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Tunisian theopath with mystical hallucinations; gun-shot wound of occiput (bullet extracted): After the trauma, Lilliputian hallucinations and micro-megalopsia.

Case 106. (Laignel-Lavastine and Courbon, 1917.)

A. ben S. was sent to Villejuif with the diagnosis: “depression, feeling of impotence, discouragement,” having been found on the public street. He was indifferent, almost completely mute, and was at first considered not to understand French. In a fortnight, however, he was talking freely and was then found to be afflicted with hallucinations, melancholia, and delusions, apparently following trauma to the skull.

A. ben S. might have been about thirty years old, and was of a rich family, indigenous in Tunis, well educated in the Koran and Arabic literature.

Upon examination, this Tunisian gunner showed contraction of visual fields, poor color vision, and general hypalgesia. During examination, the man seized the needle and plunged it deeply under his skin, exclaiming that a prophet felt nothing and that he could be cut into bits without feeling pain.

It seems that he had had divine visions from early childhood. In his youth he had once gone to a mountain near his home and talked with Mohammed and Allah. Of course, Allah did not appear in human form, but he appeared like a ball or a wheel of fire, slowly turning. Mohammed was a tall man, with a long white beard, his eyes darting rays of fire, and his forehead bearing a gleaming bright body. Allah was heard talking to Mohammed. Orders were given concerning the sun and stars. Subterranean treasures were displayed, as well as Paradise full of yellow, blue, and green houris, transparent, such that, when food was taken, it could be seen going down their throats. Hell too was visible, and the devil very tall and black, an eye behind and another on top. There were also many genii—little men who climbed over the Tunisian’s body. Sometimes in dreams, Allah carried him to all countries of the earth. It was hard to tell whether these effects were hallucinations or vivid imaginings. The Tunisian had been wounded after several months of service by two bullets in one day: the one causing an insignificant lip-wound; the other entering the skull behind. After several months the bullet had been extracted by trephining.

His further history was obscured by the fact that he wove delusional elements into his story. He said, for example, that he had been court-martialed, though there was no evidence that this was a fact. It is probable that after his wound the patient in a delirium felt that he was going to be shot. The visual hallucinations were very interesting, being Lilliputian. He would see three or four hundred Tunisian gunners walking along, knee-high or taller. Sometimes they all would stop and aim at him. He also showed micromegalopsia, real objects changing their height under his eyes. Both the Lilliputian hallucinations and the micromegalopsia dated from the trauma to the skull. There was no change whatever in the mystical delusions concerning Allah and Mohammed. These he had before the trauma.