In the following description of persecution mania
my object has been to present as forcibly as possible
the fact that the old monomanias of suspicion, persecution, and grandeur are but stages in the development
of a homogeneous disease which is known as Persecution
The term 'persecution mania' is for many reasons
an unfortunate one, and it is better to be accurate
and to describe it as the "systematised progressive
insanity of persecution, progressing from delusions
of suspicion, hallucinations of hearing,and delusions
of persecution with great mental distress and unrest
to a period of ambition with delusions of grandeur
and corresponding hallucinations, ending finally in a
state of hopeless dementia".
The insanity of persecution, however, is met with
in individuals that do not at all come under the definition just laid down. In some it begins suddenly
with symptoms of persecution, and these symptoms continue throughout the course of the malady, or perhaps
throughout the life of the patient. Or it may happen,
on the other hand, that at a certain period they may
develop ideas of grandeur. Again it may begin with
ambitious ideas which in the same way may continue
during the course of the malady or throughout the life
of the patient, or it may end in delusions of persecution. Or finally, the two manias of ambition and
persecution may occur simultaneously in the same individual, progress side by side, alternate with each
other, end abruptly, or continue during the life
of the patient. The three latter forms of persecution mania only occur in a class of patients who are
hereditarily degenerate, and who present the mental
and physical stigmata of degeneracy.
I have commenced the explanation of the subject
by an analysis of the cardinal symptoms of delusional
insanity, viz., the emotional affections, the intellectual disturbance and the sensory disorders. I have
sketched in each of these the historical development
of opinion, and the theories held by various writers
as to their explanation and origin, and J have endeavoured to set forth as clearly as possible the
most modern explanatory views with regard to these
extraordinary mental manifestations.
In Chapter II. I have described the special views
of medico-psychological authors with regard to the
classification of the monomanias and the various forms
of mental alienation that are naturally grouped under
the Insanity of Persecution. Commencing with the
opinions held at the beginning of the century, I have
sketched the development of the work accomplished,
especially by Lasègue, Falret, and Magnan in this connection.
Chapter III. deals with persecution mania proper,
the systematised progressive form of the malady which
is typical and includes the four stages (1) the
stage of invasion, (2) the stage of general hallucinations of the senses except sight, with delusions
of persecution, (3) the stage of delusions of ambition
and grandeur with corresponding hallucinations,
and (4) the stage of dementia of a limited and imperfect kind.
In Chapter IV. a description of the mental and
physical peculiarities of the degenerate is given
followed by a clinical description of the various
forms of persecution mania that occur in that class.
These forms include (1) Folie à deux (2) the
essential systematised persecution mania of the degenerate (3) the form which I have called "aggressive persecution mania" and which French Writers term
"Persécuté's persécuteurs" and the Germans as "Paranoia
Querelens". At the conclusion of the Chapter is described cursorily the systematised persecution insanity of Alcoholism in its acute and chronic forms.
Chapter V. deals with the pathology of the disease which presents nothing that is distinctively
characteristic, and the line adopted is to show as
far as possible a comparison between the morbid appearances of the brain in persecution insanity of an
advanced stage, and the same morbid appearances in
typical insanity of a grosser and more acute kind.
The second division of Chapter V. is occupied
with a review of the medico-legal aspects which are
of the greatest importance in this affection; and the
third and last division of this Chapter refers to the
treatment,, prophylactic, moral, and medical, of the
subjects of this very grave malady. An attempt has
been made to illustrate by Diagrams, photographs of
the patients, selections from their writings and microphotographs
of the microscopic appearances so far as
the limited phenomena of the disease have permitted.