Note 436 — Chapter XXVI · [430]

In reality the movement cannot even be started correctly in some cases without the kinæsthetic impression. Thus Dr. Strümpell relates how turning over the boy's hand made him bend the little finger instead of the forefinger, when his eye was closed. "Ordered to point, e.g., towards the left with his left arm, the arm was usually raised straight forward, and then wandered about in groping uncertainty, sometimes getting the right position and then leaving it again. Similarly with the lower limbs. If the patient, lying in bed, had, immediately after the tying of his eyes, to lay the left leg over the right, it often happened that he moved it farther over towards the left, and that it lay over the side of the bed in apparently the most intolerably-uncomfortable position. The turning of the head, too, from right to left, or towards certain objects known to the patient, only ensued correctly when the patient, immediately before his eye was bandaged, specially refreshed his perception as to what the required movement was to be." In another anæsthetic of Dr. Strümpell's (described in the same essay) the arm could not be moved at all unless the eyes were opened, however energetic the volition. The variations in these hysteric cases are great. Some patients cannot move the anæsthetic part at all when the eyes are closed. Others move it perfectly well, and can even write continuous sentences with the anæsthetic hand. The causes of such differences are as yet incompletely unexplored. M. Binet suggests (Revue Philosophique, xxv. 478) that in those who cannot move the hand at all the sensation of light is required as a 'dynamogenic' agent (see above, p. 377); and that in those who can move it skilfully the anæsthesia is only a pseudo-insensibility and that the limb is in reality governed by a dissociated or secondary consciousness. This latter explanation is certainly correct. Professor G. E. Müller (Pflüger's Archiv, xlv. 90) invokes the fact of individual differences of imagination to account for the cases who cannot write at all. Their kinæsthetic images properly so called may be weak, he says, and their optical images insufficiently powerful to supplement them without a 'fillip' from sensation. Janet's observation that hysteric anæsthesias may carry amnesias with them would perfectly legitimate Müller's supposition. What we now want is a minute examination of the individual cases. Meanwhile Binet's article above referred to, and Bastian's paper in Brain for April 1887, contain important discussions of the question. In a later note I shall return to the subject again (see p. 520).