be making a statement equally consistent with the facts were we to say that the first manifestation of the mental derangement occurred in the dream-life, that the disorder first broke through in the dream. In other instances, the morbid symptoms are included in the dream-life, or the psychosis remains confined to the dream-life. Thus Thomayer calls our attention to anxiety-dreams which must be conceived as the equivalent of epileptic attacks. Allison has described cases of nocturnal insanity (see Radestock), in which the subjects are apparently perfectly well in the day-time, while hallucinations, fits of frenzy, and the like regularly make their appearance at night. De Sanctis and Tissie record similar observations (the equivalent of a paranoic dream in an alcoholic, voices accusing a wife of infidelity). Tissie records many observations of recent date in which behaviour of a pathological character (based on delusory hypotheses, obsessive impulses) had their origin in dreams. Guislain describes a case in which sleep was replaced by an intermittent insanity.

* The real determining cause of the madness.

We cannot doubt that one day the physician will concern himself not only with the psychology, but also with the psycho-pathology of dreams.

In cases of convalescence from insanity, it is often especially obvious that while the functions may be healthy by day the dream-life may still partake of the psychosis. Gregory is said to have been the first to call attention to such cases (see Krauss). Macario (cited by Tissie) gives an account of a maniac who, a week after his complete recovery, once more experienced in dreams the flux of ideas and the unbridled impulses of his disease.

Concerning the changes which the dream-life undergoes in chronic psychotics, little research has been undertaken as yet. On the other hand, early attention was given to the inner relationship between dreams and mental disturbances, a relationship which is demonstrated by the complete agreement of the manifestations occurring in each. According to Maury, Cabanis, in his Rapports du Physique et du Moral, was the first to call attention to this relationship; he was followed by Lelut, J. Moreau, and more particularly the philosopher Maine de Biran. The comparison between the two is of course older still. Radestock begins the chapter in which he deals with the subject by citing a number of opinions which insist on the analogy between insanity and dreaming. Kant says somewhere: "The lunatic is a dreamer in the waking state." According to Krauss, "Insanity is a dream in which the senses are awake." Schopenhauer terms the dream a brief insanity, and insanity a long dream. Hagen describes delirium as a dream-life which is inducted not by sleep but by disease. Wundt, in his Physiologische Psychologie, declares: "As a matter of fact we ourselves may in dreams experience almost all the manifestations which we observe in the asylums for the insane."

The specific points of agreement in consequence of which such a comparison commends itself to our judgment are enumerated by Spitta, who groups them (very much as Maury has done) as follows: "(1) Suspension, or at least retardation of self-consciousness, and consequently ignorance of the condition as such, the impossibility of astonishment, and a lack of moral consciousness. (2) Modified perception of the sensory organs; that is, perception is as a rule diminished in dreams, and greatly enhanced in insanity. (3) Mutual combination of ideas exclusively in accordance with the laws of association and reproduction, hence automatic series-formations: hence again a lack of proportion in the relations between ideas (exaggerations, phantasms); and the results of all this: (4) Changes in- for example, inversions of- the personality, and sometimes of the idiosyncrasies of the character (perversities)."

Radestock adds a few additional data concerning the analogous nature of the material of dreams and of mental derangement: "The greatest number of hallucinations and illusions are found in the sphere of the senses of sight and hearing and general sensation. As in dreams, the fewest elements are supplied by the senses of smell and taste. The fever-patient, like the dreamer, is assailed by reminiscences from the remote past; what the waking and healthy man seems to have forgotten is recollected in sleep and in disease." The analogy between dreams and the psychoses receives its full value only when, like a family


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