I would “see” a smooth surface, like glass, or like the surface of a pond. . . . Concentric rings would spread from the center to the outside edges, as though a pebble had been dropped right in the middle. This rhythm starts slowly [but] . . . eventually speeds up, so that the surface is constantly agitated, and as this happens, my own agitation is heightened. Eventually the rhythm slows, the surface smooths out, and I become relieved and calmer myself.

Sometimes in a delirium there may be a deep humming sound that waxes and wanes in a similar way.

While many people describe delirious swellings of body image, Devon B., when feverish, experienced mental or intellectual swellings instead:

What made them so strange was that they weren’t sensory hallucinations, but a hallucination of an abstract idea . . . a sudden dread of a very, very large and growing number (or a thing, but a thing I never really defined). . . . I remember pacing up and down the hallway . . . in a growing state of panic and horror at an exponentially increasing, impossible number. . . . My fear was that this number was violating some very basic precept of the world . . . an assumption we hold that absolutely should not be violated.

This letter made me think of the arithmetical deliria which Vladimir Nabokov went through, wrestling with impossibly large numbers, as he described in his autobiography Speak, Memory:

As a little boy, I showed an abnormal aptitude for mathematics, which I completely lost in my singularly talentless youth. This gift played a horrible part in tussles with quinsy or scarlet fever, when I felt enormous spheres and huge numbers swell relentlessly in my aching brain. . . . I had read . . . about a certain Hindu calculator who in exactly two seconds could find the seventeenth root of, say, 3529471145760275132301897342055866171392 (I am not sure I have got this right; anyway the root was 212). Such were the monsters that thrived on my delirium, and the only way to prevent them from crowding me out of myself was to kill them by extracting their hearts. But they were far too strong, and I would sit up and laboriously form garbled sentences as I tried to explain things to my mother. Beneath my delirium she recognized sensations she had known herself, and her understanding would bring my expanding universe back to a Newtonian norm.

Some people feel that the hallucinations and strange thoughts of delirium may provide, or seem to provide, moments of rich emotional truth, as with some dreams or psychedelic experiences. There may also be revelations or breakthroughs of deep intellectual truth. In 1858, Alfred Russel Wallace, who had been traveling the world for a decade, collecting specimens of plants and animals and considering the problem of evolution, suddenly conceived the idea of natural selection during an attack of malarial fever. His letter to Darwin proposing this theory pushed Darwin to publish On the Origin of Species the following year.

Robert Hughes, in the opening of his book on Goya, writes about a prolonged delirium during his recovery from a nearly fatal car crash. He was in a coma for five weeks and hospitalized for almost seven months. In intensive care, he wrote,

One’s consciousness . . . is strangely affected by the drugs, the intubation, the fierce and continuous lights, and one’s own immobility. These give rise to prolonged narrative dreams, or hallucinations, or nightmares. They are far heavier and more enclosing than ordinary sleep-dreams and have the awful character of inescapability; there is nothing outside them, and time is wholly lost in their maze. Much of the time, I dreamed about Goya. He was not the real artist, of course, but a projection of my fears. The book I meant to write on him had hit the wall; I had been blocked for years before the accident.

In this strange delirium, Hughes wrote, a transformed Goya seemed to be mocking and tormenting him, trapping him in some hellish limbo. Eventually, Hughes interpreted this “bizarre and obsessive vision”:

I had hoped to “capture” Goya in writing, and he instead imprisoned me. My ignorant enthusiasm had dragged me into a trap from which there was no evident escape. Not only could I not do the job; my subject knew it and found my inability hysterically funny. There was only one way out of this humiliating bind, and that was to crash through. . . . Goya had assumed such importance in my subjective life that whether I could do him justice in writing or not, I couldn’t give up on him. It was like overcoming writer’s block by blowing up the building in whose corridor it had occurred.

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