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HYPNOTISM, DOUBLE CONSCIOUSNESS and alterations of personality by Etienne Eugène Azam

3. I meet Felida X...

In the first months of 1875, the Belgian Academy of Medicine, seized of the Louise Lateau question, asked Mr. Warlomont to write a report on the subject. This work, very well done ([1]), insists on the scientific reality of the phenomenon known as the doubling of life, double consciousness, second condition, states that can be spontaneous or provoked. Mr. Warlomont recalls famous but rather rare facts.

I recognized in these facts the analogies of my 1858 observation. Although from that time on I would have appreciated its importance, I had not published it, considering it too isolated in science, or too outside the surgery I profess in Bordeaux.

So I set out in search of Felida X... I found her presenting the same phenomena as before, but aggravated.

Today Felida X..., at the age of thirty-two, she is a mother and runs a grocery store.

She has only two living children; the eldest, conceived, as we have said, during a period of attack, has the nervous temperament of her mother, very intelligent, excellent musician. He has attacks of nerves, without complete loss of consciousness, and, after these nervous attacks, unexplainable terrors that remind us of the third state we have described. Obviously, this child, who is now sixteen years old, is influenced by morbid heredity.

Physically, Felida X... is slimmed down, without having the sickly appearance.

As soon as I arrived, having recognized me, she consulted me with eagerness on ways to get out of her sad situation.

This is what she tells me:

She is always sick, that is, she always has memory deficits that she incorrectly names her crises. Only these so-called crises, which are, after all, only periods of normalcy, have become much rarer; the last one was three months ago. However, the lack of memory that characterizes them made her make such mistakes in her relationships with neighbours that Felida has kept the most painful memory of them, and fears that she will be considered insane.

I examine it from the point of view of the integrity of its intellectual functions and I find no alteration.

However, in what she just told me, I can easily see that she remembers very well what happened during what she calls her last crisis, and this integrity of memory makes me think. It was right; because the next day her husband, whose visit I am receiving, told me that the state in which Felida has been for more than three months is the state of access or second condition, although she believes and maintains the opposite. Indeed, for her, today as in the past, the state in which she finds herself is always the state of reason, so the memory I had of the past had already enlightened me.

However, since I had not studied it, periods of normal state have become rarer and shorter, so that the second state of condition occupies almost the entire existence.

From that day on, recognizing the remarkable nature of a state that, for sixteen years, so completely changed the way of being, the personality of my young patient, I studied her almost every day, with the desire to publish her story.

To avoid lengths, I will only describe the main facts of my study, at least those that are characteristic.

On June 21, Felida, who is obviously in the state of second condition, tells me that four or five days ago, she had three or four small episodes in the same day, of one hour or two each; during this time, she has completely lost the memory of her ordinary existence, and during these moments, she is so unhappy with this singular state, that she thinks about suicide. She said, she was then certainly mad, because she didn't know that I had seen her again. She even begged me, in case chance would bring me to a similar moment, to act as if I were seeing her for the first time; new evidence of her infirmity would increase her grief.

She acknowledges that, in these moments, her character changes a lot; she becomes, she says, mean, and provokes violent scenes in her interior.

Warned by the memory of the past and by her husband's great familiarity with these variations, it is very easy for me to recognize that Felida is in the state of a second condition, well, that she claims the opposite.

As in the past, her words are brief, her character is determined, her nature relatively cheerful and carefree; it is indeed the same cheerfulness as sixteen years ago, but tempered by the reason of the mother of the family.

I think I have to report here some episodes of our patient's life, told by her.

They will give an excellent and complete idea of her condition.

In the summer of 1874, following a violent emotion, she was taken from what she wrongly calls a crisis, which lasted several months without interruption, and during which she, according to practice, lost the memory. Indeed, her husband had told me that she had had such a perfect and long period of normalcy at that time that he had hoped for a cure.

Two years ago, being in her ordinary state (i.e. in second condition), she returned in a carriage from the funeral of a lady she knew; when she returned, she felt the period she called her attack coming (normal state), she fell asleep for a few seconds, without the ladies who were with her in the cab noticing, and woke up in the other state, absolutely unaware of why she was in a mourning car, with people who, according to custom, were praising the qualities of a deceased person whose name she did not know. Used to these situations, she waited; through clever questions, she was informed, and no one could suspect what had happened.

A month ago, she lost her sister-in-law after a long illness. However, during the few hours of normal state I mentioned above, she had the grief of ignoring absolutely all the circumstances of this death; only in her mourning clothes did she acknowledge that her sister-in-law, whom she knew was ill, had succumbed.

Her children made their first communion while she was in second condition; she also has the sorrow of ignoring it during periods of normal state.

I must note a certain difference between our patient's old situation and her current state: once Felida lost consciousness completely during the short transition periods; this loss was even so complete that one day, in 1859, she fell into the street and was picked up by passers-by. After waking up in her other state, she thanked them with laughter, and they naturally could not understand anything about this singular joy.

Today it is no longer the same: this transition period has gradually decreased in length, and although the loss of consciousness is as complete, it is so short that Felida can hide it wherever she is. This period has the greatest analogy with what is called in medicine the little evil, which is the smallest of epilepsy attacks; however, with this difference that the little evil is most of the time absolutely suffered; while some signs, known to her, such as pressure at the temples, indicate to Felida the onset of these periods.

Here is what is going on. As soon as she feels them coming, she holds her hand to her head, complains of dazzle, and after an elusive period of time, she passes into the other state. She can thus hide what she calls a disability. However, this concealment is so complete that in her entourage her husband alone is aware of her current state. The entourage only perceives the variations in character which, I must say, are very pronounced.

We will insist on the variations that Félida herself points out with the greatest sincerity.

In the period of access or second condition, she is more proud, more carefree, more concerned about her grooming; moreover, she is less laborious, but much more sensitive; it seems that in this state she brings to those around her a greater affection.

Are these differences with the normal state due to the fact that, in the former state, she loses the memory, while in the latter state she recovers it; this is probable. We will come back to this later.

A few days later, on July 5, I was shocked when I entered Felida's house, with her sad face; she greeted me ceremoniously and seemed surprised by my visit.

Her appearance strikes me, and I feel that she is in a period of normal state; to be sure, I ask her if she remembers the last time we saw each other.

"Perfectly, she replied. About a year ago, I saw you driving up to the Place de la Comédie, I don't think you noticed me. I have seen you other times, but rarely, since you came to give me care before my marriage.»

The thing was certain. Felida was in a normal state, because she was unaware of my last visit, as we remember, during the second condition. I question her, and I learn that she is in her senses (she just said today) since the morning at eight o'clock. It is about three o'clock in the afternoon.

Taking advantage of an opportunity, perhaps difficult to find, I study it carefully. Here is a summary of my observations:

Félida is sad and desperate, and gives me the reasons in eloquent terms. Indeed, her situation is very sad, and each of us, looking back, can easily understand what his or her life would be like today, if he or she removes the memory of the three or four months preceding it through thought. Everything is forgotten, or rather nothing exists, business, important circumstances, knowledge made, information given, it is a leaflet, a chapter of a book violently ripped off, it is an impossible gap to fill.

The memory of Felida exists, we know, only for the facts that happened during similar conditions, the eleven layers, for example. I would like to make an important point here. Eleven times Felida has been a mother. Always this first-order physiological act, complete or not, was performed during the normal state.

I ask her to tell today's date. She is looking for it and is almost a month wrong.

I ask her where her husband is; she ignores him, doesn't know what time he left her, or what he said when he left her. However, at eight o'clock, the normal state had occurred, and it had gone out a quarter of an hour earlier.

She had been given a small dog, who got used to her and stroked her every day. After some time, a period of normal life occurs; when she wakes up in this life, this dog caresses her; she pushes him away with horror, she doesn't know him, she has never seen him; he is a stray dog who comes into her house by chance.

However, the animal's appearance indicates that it has been in the house for a long time.

I would only have a choice on similar circumstances; but the above examples are, I believe, sufficient.

Apart from these modifications, which are the direct result of the absence of memory, I note other differences between the normal state and the access period.

Emotional feelings are no longer of the same nature. Félida is indifferent and shows little affection for those around her; she rebels against her husband's natural authority over her.

"He keeps saying: I want, she says, it doesn't suit me; I have to let him get into this habit in my other state. What saddens me, she adds, is that it is impossible for me to have anything hidden from him, although in fact I have nothing to hide in my life. If I wanted to, I couldn't. Certainly, in my other life, I tell him everything I think."

Moreover, her character is more haughty, more complete.

What particularly affects her is the relative inability that her lack of memory leads to, especially with regard to her business.

"I make mistakes on the value of foodstuffs whose cost price I don't know, and I am forced to use a thousand subterfuges, for fear of being seen as an idiot.»

Three days later, her husband tells me that the state of complete reason I have just mentioned lasted from eight in the morning to five in the afternoon: since then, she has been in the second condition for a time whose duration he cannot predict. He adds an interesting detail:

It has happened several times that, falling asleep at night in her normal state, she woke up in the morning in the access, without her or him being aware of it, so the transition took place during sleep.

It is known that some epileptic seizures also occur during sleep, and that patients or doctors can only suspect this by the extreme fatigue felt by the patient upon waking up. There are even epileptics who have never had seizures the day before, and who, as a result, cannot be aware of their situation. At that time, periods of normal state lasted only two or three hours at most and were repeated every two to three months. The second conditions lasted about two or three months compared to normal state intervals of twelve to fifteen hours.

This situation has not been maintained. During the months of November and December 1875, each day and at unspecified times was a normal state period of a few minutes to half an hour.

In January 1876 the intervals increase, and in the following three or four months, they reach twenty-five days against two or three hours of normal state.

In September 1877, Felida had not had a normal life period for about two and a half months, and the last one lasted only three hours. Moreover, nothing changed in the respective characters of the two states; however, the despair caused by this amnesia became so great that, during one of her last periods of normal life, Felida tried to commit suicide. I only learned about this later.

This painful disposition of mind must strongly influence her character and further accentuate the differences between the two states.

Félida returns to the already described state in which the second condition lasted three and four months compared to twelve to fifteen hours of normal state, often less.

More than ever, Felida is impressionable and suffers from a thousand pains.

Here, although the phenomena I will describe relate more particularly to hysteria itself, I will mention them because of their uniqueness.

Felida loses more and more significant amounts of blood through the mucous membrane of the stomach or esophagus. It flows slowly out of her mouth while she sleeps. So, by the way, she dreams that she's at the slaughterhouse or that she sees someone's throat cut.

Once, during the night, without injury of any kind, a significant amount of blood flowed out of the upper part of the head without any injury. - She has nosebleeds from only one nostril, the left. Spontaneously, half of her face blushes; she also shows scattered limited congestions on the limbs on the same side, and these reddened spots give a strong sensation of heat, almost burning. These sensations are accompanied by a local swelling that is sometimes so marked that one day, when Felida was in the street, the glove that covered her left hand cracked.

On the sensory side, we also observe some unusual phenomena. Felida is very often deaf in her left ear; her sense of smell is almost obliterated, except for the smell of blood, which she perceives better than any other. She has almost no taste.

The prevalence of accidents on the left side is not extraordinary; it is the rule in hysteria; it is not yet clear why.

We see how much these facts support the idea that many phenomena of a hysterical nature are under the immediate dependence of capillary circulation. What are these hemorrhages, these swellings? These are passive states, the effects of temporary paralysis of the capillary tunics. As they let themselves be overstretched by the impulse of the heart, the blood flows through their walls; as a result, it oozes from the mucous membranes and blushes or swells the skin-covered parts of the body.

I asked Felida about a point I had neglected until now, about her sleep.

Felida sleeps like everyone else and at the ordinary moments, and so do most sleepwalkers. If it is complete, sleepwalking is generally added to ordinary life. Félida did not escape this practice.

Only her sleep is always tormented by dreams or nightmares; moreover, it is influenced by physical pain; thus, she often dreams of slaughterhouses and of slits, we said why. Often she also sees herself loaded with chains or tied with ropes that break her limbs. It is her ordinary muscle pain that is transformed in this way.

As in the past, the short transition period takes place either during the day before or during sleep, so that, falling asleep in the evening in one state, Felida wakes up in the other, without being aware of the moment of the transition.

It would be interesting to know if this transition takes place when Felida falls asleep or wakes up, or during sleep itself; also, according to the desire of Mr. Victor Egger, who is studying the issue of sleep in depth, I have given this young woman's husband the necessary indications to look for this observation point.

From today, I can say that a few days ago Felida was taken, in the middle of the night, during the sleep course, from a state of mind that lasted three quarters of an hour. Her husband noticed it. He also noted once again the absolute insensitivity during the two short transition periods.

This transition period is of considerable importance; I acknowledge this today better than at the beginning of my remarks. - Analogous to sleep, it is far from being sleep itself. Although it is currently very short, almost elusive as a result of Felida's habit of hiding it, she has nevertheless retained her main character: loss of consciousness. - It is like a small death, and can be perfectly compared to the condition that doctors know as a small death, which is only a very small seizure of epilepsy; if the duration of these attacks or periods is reduced to a few seconds, their importance and severity are no less important.

Mr. Victor Egger also suggested that I consider making observations on Félida on another point.

We know what role the habits play in life. Does Félida keep, during her short periods of normal state, when she seems to have forgotten everything, the habits acquired during the second condition? - This study is difficult, almost impossible, given the age of Felida who has her existence made. - However, I try it by trying to give her some new habit. - An example will make me understand; each of us sets his watch in the morning or evening, it is a habit, always places his cane or umbrella in the same place; it is a habit. - If, then, during her second condition, Felida was given something of frequent or daily use, and she used it during the three or four months of one of these periods, we would see if, despite the amnesia, there is not, during the normal state, an unconscious repetition of the same act.

If I am not able to answer today, I can say that I have become certain that during the short period of normal state Felida has forgotten the meal times; however, taking her food every day at the same time could be a habit.

However, it will not be impossible for her to remember the hours she made her meals during the short periods of the previous normal state; only these periods are short and distant.

If, at the beginning of the disease, the two states presented a great difference in terms of hysterical manifestations, this difference is now much reduced. Indeed, Félida presents in any state the phenomena of the diathesis that dominates her life. All we can say is that she suffers much less in the second state than in the first state. Moreover, in the early days, the second conditions were very short, the hysterical phenomena had almost no time to show themselves there, whereas today, these periods constituting almost the entire life, they manifest themselves there at their ease.

In the preceding lines ([2]), I have said only a few words about a third state, a third condition that resembles an attack of insanity, I must insist, this state having shown itself more often in the last two years.

Being in the second condition, Felida, if she experiences great emotion, is taken from an ordinary transition period, and instead of entering the other condition as usual, awakens into a particular mental state, characterized by excessive fear.

She only recognizes her husband, barely yet, has terrifying hallucinations of hearing and seeing, sees ghosts, throats. Her skin becomes hyperesthetic. - It is a complete mess.

She is, her husband tells me, like a madwoman.

This state lasts half an hour or three quarters of an hour, at two or three hours, returns every three to four months, and ends as it began, with a transition period after which Felida finds herself in her second condition, so that we can say that it is like an accident of this condition and that it is added to her.

If I carefully note this third state, it is not that I have the thought of seeking an explanation for it, it is a simple observation that may later be useful, if, as I trust, the medical observers are willing not to let the facts similar to the one I just told about be forgotten.

[1] Warlomont, Louise Lateau, A medical report on the stigmatized Bois d'Haine. 1875.
[2] Voyez page 72.