Multiple Personality

MULTIPLE PERSONALITY

Boris Sidis, Ph.D.

Simon P. Goodhart, M.D.

TO illustrate the varying nature of these alternations of consciousness, I may briefly summarize two English cases which have recently been reported. The first is of a girl of twelve, who was shown to the Clinical Society of London by Dr. Albert Wilson in January, 1896.¹ In this case there were no less than five different existences, including the normal, and the condition is related to hysterical somnolence, or, more accurately, to hystero-epilepsy. In 1895 the child had had severe influenza, followed by great headache, with intolerance of light and noise, probably meningitis, together with mania. After six weeks the headache disappeared and muscular symptoms of twitchings and opisthotonos developed with lividity and coma. She had many fits a day. In June the old symptoms disappeared and a fresh train of phenomena appeared. When in an apparently normal state, she would shake, turn a somersault, and enter a new and different mental state. Her memory for all events during health was quite gone; but she would remember in one such fit what had happened in a previous one. Thus was established a complete dual existence.

By education she learned the names of most things, but always employed baby pronunciation. She would write backward, and that quickly. When these attacks developed, she lost all power of walking or standing till about August, 1895. In the early stage she had fits of catalepsy, chiefly rigidity of the flexors. At times she had five or six fits a day, lasting a few minutes, and at her worst periods they lasted for days. She recovered from them quite suddenly, was never surprised at her surroundings, but very composed, and said she remembered nothing of what had occurred during the attack. The most striking feature was once when she had severe toothache during an attack. Dr. Wilson gave her chloroform and removed two teeth. On regaining consciousness, she recognized that the teeth and pain were gone. Her father hypnotized her and brought her to the normal state, when she made the discovery of the blood and the loss of the teeth, but she never remembered the previous pain or taking chloroform. There had been many variations, and she had four different existences besides the normal: (1) “Nib,” for “Old Nick,” when she had violent passions, and would bite or slide down the banisters; (2) “dreadful wicked thing,” when everything was reversed, black being white, asleep being awake, the head being the foot, and so on; (3) “Allie,” when she was amiable and good; (4) her ordinary fits, as already described. Other phenomena occasionally occurred. Thus, she was at times completely deaf and dumb, or at times she manifested loss of memory, so that she did not know those whom she ordinarily knew during the fits. Her general health and nutrition were good. Treatment had been rest and quiet and fresh air. Two years later, however, her condition remained the same.

The following case of apparently multiple personality in the insane, brought for study to my laboratory by Dr. Frost, may be of interest:²

Mary E. Vaughn, aged 22 (in 1891), single; born in Ohio; one cousin epileptic. Was admitted to Buffalo State Hospital July 27, 1891; in good bodily condition; weight 180 pounds. She had been an inmate of the State Hospital at Warren, Pa., for three years.

She was discharged from the Warren Hospital as cured of epilepsy with mental disturbance, and remained apparently well for five months, after which she suffered again from epileptic seizures, which were said to recur with marked regularity at intervals of two weeks, every alternate attack coinciding with a menstrual period. During the attacks she would pound her head and otherwise injure herself if not restrained; afterward had no recollection of anything that had taken place during the attacks.

Ancestors were all healthy people, there being no knowledge of insanity or convulsions of any kind in the family. Her mother, however, had an uncontrollable temper, and during some of her attacks of temper would beat Mary and shut her out of doors, no matter what the weather was. Until about the age of thirteen she was perfectly healthy, but at that time caught a heavy cold. The first appearance of her convulsions was at night, and for several days previous she had been rather melancholy. She began by moaning in her sleep, and it was impossible to waken her, and she slept for several hours in that way. She was attended by a local physician at the time and was afterward taken to Warren, Pa., to a hospital, where she remained for a year or two. After her return home she took patent medicines and then went to the Buffalo State Hospital. Her brother does not believe that she expressed the idea that her personality was changed while at home, as he had never heard of it.

On the evening of her arrival at this hospital, she had a series of convulsions characterized by opisthotonos and without frothing at the mouth or biting of the tongue. These attacks recurred oftener than every two weeks—sometimes daily for several weeks—always attended by suicidal attempts and succeeded by a period of calm, during; which she was childish and played with dolls and trinkets, and was pleasant and easily arranged. It was noticed that she had no recollection of the attack, but no mention of any symptom unusual in cases of epilepsy was made in her case until July, 1893, two years after her arrival at the hospital. At that time the following note had been written: “Has had a series of convulsions and has been suicidal for a long time. Has been careless, abusive, very cross and irritable, entirely unlike her former self. She came to herself on awakening this morning. Has no recollection whatever of what has passed since about 11 o’clock, July 12^th (fourteen days ago), the date of the first convulsion of this series. She asks questions about the arrival and departure of patients during this time; greets affectionately, as if just returned, a nurse who really returned three days ago, and whom she welcomed just as affectionately then as now. She is quiet and pleasant, joking, not suicidal, completely changed.”

May, 1894.—“Goes from a state of lucidity into a series of convulsions, followed by a period of mental obscuration with suicidal tendencies, which lasts several weeks, with great regularity. During these periods is cross and irritable and denies her identity.”

August, 1894.—“Lucid periods of shorter duration. Had no recollection in one periods of what had taken place, what she did or where she was, or in fact of who she was in the other period or condition. She is a typical illustration of double consciousness.”

November, 1894—“Suicidal after convulsions. Has no recollection of herself in a previous state and will not, in this condition, acknowledge her name. She continues to have occasional periods of frequent epileptic convulsions, when she loses her identity and imagines that an old woman is after her; hears her in the wall. At other times is good-natured, helpful, quite coherent.”

There is nothing additional in the history until January, 1897, when it is noted that she suffers from incontinence of urine; being then in one of the convulsive periods. From that time until the present time this symptom has always recurred with the return of convulsions; not immediately, but after the convulsions have lasted some days.

The duration of the respective periods is not exactly stated prior to 1896. On September 3d of that year convulsions commenced and her abnormal state continued with convulsions until May 9, 1897, with, however, two lucid intervals lasting two and three hours each. After “coming to herself,” on this occasion, she still had occasional convulsions and was depressed and suicidal for several weeks, the first observation of this tendency in her normal personality. From July 1^st to October, 1897, she was quite well, and during the summer went home for a month, as she had done several times before for shorter visits.

On the 5^th of October she began to have convulsions; at first only a few; the became frequent, and after a few days she was again in her second or abnormal state, which lasted with all the old symptoms until the middle of February, 1898. She was then well until June 4^th, though she had two isolated convulsions during April. She had many seizures during June, sometimes ten or twelve during the day, gradually decreasing to one daily, and then ceasing entirely at the end of the month.

During this time she was occasionally depressed, and was not nearly so suicidal as formerly, though her abnormal personality was as usual. On July 17, 1898, it is noted that she “has been herself at short intervals for several days; no convulsions since the first of the month.” From this date to the 26^th she had one or two convulsions daily and was alternately in the two personalities. Then she was well all the time until September 5^th, when she had two convulsions and passed into her abnormal state, continuing in it until May 15, 1899, with convulsions almost daily, sometimes one only—sometimes two or three, and occasionally ten or twelve. During this period it is noted that “her condition this time is different from any previous attack. She is not suicidal, but remains perfectly cheerful and works actively in the ward. She shows the change of personality so often noted previously; calls the nurse and doctors by the nicknames which she always gives them when she is not herself, but her normal personality does not seem to completely banished as heretofore.”

“Patient has lost in weight from 240 to 165 pounds; remains in a clouded mental state, with very frequent but light epileptiform seizures, which are without aura; and in that, as well as in their character, they differ from the attacks which she has usually had. Has the same delusions about the old woman, which always characterized her abnormal state and always speaks of herself as ‘we’ instead of ‘I,’ but she appreciates in a measure her connection with the other personality, for she feels the death of her father and brother, which occurred during this period and which in previous attacks she would (probably) not have noticed.”

May 15, 1899.—“Herself; quiet, natural, composed; remembers going to Collins, but not returning. Says she was well a day or two while there and remembers that. Remembers her father's death, but not her brother’s, which was more recent. Feels well; no headache, no giddiness, but is frightened at the changes of personality. The changes have occurred several times daily for several days, lasting from ten to twenty minutes.”

July 18, 1899.—“Returned to-day from a month’s visit at home. Has been quite well mentally since the middle of May. Gained nine pounds while at home; was well all the time except for indigestion, which has troubled her a good deal from time to time. At times she can take no food at all, and has to live for a prolonged period on a little malted milk.

During August, 1898, in the interval between the attack just referred to and the one preceding it, she suffered from indigestion, requiring to be confined to a diet of malted milk. This has persisted more or less ever since. She has always menstruated irregularly and suffered from neuralgic dysmenorrhoea.

She remained well from May 15 to July 26, 1899, when she had eight convulsions. After the first few seizures she became depressed, restless and suicidal, and before the end of the day had passed into her abnormal state, giving the old nicknames to those about her, saying that the “old woman” was behind her, giving her hypodermics, etc. The next day she had twenty seizures, then eighteen, twenty-four, sixteen, ten, eight, etc., until by the 1st of September she was having only one or two daily.

September 17th was well in the morning for ten minutes, and in the evening for five minutes, and later for twenty minutes; then, for two or three weeks, was alternately in one and the other personality, the normal gradually superseding the abnormal, until October 7th. From that date until November 7th she was quite well, though she had two convulsions during the interval. Had one convulsion November 7th and twelve on the 8th. Was “her other self” for an hour in the afternoon of the 8th, and again from 3 A.M. of the 9th, having twenty-one convulsions on the 9th. Was normal about twenty minutes daily from the 10th to the 15th.

Since then has been continuously in her abnormal mental state and has had usually two convulsions daily, sometimes four or five.

November 16, 1899.—Says that “we are not like what we were once; we don’t know what is the matter, but we not like anyone else.” Wants to go home while in her abnormal condition (as at present), instead of when she “is lost,” in order that she may enjoy the visit and have some recollection of it, and not be dependent upon what others tell her altogether. Has some convulsions now, one to three or four daily. Improved physically.

December 14, 1899.—This morning she is rather excited; says that something is going to happen to her; that the world is coming to an end; that she is going to die, etc.

The reason for this is that last evening, just after a convulsion more severe than usual, she remembered being at home last summer. She was so startled and puzzled by this sudden glimpse of her other life that she could not sleep at all during the night. This morning the recollection persists and is quite clear as to details.

She does not recollect going from here, but she remembers coming back. She is still haunted by the “old woman” and persists in the other peculiarities characterizing the abnormal state. She will, however, give her acquaintances their correct names, saying “that is what they call themselves.” Says she will not call anyone a liar again, as she has heretofore, when told of her trips home and other instances of her other life. Says this perception which she has to-day has confounded her so that she does not know the true from the false.

February 1, 1900.—This patient was sent to me in charge of a nurse, and was in daily attendance there under my observation and that of Dr. Frost for three weeks, during which time her condition was carefully studied and numerous graphic records made, and experiments performed. She improved quite noticeably in mental condition during her stay there, as a result of changed surroundings and the interest which she took in seeing new sights. She no longer suffered from indigestion, had fewer convulsions and very light ones, none in the daytime, and gained in flesh and took on a better color; was more cheerful and lost the anxious, worried look which she had at first.

January 8th.—Patient well nourished, presenting no physical anomalies. Temperature normal; pulse 90. Pupillary reactions normal; tendon reflexes normal, kinaesthetic sense normal. In fact, patient gave normal response to every test, which included those of sensation, heat and cold, and pain. Time localization poor. She does not know the date or anything else relating to passage of time. She is very suspicious; is afraid of instruments. In a long conversation she states in reply to numerous questions that she has six brothers living and two dead; says that she herself feels 53 or 54 years old, but does not know her true age; that her name has changed so often that she does not know what it is, but “they call her Mary.” Cannot write. Can read a little. Went to school, but not very long. Sometimes reads the papers; crochets and sews usually. Would like to know how to read better than she does; is able to read letters from home, but can read only writing which is familiar.

Q. Do you dream of your real name and of childhood’s happenings? A. Sometimes; not very often.

Q. Have you any special pains or physical disorders? She replied “Yes,” but did not give description.

Q. Are you afraid? A. Yes; afraid of the old woman, and we get scared when we get lost so much.

Q. How long have you been more than one person? A. Since a little while after we came to Buffalo Hospital.

Q. How often do you feel that you are more than one person? A. We feel so all the time.

She says that the other persons are in herself; that she hears the old woman talking to her all the time; cannot tell what the old woman says; the old woman used to be her mother; guesses she is yet; hears her all the time when waking and sometimes dreams of her; the old woman tells her only unpleasant things. Asked if she always felt like two or more persons, she says that she did not always feel so; formerly felt different. Is afraid to tell what the old woman says for fear she will harm her; the old woman forbids her telling. Asked how the old woman could talk to her when she (her mother) is absent, says that she throws her voice here. Patient recognizes that it is impossible that the old woman should really be here. Says that the old woman’s voice is distinct, but not loud. She formerly heard many voices but now only one. The old woman’s age is about 53. “We are not like what we used to be. Nothing looks the same. Nothing looks nice any more.” Explains that she says “we” instead of “I” because she thinks she must be more than one person, else she could not change as she does. She says that she used to walk the floor all the time to keep her feet from getting cramped and that she now has no numbness or queer sensations of any sort. Has been dead five times and was a different person each time upon coming to life. Has been everything that is wicked. Was Jesse James for along time, and robbed and stole. Jesse James died and she was then Mary Vaughn. She is not Mary Vaughn now. Afterward she was Jennie Longnecker; did nothing wicked as Jennie Longnecker. Jennie Longnecker died and she was then Mike Muckey, an Irishman, who drank and was wicked and finally died in prison from drinking. Was not dead long at a time. Thinks that she is not really related to her brothers and sisters, because of these previous existences, though at times she believes them to be herbrothers and sisters.

Either the patient or the examiner became confused about the succession of the personalities mentioned above. She explained afterward that their order was as follows:

January 11th. Had one slight convulsion yesterday afternoon and three during the night. Had nightmare so badly that the nurse had to walk her about the room to awaken her. In the nightmare she thought that the “old woman” was after her with a stick and she was running to catch up with her brother, whom she saw ahead. He would not wait for her. In her sleep she was moving her limbs vigorously, as if in the act of running. While pneumographic tracings are taken, patient constantly makes whispering movements with lips and tongue, of which she is apparently unconscious. Always denies it when spoken to about it. Says that the old woman constantly talks to her. It may be that the hallucination of hearing is connected with this unconscious phonation. Told to count mentally, she makes lip movements for each number, and when told to think merely of the numbers as called off by the experimenter, her lips move in the same way. An attempt was made to hypnotize her. She resists the suggestion of sleep; has told her nurse that she will fight against the desire of sleep and repeats that statement now. Says she would be afraid to go to sleep in this room. When asked her thoughts, she says she thinks always of the old woman, wishing she (the old woman) was like other people. This has been her main thought most of her life. The old woman is her mother; mother never liked her or any of the other children. Mary does not love her mother, but was devoted to her father. Mother treated her other children badly, but Mary the worst. Supposes mother must have hated her. Mother has promised a hundred times to be good to her, but Mary does not believe her. Hears the old woman’s voice “in her ears”; just the same with both ears closed. Has had earache and does now at times have earache in both ears very badly. The voice is worse during attack of earache. The voice is always more annoying when she feels badly from any cause. Dreams often of the old woman. Dreams of things which are reproductions of actual past events, of being at home with mother and of her mother treating her badly, as was actually the case. Also sees things in dreams which are not identified as actual occurrences in the past.

Q. Does the old woman give you pain? A. No; only talks all the time. Has roaring in the ears sometimes

January 12th.—Was put to sleep by suggestion after she had gone to bed in her own room. Went to sleep very quietly in about three or four minutes and slept soundly, though with sudden jerks and starts. Was awakened after fifteen minutes and said she had been dreaming of the old woman. She slept for fifteen minutes in the afternoon and dreamed that she was falling down between two houses and called to her brother George to help her. The nurse heard her call out “George” in her sleep. (George is a deceased brother.) She went to sleep again after I left the room and slept without any starts or twitchings, but had five light convulsions without awaking. The convulsions were general, but only momentary, and scarcely attracted her nurse's attention. She bites the tongue, though, even in these slight attacks.

She went to sleep readily to-day under suggestion and slept quite soundly, but we could not elicit any replies from her, and questioning awakened her with a start. Said she had been asleep for a minute and that she heard me talking to her, but was not conscious of what I was saying. Tried again, but could not induce sleep.

January 13th.—Visited her at her room at 7.30 last evening and put her to sleep without difficulty, and succeeded in eliciting a few replies from her while in the sleeping state, but the experiment was not very satisfactory, as she soon awoke when questioned sharply. She went to sleep again naturally about 9.30 and slept until about 12; during that time she cried in her sleep while dreaming; did but later when she did wake she not awake at that time, told the nurse that she had dreamed the old woman was ure which she (Mary) treasured. She saw and heard her; her voice is about the same in dream as it is when heard during the day. She did not sleep after midnight; was restless and nervous; had two convulsions, at 1 and 1.10; could not go to sleep, though she tried counting, etc. The nurse put her to sleep by rubbing her forehead, but she slept only about fifteen minutes.

January 16th.—Was examined by aurist yesterday, and her ears found perfectly normal; hearing acute; bone and air conduction normal; drum membranes normal. Posterior nares and throat quite normal. No source of irritation found which might give rise to the auditory hallucinations. Her perception of the lapse of time is not perfectly good. A certain period seems to her longer than it really is.

She was “lost” for a while this morning. She says that being “lost” is different now from what it formerly was. She does not forget what has preceded nor feels as if just awakened from sleep. Merely “feels bad,” and wants to cry. The hallucinations always disappear during the time she is “lost.”

Attempts were made to have her quickly formulate a sentence containing a given word. It is difficult for her to think of anything to say, though she understands what is meant. A word was then given and she was asked to give a string of words at random.

Afraid.—No answer. Says no words come into her head. Finally said “afraid of old woman.”

Kicking.--No answer. Says no thoughts arise; that she cannot think of anything.

Do you know of any drunken People?—“The old woman used to drink and others around her drank.”

Association of ideas when ultimately stimulated refers to the central idea of the old woman. Ideation is very slow, being inhibited by the said idea.

Don’t love.—“Don’t love the old woman; likes her well enough; don’t love her like we ought to; love her as much as she allows us to, though.”

Counting after it has been kept up for a while will stop the hallucination. She counts to herself to go to sleep. Also when doing crocheting, etc., involving counting, the voice is not so loud and persistent.

Listening to reading distracts attention from the voice, too, but not entirely. Talking has the same effect, but not so marked as listening. Watching her nurse and trying to learn a new stitch distracts her attention from the voice, but not entirely. Any kind of work gives some relief. Any ordinary conversation will distract her to some extent. Hears the voice most when doing nothing and just thinking about the old woman. Mere distraction of attention, such as watching something or doing something involving thinking, is not so effective as employment requiring talking or counting in addition to watching and thinking. Hears the voice just the same with the tongue protruded or with tongue caught between the teeth. During such experiments, however, the tongue constantly moves spasmodically; twitches. Dreams of the old woman almost every night; rarely has a dream without the old woman; never a dream without some member of the family being in it.

January 17th.—Put her to sleep last evening at her to sleep last evening at her room; she was tired and sleepy at the time; went to sleep readily and slept soundly, but did not go into real hypnosis—no catalepsy induced. She muttered at times in reply to questions—occasionally answered questions directly without awakening. She said “Jim” was talking to her; that she had also a brother named “Will”; that there are six in their family; sisters named Ivy and Alice. Would like to go home and work. These remarks all in reply to questions frequently and insistently repeated. A tendency to wake up when questioned sharply enough to elicit an answer, but if questions were stopped for a moment she would go more soundly to sleep again; called out (“Jim, did she lock you in there?”). Awakened after half an hour. She said she had been asleep and dreamed of the old woman and her brothers and sisters. Had a conversation with them at home. Did not know of my having talked to her. Attempted hypnosis at 11 A.M. Not successful. Whispering movements very marked while quiet and trying to sleep. Repeats the story of her several reincarnations into Jesse James, Jennie Longnecker, and Mike Muckey, all of which were previous to her birth as Mary Vaughn. Then Mary Vaughn died before she went to Buffalo. She knows she must have died because she could not otherwise be so changed as she is. She is called Mary Vaughn now, but does not feel like Mary Vaughn. Does not even believe that during the times when she is “well” and goes home she is really Mary Vaughn, the same Mary Vaughn as before, although at those times she does think so. Does not hear the old woman at all when she is “well.” When “well” and at home she is not really cheerful and like other people, but prefers to stay quiet.

It seems about fifty years, although she has been there about seven or eight years. Altogether it seems to her that it means about 1,000 years. When asked how this can be since the figures do not make 1,000 years, she answered she was mixed up in the figures in believing otherwise.

Mike Muckey died from drinking himself to death; lived in Ireland; was married; wife, Annie McCarthy; had ten children. Does not remember about the death of Jesse

James; also could not remember about the death of Mary Vaughn. Describes aura as before, and says besides that she sees little silver stars, and everything goes around and sometimes it gets dark. This only with eyes open; has to close eyes for relief. Never dreams about Mike, Jesse or Jennie, and never thinks about them now. Says that these memories of Mike and Jesse and Jennie came to her first after she came to Buffalo. She knew nothing about them before that. Nurse says she told the same story in all its details six years ago to her knowledge. Mike had red hair and whiskers; does not remember anyone who looks like him. Knew a girl named Jennie Longneeker, and liked her very well. Later said she did know a man named Mike Muckey, who lived at Portville ; does not know whether he was married or not. Knew a woman in Olean, a great friend of the old woman, named Annie McCarthy. She and the old woman and a man named Holmes used to drink together, and Mary “rushed the growler.” (Holmes looked much like Mike.)

On January 18, 1900, patient was more sure of being Mary Vaughn than being any of the other personalities. Has had dreams in which the old woman figures largely. Patient is now fully aware of the primary states. In the primary state, however, patient does not know the other personalities. Patient thinks that she is now more right about things than the other state with the many personalities.

Patient continues to have the auditory hallucinations of the old woman, her mother. When asked how fast the old woman talks, patient answered that the old woman kept on talking as fast as she herself did. The patient keeps on whispering to herself. The movements of her lips and larynx could be distinctly perceived. They ceased when patient’s attention was fully absorbed in some difficult task; then she heard no voice of the old woman. The movements were started again when patient was slightly distracted, and when left to herself for a few minutes low sounds of whispering could be clearly heard. Occasionally she even spoke out aloud. When her attention was called to the fact of her talking, and she was told what she said, she was surprised; she did not talk; it was the old woman who kept on talking to her.

This case presents phenomena of multiple personality having their origin rather in delusional states. Multiple personality, however, can be observed best in cases uncomplicated with insanity. In such cases each moment-consciousness has its own separate memory not commingling the stream of its recollected experiences with those belonging to the other moments. These different moments can be artificially evoked in hypnosis by indirect suggestion, such as by the action of the different metals applied to different places of the patient's body, or they may be called out to function by direct hypnotic or post-hypnotic suggestion. When the patient, however, is naturally passing from one state to another there is present a transitory state, the attack, the hypnoleptic state. The moments differ greatly in character, in disposition and inclination; still much of psychic content is common to all of them.

The case recently described by Dr. Gilbert may be regarded as falling under the category of multiple personality, although it is quite probable that they are forms of hypnotic states. The patient is of a psychopathic disposition. The breaking up of personality was occasioned by an injury to the cerebro-spinal system. The transition from the upper personal consciousness to the subconsciousness, in which the hypnoidic personalities are buried, is through an intermediary sleeping or hypnoleptic state, while the transition of one hypnoidic personality to another is by slow gradations, one imperceptibly passing into the other, since they are all subconscious. The cases reported by Dr. Prince, Flournoy, Professor Hyslop and others belong to the same type.

“Family History.—Father living and well. Not much known of him or other relatives. Mother died when three years old. Cause unknown. One brother living. None dead.

"Personal History.—Age, twenty-two years. Never ill until the present accident. No liquor or drug habit.

"History of Present Illness.—Fell from a barge onto a log in the water eight to ten feet below. Struck head on left occipital protuberance. Stunned for a short time. Rallied and crawled up on the logs. Head burned like fire all over. Walked like a drunken man. He was taken ashore and started to town. Walked part of the way; on street-car the balance of the way. After boarding the car and riding a short distance nothing more was remembered till in the hospital about three weeks later. When taken by the ambulance he was apparently rational, but exhausted. On waking in the morning he would chase rats in the bed. On second day after entrance to the hospital he rose from bed, said he felt all right and asked to be discharged. He was apparently well, and the discharge was granted. His friends noticed he was not normal and brought him back the same day. He left the hospital thus three times, apparently normal, but he remembers going out only the last time. All events previous to that are a blank since boarding a street-car after the barge accident. During his stay in the hospital in the early part of his sickness he would have spells of semi-delirium. Peevish and troublesome at times, generally quiet and orderly. There were gathered a few facts in regard to things he did and where he went during his first two trips out of the hospital, but he could not recall them after they were related to him. Throwing the head backward caused things to turn black before his eyes. Unusual movements affected his eyes. At first almost continuous pain over the eyes and in the head. Extremely nervous at times; so much so that pricking his ear for blood ‘set him on nettles.’

“The patient’s life being largely a blank since the accident, and inasmuch as he had unwittingly collected and signed a receipt for his wages, and not knowing what else of importance he may have done, with the patient’s consent I hypnotized him to ascertain his actions during the period which was a blank to him. Hypnosis was induced slowly, but successfully in about one-half hour. While in the hypnotic state, in muffled voice, in response to questions, he gave in detail his life during the time subsequent to the accident. Subsequent investigation verified his statements in every detail so far as memory could serve, for no notes were taken, inasmuch as multiple, or even double personality was not, suspected at this time. To close the hypnosis I suggested that he would awake when I counted five, having previously suggested that at the end of the counting he would wake and feel perfectly well in every regard. To our surprise he awoke with a start, the very picture of fright, trembled like a leaf, demanded where he was, knew neither Dr. Cobb nor myself and, all in all, was a picture of mental distress. The patient was quieted, and on questioning him it developed that we had before us a case of double personality. He gave his age as eighteen years, never been in Portland, and spoke of events which he said took place ‘yesterday,’ and on questioning it was found that he thought it was September, 1898. All time and events since then were an utter blank., Subsequent developments proved that this date was 1899 instead of 1898. Previous to the 1898 he had a lapse into another personality which lasted about a year. Hence the dropping a year. Mere mistake in dates, however, may account for the mistake without reference to the lapse previous. He said that ‘yesterday’ (i.e., Friday, September, 1898) he had a fight with his father in Glenrock, Wyo., and on being told that he was in Portland he asked whether it was Portland, Ore. or Portland, Me. The patient being somewhat disturbed in mind he was put in the ward to quiet down and get acquainted with his new surroundings. He knew none of his companions in the ward and had to be shown his bed, hat, and belongings in general—in short, he was a stranger in a strange land. The case throughout presented many queer and interesting data, which must, of necessity, be omitted in this presentation of it.

“At 4 P.M. on the same day (April 2d) the following history was taken from him, told in a perfectly clearheaded and intelligent way:

“Born December 15, 1878 or ’79—not sure which. Born at Nemeha City, Neb. Mother died when he was three years old. One brother, one half-sister, one step-sister, father, two grandfathers, two grandmothers, and a stepmother, giving their names and addresses. Moved to Nebraska City shortly after birth and then to St. Paul, Neb. Ran away from home when fourteen years old and went to relatives on mother’s side. Omitting details in this relatives writing, he went to Bloomington, Omaha, Ashland, and enlisted for the war with finally to Lincoln, Neb., Spain. Went as far as Chickamauga and took sick with a fever of some kind. Cannot remember how he got back to Nebraska, but the first he could remember he was working in Oxford, Neb. During the lapse, I learned subsequently, he had been hunted for desertion—the desertion, however, not being true desertion, for he changed personalities in camp and left, not knowing that he belonged to the army. Omitting details again, he went to Oxford, Mascot, Holdredge, and Glenrock. While here his father and a step-mother quarrelled, and in his attempt to interfere he and his father quarrelled. During the quarrel, it seemed to him, his father hit him on the head with something. That was the last he could remember until he woke up here in Portland. There was no headache in this personality. Perfectly well in every way. Refused to take medicine because he said it was nonsense for a well man to take medicine. He never saw but one steamboat in his life, and that was on the Missouri River. It must be remembered that the patient has lived in Portland since last August. On questioning he knew nothing of Portland, nothing of his house which he and a chum had built, and nothing of the chum or anything related to him. Although he had never seen a steamboat except one on the Missouri River, in another self he had fired on the steamer Columbia between San Francisco and Portland and had become very seasick. Furthermore, numbers of river steamers and ocean liners are to be seen daily in the Portland harbor on the very beach of which he has lived since August. Absolutely no clew could be hit upon by which to connect him with the life he lived in Portland. Letters on his person were strange to him, and their contents worried him.

“The next day, April 3, with his consent, he was hypnotized, so as to be thrown into his former self again in order to ascertain the events of his life since September, 1899. Hypnosis was again slowly induced. When completely under the hypnotic influence no answers could be elicited from him at all. By shaking him after suggesting his Portland life to him he roused, but in a delirious state, raving with headache, complained of two red men who twisted his head and begged to be taken back to the hospital, supposing he was down-town. This was evidently the stage in which he was at times after the accident on the barge. No persuasion could quiet him, and to satisfy him we told him we would take him back to the hospital. On opening the door into the corridor leading to the ward, his surprise and alarm at finding himself in a strange building threw him into a frenzy of terror, and all we could do was to take him back to the dressing-room where we had been. Here he quieted down and went to sleep on the dressing-table. After about ten minutes I cleared my throat. He started up in a fright and began chasing rats on the bed. Again I quieted him. After sleeping a few minutes, without perceptible stimulus he started up again, but on seeing me, said in a perfectly calm way, ‘Where is Dr. Cobb? Did I tell you what I did since the accident on the barge?’ (Dr. Cobb had been unavoidably called away after he fell asleep on the table. With the exception of these ten or fifteen minutes there were always from one to six witnesses besides myself.) He was back again in the self in which he was before the accident on the barge and knew absolutely nothing of the twenty-four hours which he had just passed in a different personality. No clew could be hit upon by which to connect him with it. He thought it was April 2d, and on being told it was April 3d, was somewhat surprised and supposed we had kept him hypnotized for twenty-four hours. The following history was then taken, the man apparently normal except that the old headache was back again. His life was traced backward and found to lead from Portland to San Francisco, Denver, Cheyenne, Wyo.; Edgemont, S. D.; Chadron, Neb., and finally to Glenrock, Wyo. Here he said his father and he had some sort of trouble. Could not tell how the trouble arose. His father threatened to shoot him and he ran away.

“Omitting again the many details which are confirmatory and interesting, but not absolutely necessary to the narration of the case, he went to Chadron, Edgemont, Cheyenne, Denver, San Francisco, and finally to Portland. It subsequently developed that he also spent a period of time belonging to this life when about sixteen years old, i.e., previous to the Glenrock quarrel with his father. In this personality he knew nothing of coal-mines, though he had been working in a coal-mine in his other personality for two weeks previous to the quarrel with his father. Again repeated attempts were made to connect the two lives by going over, in detail, the experiences as related by him in the two respectively, but no connection could be made between them. By putting together the two histories there still remained large gaps which were unfilled by the experiences related while in the two respective personalities.

“The gap from Chickamauga to Oxford and numerous others of less importance remaining unfilled and having received confirmatory evidence from answers to letters of inquiry sent out, I felt sure of a third personality and hypnotized him, April 24th, to throw him into said suspected personality. He was successfully thrown into it, and when he was aroused from hypnosis into the third state he was again a stranger to us and his surroundings. Acting on the difficulty experienced in gaining his confidence when he awakened the first time in a strange personality, I had written letters at that time explaining his condition and also a note which he signed to act as corroborative evidence of our friendliness, should he in the future wake and be a stranger to us. These letters were carried continually in his pocket, and were valuable aids in keeping the man’s confidence in the different personalities. Some time was thus spent in reassuring him, after which the following history was taken, unessential details being omitted in this report.

“When questioned in regard to Chickamauga and his experience there, he said he did not belong to the army there, but there were a great many soldiers all over the fields. He said, ‘I was awfully sick and I haven't got over it yet.’ In this personality he suffered continuously with pain in his head and abdomen. He was a typical tramp throughout, beating his way on trains, and working only enough to support life when it could not be done otherwise. He described in minute detail his wanderings through Chattanooga, Nashville, Green Brier, and Springfield, Tenn.; Henderson, Ky.; Evansville, Ind.; Carmi, Ill.; St. Louis, Jefferson City, Kansas City, Liberty, Red Cloud, and Oxford, having isolated and disconnected experiences in Cheyenne, San Francisco, and Portland. Here again repeated attempts failed to connect him with either of the other two lives. Frequently, in relating his experiences in the three different lives, he would come to a certain point in the narration, stop and say, ‘I can’t remember what took place then; the next I remember I woke up at such and such a place.’ In narrating the experiences of a different life he would pick up the interval which he forgot in the other life and carry you to the point where he said he ‘woke up,’ and then say, ‘I can’t remember what took place; then, the next I remember I woke up at such and such a place.’ Thus the story of each life contained numerous unfilled gaps which would be accurately filled in by experiences in another life.

“By taking the three lives and writing the stories as they dropped and picked each other up, thus filling up the gaps of each, I was able to fill out almost completely his entire life from 1879 to 1902. There still remained a number of gaps, indicated by the stars in the schedule below, which I have been unable to fill out. Thinking that perhaps these gaps might be filled in by getting a still more complete history of the three lives, on April 26th, he was thrown by hypnotism into each of the three lives successively and questioned closely in regard to the lapses without avail. The histories given were not related by him while hypnotized. Hypnotism was used merely to accomplish the transfer from one personality to another, and the history was then taken during full consciousness in the ensuing personality.

“Once of his own accord and twice by hypnosis he passed into a state which could not be connected with the other three and in which he was in a state of semi-delirium. The subject became impatient and resented the frequent hypnotizing, and so it was decided to attempt by suggestion during the hypnotic state, accompanied by repeated consecutive narration of the events of his different lives to unite them into a unitary consciousness. The attempt was made April 28th, and proved gratifyingly successful. For a day or two he was still unable to recall a short period immediately following his lapse at Chickamauga, but later that came to him with full vividness. On April 30th, after having been hypnotized and the suggestion made that he would remember even the events comprising the gaps as yet unfilled, he was able to fill in the gap preceding the waking on the bluffs above Kansas City and the one preceding his waking in Liberty. The other gaps starred, still remain a blank to him. With these exceptions he now tells a story of his life so continuous that he himself cannot tell where the breaks in the continuity used to be. On being told that a short time ago he did not know many of the things he was now reciting he answered, ‘Yes, I did, I always knew those things.’ It is only when he recalls the events of the past month that he realizes there has been any change in him.

“Immediately before uniting the three personalities the following chronological tabulation of his experiences and changes of personality was made out and used as a basis for suggestion by which to unite the three selves. The stars indicate the gaps existing just previous to the time the three personalities were united into a unitary consciousness. These gaps have been partially and tentatively filled and classified in a manner to be explained below. The dates mentioned have been verified by correspondence. The different personalities will be designated by X1, X2, and X3:

X1. Nemeha City, born December 15, 1879; Nebraska City, six years old; St. Paul, Neb., nine years old; Crawford, Neb., fifteen years old. Changed in the depot to

X2. At Crawford, April, 1896; Edgemont, S. D.; New Castle, Wyo. On way to Cambria, changed to X1. Cambria, Wyo.; Crawford, Neb.; Havensville, Kan.; August, 1896; Topeka, N. Topeka, Holton, Havensville, Kan.; Nemeha City, Neb.; White Cloud, Bloomington, August 12, 1897. Omaha, Ashland, Lincoln, Neb., May, 1898 ; Chickamauga. Changed while asleep under a tree to

X3. At Chickamauga, June 3, 1898. Chattanooga, Nashville, Green Brier, Springfield, Tenn.; Henderson, Ky.; Evansville, Ind. ; Carmi, Ill.; St. Louis, Jefferson City, California, Missouri. On train going toward Kansas City changed to

X3. “Woke up” on the bluffs above Kansas City in the weeds. Crossed Kansas River. On freight changed to

X3. “Woke up” in Liberty, Neb. To his surprise he had money in his pocket. Bought ticket to Red Cloud. On train changed to

X {X1, X2, X3}Oxford, Mascot, April 18, 1899, Holdredge, Neb. (Vague experiences recalled at these places in all three personalities. Most accurate and detailed account was given by X3. X2 only knew that he had been there.)

X2. At Glenrock, September, 1899.; Chadron, Neb.; Edgemont, S. D., February 5 to April 12, 1900. Alliance, Sidney, Cheyenne, Wyo., June, 1900. Changed to

X2. “Woke up” on Larmour Street, Denver. San Francisco. In barracks asleep and changed to

X2. In the wholesale part of San Francisco, Cal. Oakland. On train and changed to

X2. “Woke up” in Salvation Army Hall in Oakland, San Francisco. Portland, August, 1902. Changed to

X3. After the barge accident, February 20, 1902. In hospital three weeks. Changed to

“There were other very brief lapses, judging from many incidents narrated. Several such lapses occurred probably at San Francisco and here in Portland. The lapses **a, **b, and **d he was able to fill in after the uniting of his three lives. In **a he went to Kansas City, climbed the bluffs and went to sleep in the weeds. This was likely X1, inasmuch as he started in the direction of his old home, and in X2 he knew nothing of his people at this time. In **b, as filled in by his united self, he went to Topeka, Holton, and Havensville. Here his people would have nothing to do with him, and he went to Summerville and then worked near Liberty for some time. This must have been done when X1, for it is only as X1 that he knew anything of his people at Havensville. The lapse **c must have been in X2, because when in this personality previous to uniting the three he said he had been in Red Cloud, but could not remember anything about it. In lapse **d he went to Denver and loafed around for about a week. The lapses **e and **f are still in obscurity, but assuming that there are only three personalities in the case these lapses must have been spent in X3, because he changed to them from X2 and X1, knew absolutely nothing of any time between September, 1899, and April, 1902.

“Evidence seems to point to the conclusion that whatever personality or personalities he was in while at Oxford, Mascot, and Holdredge, there was at times more or less knowledge of all three selves at those places. In no single personality could any specific detailed account of his stay at Oxford and Mascot be given, though in all personalities he knew that he had been there. X3 gave the most details of any at these places. Either there was a certain amount of interfusion of the three personalities at these places, or else he had frequent changes in Oxford and Mascot. Subsequent correspondence with his acquaintances at Oxford substantiates the former view. Furthermore, he says that while he was asleep in the shock of oats near Oxford he had a very peculiar dream of having been in Red Cloud, etc. It is highly probable that this dream was not a dream, but the real experiences of the preceding lapse, probably filled by X2 or a modified X3. This vague interfusion of the selves or modification of a particular self may account for a11 the lapses and peculiarities in X3 from Chickamauga. Though there is no absolute proof, the data at hand leave one in the conviction that at Oxford, Mascot, Holdredge, and probably Glenrock there was a partial, if not complete, fusion of the experiences of the three lives, which was confusing to him then as well as to us now. His acquaintances at Oxford looked upon him as insane.

“Though his experience from Chickamauga to boarding a train near Kansas City was given in the most certain and positive way while in X3, and though he had no relatives that he knew of in this personality, yet it is probable that during that time he had inklings of his former life from some source or other which led him back to Nebraska. He may, however, have learned that he belonged in Nebraska by letters in his pocket or other means in camp before leaving Chickamauga. It seems probable, taking everything into consideration, that there was slight knowledge of his other lives in this personality.

“That the uniting of his three selves into a conscious unity did not insure against subsequent lapses is shown by experience later. On May 7th he came to my office feeling badly, suffering from headache, and depressed in general. I hypnotized him and suggested that on waking he would feel better. He woke and seemed better. After sitting for several minutes he looked about, somewhat surprised, and without any visible signs of change, he remarked, ‘Doctor, I have been asleep again.’ The last he could recall he was entering the building and waiting for the elevator, but how he reached my office and all that transpired in the meantime was an utter blank to him. His partner, with whom he lives, says that such lapses used to be rather frequent with him.

“In order to verify the history of the case numerous letters had been written to parties mentioned by X1, X2, and X3; one of these letters was sent to the army post at San Francisco to inquire as to his enlistment and desertion from the army as a result of a change of personality, but no answer was received. On May 14th, acting upon information gained from my letter to San Francisco, officers from Vancouver post came and arrested X, and took him on the car to Vancouver, charged with desertion from the army at Francisco. On May 16th, at Vancouver, I presented the history of his case to the officials in order to obtain his release. After the conference with the officials X was brought in. To my surprise he was X2 again; knew absolutely nothing of X1 or X3 or of his experiences subsequent to uniting his three selves. Only X2 was known to him.

After hypnotizing him and suggesting that he would remember all his life again he woke with full memory of X1, X2, and X3 as before he was arrested.

“So far twenty-eight letters have been received in answer to inquiries sent to relatives, acquaintances, War Department, etc., each and all of which verify most accurately the history described. Changes of personality took place twice while in the army, and he was recorded and hunted as a deserter. He enlisted the first time as X1, the second time as X2, and each personality knew nothing of the other enlistment. At first these two desertions raised a suspicion in us that he might be deceiving in order to cover up his guilt, but second thought, on the contrary, confirms his duality in the two acts, for a deserter would scarcely run the risk of re-enlisting. Furthermore, proof that he had changes of personality previous to any connection with the army in addition to confirmatory evidence from numerous other sources removes any possibility of insincerity on his part. Aside from the corroborative evidence, observation of the man during treatment would have been sufficiently convincing to remove all doubt.

“X1 was perfectly well, jovial, bright, knew the names and addresses of all his relatives and could give an accurate account of his boyhood days. He had rather accurate dates for everything. Was eager to educate himself, though he was only an ordinary laborer as a rule. X2 was quiet in disposition, preferred to be alone, had spells of sleepiness, always had some headache, knew but little of his relatives, and that was learned subsequent to age of eighteen; a good mechanic, ambitious, and inventive; desirous for an education and distinctly religious in character. All in all, his life bore a sad, melancholic aspect. X3 was a typical tramp, largely due to the fact, no doubt, that he began this life where he did. Though eighteen years old at Chickamauga, when asked where he came from, he answered ‘didn’t come from any place.’ Worked only enough to exist; severe pains in head and abdomen; always hungry; all in all, a lower type of man by far.

“All three personalities had a remarkable memory for details. The same name was retained in all. In addition to the three personalities described there was still another state which may possibly be a fourth, but each time he was thrown into it he was semi-delirious and no definite information could be obtained from him. The place of this state, in its relation to the personalities described, is difficult to determine. In it he raved with pain and was always thirsty. This state may account in part for some of the gaps remaining unfilled.

“In his united self he is radically different from what he was previous to the barge accident. Previously taciturn and fond of solitude, in his united self he became social and settled, moodiness disappeared. He still manifests the old ambition for an education, though at present he chafes under the monotony of his wait in prison until the routine of government formalities shall be accomplished. Under the circumstances his ultimate release would seem to be a mere matter of time, but the worry and mental excitement incidental to his arrest give him almost continuous headache, and at times plunge him into despondency which makes him wish he were dead.

“After the fusion of his three lives the first time, a minute and detailed history of his boyhood and early manhood was taken in order to see if any cause of the trouble could be detected. As a boy he received very rough treatment from his father, but no definite etiology of his condition could be discovered. Though changes of personality occurred two or three times under what seemed to be a definite etiological factor, such as the fight at Glenrock and the fever at Chickamauga, yet these things cannot be considered the sole cause of the trouble. In the great majority of cases his changes of personality took place while on a train or immediately following—a fact not without significance.

“The changes from one personality to another were at times gradual, instead of abrupt. At times memory of one stream of consciousness faded out gradually as the other came into prominence. One of the changes which occurred in my presence was of this type. Several times in one personality short preceding experiences were vaguely recalled and thought to have been dreams, showing that at times either the different selves overlapped, as it were, to some extent, leaving the period of change indistinct in each, or else—what is more probable—the events supposed to have been dreamed were experiences of the same self under a sort of psycho-epileptic seizure. Under the latter supposition the gap **c in the schedule above may be a sort of psycho-epileptic mutation of X3 instead of a change into X2. The whole process throughout might not improperly be called a psycho-epileptic exchange of personality.

“The personality, designated throughout this article as the ‘united self,’ cannot be considered as composed of X1, X2, and X3, as constituent parts, but, strictly speaking, the so-called ‘united self’ is a new unified experience, even as X1, X2, and X3 were originally. This was clearly exemplified by the fact that after his return to X2 at Vancouver subsequent to the uniting of X1, X2, and X3 in memory, he not only knew nothing of X1 and X3, but the experiences of the so-called `united self' were also a blank to him.”

¹ Brit. Med. Journal, February 1, 1896.
² The hospital notes were sent to me by Dr. Frost.