1. _Irruption of Partial Hypnosis._--Janet observes that the subconscious automatisms have a hypnotic influence and can bring about complete somnambulism.[84]
He made the following experiment: While the patient, who was in the completely waking state, was engaged in conversation by a second observer, Janet stationed himself behind her and by means of whispered suggestions made her unconsciously move her hand and by written signs give an answer to questions. Suddenly the patient broke off the conversation, turned round and with her supraliminal consciousness continued the previously subconscious talk with Janet. She had fallen into hypnotic somnambulism.[85]
There is here a state of affairs similar to our patient's. But it must be noted that, for certain reasons discussed later, the sleeping state is not to be regarded as hypnotic. We therefore come to the question of--
2. _The Psychic Stimulation._--It is told of Bettina Brentano that the first time she met Goethe she suddenly fell asleep on his knee.[86]
This ecstatic sleep in the midst of extremest torture, the so-called "witch-sleep," is well known in the history of trials for witchcraft.[87]
With susceptible subjects relatively insignificant stimuli suffice to bring about the somnambulic state. Thus a sensitive lady had to have a splinter cut out of her finger. Without any kind of bodily change she suddenly saw herself sitting by the side of a brook in a beautiful meadow, plucking flowers. This condition lasted as long as the slight operation and then disappeared spontaneously.[88]
Loewenfeld[89] has noticed unintentional inducement of hysterical lethargy through hypnosis.
Our case has certain resemblances to hysterical lethargy[90] as described by Loewenfeld, viz. the shallow breathing, the diminution of the pulse, the corpse-like pallor of the face, and further the peculiar feeling of dying and the thoughts of death.[91]
The retention of one sense is not inconsistent with lethargy: thus in certain cases of trance the sense of hearing remains.[92]
In Bonamaison's[93] case not only was the sense of touch retained, but the senses of hearing and smell were quickened. The hallucinatory content and loud speaking is also met with in persons with hallucinations in lethargy.[94] Usually there prevails total amnesia for the lethargic interval. Loewenfeld's[95] case D. had, however, a fleeting recollection; in Bonamaison's case there was no amnesia. Lethargic patients do not prove susceptible to the usual waking stimuli, but Loewenfeld succeeded with his patient St. in turning the lethargy into hypnosis by means of mesmeric passes, thus combining it with the rest of consciousness during the attack.[96] Our patient showed herself absolutely insusceptible in the beginning of the lethargy, but later on she began to speak spontaneously, was incapable of giving any attention when her somnambulic ego was speaking, but could attend when it was one of her automatic personalities. In this last case it is probable that the hypnotic effect of the automatisms succeeded in achieving a partial transformation of the lethargy into hypnosis. When we consider that, according to Loewenfeld's view, the lethargic disposition must not be "too readily identified with the peculiar condition of the nervous apparatus in hysteria," then the idea of the family heredity of this disposition in our case becomes not a little probable. The disease is much complicated by these attacks.