There is good reason to think that imaginative children tend to confuse mental images and percepts.[60] _The Hallucinations of Insanity._ The hallucinations of the insane are but a fuller manifestation of forces that we see at work in normal life.

Their characteristic is that they simulate the form of distinctly present objects, the existence of which is not instantly contradicted by the actual surroundings of the moment.[61] The hallucinations have their origin partly in subjective sensations, which are probably connected with peripheral disturbances, partly and principally in central derangements.[62] These include profound emotional changes, which affect the ruling mental tone, and exert a powerful influence on the course of the mental images.

The hallucinations of insanity are due to a projection of mental images which have, owing to certain circumstances, gained a preternatural persistence and vividness.

Sometimes it is the images that have been dwelt on with passionate longing before the disease, sometimes those which have grown most habitual through the mode of daily occupation,[63] and sometimes those connected with some incident at or near the time of the commencement of the disease.
In mental disease, auditory hallucinations play a part no less conspicuous than visual.[64] Patients frequently complain of having their thoughts spoken to them, and it is not uncommon for them to imagine that they are addressed by a number of voices at the same time.[65] These auditory hallucinations offer a good opportunity for studying the gradual growth of centrally originating hallucinations.

In the early stages of the disease, the patient partly distinguishes his representative from his preservative sounds.