What is it that has happened? Does everything around me really exist? What am I? What are all these things that are made like me? Why am I? Who am I? I exist, but outside of real life, and in spite of myself. Nothing, however, has given me death. Why are all these things around me which all present the same aspect? These things should enjoy life. What are these things?
"Although in this cruel condition, I have to do as I did before, and, without knowing why, something that does not appear to reside in the body urges me to continue as formerly; and I can not realize that this is true, that I really act. Everything is mechanical with me, and done unconsciously.
"When I experience a physical sensation, the substance that produces it, which is without any significance to me, is a blank. I feel a pressure on my temples and a stress between my eyes at the top of my nose, with a twitching of the nose to the top of my forehead. My ears hear well, but appear stopped up. My left nostril is sometimes obstructed, then free, then closed. Besides this strange sensation I remark that when any one speaks to me I answer immediately, and the answer is a reasonable one.
"My work has so far been done properly and without any mistake; and yet, when I say to myself, as I am saying continually, 'I am doing this, I am doing that,' I can not bring myself to realize that it is true.
"I may describe my condition in brief by saying that my personality has wholly disappeared; it seems to me that I have been dead for two years, and that the thing that exists does not recall anything that has a relation with any former myself. The manner in which I see things does not give me any realization of what they are, or that they exist, whence the doubt, etc.
"In view of this painful mental condition I come to ask you now whether I am not about to become mad, or whether I can do anything to deliver myself from a disorder which has continued so long, and which has so far only been modified. Without being able to enjoy life in any way, for I do not comprehend it, I am obliged to suffer everything that others, who are in their normal state, suffer."
The dominant fact in the psychological condition of this man is the absolute loss of the sentiment of reality. He compares himself to an empty paper sack. There is nothing in him. Nothing is left of him but an envelope which preserves a kind of external appearance, but which is in fact perfectly empty. He calls himself "a thing." Other men are "things" like him, but he does not believe in their real existence. He does not believe in what he sees, and when he puts out his hand to touch any object he is convinced in advance that he will find nothing but a phantom that will vanish. Although he really touches the object, the tactual added to the visual impression is still not enough to overcome his incredulity. The world, in his eye, is nothing
