882, Nos. 7 and 12 ; West- phal, Archiv fiir Psychiatric, 1870 and 1876. Krafft-Ebing, Ibid. 1877, etc. EMOTIONAL DISORDERS. 71 common, and the present difficulty of explaining them. Nobody will deny that the cases of opposite sexuality represent an infinitely small fraction of the sum of the cases furnished by experience. By their very rarity they are exceptions ; by their nature a psychological monstrosity; still, monstrosities are not miracles, and it is necessary to know whence they originate. One might attempt several explanations, which usually means that none of them is really sufficient. I shall refrain from inflicting any upon the reader. Psy- chology, like every other science must submit to a provisory ignorance concerning a number of points, and need not be afraid to admit it. In this respect it widely differs from metaphysics, which pretends to explain everything. Scientists who have studied these strange beings from the exclusive point of view of medical science, regard them as degenerate beings. To us the curious point at issue is to know why this degen- eracy should have assumed this particular form and not some other. It is probable that the clearing up of this mystery must be sought for in the multiple ele ments of heredity, in the complicated play of conflict- ing male and female influences ; but I shall leave this task to more clear-sighted and fortunate individuals. Setting aside the question of causes, it is altogether impossible to refuse to admit an aberration of the cereb- ral mechanism, as in the cases of Leuret and analogous cases. However, the influence of the sexual organs upon the nature and formation of character is so little contested that to dilate longer upon the subject would be time wasted, and any hypothetical explanation of opposite sexuality would not in the least advance our present researches. 72 DISEASES OF PERSONALITY. I III. The instincts, desires, tendencies, and feelings re- lating to the preservation of the individual and to that of the species have their well-determined material condi- tions — the former in the totalit}^ of organic life and the latter in a particular part of ,it. But when from the primitive and fundamental forms of emotional life we pass to those that are of secondary formation, born later in the course of evolution (social,, moral, intel- lectual, aesthetic tendencies), beside the impossibility of assigning to these their immediate organic basis, — a circumstance that would cause us to grope our way in darkness, — we observe that they have not the same degree of generality. With the exception, perhaps, of the moral and social tendencies, none of them ex- presses the individual in its totality; they are partial and only represent a group in the totality of its tendencies. Hence no one of them by itself alone has the power of producing a metamorphosis of the personality. So long as the habitude called the bodily sense, and that other habitude which is memiory, are not brought into play, a complete transformation does not take place : the individual may become changed; it cannot become another. Still these variations, even when partial, have an interest of their own. They show the transition from the normal to the morbid state. In studying the di- seases of the will we found in ordinary life many pre- dictions of the most serious forms. Here likewise common observation shows us that the normal ego is but slightly endowed with cohesion and unity. Irre- spective of characters that are perfectly concordant, (which in a rigorous sense of the word do not exist,) EMOTIONAL DISORDERS. J2> there are in every one of us all sorts of tendencies, all possible antitheses, and among these contradictions, all kinds of intermediate shades, and among those tendencies every possible combination. This is be- cause the ego is not only a memory, a store-house of recollections connected with the present, but an ag- gregate of instincts, tendencies, desires, which are merely its innate and acquired constitution coming into play. To use expressions much in vogue, we might say that memory is the static, and the group of tendencies the dynamic ego. If, instead of being guided unconsciously by this conception of an ego- entity, — a prejudice that has been strengthened in us by education and the supposed evidence of conscious- ness, — we simply agreed to take it for such as it is, to wit, as a co-ordination of tendencies and psychic states, the relative cause of which ought to be sought in the co-ordination and the consensus of the organ- ism, we should no more wonder at these oscillations, — incessant in flighty characters but rare in steady dis- positions, — which, during a long, short, or almost im- perceptible space of time, show us the person in a new light. An organic state, an external influence strengthens a tendency ; the latter becomes a centre of attraction toward which converge the states and tendencies that are directly associated with it ; there- upon the associations draw nearer and nearer : the centre of gravity of the ego is displaced, and the per- sonality has become another. "Two souls," said Goethe, ''dwell within my breast." Only two ! If moralists, poets, novelists, dramatists have shown us to satiety these two egos in a state of conflict within the same ego, common experience .is still richer ; it shows us several, each one excluding the other, as 74 DISEASES OF PERSONALITY. soon as it advances to the front. This may be less dramatic, but it is more true. ''Our ego at diverse epochs is very different from itself : according to age, the various duties and events of life, the excitations of the moment, a certain complexus of ideas, which at a given moment represents the ego, develops itself over and above all others, and advances to the front. We become another and yet are the same. My ego as a physician, as a scholar, my sensual ego, my moral ego, etc. , that is, the complexus of ideas, of inclinations,, and of directions of the will that are designated by these terms, may at any given moment enter into op- position and repel each other. This circumstance would have for a result, not only the inconsistency and separation of the thought and of the will, but also the complete absence of energy for each of these isolated phases of the ego, if, in all these spheres there was not a more or less clear return for the consciousness of some of these fundamental directions." * The ora- tor, master of his eloquence who while speaking judges himself, the actor beholding himself play, the psychologist studying himself, are also instances of this normal separation in the ego. Between these momentary and partial transforma- tions, the trivial nature of which diminishes their im- portance as psychological proofs, and the serious states, of which we shall speak, there are other inter- mediate variations more constant, more penetrating, or both. The dipsomaniac, for example, has two al- ternate lives ; in the one he is sober, methodical, in- dustrious j in the other he is entirely swayed by his * Griesinger, Traitedes maladies mentales'^ trans. Doumic, p. 55. See also an excellent study by M. Paulhan on " The variations of personality in- the normal state," June 1882, in the Revue philosophique. EMOTIONAL DISORDERS. 75 passion, improvident, disorderly, dissipated. Have we not here as it were two incomplete and contrary individ- uals welded together in one common trunk ? The same happens in the case of all persons who are subject to irresistible impulses, who insist that a mysterious power impels them to act in spite of themselves. Let us moreover recall to mind those transformations of character that are accompanied by cutaneous anaes- thesia, and which have been observed by several alienists. One of the most curious of such cases was observed by Renaudin. A certain young man whose conduct .had always been exemplary suddenly aban- dons himself to tendencies of the worst kind. In his mental condition it was impossible to verify any symp- tom of manifest alienation, but one could see that the entire surface of his skin had become absolutely insen- sible. The cutaneous anaesthesia was intermittent. ''As soon as it ceases, the inclinations of the young man are entirely different ; he is docile, affectionate, and understands thoroughly the painful character of his condition. When it manifests itself, the resistless power of the worst inclinations is its immediate con- sequence, and we have proof that it could proceed as far as murder." Maudsley reports certain anal- ogous cases of insanity in children, that suggested to him the following reflections : ''The special defective sensibiHty of skin in these cases is full of instruction in relation to the profound and general defect or per- version of the sensibility or receptive capacity of the whole nervous system which is shown in their per- verted likings and dislikes, in their inability to join with other children in play or work, and in the impos- sibility to modify their characters by disciphne ; they cannot feel impressions as they naturally should feel 76 DISEASES OF PERSONALITY. them nor adjust themselves to their surroundings, with which they are in discord ; and the motor out- comes of the perverted affections of self are accord- ingly of a meaningless and destructive character. The insensibility of skin is the outward and visible sign of a corresponding inward and invisible defect, as it no- tably is also in idiocy."* We inevitably revert to the organism, but this review we have made of facts of every kind which may seem monotonous, shows us the variations of personality in all its aspects. As there are no two identical cases, each case presents a peculiar decom- position of the ego. The cases last quoted show us a transformation of character without injury to mem- or}^ In proportion as we advance in our review of mat- ters of fact, one conclusion, as it were, becomes more and more apparent to our minds ; it is ihsit pej'sonality results from two fundamental factors, the constitution of the body with the tendencies and sentimerits that manifest it, a7id the memory. If (as said above) only the first factor is modified, there results a momentary dissociation, followed by a partial change of the ego. If the modification is so serious, that the organic bases of memory undergo a kind of paralysis, from which they cannot revive, then the disintegration of the personality is complete : there is no longer a memory of the past, and the present has taken a new form. Then a new ego is formed, usually quite unconscious of the former ego. Of these we have several examples, so well known, that I shall merely mention them : the American lady reported by Macnish, the case of Dr. Azam (Felida), and the case * Maudsley, p. 287. EMOTIONAL DISORDERS. 77 of Dr. Dufay.* By their very generality these cases do not come under any special division, and we have no reason to mention them here rather than elsewhere, except to remark, that the transition from one per- sonality to another is always accompanied by a change of character, undoubtedly connected with the un- known organic change which rules the whole situa- tion. This change is very distinctly and repeatedly pointed out by Dr. Azam : his patient during a certain period is gloomy, cold, reserved, but at other times gay, buoyant even to the verge of turbulence. This change is even still greater in the following case, and which I shall report more fully, because it is recent and but little known, f The subject is a young man of seventeen years V . . . L . . ., affected with hysterical epilepsy, who entirely lost the .memory of one year of his existence, and during this period was completely changed in character. Born of an unmarried mother, who was ^'addicted to an open life of debauchery, and of an unknown father, he began to roam and beg on the streets as soon as he could walk. Later he became a thief, was arrested, and sent to the reformatory of Saint-Urbain where he did some field-work." One day being occupied in a vineyard he happened to lay his hands upon a ser- pent, hidden in a fagot of twigs. The boy was ter- ribly frightened, and in the evening, on returning to the reformatory, became unconscious. These crises * For complete observations, seeTaine, De V Intelligence , t. i, p. 165 ; Azam, Revue scientifique, 1876, 20th May, and i8th September ; 1877, loth November ; 1879 8th March ; and Dufay ibid., 15th July, 1876. As regards the part played by memory in these pathological cases we refer the reader to our v7ork Maladies de la memoire, p. 76 and following. t This observation of Dr. Camuset is found in extenso in Annales inedico- psychologiques, January, 1882. 78 DISEASES OF PERSONALITY. from time to time were repeated, his legs grew weak, finally a paralysis of the lower limbs set in, his intel- lect remaining unimpaired. He was thereupon trans- ferred to the asylum of Bonneval. There it was re- ported ^'that the patient has an open and sympathetic expression, that his character is amiable, and that he shows himself grateful for the care that is bestowed upon him. He tells the history of his life with all its minute details, even his thefts which he deplores, of which he is ashamed, and which he attributes to his forsaken condition and his comrades who led him into evil ways. He regrets very much what has happened, and declares that in the future he will be more honest. " It was then decided to teach him a trade compatible with his infirmity. ''He can read, and is learning to write. He is taken every morning to the tailors-shop, where he is placed upon a table and assumes naturally the classical position by virtue of the condition of his lower limbs which are atrophied and contracted. In two months time he learned to sew pretty well. He works with enthusiasm, and everybody is satisfied with his progress." At this stage he is seized by an attack of hyster- ical epilepsy, which ends after fifty hours with a tran- quil sleep. It is then that his old personality reap- pears. ''On awakening, V . . . wants to get up. He asks for his clothes, and is able to dress himself, but per- forms the operation in a very bungling manner; he then takes a few steps through the hail ; his para- plegia having disappeared. His legs totter and with difficulty support the body because of the atrophy of the muscles. . . . When once dressed, he asks to go with his comrades into the vineyards to work. . . . EMOTIONAL DISORDERS. 79 We quickly perceive that our subject still believes himself at Saint-Urbain, and wishes to assume his ha- bitual occupations. In fact, he has no recollection of his crisis, and recognises nobod}^, not even the physi- cians and attendants any more than his companions in the ward. He does not admit having been par- alysed and accuses those about him of teasing him. This appeared like temporary insanity, which was only to be expected after so severe an attack of hysteria, but time passes and still his memory does not return. V . . . very distinctly remembers that he had been sent to Saint-Urbain; he knows that 'the other day ' he was frightened by a serpent ; but from this moment all is oblivion. He remembers nothing more and does not even realize the lapse of time. ''It was thought that he might be simulating, as hysterical patients often do, and we emplo37ed all means to make V . . . contradict himself, but without ever succeeding in doing so. Thus, without letting him know where he was going, we have him taken to the tailors' workshop. We walk by his side, and take care not to influence him as to the direction to be taken. V . . . does not know whither he is going. On arriving in the shop he has every appearance of a person who does not know where he is and he de- clares that he has not been there before. He is given a needle, and asked to sew. He sets about the task as awkwardly as any man who performs for the first time a job of this kind. They show him some clothes the seams of which had been sewn by him, during the time he was paralysed. He laughs and seems to doubt, but finally yields to our observations. After a month of experiment and trials of all kinds, we remain con- vinced that V . . . really remembers nothing." 8o DISEASES OF PERSONALITY. One of the most interesting points in regard to this case is the modification that the character of the patient underwent, namely, a return to his early life and to his hereditary antecedents : ''He is no longer the same subject ; he has become quarrelsome and a glutton ; he answers impolitely. Formerly he did not like wine and most frequently gave his share to his companions ; but now he will steal theirs. When they tell him that he once committed thefts, and caution him not to begin again, he becomes arrogant and will say : 'if he did steal, he paid for it, as they put him into jail.' They employ him in the garden. One day he escapes taking with him sixty francs belonging to an attendant of the infirmary. He is recaptured five miles from Bonneval, at the moment when, after sell- ing his clothes in order to purchase others, he is on the point of boarding the railway train for Paris. He resists arrest, and strikes and bites at the wardens sent in search of him. Returned to the asylum, he be- comes furious, cries, rolls on the ground ; finally it is necessary to confine him in a solitary cell." IV. Although we have not as yet studied the anomalies of personality in all their forms, it will not be out of place to essay here a few conclusions, although par- tial and provisory, which may contribute to diminish the obscurity of the subject. In so doing, I shall, however, confine myself to a single feature, — to cases of fictitious personality, reducible to a fixed idea ; to a predominant idea toward which an entire group of concordant ideas usually converge, all others being eliminated, and as if annihilated. Such are those who imagine themselves to be God, pope or emperor, and EMOTIONAL DISORDERS. 8i speak and act accordingly. The study of the intel- lectual cond,t.ons of personality has in store for us a jects upon whom is imposed a personage or roleV the cases of this kind that we already knol are s ffid n for us to enquire what they teach At first sight, these cases are quite simple as regards obscure . Why is a particular idea produced and not some other? Usually we know nothing whatever about It; but the morbid conception once borlgrows and increases until its climax is reached, throi^gh Z mere automatism of the association of ideas. I need not dwell upon this point, longer than to show that «iese pathological cases explain for us an illusion, nto which psychology has almost always fallen when it has based itself simply upon internal observation and which can be thus stated : the substitution for the' real ego of a factitious ego that is much more simple In order to lay hold of the real concrete person- ality, and not a mere abstraction that takes its place It IS not necessary to withdraw within our con- sciousness, with closed eyes, and obstinately to ques- tion it ; on the contrary, we need to keep our eyes wide open, and observe. The child, the peasant The workingman, the millions of people that walk in the streets and in the fields, who never in their lives have heard anything about Fichte, about Maine de BFran who never have read dissertations upon the ego and the non-ego, or even a line of psychology-one and all of them have their definite personally and each instant affirm it instinctively. Ever since that ong.forgotten epoch when their ego was const tued that IS, since their ego was formed as a coherent 82 DISEASES OE PERSONALITY. group in the midst of the processes assailing it, — this group maintains itself constantly while continually modifying itself. This coherent group is composed for the greater part of states and acts, almost auto- matic, that constitute in each the feeling of his body and the routine of life, and that serve as a support for all the rest, yet any alteration of which, even a short and partial one, is immediately felt. In a great measure also it is composed of an aggregate of sensa- tions, images, and ideas representing the usual sur- roundings amidst which we live and move, together with the recollections that are connected with them. All this represents organised states solidly connected among themselves, reciprocally supporting each other, and forming a bodily whole. We verify now the fact, without seeking the cause of it. All that is new or unusual, any change in the state of the body or of its surroundings, is adopted without hesitation and classed by an instinctive act, either as making a part of the personality or as being strange to it. This operation is performed every moment, not through any clear and explicit judgment, but through an unconscious and far deeper logic. If we have to characterize by a definite word this natural, spontaneous and real form of personality, I should call it a habit, for it cannot be anything else, being, as we maintain, only the ex- pression of an organism. If the reader instead of ob- serving himself will rather proceed objectively, that is, observe and interpret by the aid of the data of his own consciousness the condition of those who have never reflected on their personality, (and this is the vast ma- jority of the human species,) he will find that the pre- ceding thesis is correct, and that real personality .affirms itself not by reflection but by acts. EMOTIONAL DISORDERS. 83 Let us now examine what is called factitious or artificial personality. When the psychologist through internal observation tries, as it were, to comprehend himself, he attempts an impossibility. At the mo- ment he assumes the task in question, either he will adhere to the present, and then hardly advances at all ; or in extending his reflection toward the past, he affirms himself to be the same as he was one year or ten years ago ; in either case he only expresses in a more learned and laborious manner what any peasant knows as well as he does. Through inward observa- tion he can only apprehend passing phenomena ; and I am not aware that any reply has been given to the following just remarks of Hume: ''For my part, when I enter most intimately into what I call myself, I always stumble on some particular perception * or other of heat or cold, light or shade, love or hatred, pain or pleasure. I never can catch myself at any time without a perception, and never can observe anything but the perception. If anyone, upon seri- ous and unprejudiced reflection, thinks he has a different notion of himself, I must confess I can reason no longer with him. All I can allow him is, that he may be in the right as well as I, and that we are essentially different in this particular. He may, perhaps, perceive something simple and continued, which he calls himself, though I am certain there is no such principle in me."f Since Hume, it has been said: ''Through effort and resistance we feel our- selves cause." This is very well; and all schools more or less agree, that through this the ego is distin- * In Hume's language, "perception " corresponds almost to what we now call state of consciousness. t Philosophical Works. Vol. I., p. 312. 84 DISEASES OF PERSONALITY. guished from the non-ego ; but this feeling of effort none the less remains a simple state of consciousness like others, the feeling of muscular energy displayed in order to produce any given act. To seek through analysis to comprehend a syn- thetic whole like the personality, or through an in- tuition of consciousness that scarcely lasts a few seconds, to encompass such a complex thing as the ego, is to attempt a problem, the data of which are contradictory. So, as a fact, psychologists have taken another ground. They have considered the states of consciousness as accessories, and the bond which unites them as the essential element, and it is this mysterious underlying something that under the names of unity, identity, and continuity, has become the true ego. It is clear, however, that we have nothing here but an abstraction, or more precisely, a scheme. For the real personality there is substituted the idea of personality, which is altogether another thing. This idea of per- sonality is, like all general terms, formed in the same manner as sensibility, will, etc. ; but it does not resemble the real personality more than the plan of a city resembles the city itself. And as in cases of aberration of personality, which have led us to the present remarks, one single idea has been substituted for a plexus, constituting an imaginary and a dimin- ished personality ; in the same manner a fixed scheme of personality has been substituted by psychologists for concrete personality, and upon this framework, almost devoid of contents, they reason, induce, deduce, and dogmatize. It is clear, however, that this com- parison is only done by way of mutatis mutandis and with many restrictions, which the reader himself will discover. There are still many other observations that EMOTIONAL DISORDERS. 85 could be made, but I am not engaged here on a strictly critical work. In short, to reflect upon our ego, is to assume an artificial position, which changes the nature of the ego ; it is merely to substitute an abstract representa- tion for a reality. The true ego is the one that feels, thinks, acts, without making of itself an object of vision, for it is a subject by nature and by definition, and in order to become an object, it has to undergo a reduction, a kind of adaptation to the optics of the mind which transform and mutilate it. Up to this point we have treated the question from its negative side. To what positive hypothesis as to the nature of the personality are we led by a consider- ation of morbid cases? Let us first eliminate the hypothesis of a transcendental entity, incompatible with pathology, and which, besides, explains nothing. Let us set aside, moreover, the hypothesis which makes of the ego ''a bundle of sensations," or of states of consciousness, as is frequently repeated after Hume. This is to be influenced by appearances, to take a group of signs for a real thing, or more precisely, to take effects for their cause. And again, if, as we maintain, consciousness is only an indicatory phenom- enon, it cannot be a constitutive state. We must advance still further, to that consensus of the organism, namely, of which the conscious ego is only the psychological expression. Has this hypoth- esis more solidity than the other two? Objectively, as well as subjectively, the characteristic trait of person- ality is that continuity in time, that permanence which we call identity. This has been denied to the organ- ism, upon the strength of arguments too well known to need repeating here ; but it is strange that it should 86 DISEASES OF PERSONALITY, not have been perceived, that all arguments pleaded in favor of a transcendental principle are really ap- plicable to the organism, and that all reasons that can be advanced against the organism are applicable to a transcendental principle. The remark that every su- perior organism is one in its complexity is as old, at least, as the Hippocratic writings, and since Bichat no one attributes this unity to a mysterious vital prin- ciple ; yet certain people make a great stir about this whirlwind or continuous molecular renovation which constitutes life, and ask, '^ Where is the identity?" As a matter of fact, however, everybody believes in this identity of the organism and affirms it. But, identity is not immobility. If, as some scientists think, life resides less in the chemical substance of the protoplasm than in the movements with which the particles of this substance are animated, identity would be a ^'combination of movements" or a "form of movement," and this continuous molecular renovation itself would be subordinated to conditions more pro- found. Without dilating upon the subject, it must be evident to any unprejudiced mind that the organism has its identity. And from this point, what simpler or more natural hypothesis than that of perceiving in conscious identity the internal manifestation of the external identity which is in the organism ? "If any one chooses to assure me that not a single particle of my body is what it was thirty years ago, and that its form has entirely changed since then ; that it is absurd, therefore, to speak of its identity; and that it is abso- lutely necessary to suppose it to be inhabited by an immaterial entity which holds fast the personal iden- tity amidst the shifting changes and chances of struc- ture : — I answer him that other people who have EMOTIONAL DISORDERS. 87 known me from my youth upwards, but have not my self-conscious certainty of identity, are, nevertheless, as much convinced of it as I am, and would be equally sure of it even if, deeming me the greatest liar in the world, they did not believe a word of my subjective testimony ; that they are equally convinced of the per- sonal identity of their dogs and horses whose self- conscious testimony goes for nothing in the matter ; and lastly, that admitting an immaterial substance in me, it must be admitted to have gone through so many changes, that I am not sure the least immaterial particle of it is what it was thirty years ago ; that with the best intention in the world, therefore, I see not the least need of, nor get the least benefit from, the assumed and seemingly superfluous entity."* It is, however, upon this physical basis of the or- ganism, that rests, according to our thesis, what is called the unity of the ego, that is to say, the solid- arity which connects the states of consciousness. The unity of the ego is that of a complexus, and it is only through a metaphysical illusion that the ideal and fictitious unity of the mathematical point has been attributed to it. It does not consist in the act of a supposed simple ''essence, " but in a co-ordination of the nerve-centres, which, themselves, represent a co- ordination of the functions of the organism. Un- doubtedly we are here within the sphere of hypothesis, but at least, it is not of a supernatural character. Let us take man in the foetal state, before the birth of any psychic life, leaving aside any hereditary inclin- ations, already impressed upon him in any manner whatever, an*d which, at a subsequent time, will mani- fest themselves. At some period of the foetal state, at * Maudsley, Body and Will. p. -j-j. 88 DISEASES OF PERSONALITY. least during the last few weeks of it, some kind of sense of the body must have been produced, consist- ing in a vague feeling of well-being or discomfort. No matter how confused we may suppose it to be, it im- plies certain modifications in the nerve-centres, as far as compatible with their rudimentary state. When to these simple, vital organic sensations there are added sensations from an external cause (objective or not) they also necessarily produce a modification in the nerve-centres. But they will not be inscribed upon a tabula 7'asa ; the web of the psychic life has already been woven, and this web is the general sensibility, the vital feeling, which, vague as it may be at this period, definitively constitutes almost the whole sum of consciousness. The bond of the states of conscious- ness among themselves now reveals its origin. The first sensation (if there be one in an isolated state) does not come unexpectedly, like an aerolite in a desert ; at its first entrance it is connected with others, with those states that constitute the sense of body, and which are simply the psychic expression of the organ- ism. Translated into physiological terms, this means that the modifications of the nervous system that represent materially the sensations and desires which follow the first elements of the higher psychic life, attach themselves to the previous modifications that are the material representatives of the vital and or- ganic sensations ; and by this means there are estab- lished relations between these nervous elements ; so that from the very outset the complex unity of the ego has its conditions of existence in this general conscious- ness of the organism, which, though so frequently overlooked, serves as the support of all the rest. Thus, finally, upon the unity of the organism every- EMOTIONAL DISORDERS. 89 thing depends, and when passing also from the em- bryonic state, the psychic life is formed, the mind may be compared to some gorgeous piece of tapestry, in which the warp has completely disappeared, at one place beneath a faint design, at another beneath a thick embroidery in high relief ; the psychologist who restricts himself to internal observation, perceives only the patterns and embroidery and is lost in con- jectures and guesses as to what lies hidden beneath ; if he would but consent to change his position and to look at it from behind, he would save himself many useless inductions, and would know more about it. * We might discuss the same thesis under the form of a criticism of Hume. The ego is not, as he main- tained, a mere bundle of perceptions. Without inter- posing the teaching of physiology but confining our- selves to ideological analysis, we observe a serious omission — that of the relations between the primitive states. A relation is an element of a vague nature, difficult to determine, because it does not exist by itself. It is nevertheless, something more than and different from the two states by which it is limited. In Herbert Spencer's Principles of Psychology there is an ingenious study (which has been too Httle noticed) of these elements of psychic life, with certain hypoth- eses regarding their material conditions. Prof. W. James has quite recently treated of this question."^ He compares the irregular course of our consciousness to the transit of a bird that alternately flies and perches. The resting-places are occupied by relatively stable sensations and images ; the places passed in flight are * Herbert Spencer, Principles of Psychology, Vol. I, § 65. Prof. James in Mind, Jan. 1884, p. i, and following. See also Huxley's Hutne, go DISEASES OF PERSONALITY. represented by thoughts of relations between the points of rest : the latter — the ^'transitive portions " — are al- most always forgotten. It seems to us that this is another form of our thesis, that of the continuity of the psychic phenomena, by virtue of a deep, hidden substratum, which must be sought in the organism. In truth, it would be a very precarious personality that had no other basis than consciousness, and this hypothesis is defective in the face of even the simplest facts ; as, for example, to explain how after six or eight hours of profound sleep, I have no hesitation in recognizing my own identity. To place the essence of our personality in a mode of existence (conscious- ness) which vanishes during almost one third of our life is a singular solution. We, accordingly, maintain here, as we have else- where in regard to memory, that we must not con- found individuality in itself, as it actually exists in the nature of things, with individuality as it exists for itself, by virtue of consciousness (personality). The organic memory is the basis of all the highest forms of memory, which are only the products of its perfec- tion. The organic individuality is the basis of all the highest forms of personality, which are only the pro- ducts of its perfection. I shall repeat of personality as of memory, that consciousness completes and per- fects it, but does not constitute it. Although, — in order not to prolong these already protracted considerations, — I have strictly refrained from all digression, from criticism of adverse doctrines, and from the exposition of points of detail, I must, in- cidentally, point out a problem which naturally pre- sents itself. There has been a great deal of discus- sion as to whether the consciousness of our personal EMOTIONAL DISORDERS. 91 identity rests on memory or vice versa. One says : It is evident that without memory I should only be a present existence incessantly renovated, which does away with all, even the faintest possibility of identity. The other says : It is evident that without a feeling of identity that connects them reciprocally, and stamps upon them my own mark, my recollections are no longer my own ; they are extraneous events. So then, is it the memory that produces the feehng of identity, or the feehng of identity that constitutes the memory? I answer : neither the one nor the other ; both are effects, the cause of which must be sought in the or- ganism ; for, on the one hand, its objective identity reveals itself by that subjective condition which we call the feeling of personal identity ; and, on the other hand, in it are registered the organic conditions of our recollections, and in it is to be found the basis of our conscious memory. The feehng of personal identity and the memory in the ps3^chological sense, are, ac- cordingly, effects of which neither one can be the cause of the other. Their common- origin is in the organ- ism, in which identity and organic registration (i. €., memory) are one. Here we encounter one of those in- correctly formulated problems, that frequently occur in connection with the hypothesis of a "conscious- ness-entity." CHAPTER III. DISORDERS OF THE INTELLECT. In certain morbid states, the five universally ad- mitted classical senses are subject to very serious de- rangements. Their functions are perverted or dis- torted. Do these parastheses and dyscestheses play a part in the alterations of personality? Before exam- ining this point there arises a preliminary question : What happens in the case of the suppression of one or of several senses? Is the personality altered, thwarted, transformed ? The answer, resting upon experience, seems to be a negative one. The total loss of a sense may be acquired or be congenital. Let us first examine the former case. We shall not here consider the two secondary senses of taste and smell, nor the sense of touch in all its dif- ferent forms, coming, as it does, so near to general sensibility. We will limit ourselves to sight and hear- ing. Acquired blindness and deafness are not rare; and are often accompanied by certain modifications of character, but these changes are not radical, and the individual remains the same. Congenital blind- ness and deaf-muteness affect personality more deeply. Individuals who are deaf and dumb from birth, limited thus to their own resources and deprived of artificial language, remain in a state of notorious in- tellectual inferiority. This however has been at times DISORDERS OF THE INTELLECT. 93 exaggerated,* but nevertheless it is incontestable, and is due to causes that have been too frequently dis- cussed to need repetition. Conscious:personality in the above instance falls below the normal medium ; but in such a case there is rather an arrest of devel- opment than an alteration of personality in a strict sense of the term. As regards those who are born blind it is well known that many attain a high standard of intellectu- ality, and therefore we have no authority to attribute to them any diminution or alteration of personahty whatever. Notwithstanding that their conception of the visible world, formed only from descriptions of it, may seem odd and whimsical to us, it does not seriously influence either the nature of their person or the idea they entertain of it. Let us take the case of Laura Bridgman, a most remarkable instance of sensorial privation, and one that has been very minutely observed, and fully re- corded, f Here we find a woman, deprived of sight and hearing at the age of two years, and almost en- tirely of the senses of smell and taste, and possessing only the sense of touch. We must, no doubt, make a liberal allowance for the patient and the intelHgent education to which she owed her development. At the same time the fact remains, that her teachers could not endow her with new senses, and the sense of touch alone had to suffice under all circumstances. In spite of all these disadvantages this woman presents * Compare upon this point the facts reported by Kussmaul, Die Stdrungen der Sprache, Chap. VII, p. i6, and following. t As to Laura Bridgman, see Revue Philosophique , Vol. I, p. 401 ; Vol. VII, p. 316. The principal data relating to her have be.en compiled by her teacher Mary Swift Lamson, m her work : The Life and Education of Laura Dewey Bridgman, the deaf dumb, and blind girl. London : 1878. Triibner. 94 DISEASES OF PERSONALITY. herself to us in her own individuality, possessed of a well-marked character ; an amiable disposition, an almost inalterable good temper, as patient as she was eager in her efforts for self-improvement ; in short she confronts us as an ordinary person. Omitting the innumerable details involved in the preceding cases, we may safely infer, that the natural or acquired privation of one or of several senses is not necessarily accompanied by a morbid state of per- sonality. In the least favorable cases there is a rel- ative arrest of development, which is remedied by education. It is clear to those who maintain that the ego is an exceedingly complex compound (and this is our own thesis), that every change, addition, or subtrac- tion in its constituent elements will affect the ego more or less. But the purpose of our analysis is, just to distinguish among such elements those that are essen- tial from those that are accessory. The part contrib- uted by the external senses (touch excepted) is not an essential factor. The senses determine and cir- cumscribe personality, but do not constitute it. If in questions of observation and experience it were not too rash to rely upon pure logic, this conclusion might have been drawn a priori. Sight and hearing are pre- eminently objective; they reveal to us that which is without, not that which is within. As regards touch^ a complex sense, which many physiologists resolve into three or four senses — in so far as it acquaints us with the properties of the external world, and is an eye to the blind, it belongs to the group of vision and hearing ; otherwise it is only one form of the feeling that we have of our own body. It may seem strange \}ii'aXpar(Bsthesis and dyscesthesis^ DISORDERS OF THE INTELLECT. 95 the simple sensorial derangements which will now oc- cupy our attention, should disorganize the ego. Still, observation proves and reflection explains the fact. This work of destruction does not really proceed from the sensorial derangements alone ; they are but exter- nal symptoms of a much deeper internal disorder, which affects the bodily sense. The sensorial altera- tions are rather auxiliary than efficient causes. This is confirmed by the facts. Alterations of the personality with sensorial dis- turbances, but without significant hallucinations, or loss of judgment, are met with in a certain number of morbid states. We shall select as a type the neuro- sis, studied by Krishaber under the name of ''cerebro- cardiac neuropathy." It matters little to us whether or not this group of symptoms should or should not be regarded as a distinct pathological unity; this is a question for physicians.* The purpose of our inves- tigation is an entirely different one. Let us resume the study of the physiological dis- orders, the immediate effect of which is to produce a change in the coenesthesis (the sense of body). At first there occur derangements of the circulation, con- sisting chiefly in an excessive irritability of the vas- cular system, probably due to an excitation of the cen- tral nervous system, whence are produced contractions of the smaller vessels, ischcemia in certain regions, in- sufficient nutrition and exhaustion. Then there are disorders of locomotion, dizziness, continuous feeling of vertigo and of inebriation, with stumbling, relaxa- tion of the limbs, or hesitating gait, and an involun- ■^ De la nevropathie cerebro-cardiaque, by Dr. Krishaber. Paris: 1873. Masson. In general this disease is regarded not as a distinct species, but as a particular case of spinal irritation or of neurasthenia. See Axenfeld and Huchard : TraiU des nevroses, 1873, pp. 277 and 294. 96 DISEASES OF PERSONALITY. tary forward impulsion ^^as if moved by a sort of spring." In passing from the internal to the external, we find the sense of touch, which forms the transition from general sensibility to the special senses. Some persons have the feeling as if they had no longer any weight, or were very light. Many persons lose the exact notion of resistance, and are unable, through the sense of touch alone, to recognize the form of objects. They imagine themselves as *' separated from the world ; " their body enveloped, as it were, by isolating surroundings, that interpose themselves between the individual and the external world. *' There appeared," said one of them, ^^a dark atmosphere all around my person ; still, I saw very well that it was broad daylight. The word 'Mark" does not exactly express my thought j I ought to use the German word dump/, which also means heavy, dense, dull, extinguished. This sensation was not only ' visual but also cutaneous. I was wrapt in a murky atmosphere ; I beheld it, felt it ; it was like a heavy layer of some bad conducting medium that isolated me from the external world. I am entirely unable to tell you how impressive this sensation was ; but, it seemed to me, that I was transported far, very far from this world, and mechanically I cried out, in a loud voice, *I am far, far away.' At the same time I knew perfectly well that I was not far away; I dis- tinctly remembered all that had happened to me ; but between the moment that preceded, and that which followed my attack, there intervened an immense in- terval, a distance like that from the earth to the sun." In a case of this kind, vision is always affected. Without speaking of slight disorders (such as photo- DISORDERS OF THE INTELLECT. 97 phobia, amblyopia) some persons will perceive objects as double ; to others they seem flattened, and a man appears to them as a reliefless silhouette. To many, the surrounding objects seem to grow diminished and to recede into infinite space. Auditory derangements are of the same nature. The patient no longer recognizes the sound of his own voice ; it seems to come from afar, or to lose itself in space, without being able to reach the ear of those with whom he converses, whose answers, likewise, are scarcely heard. If now, in thought, we unite together all these different symptoms (accompanied by physical pain,, and by derangements of taste and smell) suddenly, and in a single block, arises a group of internal and ex- ternal sensations, marked by a new character, con- nected among themselves by their simultaneousness in time, and still more profoundly so through the morbid state which is their common source. Here we have all the elements of a new ego, and, as a matter of fact,, sometimes it is actually formed. '^I have lost all consciousness of my being; I am no more myself." Such is the formula which is repeated in almost all the observations of this kind. Others will even go still further, and at times, imagine themselves double. ''One of the strangest ideas, which, despite myself,, is forced upon my mind," said a certain engineer, '* is. to believe myself double. I seem to possess one ego, which thinks, and another which acts." (Obs. 6.) This process of formation has been top well studied by M. Taine, to need to be repeated. ''We could not more aptly compare the condition of the patient than likening it to that of a caterpillar, which, while pre- serving all the ideas and recollections of a caterpillar, 98 DISEASES OF PERSONALITY. should suddenly become a butterfly, with the senses and sensations of a butterfly. Between the old state and the new state, between the first ego — that of a caterpillar — and the second ego — that of a butterfly — there is a deep gulf, a complete rupture. The new sensations do not find any anterior series to which they can connect themselves ; the patient can no longer interpret or make use of them ; he does not even recognize them, they are unknown to him. Hence, there follows two strange conclusions ; the first, which consists in saying : ^^ I am not ; " the second, a trifle more advanced, which says, ''I am another." * It is, indeed, difficult for any sane and well-balanced mind to figure to itself an extraordinary mental state of this kind. But although inadmissible to the sceptical observer, who looks at the matter from without, these conclusions are strictly correct to the patient who sees them from within. For, to him alone is the continual state of vertigo and intoxication like a permanent chaos, in which the state of equilibrium, of normal co-ordina- tion, cannot be established, or, at least, cannot endure. If now we compare with the other more or less serious forms, this change of personality a sensibus Icesis, we shall find that a new ego is not formed in all cases. When it is formed it always disappears with the cessation of sensorial derangements. It is never able entirely to supplant the normal ego ; there is alternation between both : the elements of the orig- inal ego preserve enough cohesion to allow it by turns to gain predominance. Hence the illusion of believ- ing oneself double, which, strictly speaking, to the patient himself is not an illusion. * Revue philosophique, Vol. I., page 289, and Z'/^if^//z^^«\AXiQX habitus, each of which serves as a basis for a psychic organization. This seems all the more probable, when we remem- ber that the alternation in question bears upon char- acter, upon that which is innermost in personality, and which most deeply expresses individual constitu- tion (e. g. the cases of Azam, Dufay, Camuset). We have also in this type of alternation different forms. Sometimes the two personalities are both ig- norant of each other (case of Macnish). At other times the one embraces the whole of life, the other being only partial j such is the case of Azam. Finally in this case — which is the most instructive, because it now covers a period of twenty-eight yearsf — we behold * The Journal of Mental Science, April, 1883. t In 1885. DISSOL UTION OF PERSONA LITY. 1 3 7 the second personality constantly encroaching upon the first ; which having been very long originally, be- comes by degrees shorter and shorter, so that we can foresee a time when it will completely disappear, and the second only will remain. It would seem accord- ingly that this state of alternation when it is prolonged, has a fatal tendency toward reducing itself to the first type, occupying thus an intermediate position between the normal state and the complete alienation of per- sonality. 3. The third type is more superficial ; I shall call it a substitution of personality. To this type I refer the rather common cases in which the individual simply believes his or her condition to be changed ; e. g. a man declares himself to be a woman, and vice versa ; a rag-picker believes himself a king, etc. The state of certain hypnotized subjects, of whom I have spoken, may serve as examples of this class. The alteration is rather psychical in the strict sense of the word, than organic. I do not for a moment suppose that it arises and persists without material conditions. I onl}' wish to say, that it is not as in the two preceding groups caused and supported by any deep modifica- tion of the sense of body, which carries with it a com.- plete transformation of person. It proceeds from the brain, not from the inmost depths of the organism ; and is rather a local than a general disorder, — -the hypertrophy of a fixed idea, which renders impossible the co-ordination that is necessary to the normal life of the mind. Hence, while in alienation and alternation of personality everything conspires and co-operates in its way, exhibiting a logical internal unity of the organic compounds, it is not uncommon for him who claims to be a king to admit he has been a workingman, and 138 DISEASES OF PERSONALITY. for the pretended millionaire to confess that he used to earn two francs a day. Even irrespective of these cases, in which the incoordination is obvious, we can easily see that a fixed idea is but a diseased excres- cence which by no means indicates a total transforma- tion of the individual. This classification, proceeding from the most se- rious to the most trivial forms, makes no pretensions to completeness. It merely serves to bring something like order into a mass of facts : to show how unlike they are ; and, above all, once more to demonstrate that personality has its roots in the organism, and that it changes and is transformed along with it. CONCLUSION. It is an inevitable consequence of the doctrine of evolution that the higher forms of individuality must have proceeded from the lower by way of aggregation and coalescence ; and further also, that individuality at its highest degree, in man, is the accumulation and condensation in the cortical layer of the brain of ele- mentary consciousnesses that were autonomous and dispersed at their origin. All the different types of psychic individuality in the animal series, from the lowest to the highest, could be described and fixed only by a psycho-zoolo- gist, and at the cost of much groping amidst uncer- tainties and conjectures. Hence we shall merel}^ call attention to a few types, in view of the principal aim of the present work, which is to demonstrate that the ascending progress toward higher individuality is summed up in an increasing complexity and coordina- tion. When we speak of a man, a vertebrate, or even of an insect, nothing can be clearer than the term ''in- dividual "; but nothing is more obscure in proportion as we descend the scale. Upon this point all zoologists are perfectly agreed.* According to the etymology of * See in particular: Haeckel, General Morphology ; Gegenbaur, Cotnpara- tive Anatofjiy : Espinas, Societ'es animales, second edit., Appendix II ; Ponchet, Revue scientifique, Feb. lo, 1883, etc. I40 DISEASES OF PERSONALITY. the word, the individual {individuiis) is that which is not divided. In that case, the individual, in the strict and exclusive sense of the word, must be sought for at a very low stage. While there is nothing to limit the dimensions of inorganic compounds (cr^^stals), "every protoplasmic mass which has attained a few tenths of millimeters at the maximum, spontaneously divides itself into two or several distinct masses, equivalent to the mass from which they are derived, and v/hich are reproduceH in them. Protoplasm, ac- cordingly, exists only in the individual state, having a limited size ; and this is why every living being is ne- cessarily composed of cells."* Life could not attain to any considerable growth except by means of an in- finite repetition of the same fundamental theme, through the aggregation of an infinite number of small elements, as the real types of individuality. The living and homogeneous matter constituting these elementary, primordial individualities unfolds itself, rolls itself up, lengthens out into tiny filaments, moves from place to place, creeps toward substances adapted to its nutrition, absorbs them, decomposes them, and assimilates their atoms with itself. In this sense scientists have spoken of' "rudiments of con- sciousness," of an obscure volition, determining itself under the action of external stimulations and vague cravings. We may certainly employ this term in default of a better, but we must not forget that it has no precise signification for us. In a homo- geneous mass which does not present the slightest trace of differentiation, in which the vital and essential * Perrier, Les Colonies animales et la /onnation des organismes. Paris, 1881, p. 41. According to Cattaneo : Le Colonic liiteari e la morfologia dei juolluschi, the division might be carried still further. CONCLUSION. 141 properties (nutrition, generation) are in a state of diffusion and indistinctness, the only and rather hum- ble representative of psychic activity is simply the irritability common to all living beings, which later in the course of evolution will become general sensibil- ity, special sensibiHty, and so on. Can this be called a consciousness? The first step towards a higher individuality con- sists in an association of individuals almost com- pletely independent of each other. "Nevertheless, en- forced proximity, the continuity of the tissues, and almost constant unity of the digestive apparatus, establish among them a certain number of relations, and these prevent the individual from remaining a perfect stranger to what takes place among its near- esL companions. Such is the case with sponges, col- onies of hydra-polyps, coralline polyps, bryozoans, and a few colonies of ascidians.^ Yet, properly speak- ing, all this is but a juxtaposition, an intertwine of a heap of small, contiguous, and homogeneous conscious- nesses, not having among themselves any other com- munity than that given them by the limitation of their assemblage in space. The birth of a ^^/^/z/^/ individuality and conscious- ness marks a great step toward co-ordination. Bein^ to formed of elementary individualities, such a colony tends toward transforming itself into an individuality of a higher order, in which a division of labor takes place. In colonies of Hydractmia we meet with seven different kinds of individuals — nurses or feeders, repro- ducers, others of either sex (male and female), others that feel or seize their prey, etc. In the siphonophor- ous species, among AgalmidcE, whose entire organism * Perrier, Op. cit. p. 774 ; Esp-nas, Des societts an/males, section 2. 142 DISEASES OF PERSONALITY. measures more than a metre, and in similar types, the faculty of locomotion is completely centralised. The individuals that compose it seem independent, while the animal allows the common axis upon which they are imbedded to float ; but when in danger, or if the animal wishes to execute any complex movement, the axis contracts, and drags along with it all the polyps. Physalia (Portuguese man-of-war) is able to accelerate or slacken its movements, to emerge or dive at will, ascend, descend, go straight forwards, or swerve aside ; it can make all its individual organs concur in these complicated acts. An errant life, as observed by M. Perrier, seems to favor the development of individuality. ''Thence there necessarily results a greater dependence of all the individuals ; more inti- m.ate bonds are established among them ; the impres- sions produced upon any part of the whole must ne- cessarily be transmitted to the locomotory parts ; and the movements of the latter must be co-ordinate, or all would be in disorder. There accordingly arises a kind of colonial consciousness; through which the colony tends towards constituting a new unity, and toward forming what we call an individual.'" '^ As regards other colonies the common consciousness is formed in a different manner. In Botryllidce (tunicaries) there is a common orifice, the cloaca, round which are dis- posed all the individuals. Each of them emits toward the cloaca a tongue-like member provided with a nerv- ous process, by the aid of which communication can be established in a permanent manner between all the members of the same group. f But ''because one colony acquires the notion of its own existence as a * Perrier, 0J>. cit. pp. 232, 239, 770, 248, and 262. + Ibid., p. 771. CONCLUSION. 143 colony, it does not follow necessarily that each of the individuals that compose it loses its particular con- sciousness. On the contrary, each individual contin- ues to act as if it were single With certain kinds of star-fish each separate arm continues to creep, to follow a determined route or to deviate from it, as the case may happen, to quiver when it is excited, and to betray, in a word, real consciousness. The con- sciousness of a ray is nevertheless subordinate to the consciousness of the whole star-fish as is proved by the harmony which is established between the move- ments of the several parts, when the animal changes its position." * As regards man, in whom centralisation is devel- oped to a very high degree, it will always be exceed- ingly difficult to obtain anything like a clear idea of a mode of psychic existence in which partial in- dividualities and a collective individuality are found coexisting. Strictly speaking, we might find an ana- logue to this in certain morbid states. We might further say that the human individual is conscious of itself at the same time as a person and as a member of the body social ; but I shall avoid comparisons that might be contested. Taking the question objectively and looking at it from without,— the only accessible point, — we shall see that this colonial consciousness, howsoever intermittent and feebly co-ordinated it may have been at its origin, still marks a capital moment in the process of evolution. Colonial consciousness, in fact, is the germ of higher individualities,— of per- sonality itself. By degrees it will pass to the foremost rank, appropriating for its own profit all special indi- vidualities. In the political order we see an analogous * Ibid., pp. 772-773. 144 DISEASES OE PERSONALITY. evolution in strongly centralized countries. The cen- tral power, at first very feeble, hardly recognised, and often less important than its subordinates, is strength- ened at their cost, and has, by absorbing them, slowly reduced them. The development of the nervous system — pre-emi- nently the factor of co-ordination — is the visible sign of a progress toward a more complex and more har- monious individuality. But this centralization is not established all at once. Among the annelidous animals the cerebroid ganglia, which emit nerves to the organs of the senses, seem to discharge the same functions as the brain of the vertebrates. Still, complete centrali- zation is far from being effected here. The psycholog- ical independence of the different rings is perfectly evi- dent. ''Consciousness, which is more distinct in the brain, has a tendency toward growing fainter in pro- portion as the number of rings increases. Certain EuiiicecE. (a group of Annelids) which may attain to a length of I -5 metres, bite the posterior extremity of their body without seeming in the least to feel it. To this diminution of consciousness we have doubtless to attribute the facility with which Annelids, held in captivity under disagreeable conditions, voluntarily mutilate themselves." In linear colonies, the indi- vidual forming the front, being compelled to take the initiative for all the others, to advance or retreat, to modify the attitude of the colony which it drags be- hind, — becomes a head ; but it must be understood that zoologists only use this term comparatively, and we must not assume that it exactly corresponds to what is called a head in an insect or an}^ other artic- ulated animal. The individuality which it represents is to such a degree transitory, that in certain asexual CONCLUSION. 145 Annelids, composed of some forty rings, we see the head of a sexual individual form at the level of the third ring, furnish itself with tentacles and antennae, and thereupon detach itself from the primitive indi- vidual in order to live its own life.* As regards details we refer the reader to other spe- cial works ; it is unnecessary to dwell upon the subject of higher animals ; individuality in the usual sense of the word is constituted ; and is represented by the brain becoming more and more predominant. But this digression into the domain of zoology will not be in vain, if we have made it understood that this co- ordination, so often mentioned, is not a simple theory, but, on the contrary, is an objective, visible, and tan- gible fact ; that, as Espinas maintains, psychic indi- viduality and physiological individualit}'^ are parallel, and that consciousness is unified or dispersed along with the organism. Still, the term consciousness or physical individuality is full of pitfalls that I shall not attempt to disguise. If psychic individuality is, as we maintain, only the subjective expression of the organism, in proportion as we deviate from the human type the greater is the obscurity that surrounds us. Consciousness is a function which can be compared to that of generation, because they both express the whole individual. Let us grant to even the most ele- mentary organisms a consciousness — diffuse as all their vital properties, particularly generation. We see the latter, in proportion as we ascend, become localized, monopolize a part of the organism, which, through countless modifications and improvements, becomes as regards that function and it alone the representa- tive of the whole organism. The psychic function * Periier, Ibid., p. 448, 491, 501. 146 DISEASES OF PERSONALITY. follows an analogous process. In its highest degree it is distinctly localized ; and has monopolized a part of the organism, which as to this function and this func- tion alone becomes a representative of the whole or- ganism. By a long series of successive functional delegations, the brain of higher animals has succeeded in concentrating within itself the greater part of the psychic activity of the colony; by degrees it has re- ceived a more and more extended mandate, before obtaining the complete abdication of its associates.* But, in taking a species of animals at hazard, how shall we know correctly the degree which the psychic activity has attained ? Physiologists have made many experiments upon the spinal cord in frogs ; is its re- lative psychic value the same with man ? It is very doubtful. II. Let us revert to man, and let us first study his purely physical personality. For the present we shall eliminate all states of consciousness, — without for- getting to restore them later, — in order to consider only the material bases of human personality. We need scarcely remind the reader that all the organs belonging to what is called vegetative life — the heart, the vessels, the lungs, the intestinal canal, the liver, kidneys, etc. — although they may appear in- dependent of each other, and each seem entirely ab- sorbed in its particular function, are yet closely and solidly bound together. The centripetal and centrif- ugal nerves of the great sympathetic nerve and of the cerebro-spinal system (the difference between which tends more and more to become effaced) are with their * Espinas. Les Societes Animales, p. 520. CONCLUSION. 147 ganglia the innumerable agents of this co-ordination. Now is their activity confined to the simple molecular disturbance which constitutes the nervous influx, or has it also a psychic, conscious effect? There can be no doubt as regards morbid cases that the activity in question is felt. In the normal case it only produces that vague consciousness of life which we have so frequently mentioned. But whether vague or not it matters but little. We maintain even that the nervous actions which represent the totality of organic life are really the fundamental facts of personality, and that their value as such, thus to speak, is in inverse ratio to their psychological intensity. They do vastly more than merely call forth a few unstable and superficial states of consciousness ; they fashion the nervous cen- tres, impart to them a proper tone and habit. Let us imagine for a moment the prodigious power of such actions (however weak we may suppose them to be) incessantly transmitted, without rest or respite, ever repeating the same theme with only a few variations. Why should they not produce as a result the constitu- tion of organic states, that is, states defined as stable, which are the anatomical and physiological represen- tatives of the internal life? Evidently all is not de- pendent upon the viscera alone, because the nervous centres also have their own innate or hereditary con- stitution by virtue of which they react; they are not only receivers, but inciters ; and we must not separate them from the organs which they represent, and with which they make one : between both there is recipro- city of action. Where do all these nervous actions finally unite that constitute the resu7ne of organic life ? No one knows. Ferrier supposes that the occipital lobes are in some 148 DISEASES OF PERSONALITY, special relation with the sensibility of the viscera, and constitute the anatomical substratum of the sensations. Let this be granted purely by way of hypothesis, and in order to fix ideas. The result would be that passing from stage to stage, from one delegation to another, visceral life would here find its last representation ; here it is registered in a language unknown to us but which by its very inscriptions, or (to continue the metaphor) by the disposition of its words and phrases, expresses the internal individuality, and only that, to the exclusion of all other individuality. But in truth, whether this anatomical representation exists there or elsewhere, whether it be localized or disseminated, does not in the least alter our conclusion, provided it actually exists. I do not regret having dwelt upon this point, because the co-ordination of the in- numerable nervous actions of the organic life is the basis of the physical and psychical personality ; be- cause all other co-ordinations rest upon and are added to it ; because it is the inner man, the material form of his subjectivity, the ultimate reason of his manner of feeling and acting, the source of his instincts, his sentiments, and his passions, and, as they used to say in the middle ages, his principle of individuation. Let us now pass from within to without. The periphery of the body forms a surface upon which the terminal laminae of the nerves are unequally distributed. Whether few or many the nervous filaments receive and transmit impressions, that is molecular shocks, from the differ'^nt points of the body, centralize them- selves in the spinal cord, and ascend into the me- dulla and isthmus cerebri. Here there is a new im- portation, — that from the cranial nerves, — and now the transmission of the sensorial impressions is complete. CONCLUSION. 149 Let us not forget that the centrifugal nerves behave in the same vi^ay, yet in the direction of increasing de- centralization. Briefly, the spinal cord, consisting of a mass of contiguous and accumulated ganglia, and particularly the medulla with its special centres (of respiration, phonation, deglutition, etc.), while they are organs of transmission, represent a reduction to unity of an infinity of nervous actions disseminated throughout the body. At this point the question becomes exceedingly ob- scure. The mesencephalon seems to possess a more complicated reflex function than the medulla, and the medulla a more complex function than the spinal cord. The striated bodies would seem to be a centre in\ which are organized the habitual or automatic move-/ ments. The optic thalami would be the points in which the sensitive impressions gather together, in order to reflect themselves in movements. However this may be, we know that the internal capsule — a bundle of white substance forming a con- tinuation of the cerebral peduncle — traverses the opto- striate bodies, penetrating into the channel between the optic thalami and the lenticular nucleus, and that it expands within the hemisphere, forming the corona radiata of Reil. This is the gateway through which pass all the sensory and motor fibres that come from or move toward the opposite part of the body. The anterior part contains only motor fibres. The poste- rior part contains all the sensory fibres, a certain num- ber of motor fibres, and all the fibres coming from the organs of sense. The sensory bundle of fibres being completed is again divided : one part ascends towards the fronto-parietal convolution ; the others bend back- ward towards the occipital lobe; the bundle of motor I50 DISEASES OF PERSONALITY. fibres is distributed in the gray cortex of the motor zones. All these details, however wearisome they may seem to the reader notwithstanding their brevity, prove the intimate correlation established between all the parts of the body and the cerebral hemispheres. Here the study of the localization of the functions, although imperfect, admits of some precision : for in- stance, it is established that there is a motor zone (formpd by the ascending frontal and parietal convolu- tions, paracentric lobe, and base of the frontal convo- lutions) in which appear represented the movements of the different parts of the body; there is also a sen- sory zone, which is less defined [the occipital lobes (?) and the temporo-parietal region]. The function of the frontal lobes is not exactly known. We may however incidentally notice the recent hypothesis of Dr. Hugh- lings Jackson, who regards them as more complex combinations and co-ordinations of the other centres — being as it were a representation of representations.* We must leave aside all past and present discus- sions upon the physiological and psychological role of these centres ; which would fill a large volume. Taking the question in its entirety, we may say that the cor- tical substance represents all the forms of the nervous activity : visceral, muscular, tactile, visual, auditory, olfactory, gustatory, motor, significatory. This repre- sentation is not direct ; an impression does not go from the periphery to the brain like a telegraphic dispatch from one office to another. In a certain case in which the spinal cord was reduced to the size of a quill, and the gray substance infinitely small, the subject still had feeling (Charcot). But, whether indirect or even * Lectures on Evolution and Dissolution of Nervous System^ 1884. CONCLUSION. 151 doubly indirect, this representation is or can be a total representation. Between the equivalents of these ner- vous actions disseminated in the body there exist in- numerable connections (commissures between the two hemispheres, and between the different centres of each hemisphere); some innate, others established by experience,* having all possible degrees from the most stable to the most ephemeral. Physical personalit}^, accordingly, or more exactly its last representation, appears to us, not like a central point from whence everything radiates and on which everything abuts (e. g. the pineal gland of Descartes), but like some prodigiously tangled and inextricable maze in which histology, anatomy, and physiology are bewildered at every turn. Even from this exceedingly imperfect sketch we are able to perceive that the term consensus or coordina- tion is not a simple flatus vocis, an abstraction, but the expression of the nature of things. II. Reinstating, now, the psychic element which up to this point had been eliminated, let us see what will follow. We must bear in mind that to us conscious- ness is not an entity, but a sum of states of which each is a phenomenon of a particular kind, bound up with certain conditions of the activity of the brain, which exists when they exist, is lacking when they are absent, disappears when they disappear. Hence it fol- lows that the sum of the states of consciousness in man *It is clear, for example, that with a man who does not know how to write, certain associations of very delicate movements are not established, and consequently are neither represented in the encephalon, nor associated with the nervous dispositions which represent the same words in a vocal form. This applies to many other cases. 152 DISEASES OF PERSONALITY. is very inferior to the sum of the nervous actions (re- flexes of every order from the most simple to the most compound). To be more precise : during the lapse of say five minutes there is produced in us a successive series of sensations, feelings, images, ideas, acts. It is possible to count them, and to determine their num- ber with tolerable certainty. During the same lapse of time, in the same man, there will be produced a much greater number of nervous actions. Conscious personality, accordingly, cannot be a representation of all that takes place in the nervous centres ; it is but an extract, a synopsis of it. Such is the inevitable consequence of our mental nature : our states of con- sciousness are arranged in time, not in space, accord- ing to one dimension, not according to several. By fusion and integration of the simple states among them- selves, very complex states are formed which enter into the series as if they were simple ; to a certain extent they may even coexist for a time ; but ultimately we have to admit that the sphere of consciousness, the ''Um- fang des Bewusstseins," above all of clear conscious- ness, remains always very limited. It is, accordingly, impossible to regard conscious personality in refer- ence to objective, cerebral personality, as an impres- sion that corresponds exactly to the design from which it is made : it resembles rather a topographical plan with respect to the country which it represents. Why do certain nervous actions become conscious, and which are they ? To answer this question would be to solve the problem of the conditions of conscious- ness. But as we have already said, these are in a great measure unknown. There also has been much discussion concerning the part played in the genesis of consciousness by the five layers of the cortical cells ; CONCLUSION. 153 but by the admissions of the authors themselves all this is pure hypothesis. Let us pass beyond, there- fore ; psychology derives no profit from leaning upon a physiology without foundation. We can prove that the ever unstable states of consciousness evoke and supplant each other. It is the effect of a transmis- sion of force and of a conflict of forces which, in our view, takes place, not between the states of con- sciousness, as is generally supposed, but between the nervous elements that support and engender them. These associations and antagonisms, so well studied in our own time, do not pertain to the present subject. We must advance still further, and go down to the conditions of their organic unity. The states of con- sciousness, in fact, are not like will-o'-the-wisps, b}' turns kindled and extinguished : there is something that unites them, and which is the subjective expres- sion of their objective co-ordination. Here we may discern the ultimate ground of their continuity. Al- though we have already studied this point, still, in view of its paramount importance, I do not hesitate to revert to it under a different form. We observe that for the present it is not a ques- tion of reflective personality, but of that spontaneous, natural feeling of ourselves, which exists in every healthy individual. Each of my .states of conscious- ness enjoys the double character of being such or such a one, and moreover of being mine : a pain is not merely a pain, but is also my pain ; the vision of a tree, not only the vision of a tree, but my vision of a tree. Each state bears a mark through which it appears to me as belonging to myself ; without which it appears as something foreign to me ; as happens, we have already seen, in several morbid cases. This common mark is the 154 DISEASES OF PERSONALITY. sign of their common origin, and whence could it spring except from the organism? Let us imagine that we were able to suppress in a fellow man the five special senses and along with them their entire psychological products (perceptions, images, ideas, associations of ideas among themselves and of emotions along with the ideas). A suppression of this kind having been made, there still remains the internal, organic life, with its own, peculiar sensibility — the expression of the state of the function of each organ, of their general or local variations, of the rise or the fall of the vital tone. The state of a man immersed in profound slumber sen- sibly approaches to our hypothesis. If, now, we essay the contrary hypothesis, we find it absurd and con- tradictory. We cannot conceive to ourselves the spe- cial senses, with the psychic life which they support^ as having no real form, as being isolated from general sensibility and suspended in vacuo. Each sensorial apparatus is not as a matter of fact an abstraction :. there does not exist a visual or auditory apparatus in general, such as is described in treatises on physiology^ but a concrete, individual apparatus, of which there are never produced two perfectly identical specimens in individuals of the same species, except, perhaps,, occasionally in twins. Yet this is not all. Besides hav- ing its peculiar constitution in each individual — the stamp which it directly and necessarily impresses upon all its products — each sensorial apparatus, at every instant and under all forms, depends on the organic life, on circulation, digestion, respiration, secretion, and the rest. These different expressions of individuality are added to every perception, emotion, and idea ; they are one with these, as harmonics are with a fundamental tone. This personal, possessive char- CONCLUSION. 155 acter of our states of consciousness is not, accordingly, as some authors have maintained, the result of a more or less expHcit judgment which affirms them as mine, at the instant they are produced. The personal mark is not superadded, but is included ; it forms an inte- gral part of the event, and results from its physio- logical conditions. By studying the state of conscious- ness alone we shall not be able to discover its origin ; for it cannot be at the same time effect and cause, subjective state and nervous action. And pathological facts confirm this conclusion. We have seen the feehng of the ego rise or fall ac- cording to the state of the organism and certain pa- tients maintain that their ''sensations have changed," which means that the fundamental tone has no longer the same harmonics. Finally, we have seen states of consciousness by slow degrees lose their personal char- acter, become objective and foreign to the individual. Now can these facts be explained on any other theory? Stuart Mill, in a passage often quoted,* asks where is the bond, the inexplicable law, ''the organic union," which connects one state of consciousness with an- other, the common and permanent element ; and he finds that we know nothing definite about the mind, except its states of consciousness. Doubtless so, if we limit ourselves to pure ideology. But a group of effects is not a cause, and however minutely we may * In his Examination of Sir William Hamilton's Philosophy. It would only be fair to observe that in the form in which Mill puts the question— the reduc- tion of the ego to organism would not aid him much, for in this passage he con- siders the body not as a physiologist, but as a metaphysician. We note inci- dentally that the theory maintained here, although materialistic in form can adopt itself to any metaphysics. We essay to reduce conscious personality to its immediate conditions— the organism. As regards the final conditions of these conditions, we have nothing to say, and everybody is free to conceive them according to his own fancy. Regarding this point see the very pertinent remarks of M. Fouillee in his La science sociale contejnporaine, pp. 224-225. 156 DISEASES OF PERSONALITY. study them, our work will be incomplete if we do not descend lower — into that dark region where, as Taine says, '' innumerable currents incessantly meander with- out our being conscious thereof." The organic bond demanded by Stuart Mill exists, by definition so to speak, in the organism. Thus the organism and the brain, as its highest representation, constitute the real personality, con- taining in itself all that we have been, and the possi- bilities of all that we shall be. The complete individ- ual character is inscribed there with all its active and passive aptitudes, sympathies, and antipathies ; its genius, talents, or stupidity; its virtues, vices, torpor, or activity. Of all these, what emerges and actually reaches consciousness is only a small item compared with what remains buried below, albeit still active. Conscious personality is always but a feeble portion of physical personality. The unity of the ego, consequently, is not that of the one-entity of spiritualists which is dispersed into multiple phenomena, but the co-ordination of a cer- tain number of incessantly renascent states, having for their support the vague sense of our bodies. This unity does not pass from above to below, but from be- low to above ; the unity of the ego is not an initial, but a terminal point. Does there really exist a perfect unity ? Evidently not in the strict, mathematical sense. In a relative sense it is met with, rarely and incidentally. In a clever marksman in the act of taking aim, or in a skilled surgeon performing a difficult operation all is found to converge, both physically and mentally. Still, let us take note of the result : in these conditions the awareness of real personality disappears ; the conscious CONCLUSION. 157 individual is reduced to an idea ; whence it would follow that perfect unity of consciousness and the awareness of personality exclude each other. By a dif- ferent course we again reach the same conclusion ; the ego is a co-ordination. It oscillates between two extreme points at which it ceases to exist : viz. perfect unity and absolute incoordination. All the intermediate degrees are met with in fact, and without any line of demarcation between the healthy and the morbid ; the one encroaches upon the other. "*" The unity of the ego, in a psychological sense, is, therefore, the cohesion, during a given time, of a cer- tain number of clear states of consciousness, accom- panied by others less clear, and by a multitude of phys- iological states which without being accompanied by consciousness like the others, yet operate as much and even more than the former. Unity, in fact, means co-ordination. The conclusion to be drawn from the above remarks is namely this, that the consensus of consciousness being subordinate to the consensus of the organism, the problem of the unity of the ego is, in its ultimate form, a biological problem. To biol- ogy pertains the task of explaining, if it can, the gen- esis of organisms and the solidarity of their component parts. Psychological interpretation can only follow in its wake. 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