hysteria. Janet notes the following as to the "troubles de l'attention": "One can say that the main trouble exists not only in a suppression of the intellectual faculties, but in the difficulty of fixing the attention. Their mind is always distracted by some vague preoccupation and they never give themselves up entirely to the object which one assigns to them." As shown in the first chapter, the words of Janet may also be applied to dementia præcox. It is the autonomous complex which disturbs the concentration of the patients, it paralyzes all other psychic activities, a fact which curiously escaped Janet. What is striking in hysteria (just as in other affective states) is the fact that the patients always return to their "stories" (as in traumatic hysteria!) and that all their thoughts and actions are constellated by the complex only. A similar narrow-mindedness, but of the highest intensity, we frequently observe in dementia præcox, especially in the paranoid form. It is hardly necessary to give examples. Orientation in both diseases changes in a similar capricious manner. In dementia præcox, where one is not actually dealing with marked excitability and deep confusion, we often get the impression that the patients are only disturbed by illusions, but that in reality they are properly oriented. In hysteria we do not always receive the same impression, but we may convince ourselves that proper orientation exists by hypnotizing the patient. Hypnosis represses the hysterical complex and allows a reproduction of the ego-complex. As in hysteria, disorientation is due to the fact that some pathogenic complex pushes the ego-complex away from the reproduction, a thing which may happen instantaneously; likewise in dementia præcox it may readily happen that quite clear answers are often replaced at the very next moment by the most singular utterances.[1] The lucidity of consciousness is especially
- ↑ A nice example of momentary variations in hysteria is found in the work of Riklin: Über den Ganserschen Symptomencomplex. Psych, neur. Wochenschr., 1904. He shows that a patient manifested correct or delusional orientation depending on the manner of questioning. The same thing can happen spontaneously when the complex is excited by a stimulus. Riklin reports a corresponding experimental case in Cont. VII of the Diag. Assoz.-Stud. where at a critical stimulus word a dreamy state occurred and held on for some time. The pathological fancies are principally the same thing, as e. g., the automatic insertions in the language or writing in somnambulism (See Flournoy).
