must agree that the patient had kept the memory-picture of her lover unaltered in her heart for thirty-five years.
One might easily think that these patients who give an impression of imbecility are only burnt-out ruins of humanity. But such is probably not the case. One can often prove directly that such patients register everything going on around them even with a certain curiosity, and have an excellent memory for it all. This is the reason why many patients become for a time pretty sensible again, and develop mental powers which one believed they had long since lost. Such intervals occur occasionally during serious physical disease, or just before death. We had a patient with whom it was impossible to carry on a sane conversation; he only produced a mad medley of delusions and words. He once fell seriously ill physically, and I expected it would be very difficult to treat him. Not at all. He was quite changed, he became friendly and amiable, and carried out all his doctor’s orders patiently and gratefully. His eyes lost their evil darting looks, and shone quietly and understandingly. One morning I came to his room with the usual greeting: “Good morning. How are you getting on?” The patient answered me in the well-known way: “There again comes one of the dog and monkey troupe wanting to play the Saviour.” Then I knew his physical trouble was over. From that moment the whole of his reason was as if “blown away” again.
From these observations we see that reason still survives, but is pushed away into some corner by the complete preoccupation of the mind with diseased thoughts.
Why is the mind compelled to exhaust itself in the elaboration of diseased nonsense? On this difficult question our new insight throws considerable light. To-day we can say that the pathological images dominate the interests of the patient so completely, because they are simply derivatives of the most important questions that used to occupy the person when normal—what in insanity is now an incomprehensible maze of symptoms, used to be fields of vital interest to the former personality.