From James Crichton-Browne [29–31 March 1871]1
I have no doubt whatsoever that the intense concentration of attention—for a prolonged period, upon a part or organ—may ultimately influence its capillary circulation and nutrition—particularly in certain temperaments and morbid states.2 I found my opinion—not upon the stories about the ecstatics—who by fervent religious meditation—obviously of a diseased character—produced hemorragic spots corresponding to the five wounds of Christ—for such stories although well authenticated have a suspicious resemblance to that of the Welsh fasting girl3—but upon facts which have fallen under my observation—in my professional experience. Let me describe a case. Mrs. N. from Leeds. 50 years of age and 6 years past the change of life was admitted into this Asylum on June 4th. 1870. labouring under various delusions—and this amongst others that she was two months advanced in pregnancy.4 No argument or assurances could convince her that she was in error on this point.
“It is no use” she said ‘I have had five children and know what it is to be in the family way—better than the doctors. The delusion continued unshaken—until the 7th of January—the end of nine months dating from the time of impregnation fixed by her, when she intimated that labour had set in. She took to bed and insisted on going through all the formalities of the lying-in-room. She presented signs of suffering at stated intervals. At this time there was a little flatulent distension of the bowels. On the 9th. when I visited her—she announced that delivery was close at hands. Every few minutes she presented the appearance of suffering from a labour pain, held firmly by a sheet which she had fastened to the top of her bed—and cried out in the usual way. At these times perspiration broke out on her forehead. This went on until the 12th. of January—when a discharge from the vagina commenced—which proved to be a distinct return of menstruation—and which lasted for three days. The intense direction of attention to the reproductive organs—which examination proved to be in a perfectly healthy condition had re-induced a function of theirs previously interrupted for 6 years. It seems to me clear that in this case a delusion—long & intensley projected if I may so say upon one set of organs, had altered their state in a material manner and modified their capillary circulation.
I do not give implicit credence to the case quoted by Maudsley and many others, in which a lady seeing a childs ankle bruised in a gate way—and feeling intense anguish at the sight, found afterwards that there was a discoloration and bruise of her own ankle, in the situation of the injury in that of the child.5 I notice various elements of doubt in the annecdote—and in others of the same kind.
The coexistence of a persistent delusion in a lunatic respecting some bodily organ—and a state of actual disease in that organ, is of very common occurrence, but in such cases it seems probable—that the altered sensations produced by the morbid condition of the organ suggested the delusion. This is not however always the case. I remember a patient of mine who had asserted for ten years that she had scorpions in her stomach—and who was greatly distressed by their presence there, and who died of cancer of that viscus the first symptoms of which appeared about twelve months before her death.6 Is it not probable that in this case the delusion—determined at any rate the localization of the malignant action.
I had occasion to see a murderer on Friday last—a couple of hours after he had perpetrated a brutal homicide and while he was still in a paroxysm of murderous rage. His pupils were dilated.7 He is however an epileptic and in patients of that class dilatation of the pupil is the rule.
On the power of concentration to influence body organs.