Page:A case of double consciousness Albert Wilson 1904 MPD in a child.djvu/4

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A CASE OF DOUBLE CONSCIOUSNESS,

drawn up like a ball, so that one can lift her en masse by one limb. They last about ten minutes, and any sudden noise or start will bring them on. It was not until July 20th, 1895, that I saw her in her normal state. She suddenly changed to the normal, and was very modest and well-behaved for a child of her age. In the abnormal she was noisy and very familiar in her manner. She told me she knew nothing of these attacks, and she said she had not seen me before. This is very remarkable, for I had seen her nearly every day for ten weeks, and she had heard my voice, so that in her abnormal condition she and I were very old friends. In about five minutes she changed back to the abnormal. She put on a very annoyed expression, pouting and frowning. In a minute her features relaxed, she smiled, and began chatting in her usual way.

I have kept a chronological record of the various sub-stages, which would fill a small volume; but I propose only to deal with the chief sub-stages, leaving out five or six which were ill-defined. As a rule she gave herself a name in each sub-stage, or, if not, we suggested one. Thus in the last described she was called "a thing." We have now seen two sub-stages:

B 1, the mania, with fear of snakes and great thirst.

B 2, "a thing."

Whilst admitting the intricacy and dense obscurity of this and similar cases, yet I wish to advance a theory for consideration. It seems to me poor fun to label this hystero-epilepsy and toss it aside, shutting one’s eyes to the vast issues which such a case raises in our social economy, especially in the question of the day, Individual Responsibility, whether viewed from the legal or the moral aspect. I think the tendency of to-day is to regard hysteria and its many manifestations as a disease of the sympathetic system. We all know the patches of flushing that occur on the face and neck of certain persons; while in opposition to the local hyperæmias we have local anæmias and lividities as in Raynaud's disease, chilblains, so-called "dead fingers," and allied diseases. We have also local hyper-æsthesia and local anæsthesia.

Are not all of them dependent on vaso-motor changes? These we might term the coarse manifestation of disturbance in the sympathetic system. If we instead apply the same vaso-motor changes to the delicate cortex of the brain, must we