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  • We see with the eyes,

    人は目だけではなく

  • but we see with the brain as well.

    脳でも見ています

  • And seeing with the brain is often called imagination.

    想像は脳で見るものです

  • And we are familiar with the landscapes of our own imagination,

    想像が描き出す心象は馴染みがあるでしょう

  • our inscapes. We've lived with them all our lives.

    どんな人だって想像はしますから

  • But there are also hallucinations as well,

    しかし 幻覚もあります

  • and hallucinations are completely different.

    幻覚は全く異なるもので

  • They don't seem to be of our creation.

    我々の創造ではありません

  • They don't seem to be under our control.

    抑制もできません

  • They seem to come from the outside,

    幻覚は外から現れて

  • and to mimic perception.

    現実と区別がつきにくい

  • So I am going to be talking about hallucinations,

    その幻覚について話をします

  • and a particular sort of visual hallucination

    私の患者が体験した-

  • which I see among my patients.

    特殊な幻視を紹介します

  • A few months ago, I got a phone call

    数か月前に電話がありました

  • from a nursing home where I work.

    私が働く老人ホームからです

  • They told me that one of their residents, an old lady in her 90s,

    入居中の90代の女性が

  • was seeing things,

    幻覚を見ているので

  • and they wondered if she'd gone bonkers

    気が狂ったのではないか と

  • or, because she was an old lady,

    または 高齢のために

  • whether she'd had a stroke, or whether she had Alzheimer's.

    脳卒中かアルツハイマーではないか と

  • And so they asked me if I would come and see Rosalie,

    それで診に来てほしいと頼まれました

  • the old lady.

    ロザリーおばあさんです

  • I went in to see her.

    診に行ったら

  • It was evident straight away

    彼女が正気なのは

  • that she was perfectly sane

    明らかでした

  • and lucid and of good intelligence,

    頭ははっきりしていて 理解力もある

  • but she'd been very startled and very bewildered,

    でも非常に当惑していました

  • because she'd been seeing things.

    幻覚が現れるからです

  • And she told me --

    事前に聞いていませんでしたが

  • the nurses hadn't mentioned this --

    彼女は盲目だったのです

  • that she was blind,

    彼女は5年前に

  • that she had been completely blind from macular degeneration for five years.

    加齢黄斑変性症のため 失明したのですが

  • But now, for the last few days, she'd been seeing things.

    数日前から幻覚を見るようになりました

  • So I said, "What sort of things?"

    “何が見える?” と聞くと

  • And she said, "People in Eastern dress,

    “東洋風の服を着た人たちが

  • in drapes, walking up and down stairs.

    階段を上り下りしている

  • A man who turns towards me and smiles.

    私の方を見て微笑んでいる男

  • But he has huge teeth on one side of his mouth.

    口の脇から大きな歯が出ているの

  • Animals too.

    動物も見える

  • I see a white building. It's snowing, a soft snow.

    白い建物  わた雪が降っている

  • I see this horse with a harness, dragging the snow away.

    雪かき用ハーネスをつけた馬が見える

  • Then, one night, the scene changes.

    そして ある晩 シーンが変わったの

  • I see cats and dogs walking towards me.

    猫や犬が寄ってきて

  • They come to a certain point and then stop.

    ある程度近づいたら立ち止まる

  • Then it changes again.

    そして また変わる

  • I see a lot of children. They are walking up and down stairs.

    階段を上り下りしている たくさんの子ども

  • They wear bright colors, rose and blue,

    バラ色や青の明るい服を着ている

  • like Eastern dress."

    東洋の服のよう”

  • Sometimes, she said, before the people come on,

    その人たちが現れる前に

  • she may hallucinate pink and blue squares on the floor,

    床に広がるピンクと青の四角い模様が

  • which seem to go up to the ceiling.

    天井に上がる幻覚が見えることも

  • I said, "Is this like a dream?"

    “夢のような感じ?” と尋ねると

  • And she said, "No, it's not like a dream. It's like a movie."

    “いいえ  夢ではなく映画のよう

  • She said, "It's got color. It's got motion.

    色もついていて 動きがある

  • But it's completely silent, like a silent movie."

    でも無声映画のように音がない”

  • And she said that it's a rather boring movie.

    やや退屈な映画だ と

  • She said, "All these people with Eastern dress,

    “東洋風の服をまとった人たちは

  • walking up and down, very repetitive, very limited."

    上り下りを繰り返すばかりで 行動が限られている”

  • (Laughter)

    (笑)

  • And she has a sense of humor.

    ユーモアのある女性なんです

  • She knew it was a hallucination.

    幻覚だとわかっていても

  • But she was frightened. She'd lived 95 years

    怖がっていた 95年の人生で

  • and she'd never had a hallucination before.

    幻覚を見たことがなかったから

  • She said that the hallucinations were unrelated

    その幻覚は彼女の思考や感覚

  • to anything she was thinking or feeling or doing,

    行動と無関係だというのに

  • that they seemed to come on by themselves, or disappear.

    やって来ては消えていくようです

  • She had no control over them.

    コントロールすることはできず

  • She said she didn't recognize

    彼女には幻覚の中の

  • any of the people or places

    人物や場所は

  • in the hallucinations.

    どれも見覚えがない

  • And none of the people or the animals,

    しかも人も動物も

  • well, they all seemed oblivious of her.

    彼女に気がついていないようだった

  • And she didn't know what was going on.

    彼女は状況が把握できず

  • She wondered if she was going mad

    狂ってしまったかと

  • or losing her mind.

    心配していました

  • Well, I examined her carefully.

    私は入念に診察しました

  • She was a bright old lady,

    陽気なおばあさんで

  • perfectly sane. She had no medical problems.

    異常はなし 体調良好

  • She wasn't on any medications which could produce hallucinations.

    幻覚を引き起こす薬も飲んでいません

  • But she was blind.

    盲目ということだけ

  • And I then said to her,

    それで 言ったんです

  • "I think I know what you have."

    “察しがつきました

  • I said, "There is a special form of visual hallucination

    視力低下や失明によって起きる-

  • which may go with deteriorating vision or blindness.

    特殊な幻視があるんです”

  • This was originally described," I said,

    “これはシャルル ボネという男性が

  • "right back in the 18th century,

    18世紀に初めて

  • by a man called Charles Bonnet.

    記述した症状です

  • And you have Charles Bonnet syndrome.

    あなたはシャルルボネ症候群です

  • There is nothing wrong with your brain. There is nothing wrong with your mind.

    脳も精神も正常

  • You have Charles Bonnet syndrome."

    シャルルボネ症候群ですよ”

  • And she was very relieved at this,

    それを聞いて彼女は安心し

  • that there was nothing seriously the matter,

    深刻な問題ではないことにホッとした

  • and also rather curious.

    そして むしろ 好奇の目で

  • She said, "Who is this Charles Bonnet?"

    “シャルルボネって誰?

  • She said, "Did he have them himself?"

    彼にも幻覚が見えたの?” と

  • And she said, "Tell all the nurses

    さらには “看護師のみんなに

  • that I have Charles Bonnet syndrome."

    私はシャルルボネ症候群だと言ってちょうだい”

  • (Laughter)

    (笑)

  • "I'm not crazy. I'm not demented. I have Charles Bonnet syndrome."

    “狂ってもボケてもいない  シャルルボネ症候群なだけ”

  • Well, so I did tell the nurses.

    彼女の言うとおりにしました

  • Now this, for me, is a common situation.

    これは よくあるケースです

  • I work in old-age homes, largely.

    主として老人ホームで仕事をするので

  • I see a lot of elderly people

    高齢者が相手です

  • who are hearing impaired or visually impaired.

    聴覚 視覚障害者も多く

  • About 10 percent of the hearing impaired people

    聴覚障害者の約1割は

  • get musical hallucinations.

    音楽性幻聴が聴こえます

  • And about 10 percent of the visually impaired people

    視覚障害者の約1割は

  • get visual hallucinations.

    幻視を見ます

  • You don't have to be completely blind,

    全盲ではなく

  • only sufficiently impaired.

    弱視も含まれます

  • Now with the original description in the 18th century,

    18世紀に話を移しますが

  • Charles Bonnet did not have them.

    この幻覚症状があったのは

  • His grandfather had these hallucinations.

    シャルルボネではなく彼の祖父でした

  • His grandfather was a magistrate, an elderly man.

    祖父は高齢の裁判官でした

  • He'd had cataract surgery.

    白内障の手術を受け

  • His vision was pretty poor.

    視力は相当悪かった

  • And in 1759, he described to his grandson

    1759年 彼は自分の幻覚症状を

  • various things he was seeing.

    孫に話したのです

  • The first thing he said was he saw

    まず彼が話したのは

  • a handkerchief in midair.

    宙に浮くハンカチです

  • It was a large blue handkerchief

    大判で青地に

  • with four orange circles.

    オレンジの丸が4つ

  • And he knew it was a hallucination.

    祖父は幻覚だと認識していました

  • You don't have handkerchiefs in midair.

    宙に浮くハンカチはありませんから

  • And then he saw a big wheel in midair.

    そして宙に浮く大きな車輪を見た

  • But sometimes he wasn't sure whether he was hallucinating or not,

    でも 時々 幻覚か否か自信がなかった

  • because the hallucinations would fit

    幻覚が身の回りのものと

  • in the context of the visions.

    調和しているからです

  • So on one occasion, when his granddaughters were visiting them,

    ある日 孫娘が来ていた時

  • he said, "And who are these handsome young men with you?"

    “男前の若い衆は誰かね?” と聞きました

  • And they said, "Alas, Grandpapa, there are no handsome young men."

    “まぁ お祖父様 そんな人いないわ”

  • And then the handsome young men disappeared.

    そうすると その男たちは姿を消しました

  • It's typical of these hallucinations

    幻覚ではよくあることです

  • that they may come in a flash and disappear in a flash.

    パッと現れ パッと消える

  • They don't usually fade in and out.

    徐々に現れたり消えたりしません

  • They are rather sudden, and they change suddenly.

    むしろ突然起きるのです

  • Charles Lullin, the grandfather,

    シャルルボネの祖父には

  • saw hundreds of different figures,

    何百もの人影や形

  • different landscapes of all sorts.

    風景が見えました

  • On one occasion, he saw a man in a bathrobe smoking a pipe,

    バスローブ姿でパイプを吸う男も見えました

  • and realized it was himself.

    それは彼自身だったのです

  • That was the only figure he recognized.

    見覚えのあるのは それだけでした

  • On one occasion when he was walking in the streets of Paris,

    ある時 パリの街を歩いていたら

  • he saw -- this was real -- a scaffolding.

    目に入った本物の工事現場の足場が

  • But when he got back home, he saw a miniature of the scaffolding

    帰宅すると15cmのミニチュアとなって

  • six inches high, on his study table.

    書斎の机にのっていました

  • This repetition of perception

    映像を繰返し見ることは

  • is sometimes called palinopsia.

    反復視と呼ばれます

  • With him and with Rosalie,

    シャルルボネの祖父やロザリーに

  • what seems to be going on --

    起こっている現象を

  • and Rosalie said, "What's going on?" --

    ロザリーに説明しました

  • and I said that as you lose vision,

    視力を失うと 脳の視覚部分に

  • as the visual parts of the brain are no longer getting any input,

    入る情報が無くなるため

  • they become hyperactive and excitable,

    そこが活動過多になります

  • and they start to fire spontaneously.

    そして自発的に作用してしまい

  • And you start to see things.

    幻覚を見始めるのです

  • The things you see can be very complicated indeed.

    時に内容も非常に複雑化します

  • With another patient of mine,

    別の患者の体験です

  • who, also had some vision,

    その女性は弱視で

  • the vision she had could be disturbing.

    彼女に見えるものは厄介でした

  • On one occasion, she said she saw

    ある時 彼女はレストランで

  • a man in a striped shirt in a restaurant.

    縞模様のシャツを着た男を見た

  • And he turned around. And then

    男は彼女の方を振り向き

  • he divided into six figures in striped shirts,

    6人に分離して 彼女の方へと

  • who started walking towards her.

    歩き始めたのです

  • And then the six figures came together again, like a concertina.

    そして 6人はスーっと1人に戻りました

  • Once, when she was driving,

    ある時 彼女は夫が運転する-

  • or rather, her husband was driving,

    車に乗っていたら

  • the road divided into four

    道が4つに分かれました

  • and she felt herself going simultaneously up four roads.

    そして彼女も4つに分かれて進む感覚を覚えました

  • She had very mobile hallucinations as well.

    動きのある幻覚も見えました

  • A lot of them had to do with a car.

    その多くは車に関連したものでした

  • Sometimes she would see a teenage boy

    時々彼女はボンネットに座っている―

  • sitting on the hood of the car.

    10代の男の子が見えました

  • He was very tenacious and he moved rather gracefully

    車にくっつき 道を曲がるたびに

  • when the car turned.

    優雅に動くのです

  • And then when they came to a stop,

    そして 車が止まると 男の子は

  • the boy would do a sudden vertical takeoff, 100 foot in the air,

    30m 真上に急上昇して

  • and then disappear.

    姿を消してしまうのです

  • Another patient of mine had a different sort of hallucination.

    こんな幻覚を見る患者もいました

  • This was a woman who didn't have trouble with her eyes,

    その女性は目には問題ないけれど

  • but the visual parts of her brain,

    脳の視覚部分に問題がありました

  • a little tumor in the occipital cortex.

    後頭皮質にある小さな腫瘍です

  • And, above all, she would see cartoons.

    とりわけ 彼女にはアニメ映像が見えました

  • These cartoons would be transparent

    そのアニメは透けて見えるもので

  • and would cover half the visual field, like a screen.

    画面のように視野の半分を占めています

  • And especially she saw cartoons of Kermit the Frog.

    よく見るのはカエルのカーミットでした

  • (Laughter)

    (笑)

  • Now, I don't watch Sesame Street,

    私はセサミストリートは見ませんが

  • but she made a point of saying,

    彼女は こう主張するんです

  • "Why Kermit?" she said, "Kermit the Frog means nothing to me.

    “なぜ?カーミットが出てくる理由がわからない

  • You know, I was wondering about Freudian determinants.

    フロイト的な意味が知りたい

  • Why Kermit?

    なぜカーミットなの?

  • Kermit the Frog means nothing to me."

    何の意味もなさないのに”

  • She didn't mind the cartoons too much.

    アニメは我慢できても

  • But what did disturb her was she got very persistent

    しつこく出てくるイメージや顔の幻覚に

  • images or hallucinations of faces

    彼女もロザリーも困っていました

  • and as with Rosalie, the faces were often deformed,

    多くの場合 巨大な歯や目をした

  • with very large teeth or very large eyes.

    デフォルメされた顔が見えるからです

  • And these frightened her.

    彼女は怖がっていました

  • Well, what is going on with these people?

    彼らには何が起きていたのでしょう

  • As a physician, I have to try and define what's going on,

    医者である私は患者の症状を見極め

  • and to reassure people,

    安心させるのが仕事です

  • especially to reassure them that they're not going insane.

    狂ったのではないと伝えるのは特にそうです

  • Something like 10 percent, as I said,

    先ほども言いましたが 視覚障害者の

  • of visually impaired people get these.

    1割がこの症状を持っています

  • But no more than one percent of the people acknowledge them,

    しかし 症状を訴えるのは そのうちの1%以下

  • because they are afraid they will be seen as insane or something.

    精神障害だと思われるのが怖いからです

  • And if they do mention them to their own doctors

    病院に行っても誤診される-

  • they may be misdiagnosed.

    可能性だってあります

  • In particular, the notion is that if you see

    特に 幻覚の概念は

  • things or hear things, you're going mad,

    気が狂ってる とみられがちです

  • but the psychotic hallucinations are quite different.

    しかし 精神病性幻覚は かなり違います

  • Psychotic hallucinations, whether they are visual or vocal,

    精神病性の幻視や幻聴の場合

  • they address you. They accuse you.

    声をかけてくる 責められる

  • They seduce you. They humiliate you.

    誘惑してくる 侮辱される

  • They jeer at you.

    馬鹿にされる

  • You interact with them.

    巻き込まれてしまいます

  • There is none of this quality of being addressed

    シャルルボネ症候群において

  • with these Charles Bonnet hallucinations.

    声をかけられることはありません

  • There is a film. You're seeing a film which has nothing to do with you,

    自分とは無関係の映画を見るようなもの

  • or that's how people think about it.

    そのように 捉えられています

  • There is also a rare thing called temporal lobe epilepsy,

    側頭葉てんかん という稀なケースがあります

  • and sometimes, if one has this,

    この症状は 過去に遡る感覚や

  • one may feel oneself transported back

    以前訪れた場所へ戻るような

  • to a time and place in the past.

    感覚が生じることがあります

  • You're at a particular road junction.

    ある交差点に立っている

  • You smell chestnuts roasting.

    焼き栗の香りがする

  • You hear the traffic. All the senses are involved.

    車の音 五感で感じ取れます

  • And you're waiting for your girl.

    彼女を待っていた-

  • And it's that Tuesday evening back in 1982.

    忘れもしない1982年 あの火曜の夜

  • And the temporal lobe hallucinations

    側頭葉に関わる幻覚は

  • are all-sense hallucinations,

    すべての感覚に関係しています

  • full of feeling, full of familiarity,

    感覚があり 馴染みがあり

  • located in space and time,

    場所や時間もはっきりしていて

  • coherent, dramatic.

    話に筋が通っていて芝居のよう

  • The Charles Bonnet ones are quite different.

    シャルルボネは かなり違います

  • So in the Charles Bonnet hallucinations,

    シャルルボネ症候群には

  • you have all sorts of levels,

    様々なレベルがあります

  • from the geometrical hallucinations --

    幾何学模様の幻覚や

  • the pink and blue squares the woman had --

    ロザリーが見たピンクや青の四角

  • up to quite elaborate hallucinations

    人や 特に顔の出てくる

  • with figures and especially faces.

    とても精緻な幻覚もあります

  • Faces, and sometimes deformed faces,

    デフォルメされた顔が現れるのは

  • are the single commonest thing

    シャルルボネ症候群で

  • in these hallucinations.

    最も一般的です

  • And one of the second commonest is cartoons.

    2つ目によくあるのはアニメ

  • So, what is going on?

    これは どういうことか

  • Fascinatingly, in the last few years,

    面白いことに過去数年の間に