Hogan R Edward, Kaiboriboon Kitti
Greater Midwest Epilepsy Treatment Center, Deparment of Neurology, Saint Louis University School of Medicine, St Louis, MO 63110, USA.
Am J Psychiatry. 2003 Oct;160(10):1740-7. doi: 10.1176/appi.ajp.160.10.1740.
The authors review John Hughlings-Jackson's writings on the "dreamy state" and his subsequent derivation of degrees of consciousness.
They reviewed the publications of Hughlings-Jackson from his initial description of the "dreamy state" in 1876 until his writing about the "uncinate group of fits" in 1899. They then examined Hughlings-Jackson's use of the associated signs and symptoms of the "dreamy state" to formulate his ideas about human consciousness.
Hughlings-Jackson defined the "dreamy state" as "over-consciousness," or a heightened intellectual state. He described associated symptoms of "crude sensations" of smell and taste, an unusual epigastric sensation, chewing and lip smacking, automatisms, postictal symptoms, and at least some degree of alteration of consciousness. Using his observations of the "dreamy state" as a model, Hughlings-Jackson proposed three degrees of consciousness, each with an object and subject component.
Through his description of the "dreamy state," Hughlings-Jackson accurately characterized and localized medial temporal epilepsy. Correlating the ictal semiology of the "dreamy state" with consciousness, he developed a theory of consciousness that remains relevant to current understanding of the mind-brain relationship.
作者回顾约翰·胡克林·杰克逊关于“梦幻状态”的著作以及他随后对意识程度的推导。
他们查阅了胡克林·杰克逊从1876年首次描述“梦幻状态”到1899年撰写关于“钩回发作组”的出版物。然后，他们研究了胡克林·杰克逊对“梦幻状态”相关体征和症状的运用，以形成他关于人类意识的观点。
胡克林·杰克逊将“梦幻状态”定义为“过度意识”，即一种高度的智力状态。他描述了嗅觉和味觉的“粗糙感觉”、异常的上腹部感觉、咀嚼和咂嘴、自动症、发作后症状以及至少某种程度的意识改变等相关症状。以他对“梦幻状态”的观察为模型，胡克林·杰克逊提出了三个意识程度，每个程度都有一个客体和主体成分。
通过对“梦幻状态”的描述，胡克林·杰克逊准确地对内侧颞叶癫痫进行了特征描述和定位。将“梦幻状态”的发作期症状学与意识相关联，他发展了一种意识理论，该理论至今仍与当前对脑-心关系的理解相关。
