[3] For the privilege of using observations made on this patient at the Sheppard and Enoch Pratt Hospital, we wish most heartily to thank the Superintendent, Dr. Edward N. Brush.
His ideas were found to be no less interesting than his formal picture. In fact, if the theory we are now advancing be correct and we had had it then, we believe it would have been possible to state at the time of his first attack that his psychosis would not show rapid deterioration; we might even have gone further and predicted that he would reach some such stage of relative sanity as he now enjoys. He has presented three types of ideas. The first is crude expressions of bald sexual fancies; the second is transitional in that—as many praecox patients do—he gave these ideas a religious or philosophical setting, but in the hallucinations and delusions embodying them, still retained his personal connection with the fancies. For instance, he identified himself with Christ, or he suffered from psychological influences exerted by others on him. These two types occurred only during attacks. The third type represented the real constructive tendency, during his "normal" intervals when he objectivized these ideas in the form of speculations as to the origin of life, the laws of society, religion, etc. The second type—the transitional—represented reciprocally two tendencies: in the psychosis it showed his constructive, healing capacity, while the development of such fancies, as allied himself directly with his speculations when "normal," was invariably the signal for another attack, the severity of which was in direct proportion to the crudity which his formulations reached. The complexity and number of his theories when going about his work was tremendous, which could be partially accounted for by his omnivorous reading. He read all sorts of historical, occult, scientific and philosophical works, the material of which he absorbed only in so far as he could weave it into the fabric of his depraved speculations. This colored his transitional ideas as well, for in each attack he would have a new dramatization of his fancies determined by what he had just been reading. To present these ideas with anything like completeness would take hours. We must be content, therefore, with a few fragmentary examples.
The more important of his crude ideas were: His trouble was caused by loss of semen (his attacks were always ushered in by emissions), to prevent which he sometimes put rubber bands around his penis; numerous homosexual fancies, he was a woman, he had a vagina, there was a maiden head in his forehead which was operated on to cause him to lose semen; different people made immoral proposals or had designs on his virginity. These people he all identified directly or indirectly with his father. Finally there was an idea that his mother's marriage with his father was not right, that he was not his father's son, and that his father was inimical to him. He talked of killing different persons whom at other times he identified plainly with his father. During an attack he assaulted his father; not infrequently he would take his father's picture from the wall and spit on it. The relations between his father and mother were adulterous, he claimed.
If we now take the crude homosexual fancies and study their first elaboration we find that he had many ideas about eunuchs. They worked on him by psychological influence. The eunuchs, who could control sun and moon, influenced him through them. Once he had a vision of the sun approaching him with which he was physically connected; the vision would disappear if he lost his virginity. These influences when referred to himself were agencies causing loss of semen, so that he would become a eunuch himself. At the time of his heart attack and later he thought there was a snake around his heart. This was a man who had turned himself into a snake in order to incorporate himself into the patient's body. His religious fancies apparently began with his delusion that he was Christ and in connection with this we find he had the theory that Christ was a virgin. One setting of his "psychological influence" experience, when he was in bed in one room and eunuchs were influencing from the next. he duplicated by saying he was Jesus Christ in one room and God was in the next. He explained after one of his attacks that his attention was fixed on the windowpane on which he spat because there was a flower there. During an attack he was heard to say something about the struggle of men against being raped by ions and flowers. In these primitive elaborations we find an effort at distortion, a getting away from the absolutely crude and that the added elements which cause this distortion are in the form of ideas which imply a certain degree of philosophizing. The truly constructive delusions appear when he has ceased to dramatize these theories with himself as the hero and treats them objectively. We then find that eunuchs are very important people in his philosophy (the medium of their power we shall see shortly). All women are eunuchs because they have no testicles. There is no difference between men and women; if a woman is stronger than her husband, he takes on her qualities. In India men suckle the children. He says that this is a well-known fact. A person could change himself into a cancer and so get into another's body. This is perhaps an echo of something he had read of Ribbert's theory of neoplasms. Another pseudoscientific theory concerns a method of reproduction which could be developed, he thought. If a beautiful, strong man reaches his normal growth, all life above that is moulded by his ideals. He can develop within himself another personality which may be divorced from his body. Immaculate Conception takes place this way. An argument he had in favor of this view was prenatal influence and the strong influence a woman's belief is supposed to have on pregnancy. Eunuchs control the sun and moon. The Jews have a secret process of eunuchry; they have a way of inserting an instrument (a drawing of which he made, showing distinctly phallic features) by psychological means into the glands or bodies of men, thus cleaning them out. The eunuchs of the Romans used to cure their fellow countrymen of snakes growing around the heart by ingratiating themselves into persons, thus displacing the snakes and killing them. The government has many eunuchs in their employ. The influences of these men are malign or beneficial. They can injure enemies of the government or the government can incorporate them into bodies of other men to save the latter. All cardinals, most diplomats and many missionaries are eunuchs. The psychological influence exerted by such individuals may cause a loss of blood to their victims or they may use this power beneficially. The Romans, for instance, put blood of crucified people into the hands of eunuchs, who impregnated it by psychological influence into others. This would save their lives and eventually save the nation.
The ideas we have mentioned showing rivalry with his father, apparently in relation to his mother, were largely elaborated in political and religious disguises in their transition states, which in turn led to an objective interest in politics and religions. He spoke of killing the President which may be taken as a disguise for killing his father since he often claimed that his father was this or that ruler. He also spoke of killing one of his employers. He was prone to speak of his father as Edward VII. His envy of this situation of authority was shown when he once told the physician that his face was suspended in the face of the physician who was a King of England. But not the real King, he added, Edward VII was the real King. Again he said that he was Robert Emmet and the physician was Lord Norbury, the judge who convicted Robert Emmet, after whom the patient was named. In that role the physician told him it was all up, that there was no more Irish race. (It must be remembered that his father was a Fenian.) A fruitful source of speculations about international politics was found in the transitional ideas he expressed about the extraction of his parents. Beginning with his cogitations about the friction which actually existed between his parents, he ascribed this to their differing nationalities and religions. This led in turn to his fancying that on both sides his blood was drawn from many sources. He was particularly fond, for instance, of identifying his father with Hebrews, or Chinese; his mother with Romans, Italians or Spaniards. His original interest in the union (or disharmony) of his parents was easily transferred to this international setting and most of his attacks were heralded by dramatizations of political ar international situations with which he was intimately connected. This was true of his first attack when he had an idea that he was to succeed Secretary Hay and make peace between Russia and Japan (his mother and father). On recovery these fancies were objectivized into a most intense interest in diplomacy. He knew the history and achievement of every diplomatist in Europe, though of course his data were always being distorted to fit with his insane theories. Intermarriage, for example, was the cause of political trouble. He developed the ideas as follows: When an Irishman marries one of another race a confusion of races results; this was what took place in the tower of Babel; this is what causes disunion between states. He elaborated, too, on popular associations of certain customs with certain peoples. Gypsies, it is popularly supposed, frequently abduct children. With the patient this became an elaborate theory about an Egyptian custom or Egyptian influence. The Egyptians, he said abducted children and brought them up as their own acquiring a sinister influence over them because of the belief the children had that these adults who were their guardians were their real parents. In one attack he spoke of his father as "An Egyptian influence." This is plainly the same idea as he put into another form when he remarked that he would be all right if he could become English. When in his free intervals, he made it a practice sedulously to cultivate English people.
This undercurrent of rivalry with the father came out in a religious disguise as well. His first attack when he was for many months interned he described as a religious mania. By means of identifying himself with Christ he dramatized both his subjugation and defiance. He went through many crucifixion experiences; said he was commanded by God. On the other hand he said Christ was a virgin and retained his virginity in order that he might discover the secrets of the elders. For this reason he was crucified. The crudest expression he gave of defiance in a religious form was when he said "I was two persons in one—God and Jesus Christ. God was damned." The more constructive tendency was shown by his fasting. This was due to an experience of some duration when he was translated back to the first century, was in a convent (sic!) and was tempted by the devil to eat. His fasting, he claimed, saved the other patients. His most constructive delusion was that all the churches would come together and then there would be only one church. During his first attack this was his "prophecy," during his saner intervals there were endless ramifications of this idea which are too tedious to recite. It is important to note as evidence of the purely psychotic character of his ideas that he has never been either religious in his spirit or in action a propagandist.
Perhaps the most luxurious fancies this patient evolved were around the theme of semen. We have seen that his emissions were his constant worry, an increase in their frequency heralded an attack and he was convinced that if he could but retain this secretion he would be permanently cured; nay more, if he could retain enough he would grow to be like the giants of old. Whenever he had an emission he felt on waking a pain in his head and could never get totally rid of the idea that this was cancer. In his attacks the cancer was the result of a homosexual assault and in his intervals he elaborated theories as to the origin of cancer; it came from friction, therefore coitus could produce it, it might be the result of adultery or cancer of the breast could come from a man rubbing his penis on the breasts of a woman; the cancer germs might come from semen if one believed in cancer and in germs. Life both as vital force and in the biological sense he identified with semen. Psychic activities too had the same origin which he explained thus: food taken into the mouth goes into the stomach and becomes chyle, chyle passes to the scrotum, thence to the spine and brain. Brain power is in direct proportion to the amount of semen retained. We see now why eunuchs had such power according to his philosophy. By childish reasoning, since they could not have emissions, their semen must be retained. He spoke of psychological influence in these terms: "It is the transformation from the moisture state of the life principle to the moist electric state of warmth and its transference from the central ducts and glands to the head and being thrown out of the head in waves from the top of the head and eyes. It redounds to the other person's good. Have an eunuch near you—it tends to make semen go to the head and gives the mental mouth something to think of. It could be used in a baleful way if one had will power over another person like hypnotism—(Svengali and Trilby)—In hypnotism the will goes on the same lines as psychological influence." The Jews, he said, lay around temples so much that their life had to go into sensuality or wisdom and it mostly went into wisdom. Continual seminal losses, he claimed, would lead to a change in personality. "Life," he said, permeated nature, it could not be lost. Wind was thus identified with it: "life" goes on a sheet (from an emission), the sheet is washed and the "life" passes to the water, then is taken up by the air and breathed. Thus he suffered both immediate and remote effects from emissions. The first result was to make him incapable of work; by breathing in the "life" later on he became a degenerate. Wind or the spiral movements of air was another origin of life. Wind is a spirit, in defence of which he quoted the Greek pneuma. The words wind and word are the same, the former being derived from the latter through wird. (Cf. "In the beginning was the word," or "The word was made flesh"). A cyclone is an effort hampered by civilization of what the world was originally. Life began as a spiral movement of air. Wind as the origin of life could be duplicated by mechanical methods or eunuchry. The sun he claimed was an accident. Men lived for centuries without it, till an accident, internally, led to vital forces being emanated and that was the origin of sun. The accident was the cutting of some man's testicles.
Now what was his further course? We have seen that in his attacks he expressed resentment against his father's domination. At the beginning of one of them, for instance, which he said was brought on by "Egyptian influence," he had a dream of an old Hebrew play of father and son. In this play they were trying to make him return to the old situation of bondage to his father. This bondage was an actuality. Owing to his monthly attacks he could hold no regular position and so worked for his father. The latter gave him no money except occasional small silver but bought for him clothes or anything else he might need. A psychotic man of nearly thirty, with a feminine character, he was hopelessly dependent on his father. It is small wonder that he sought relief in recurring psychotic episodes. But a change came. On May 12, 1911, his father died suddenly of heart trouble. The patient was beginning to go into an attack at the time but pulled himself together, managed the funeral three days later, got his sister home, who had a hysterical attack at the grave, and then proceeded to indulge in his postponed attack. The sister was unable to care for him so he was sent again to the Sheppard and Enoch Pratt Hospital. In a few days he recovered. He was then talked to, told that this baleful relationship was over and that there was no longer any reason for his having attacks. With the exception of one attack at the beginning of 1912 he has had none, and seems to be able to maintain the mental equilibrium that previously characterized his intervals. For two and a half years he has been employed in the Customs House, Baltimore, a position which he secured by competitive examination, and has received an advance in salary from $900 to $1200 a year. He was recently written to and replied in exceptional literary form detailing more of his ideas. They seem to be essentially similar to those held four years ago. One may be quoted. A favorite "scientific" method with him has always been (from boyhood, he said) to divide up or distort words so as to get at their true meaning. This is now his explanation of the word "cancer."
"You may remember the origin of the word 'cancer' was once the topic of our meeting and strangely this matter has kept revolving itself in my mind ever since. My new solution is 'Kahns' and 'Ur.' You know there are a good many people named 'Kahn' and as probably you have noted in the Bible allusion to the ancient race of the name 'Ur.' Now, you can place what construction you will on the combination. There are several; here is one: I have heard it stated that the word 'Ur' originally meant 'wife' hence, from our point of view the solution is easy, Kahn's Ur or Kahn's wife, but what has puzzled me is what she is doing in so many people.
"Here's another: Signifying the overcoming of the Jew by Ur or Kahn by Ur
(Kahn by 'er) much on the same principle as the words 'Spanish-American' and
'Graeco-Roman' are used with reference to the late 'unpleasantness' and the
ancient one.