‘Detective Story. From Chronic Hallucinatory Delirium to Imaginary Delusion.’
Presented by MM. Lévy-Valensy, P. Meignant and J. Lacan at the Société de psychiatrie; published in l’Encéphale (n. 5, 2, 1928) pp. 550–1.
We present a patient, forty-years of age, who for thirteen months constructed a police-themed delirium: from Beaucaire, he was witness to scenes of robberies taking place in Paris and, in order to hand the criminals over to the authorities, he communicated via thought with the Paris agents and the gendarmerie of Beaucaire. Finally, he made the trip to Paris so as to complete his declarations to the police and, after being taken to the police station, he was interned. Without going into the specifics of this very rich case of delirium, we shall say a few words regarding its underlying causes.
At the time of internment, a diagnosis of chronic hallucinatory psychosis was made with the following features appearing to be present: visual, auditory and even genital hallucinations, and echoing of thoughts and actions [d’echo des actes et de la pensées]. Two facts, however, were striking from the outset: on the one hand, the predominantly nocturnal or hypnagogic character of the phenomena, which was reminiscent of the ‘dream delirium’ previously reported by Klippel, but, in this case, however, the delirious conviction persisted throughout the entire day. On the other hand, there existed the presence of an important imaginary support: ‹‹ mentism perceived as exogenous, visual inventions. . . hypnogogic and lucid visions, animated and combined and, perhaps, able to be evoked at times (?) ›› (from de Clérambault’s original [diagnostic] certificate).
Two months later, the patient presented himself as an imaginative. No interpretation. The hallucinations were found to be extremely reduced, if not completely absent (with the phenomena of echoing of thoughts and actions appearing to have been the last to disappear). Now present was an extremely rich imaginary story [roman imaginatif], increasing, so to speak, by avalanches; along with suggestibility was the possibility of bringing about, in addition to the stories already constructed, the attachment of immediate conviction [to the imaginary story], as well as the presence of more and more fantastic, megalomaniacal ideas.
The lack of information obtained regarding the patient’s history makes a judgement pertaining to prior mental constitution difficult. Nonetheless, it seems that the patient has always been an imaginative or mythomaniacal [in character] (poetic, unstable. . .). On the other hand, during the patient’s stay in the asylum, there were no signs of the effects of ethylism [subéthylisme]; that the patient is suffering from syphilis is a possibility (though biological reactions were negative, pupillary irregularities and leukoplasia were present). Without being able to confirm our judgment, we believe that the cause is an oneiric flare-up [poussée onirique] (toxic or infectious), owing to a predisposition in the patient. With the termination of the flare up, the properly oneiric character of the delirium and its hallucinations were attenuated and tended towards disappearance. But with this, the mythomaniacal tendencies then underwent a boost [coup de fouet]. The condition [affection] then assumed more and more the character of a purely imaginary delusion [délire d’imagination]; thus, the case falls into the framework of the ‹‹ post-oneiric, chronic, systematic delusion from the development of original [delirious] tendencies ›› (de Gilbert-Ballet [Bulletin médical, n. 87, 8 November, 1911, p. 959]).
Translated by Simon McNamee
 A commune in the Gard department in the Occitanie region of southern France.
 The term echo de la pensées in French psychiatry is equivalent to ‘audible thoughts’ or ‘audible thinking’; i.e., a subject hears his thoughts spoken; similarly, ‘audible actions’ might be the equivalent translation, designating, in the same way, the subject hearing his actions spoken (whilst performing the action or after).
 Maurice Klippel, the French physician (1858–1942) is, I believe, being referred to here.
 Following Phillipe Chaslin, mentism [mentisme] (from the Latin mens, ‘thought’): rapid and uncontrollable procession of thought and images which the subject cannot control or interrupt, typically coupled with anxiety or provoking anxiety and typically occurring at the time of attempting to go to sleep and causing insomnia.
 I have retained the use of ‘imaginative’ as a noun.
 See fn. 2.
 In the medical sense, pousée is used, beyond the sense of ‘push’ or ‘thrust’, to mean ‘a sudden manifestation of an illness or disease,’ hence, the sense of ‘flare up,’ as translated here. Additional, the descriptors ‘toxic or infectious’ seem to echo Klippel’s notion of oneiric delirium resulting from ethylism (see, e.g., Klippel & Lopez, ‘Du reve et du delire qui lui fait suite dans les infections aigues’, Revue de psychiatrique’ (April, 1900).