Visual Disturbances Experienced
By A Former Medical Superintendent of The Insane. V61 Art. VIII.? The subject of the following illusions, after six months’ unheeded warning’s, broke down about two years ago from heart disease. At first, and for about two months, it manifested itself chiefly in attacks of angina pectoris, which were specially neurotic in character.
These were followed by gradual general improvement, but leaving the subject of them open to recurrent attacks, and especially liable to suffer from physical or mental exertion. This condition of improved, yet impaired health, continued till the spring of this year, when the writer became the subject of what may be called an attack of acute dyspepsia, during the development and persistence of which occurred the phenomena of which the following notes are an imperfect record.
The attack referred to was indicated mainly by intense thirst, a foul tongue, bad taste, loss of appetite, persistent constipation, loss of sleep and mental exaltation. The notes were sent to a medical friend during convalescence, but were certainly not intended for publication, which, however, has been assented to on the advice of others. They embrace a period of nine weeks, three of which, however, are a blank, as the phenomena then were too complicated and confused, and the writer too ill to analyse or remember them. During the two last weeks of the period they were too vague to be worth noting.
They have been re-read, but left nearly in the condition in which they were at first recorded. As the attack was followed by considerable prostration, during which was penned the description of the unusual phenomena, it is neither so lucid nor so vivid as otherwise it might have been. After all, only salient points are recorded.
I. Visual disturbances first noticed. (a) Flashes of light. These were similar to so-called summer lightning?sudden faint flashes of light, seen, however, in daylight, which involuntarily drew attention to the sky and the clouds. It was only by careful observation that they were made out to be subjective. The moment attention was directed to them they ceased to exist. (6) Zones of light.
This was a more advanced, and therefore more persistent condition. On looking at a cloud a yellowish zone of light surrounded it, or a portion of it, which persisted only for a short time, hut long enough to determine its source and reality. The area within the zone seemed a little darker than the cloud itself. (n) A dark central area.
This, as seen, presented a dark circular field, which increased in darkness until the ground became broken up into a mass of black minute moving objects. In form they were stellar cruciform, or exhibited some irregular polygonal outline. In size they were -J-rtli to the -J^nd of an inch. In number, say a thousand. In colour, black. Their motions rapid?a veritable dance ot atoms. They had very much the appearance of a swarm of ? animalcules on the field of the microscope. The above series of phenomena were introductory to those which follow. They were most marked when looking into diffused daylight. They lasted for about ten days. They regularly succeeded each other, each gradually increasing in intensity, then declining and merging into its successor. II. Disturbances which occurred after a three weeks’ interval. They are described when they are supposed to have reached their greatest intensity. (a) The gas when burning looked like a jet of electric light.
The fire like a reservoir of melted metal at whjte heat.
Daylight a brilliant haze.
The sun was too bright for even a venturesome gaze.
(e) A page of print looked exactly as if a strong brush had been dashed through the paper, leaving the words and letters broken into fragments. As the fragments were dissociated from each other only within narrow limits, by a special effort of attention a word, or even a line, could be made out, but leading was impossible, and for many weeks the writer was deprived of his main solace during the previous eighteen months’ forced retirement from active work.
The disjecta membra, verbal and literal, were confined to the centre of the visual area, outside of which the rest of the page was a vague confused mass.
(J) On looking into the open.day nothing was seen but a confused haze, in the centre of which fragments of objects could be seen very much as the words and letters referred to. Here, as there, by a special effort of attention they could be made out more distinctly.
III. Phenomena which are still more complex and peculiar. (a) Looking at the ceiling in the dark, or with the eyes shut, it matters not which provided light be absent, a dark form is seen, representing the shape of the human eye enlarged, that is, a spheroid, with its longer axis horizontal, apparent size a foot to 18 inches, the central third of which corresponds to the central axis of vision. This is a dark grey oval plane, on which is seen a moving for min soft bright silvery light. The nearest comparison to it which I can think of is the frilled border of a lady’s cap, or much better, a piece of intestine. In the latter you have the convolutions extending along one side, on the other a puckered line. Suppose this laid on the plane referred to in a circle, the puckered line towards the centre, the convolutions looking away from it, the central third of the area being free. The white glistening appearance of the intestine, as well as its outlines, presents as nearly as possible the phenomenon described.
It has, however, not only form and colour, but motion. This motion is continuous, and very peculiar. The circle of convolutions move slowly and regularly backwards and forwards towards the centre, but never reach it. The whole circle does not move at once, but successively in three or four sections. They invariably left the impression that they were the result of some regulated piece of mechanism.
This vision lasted for many days and nights, seen with eyes open or shut, best seen in darkness; even in daylight it could be made out, though indistinctly; in short, it was evidently persistent, though it ceased to become an object of consciousness when attention was strongly directed elsewhere. Like all the other phenomena it gradually declined in intensity, and merged into others ; however, even when others had taken its place and had become more prominent, it could still be traced as a shadow.
(b) Another figure which succeeded this was entirely different. Its form was that of a rayless composite flower, say a Michaelmas daisy. It was about y ^-ths of an inch in diameter. The centre was filled with a golden flame colour, surrounded by a narrow, somewhat irregular black line or border. Whenever the attention was directed to it the golden centre became gradually filled with black points, which passed into rapid motion, then it gradually faded into darkness. This vision lasted for two or three minutes, was constantly seen in darkness or with the eyes shut, but only imperfectly, in light. It lasted for a period of about ten days, when, like others, it gradually declined in vividness till it disappeared. IV. Another vision, or rather series of them, still more extraordinary, presented themselves as figures of living creatures. The larger mammalia wild and tame, birds, serpents, and fishes.
They seemed to occupy the same relative position to the central axis of vision as the intestinal circle already described. (?) As to their forms, they were only partial, that is, only a portion of the figure was visible, viz., the head and shoulders. They were not only partial, but imperfect, that is, the forms were always distorted, just enough of regularity left to ensure identification.
(?) In position their heads were always towards the centre. (c) Their numbers were four to six standing in a circle. (d) Their motions, as in other cases, were slow, deliberate, see-saw, not altogether, but successively in sections to and from the centre, but never reaching it.
(e) The same set of figures always appeared together, and continued for a day or two, when they were succeeded by a new series. V. Another series may be described as follows: When the room was dark, or the eyes shut, the whole area of vision,not the centre merely, as hitherto described, was occupied by a black ground, on which appeared, as if painted, a series of geometrical figures as lines, angles, in flame or gold colour. They had very much the appearance of Japanese paintings minus, however, all organic forms.
This appearance gradually faded away as improvement progressed. The forms remained the same, but the colours gradually grew fainter, the dark ground becoming lighter, the golden patterns passing into dull yellow, salmon, and various shades of grey.
VI. Eccentric Phenomena. In looking at an object in the axis of vision we see it directly and distinctly, but are at the same time indistinctly conscious of other objects lying in an outer circle. The preceding series of phenomena were confined to, or at least most prominent in the central area of vision ; the fifth, just described, occupied the whole field, outer and inner ; that which we now proceed to describe was confined to the outer circle. The centre in this case was dark and unoccupied by objects of any kind. The outer circle was filled by what can only be described as exactly resembling the ordinary patterns seen in wirework. These varied from time to time, each new pattern succeeding a former one, while within the meshes of the network the animalcular forms already described continued vigorously their atomic dance. VII. Special Phenomena. We may here add that visions of a more pleasing if not more interesting character sometimes, though rarely, made their appearance. They were entirely scenic, as distant towns, seas, lakes, cliffs, mountains, &c. They were always single pictures, VISUAL DISTURBANCES EXPERIENCED. 241 and were never repeated, as was the case with the other visions described. As to an explanation of these phenomena, the writer has nothing whatever to say. His object has been to record and describe the facts as truthfully as he was able, and he begs now to conclude with a few general observations which he thinks worth noting.
1st. The absence of colour.
Black, white, and flame colour, that is modifications of natural or artificial light, were characteristic of all the phenomena, the more intense passing into fainter shades as the successive visions gradually declined. On only two or three occasions were colours seen, and these faint and transient, as a pale pink, a. light blue. 2nd. There is the rarity of single pictures or objects, these only occurring a few times and within the limits of two or three days, apparently just when improvement had begun. 3rd. There is the gradual growth, perfection, and decay of the successive visions as they gave place to or merged into one another.
4th. Another characteristic was the persistence of the declining phenomena alter their more marked and vigorous successors had taken their place. This was constantly noticed. Sometimes three successive visions could be made out at the same time, each appearing more faint according to its distance in time. When so seen they were never mixed up irregularly, but appeared as occupying successive strata, leaving the impression that they were really persistent, but lost to view by the successive additions made by their more recent and more vigorous companions.
5th. The deliberate, regular, machine-like motions, as well as their repeated similarity in this respect in the successive visions, is another interesting characteristic. 6th. There is the position the various phenomena occupied relative to the axis of vision. By far the greater number presented themselves in the centre of the visual field where objects are seen directly and distinctly. A few only occupied the external area where objects are seen indirectly, as the zones of light and the wire-net phenomena. Fewer still occupied the whole area, as for example the Japanese figures. In conclusion, as to the eyes themselves, no change was noted in the body of the eye external or internal, no pain was felt nor discomfort experienced except what arose from a tendency to lachrymation. This tendency was especially manifested during the later stages of the disease, and continued for about a fortnight after visual disturbance had ceased, and when convalescence was far advanced. J. Gr., ]1. D.
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