Page:Mind (New Series) Volume 9.djvu/115

P. JANET AND F. RAYMOND, Nevroses at Idees Fixes. 101 brain in a way to provoke the continued affection of "la perception personnelle " (p. 142). Psychological treatment based on this hypothesis resulted in partial improvement of some cases. The improvements, temporary and permanent, are admirably expressed in the graphics. Curiously and this is a problem by itself the progress made in one case during waking hours was always lost again during sleep (p. 154). Probably the most elaborate of all the analyses is chapter iv. " histoire d'une idee fixe " (pp. 156-212). This case illustrates well the stratification of fixed ideas, one layer being derived from the other. To separate primitive from derivative is extremely difficult ; but by steadily keeping to his method of minute observation and correlating every word and movement with the personal history, Dr. Janet succeeded in unveiling the history of the fixed idea of " cholera ". By gradual displacement of syllables, and the patience of the process is not less than the ingenuity, he succeeded in breaking the power of this sound to cause hysterical convulsions. But the great difficulty was to keep the secondary fixed ideas from entering, like the seven devils, into the empty mind. A certain improvement did take place, suggestibility being reduced (p. 199). Not less interesting is chapter v. " Les idees fixes de forme hysterique " (pp. 213-233). The cases go to establish the existence of subconscious fixed ideas, manifested only in dreams or induced somnambulism, automatic writing, or the like, but still capable of initiating " crises ". The hysterical form of fixed idea is held to be the simplest (p. 232). In the next three chapters vi., vii., viii. (pp. 234-353) Dr. Janet makes a minute study of certain forms of perceptional and muscular affections in hysterical subjects. In chapter vi., the problem of allochiria is analysed. Without claiming to offer an ex- haustive explanation, Dr. Janet concludes that "simple allochiria" is really due to misinterpretation of local signs, these being affected on account of anaesthesia or hyposesthesia (p. 255). " Complete allochiria," he suggests, grafts itself on to the other form as a result of a pathological habit (p. 262). The problem of right and left in perception has always been difficult, and some of the observations here will certainly assist in the solution. In chapter vii. a case of hysterical hemianopsia the chief interest lies in the demonstra- tion of the varying limits of the conscious visual field, the persistence of subconscious vision, the varieties of the anesthetic areas, the corresponding variations in the field of consciousness and the restorations of sensation possible in the hypnotic state. " Nous avons affaire ici, en resum6, A un phenomene qui a ete jusqu'ici peu observe, la determination d'une forme de champ visuel par 1'idee fixe " (p. 290). It is iittle wonder if those cases of the major hysteria puzzle the alienist, when " retrecissements du champ visuel, douleurs localisees singulierement, des contractures de forme etrange, des paresies " (p. 290) can all be exhibited as a