In the third degree of somnambulism, consciousness and the entire range of intellectual faculties have disappeared. The individual resembles a creature from which the cerebral hemispheres have been removed. He is little better than a living automaton, guided only by impressions received from without. In this condition the movements of the body may become wholly responsive to the will of another--a prominent characteristic of artificial somnambulism or hypnotism.

A fourth degree of somnambulism is marked by the disappearance of consciousness, intellect, sensibility, and the power of motion. Only the lower functions of organic life remain. The patient merely lives, he neither thinks nor acts. This constitutes the state of somnambulic lethargy, a condition which differs from deep sleep only in the fact that under the influence of external impulses or of partial awaking it may easily pass into the second form of the affection, the somnambulic dream.

Insomnia; and Other Disorders of Sleep — Part 92

Such is the classification of MM. Ball and Chambard. It possesses the merit of great precision and clearness. If the warning which its authors themselves utter against its too literal acceptance be respected, it will be found to afford a very convenient explanation of the manner in which the various degrees of somnambulism are reached. But it must be remembered that between these pronounced and definite forms exist a great number of intermediate degrees. Partial revivals and temporary resurrections of the higher faculties of the mind may intrude themselves among the activities which depend upon lower functions; as, for example, when the ordinary unconsciousness of lethargy is briefly interrupted by an event which may remain permanently fixed in memory after waking, even though all other concurrent incidents were unnoticed and left no trace behind. Keeping this caution in mind, the following diagram will be found useful:

Insomnia; and Other Disorders of Sleep — Part 92

+=======================================================================+ | |Organic|Sensibility:|Imaginative|Coördinative|Consciousness| | | Life | Motion | Faculties:| Faculties:| | | | | | Memory, | Judgment, | | | | | |Imagination| Attention, | | | | | | | Volition | | |-----------|-----------------------------------------------------------| |Normal life|XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX | |-----------|-----------------------------------------------------------| |Somnambulic| | | life |XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX | |-----------|-----------------------------------------------------------| |Somnambulic| | | dream |XXXXXXXXXXXXXXXXXXXXXXXXXX | |-----------|-----------------------------------------------------------| |Somnambulic| | | automatism|XXXXXXXXXXXXXX | |-----------|-----------------------------------------------------------| |Somnambulic| | | lethargy |XX | +-----------------------------------------------------------------------+

Insomnia; and Other Disorders of Sleep — Part 92