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譯者: Clare Wang
審譯者: Bill Hsiung
00:12
We see with the eyes,
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我們用眼睛看東西,
00:14
but we see with the brain as well.
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但也用腦看東西。
00:18
And seeing with the brain
is often called imagination.
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用腦看就是所謂的想像。
我們很熟悉自己的想像世界是什麼樣貌。
00:23
And we are familiar with the landscapes
of our own imagination,
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00:27
our inscapes.
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那是我們的本質,一輩子跟著我們。
00:28
We've lived with them all our lives.
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00:31
But there are also hallucinations as well.
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但此外還有一種東西是幻覺。
00:35
And hallucinations
are completely different.
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幻覺就截然不同了。
00:38
They don't seem to be of our creation.
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幻覺不像是我們創造出來的,
00:40
They don't seem to be under control.
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似乎不受我們控制,
00:42
They seem to come from the outside
and to mimic perception.
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好像是從外面來的,
然後偽裝成知覺。
00:47
So I am going to be talking
about hallucinations
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我今天要講的就是幻覺。
00:51
and a particular sort
of visual hallucination,
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而且是我在病患身上看到的
00:55
which I see among my patients.
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一種特殊的視覺幻覺。
01:00
A few months ago, I got a phone call
from a nursing home where I work.
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幾個月前,我接到一通電話。
是我服務的安養院打來的。
01:06
They told me that one of their residents,
an old lady in her 90s,
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他們說院裡有一位90幾歲的老太太
01:11
was seeing things,
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出現了幻視。
01:13
and they wondered if she'd gone bonkers
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他們不知道她是瘋了呢?
01:16
or, because she was an old lady,
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還是說,因為她是老太太,
01:18
whether she'd had a stroke,
or whether she had Alzheimer's.
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也許她中風了,或者得了阿茲海默氏症。
01:21
And so they asked me
if I would come and see Rosalie,
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所以他們問我能不能來看一下羅莎莉,
01:26
the old lady.
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也就是這位老太太。
01:28
I went in to see her.
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我去探視她,
01:30
It was evident straightaway
that she was perfectly sane
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馬上就看得出來
她的心智很正常,
01:35
and lucid and of good intelligence,
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神智清楚,也很聰明。
01:38
but she'd been very startled
and very bewildered,
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但是她很驚慌、很困惑,
01:42
because she'd been seeing things.
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因為她出現了幻視。
01:45
And she told me --
the nurses hadn't mentioned this --
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她跟我說,
這一點護士沒提到,
01:50
that she was blind,
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她是盲人。
01:52
that she had been completely blind
from macular degeneration for five years.
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她因為黃斑病變,已經完全失明5年了。
01:57
But now, for the last few days,
she'd been seeing things.
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可是,這幾天卻開始看到東西。
02:00
So I said, "What sort of things?"
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我就說:「什麼樣的東西?」
02:02
And she said, "People in Eastern dress,
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她說:穿東方服飾、穿袍子的人
02:06
in drapes, walking up and down stairs.
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走樓梯上上下下。
02:10
A man who turns towards me and smiles,
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一個男的轉身對我微笑,
02:13
but he has huge teeth
on one side of his mouth.
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但他臉上有一邊的牙齒非常巨大。
02:17
Animals too.
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也會看到動物。
02:19
I see a white building.
It's snowing, a soft snow.
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我看到一棟白色建築。下著一點雪。
02:22
I see this horse with a harness,
dragging the snow away.
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我看到一匹上了馬鞍的馬,把雪拖走。
02:27
Then, one night, the scene changes.
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後來有天晚上,場景變了。
02:30
I see cats and dogs walking towards me.
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我看到很多貓跟狗走向我,
02:33
They come to a certain point
and then stop.
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走到一個地方就停住,
02:36
Then it changes again.
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然後場景又變了。
02:38
I see a lot of children.
They're walking up and down stairs.
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我看到很多小孩,上上下下地走樓梯。
02:41
They wear bright colors, rose and blue,
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他們穿著鮮豔的玫瑰色跟藍色,
02:44
like Eastern dress."
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像是東方服飾。
02:47
Sometimes, she said,
before the people come on,
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她說,有時候在這些人物出現之前,
02:50
she may hallucinate
pink and blue squares on the floor,
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她會出現幻視,看到地板上有粉紅色跟藍色方塊,
02:54
which seem to go up to the ceiling.
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一路連到天花板上。
02:57
I said, "Is this like a dream?"
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我說,這像是做夢嗎?
03:01
And she said, "No, it's not
like a dream. It's like a movie."
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她說,不像做夢,像電影。
有顏色,有動作,
03:05
She said, "It's got color.
It's got motion.
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03:07
But it's completely silent,
like a silent movie."
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但是完全沒有聲音,像是默劇。
03:11
And she said it's a rather boring movie.
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她說,而且是挺無聊的電影。
03:13
(Laughter)
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一堆穿著東方服飾的人
03:14
She said, "All these people
with Eastern dress,
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03:16
walking up and down,
very repetitive, very limited."
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走上走下,一直重複,沒什麼變化。
03:20
(Laughter)
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(笑聲)
03:22
And she had a sense of humor.
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她很幽默,
03:24
She knew it was a hallucination,
but she was frightened.
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她知道那是幻視,
但是她很害怕。她活到95歲了,
03:28
She had lived 95 years,
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03:29
and she'd never had
a hallucination before.
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以前從沒出現過幻覺。
03:32
She said that the hallucinations were
unrelated to anything she was thinking
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她說這些幻覺
跟她的思考感覺或動作完全不相關。
03:37
or feeling or doing,
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幻視好像憑空出現,或憑空消失,
03:40
that they seemed to come on
by themselves, or disappear.
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03:43
She had no control over them.
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她沒辦法控制。
幻視中
03:46
She said she didn't recognize
any of the people or places
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出現的人或地點
03:49
in the hallucinations,
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她都不認得。
03:51
and none of the people or the animals --
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而這些人或動物,
03:53
well, they all seemed oblivious of her.
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似乎也都無視於她的存在。
03:57
And she didn't know what was going on.
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她不知道這是怎麼一回事,
03:59
She wondered if she was going mad
or losing her mind.
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不知道自己是發瘋了,
還是神智不清了。
04:03
Well, I examined her carefully.
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我仔細地幫她檢查。
04:05
She was a bright old lady,
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她是一位聰明的老太太。
心智完全正常,沒有什麼病症,
04:08
perfectly sane.
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04:09
She had no medical problems.
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04:11
She wasn't on any medications
which could produce hallucinations.
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沒有服用可能導致幻覺的藥物。
04:15
But she was blind.
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但是她失明了。
04:17
And I then said to her,
"I think I know what you have."
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於是我就跟她說:
「我想我知道你得了什麼病。」
04:21
I said, "There is a special form
of visual hallucination
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我說,這是一種特殊的幻視,
04:25
which may go with deteriorating
vision or blindness.
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常伴隨視力惡化或失明出現。
04:29
This was originally described," I said,
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這種症狀最早的紀錄,
04:32
"right back in the 18th century,
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是在18世紀,
04:34
by a man called Charles Bonnet.
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由一位查爾士•邦奈特最先發現的。
04:37
And you have Charles Bonnet syndrome.
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你有邦奈特症候群,
04:40
There's nothing wrong with your brain.
There's nothing wrong with your mind.
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你的大腦沒問題,心智沒問題,
你得的是邦奈特症候群。
04:43
You have Charles Bonnet syndrome."
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04:45
And she was very relieved at this,
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她聽了就放心了,
04:48
that there was nothing
seriously the matter,
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還好不是什麼嚴重的病。
04:51
and also rather curious.
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同時她也很好奇。
04:54
She said, "Who is this Charles Bonnet?"
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她說:「查爾士•邦奈特是誰?」
04:57
She said, "Did he have them himself?"
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他自己有這個症狀群嗎?
05:00
And she said, "Tell all the nurses
that I have Charles Bonnet syndrome."
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然後她說,去跟所有的護士說,
我有邦奈特症候群。
05:05
(Laughter)
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(笑聲)
05:07
"I'm not crazy. I'm not demented.
I have Charles Bonnet syndrome."
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我沒發瘋,不是精神失常,我有邦奈特症候群。
05:12
Well, so, I did tell the nurses.
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我也的確跟所有的護士說了。
05:14
Now this, for me, is a common situation.
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這對我來說是常見的情況。
05:17
I work in old-age homes, largely.
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我主要在老人院服務,
05:19
I see a lot of elderly people
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我有很多老人病患
他們聽力或視力受損。
05:22
who are hearing-impaired
or visually impaired.
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05:25
About 10 percent
of the hearing-impaired people
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聽力受損的人當中約有10%
05:27
get musical hallucinations.
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出現音樂的幻聽。
05:30
And about 10 percent
of the visually impaired people
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視力受損的人當中約有10%
05:33
get visual hallucinations.
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出現幻視。
05:35
You don't have to be completely blind,
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不一定要全盲,
05:37
only sufficiently impaired.
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視力受損到一定程度就有可能。
05:39
Now, with the original description
in the 18th century,
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說到18世紀對這症候群的描述,
05:43
Charles Bonnet did not have them.
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查爾士•邦奈特本人沒有這個症候群,
05:45
His grandfather had these hallucinations.
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是他的外祖父有。
05:48
His grandfather was
a magistrate, an elderly man.
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他的外祖父是一位地方官員,年紀很大了。
05:51
He'd had cataract surgery.
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他動過白內障手術,
05:54
His vision was pretty poor.
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視力非常差。
05:56
And in 1759, he described to his grandson
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1759年,他把他所看到的幻視
06:01
various things he was seeing.
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描述給外孫聽。
06:03
The first thing he said
was he saw a handkerchief in midair.
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首先他說他看到
一條手帕浮在半空中。
06:07
It was a large blue handkerchief
with four orange circles.
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一條藍色的大手帕,
上面有四個橘色圓圈。
06:11
And he knew it was a hallucination.
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他知道那是幻視,
06:14
You don't have handkerchiefs in midair.
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手帕不會浮在半空中。
06:16
And then he saw a big wheel in midair.
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然後他看到一個大輪子浮在半空中。
06:20
But sometimes he wasn't sure
whether he was hallucinating or not,
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但有時他不太確定到底是不是幻覺,
06:25
because the hallucinations would fit
in the context of the visions.
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因為幻覺
會符合他的視覺情境。
06:29
So on one occasion, when
his granddaughters were visiting them,
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有一次,外孫女來看他,
他說,跟妳一起來的這些英俊小夥子是誰呀?
06:33
he said, "And who are these
handsome young men with you?"
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06:36
(Laughter)
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06:37
And they said, "Alas, Grandpapa,
there are no handsome young men."
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家人說,外公,沒有什麼英俊小夥子呀。
06:41
And then the handsome
young men disappeared.
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然後英俊小夥子就消失了。
06:45
It's typical of these hallucinations
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這類幻視的一個特色是
06:48
that they may come in a flash
and disappear in a flash.
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會憑空出現,憑空消失。
06:51
They don't usually fade in and out.
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通常不是淡入淡出,
06:53
They are rather sudden,
and they change suddenly.
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而是很突然的,而且會一下子改變。
查爾士•盧蘭,這位外祖父
06:57
Charles Lullin, the grandfather,
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06:59
saw hundreds of different figures,
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看到幾百個不同的人物,
07:02
different landscapes of all sorts.
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各式各樣的景色。
07:04
On one occasion, he saw a man
in a bathrobe smoking a pipe,
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有一次他看到一個男的穿著浴袍抽煙斗,
07:08
and realized it was himself.
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結果發現那是他自己。
07:11
That was the only figure he recognized.
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那是他唯一認得的人物。
07:14
On one occasion, when he was walking
in the streets of Paris,
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有一次他走在巴黎街頭,
07:18
he saw -- this was real -- a scaffolding.
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他看到真的鷹架,
07:21
But when he got back home,
he saw a miniature of the scaffolding,
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但回到家以後,他看到鷹架的縮小版,
07:24
six inches high,
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6吋高的鷹架出現在他書桌上。
07:26
on his study table.
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07:28
This repetition of perception
is sometimes called "palinopsia."
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這種重複出現的知覺,
有時候叫做視覺重複。
他跟羅莎莉
07:34
With him and with Rosalie,
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07:38
what seems to be going on --
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經驗到的...
07:40
and Rosalie said, "What's going on?" --
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羅莎莉也問,這是怎麼回事?
07:42
and I said that as you lose vision,
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我說,當視覺惡化,
07:45
as the visual parts of the brain
are no longer getting any input,
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腦中負責視覺的部分再也收不到刺激,
07:48
they become hyperactive and excitable,
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就變得特別活躍,特別容易被激發,
07:51
and they start to fire spontaneously.
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開始自發性的活躍起來,
幻視就出現了。
07:54
And you start to see things.
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07:56
The things you see
can be very complicated indeed.
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幻視的內容可能非常複雜。
我有另一位病患,
08:00
With another patient of mine
who also had some vision,
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她還保有一些視力。
她看到的東西就有點恐怖。
08:06
the visions she had could be disturbing.
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08:09
On one occasion, she said she saw
a man in a striped shirt in a restaurant.
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有一次她說她看到
餐廳裡有一個穿著條紋襯衫的男子,
08:15
And he turned round,
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男子轉過身來,
08:16
and then he divided
into six figures in striped shirts,
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分裂成六個穿著條紋襯衫的人,
08:20
who started walking towards her.
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開始朝她走來。
08:23
And then the six figures came
together, like a concertina.
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然後六個人物又合併成一個,像六角手風琴摺起來一樣。
08:26
Once, when she was driving,
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有一次她開車,
08:28
or rather, her husband was driving,
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應該說,是她先生在開車,
08:30
the road divided into four
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道路分裂成四條,
08:32
and she felt herself going
simultaneously up four roads.
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她覺得自己同時走在四條路上。
她的幻視也有很動作鮮明的,
08:37
She had very mobile
hallucinations as well.
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08:41
A lot of them had to do with a car.
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很多都跟汽車有關。
08:44
Sometimes she would see a teenage boy
sitting on the hood of the car.
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有時候她會看到一個青少年
坐在汽車引擎蓋上,
08:48
He was very tenacious,
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車子轉彎,他很頑強地坐在那兒,
08:50
and he moved rather gracefully
when the car turned.
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動作卻很優雅。
08:53
And then when they came to a stop,
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當車子停下來時,
08:56
the boy would do a sudden vertical
takeoff, 100 foot in the air,
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男孩會突然直線向上衝,離地100呎,
08:59
and then disappear.
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然後消失。
09:02
Another patient of mine
had a different sort of hallucination.
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我還有一位病患,她有另一種幻視。
09:07
This was a woman
who didn't have trouble with her eyes
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這位女士不是眼睛有問題,
09:10
but the visual parts of her brain,
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而是大腦處理視覺的部份,
09:12
a little tumor in the occipital cortex.
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枕葉皮質長了一個小腫瘤。
09:15
And, above all, she would see cartoons.
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她最常出現的幻視是卡通。
09:20
And these cartoons would be transparent,
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這些卡通是透明的,
09:24
and would cover half
the visual field, like a screen.
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像一層螢幕一樣,遮蓋半個視野。
09:28
And especially, she saw
cartoons of Kermit the Frog.
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特別的是她會看到科米蛙的卡通。
09:33
(Laughter)
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(笑聲)
09:35
Now, I don't watch Sesame Street,
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我不看芝麻街的。
但她特別提出來說:
09:39
but she made a point of saying,
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09:41
"Why Kermit?" she said,
"Kermit the Frog means nothing to me."
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「為什麼是科米蛙?它對我來說沒有任何意義。」
09:45
You know, I was wondering about
Freudian determinants: Why Kermit?
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我本來在猜想佛洛依德決定因素。
為什麼是科米蛙?
09:50
"Kermit the Frog means nothing to me."
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科米蛙對我來說沒有任何意義。
09:52
She didn't mind the cartoons too much.
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這些卡通她是不太介意,
09:54
But what did disturb her
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讓她很不安的是
09:56
was she got very persistent images
or hallucinations of faces,
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臉的幻視不斷出現。
10:01
and as with Rosalie,
the faces were often deformed,
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跟羅莎莉一樣,這些臉經常是扭曲的,
10:04
with very large teeth or very large eyes.
188
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牙齒很大,或是眼睛很大,
10:08
And these frightened her.
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這讓她很害怕。
10:11
Well, what is going on with these people?
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這些人究竟是怎麼了呢?
10:15
As a physician, I have to try
and define what's going on
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身為醫生,我必須試著解釋,
10:18
and to reassure people,
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並且讓病患放心。
10:20
especially to reassure them
that they're not going insane.
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特別是要讓他們放心,他們並不是發瘋了。
我剛剛說,約有10%
10:25
Something like 10 percent, as I said,
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2225
10:27
of visually impaired people get these.
195
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2953
視覺受損的人會出現這些幻視,
10:30
But no more than one percent
of the people acknowledge them,
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3731
但只有不到1%的人會說出來。
10:34
because they are afraid
they will be seen as insane or something.
197
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3356
因為他們擔心被認為是瘋子之類的。
10:37
And if they do mention them
to their own doctors,
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就算他們跟醫生說,
也有可能被誤診。
10:40
they may be misdiagnosed.
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10:42
In particular, the notion
is that if you see things or hear things,
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一般的看法是,如果你有
幻視或幻聽,你就是發瘋了。
10:45
you're going mad.
201
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10:47
But the psychotic hallucinations
are quite different.
202
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然而,精神病患的幻覺是很不一樣的。
10:50
Psychotic hallucinations,
whether they are visual or vocal,
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精神疾病產生的幻覺,不管是幻視或幻聽,
10:53
they address you.
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1176
會跟你對話,指責你,
10:54
They accuse you, they seduce you,
they humiliate you, they jeer at you.
205
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4710
誘惑你,羞辱你,
嘲笑你,
11:00
You interact with them.
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你跟幻覺有互動。
11:02
There is none of this quality
of being addressed
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但邦奈特症候群的幻視
11:05
with these Charles Bonnet hallucinations.
208
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沒有這種互動的特性。
11:08
There is a film. You're seeing a film
which has nothing to do with you --
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4603
是電影,你在看一場跟你不相關的電影,
11:12
or that's how people think about it.
210
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2542
這是病患的感覺。
11:15
There is also a rare thing
called temporal lobe epilepsy,
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有一種罕見的症狀叫顳葉癲癇。
11:19
and sometimes, if one has this,
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2415
有時候,顳葉癲癇的患者
11:22
one may feel oneself transported
back to a time and place in the past.
213
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5025
可能會覺得自己回到過去,
特定的時間地點。
11:27
You're at a particular road junction.
214
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2469
你人在一個特定的路口,
11:29
You smell chestnuts roasting.
215
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2027
聞到烤栗子的香味,
11:31
You hear the traffic.
All the senses are involved.
216
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3246
聽到車聲,所有的感官刺激都有,
你在等你的女朋友。
11:35
And you're waiting for your girl.
217
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1710
11:36
And it's that Tuesday
evening back in 1982.
218
696757
4189
時間回到1982年那個星期二晚上。
11:40
The temporal lobe hallucinations
are all sense hallucinations,
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3898
顳葉癲癇的幻覺
是多感官幻覺,
11:44
full of feeling, full of familiarity,
220
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2537
充滿感受,充滿熟悉感,
11:47
located in space and time,
221
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2067
發生在特定的時間地點,
11:49
coherent, dramatic.
222
709544
1704
情節一致而戲劇化。
11:51
The Charles Bonnet
ones are quite different.
223
711882
2254
邦奈特症候群的幻覺很不一樣。
11:54
In the Charles Bonnet hallucinations,
you have all sorts of levels,
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邦奈特症候群的幻覺
有各種不同的層次。
12:00
from the geometrical hallucinations --
225
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2105
從幾何圖形的幻覺,
12:02
the pink and blue squares the woman had --
226
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3264
老太太看到的粉紅色和藍色方塊,
12:05
up to quite elaborate hallucinations
227
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4447
到很繁複的幻覺,
12:09
with figures and especially faces.
228
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2681
像是人物,特別是臉孔。
12:12
Faces, and sometimes deformed faces,
229
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3112
臉孔,有時候是扭曲的臉孔,
12:15
are the single commonest thing
in these hallucinations.
230
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4438
是這類幻覺中
最常見的。
12:20
And one of the second
commonest is cartoons.
231
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2914
第二常見的是卡通。
12:23
So, what is going on?
232
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2836
究竟是怎麼回事呢?
12:26
Fascinatingly, in the last few years,
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1991
有趣的是,過去幾年
12:28
it's been possible to do
functional brain imagery,
234
748439
3919
我們開始可以做功能性大腦造影,
12:32
to do fMRI on people
as they are hallucinating,
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4753
在人出現幻覺時做 fMRI(功能性磁振造影)。
實際上也發現
12:37
and, in fact, to find that different parts
of the visual brain are activated
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757159
6165
當人出現幻視時
12:43
as they are hallucinating.
237
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1836
大腦處理視覺的不同部位活躍起來。
12:45
When people have these simple,
geometrical hallucinations,
238
765208
3350
如果是簡單的幾何幻視,
12:48
the primary visual cortex is activated.
239
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3554
主要視覺皮質會活動,
12:52
This is the part of the brain
which perceives edges and patterns.
240
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3736
這是大腦負責感受邊界、圖案的部位。
12:55
You don't form images
with your primary visual cortex.
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4008
主要視覺皮質無法形成影像,
12:59
When images are formed,
242
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2322
要形成影像,
13:02
a higher part of the visual cortex
is involved, in the temporal lobe.
243
782298
5587
要牽涉到位於顳葉,
更高等的視覺皮質。
特別是顳葉有一個區域
13:07
And in particular,
one area of the temporal lobe
244
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3069
13:11
is called the fusiform gyrus.
245
791002
2849
叫做梭狀回 (fusiform gyrus)。
13:13
And it's known that if people
have damage in the fusiform gyrus,
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3647
我們已經知道,梭狀回如果受損,
13:17
they may lose the ability
to recognize faces.
247
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3409
人就可能無法辨識臉孔。
13:21
But if there's an abnormal activity
in the fusiform gyrus,
248
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3572
但是如果梭狀回活動異常,
13:25
they may hallucinate faces,
249
805289
2158
就可能出現臉孔的幻視。
13:27
and this is exactly what you find
in some of these people.
250
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3202
這也正是我們在這些人身上看到的。
13:30
There is an area
in the anterior part of this gyrus
251
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4183
梭狀回前端有一個區域
13:34
where teeth and eyes are represented,
252
814904
4232
負責處理牙齒和眼睛。
13:39
and that part of the gyrus is activated
253
819160
3612
當患者出現變形臉孔的幻視,
13:42
when people get
the deformed hallucinations.
254
822796
3769
梭狀回的這個部分是活躍的。
13:46
There is another part of the brain
which is especially activated
255
826589
3797
大腦還有另一個部分,
在看到卡通時
13:50
when one sees cartoons.
256
830410
1976
會活躍起來。
13:52
It's activated
when one recognizes cartoons,
257
832873
2885
當我們辨識卡通,畫卡通,
13:55
when one draws cartoons
and when one hallucinates them.
258
835782
3230
出現卡通幻視時,這部份會活躍起來。
13:59
It's very interesting
that that should be specific.
259
839036
3256
很有趣地腦中竟然有這樣專門的部位。
14:02
There are other parts of the brain
which are specifically involved
260
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3128
大腦還有其他部位經過特化,
14:05
with the recognition and hallucination
of buildings and landscapes.
261
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4487
處理建築物、景色的
辨識及幻覺。
14:09
Around 1970, it was found that there were
not only parts of the brain,
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3938
1970年左右,研究人員發現大腦不只有特化的部位,
14:13
but particular cells.
263
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1880
還有特化的細胞。
14:15
"Face cells" were discovered around 1970.
264
855845
4184
「臉部細胞」是在1970年左右發現的。
14:20
And now we know that there are
hundreds of other sorts of cells,
265
860053
4086
現在我們知道有上百種
不同的細胞,
14:24
which can be very, very specific.
266
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2254
負責非常特定的功能。
14:26
So you may not only have "car" cells,
you may have "Aston Martin" cells.
267
866441
6972
可能不只有
「汽車」細胞,
可能還有「奧斯頓馬汀車」細胞。
14:33
(Laughter)
268
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2274
(笑聲)
14:35
I saw an Aston Martin this morning.
I had to bring it in.
269
875735
3222
我今天早上看到一台奧斯頓馬汀車,
非提一下不可。
14:38
(Laughter)
270
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1023
現在那在我腦子裡了。
14:40
And now it's in there, somewhere.
271
880028
2816
14:42
So --
272
882868
1158
(笑聲)
14:44
(Laughter)
273
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1464
14:45
now, at this level, in what's called
the inferotemporal cortex,
274
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4729
在這個層級,在顳下皮質的地方
只有視覺影像,
14:50
there are only visual images,
275
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2286
14:52
or figments or fragments.
276
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2572
或者說片段。
14:55
It's only at higher levels
that the other senses join in
277
895197
5037
要到更高的層級,
才有其他感官融入進來,
15:00
and there are connections
with memory and emotion.
278
900258
2925
跟記憶、情緒連結起來。
邦奈特症候群
15:03
And in the Charles Bonnet syndrome,
279
903207
1701
15:04
you don't go to those higher levels.
280
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2215
則不會牽涉到較高層級,
15:07
You're in these levels
of inferior visual cortex,
281
907171
3011
是在顳下視覺皮質的層級。
15:10
where you have thousands
and tens of thousands
282
910206
2676
這裡有成千上萬,
15:12
and millions of images,
283
912906
2317
甚至好幾百萬的影像,
15:15
or figments or fragmentary figments,
284
915247
2406
或者說片段的虛構影像,
15:17
all neurally encoded in particular cells
or small clusters of cells.
285
917677
5797
以神經編碼的方式
儲存在特定的細胞或細胞群中。
15:23
Normally, these are all part
of the integrated stream of perception,
286
923847
5389
正常情況下,
這會跟知覺、想像整合在一起,
15:29
or imagination,
287
929260
1673
15:30
and one is not conscious of them.
288
930957
2038
我們不會意識到這些影像。
15:33
It is only if one
is visually impaired or blind
289
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4075
只有當我們視力受損,或失明時,
15:37
that the process is interrupted.
290
937118
2570
這個程序才被打斷。
15:39
And instead of getting normal perception,
291
939712
2473
出現的就不是正常的感知,
15:42
you're getting an anarchic,
292
942209
2539
而是下顳葉的
15:44
convulsive stimulation, or release,
293
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2989
這些視覺細胞
15:47
of all of these visual cells
in the inferotemporal cortex.
294
947785
3867
雜亂無章、痙攣似的
被刺激、釋放。
15:51
So, suddenly, you see a face.
Suddenly, you see a car.
295
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2789
所以你突然看到一張臉,突然看到一台車。
15:54
Suddenly this and suddenly that.
296
954489
2714
一下子這個,一下子那個。
15:57
The mind does its best to organize
297
957227
2373
大腦會盡可能地組織,
15:59
and to give some sort
of coherence to this,
298
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2678
讓它有一點連貫性,
16:02
but not terribly successfully.
299
962326
2539
但也不是太成功。
16:04
When these were first described,
300
964889
1648
這種症狀當初被發現時,
16:06
it was thought that they could be
interpreted like dreams.
301
966561
3565
心理學家以為這些影像可以當做夢一樣來解析。
16:10
But, in fact, people say,
302
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1826
但實際上患者會說:
16:12
"I don't recognize the people.
I can't form any associations.
303
972000
4412
「我不認得這些人,想不出什麼關連。」
「科米蛙對我來說沒有任何意義」
16:16
Kermit means nothing to me."
304
976436
1950
16:18
You don't get anywhere,
thinking of them as dreams.
305
978410
5651
把這些幻視當成夢來處理是沒有用的。
好,我想說的差不多說完了。
16:24
Well, I've more or less
said what I wanted.
306
984085
4301
16:28
I think I just want to recapitulate
and say this is common.
307
988410
4914
我只想再次說明,
邦奈特症候群是常見的。
16:33
Think of the number of blind people.
308
993348
1779
想想看世界上有多少盲人,
16:35
There must be hundreds
of thousands of blind people
309
995151
2591
當中一定有幾十萬盲人
16:37
who have these hallucinations
310
997766
1714
有這些幻視,
16:39
but are too scared to mention them.
311
999504
2121
但是因為害怕,所以不敢說出來。
16:41
So this sort of thing
needs to be brought into notice,
312
1001649
5488
所以這樣的事情必須要讓大家了解,
要讓病患、醫師、大眾知道。
16:47
for patients, for doctors, for the public.
313
1007161
2431
16:49
Finally, I think they are
infinitely interesting and valuable,
314
1009973
5026
最後,我認為
這類幻視非常有意思,也很有價值,
16:55
for giving one some insight
as to how the brain works.
315
1015023
4274
能讓我們一窺大腦的運作。
16:59
Charles Bonnet said, 250 years ago --
316
1019321
3597
250年前,查爾士說,
17:02
he wondered how,
thinking of these hallucinations,
317
1022942
3444
關於這些幻視,
17:06
how, as he put it, the theater of the mind
318
1026410
2680
照他的說法是,在心靈的舞台上,
17:09
could be generated
by the machinery of the brain.
319
1029114
3350
不知道大腦的機器是如何創造出這些幻視的。
17:12
Now, 250 years later,
320
1032964
2422
現在,250年之後,
17:15
I think we're beginning
to glimpse how this is done.
321
1035410
3286
我想我們開始慢慢看到背後的機制。
17:18
Thanks very much.
322
1038720
1200
謝謝大家。
17:19
(Applause)
323
1039944
2977
(掌聲)
17:22
Chris Anderson: That was superb.
Thank you so much.
324
1042945
2977
真是太棒了,非常感謝。
17:25
You speak about these things
with so much insight
325
1045946
2970
您的演講充滿了洞見,
17:28
and empathy for your patients.
326
1048940
2451
以及對病人的同理心。
17:31
Have you yourself experienced
any of the syndromes you write about?
327
1051783
3820
您書中所寫的症候群,您本人有任何經驗嗎?
17:35
Oliver Sacks: I was afraid
you would ask that.
328
1055627
2217
我就擔心你問這個。
17:37
(Laughter)
329
1057868
1828
(笑聲)
17:39
Well, yeah, a lot of them.
330
1059720
2368
有的,很多。
17:42
And, actually, I'm a little
visually impaired myself.
331
1062112
3067
其實我自己的視力也有點受損,
17:45
I'm blind in one eye
and not terribly good in the other.
332
1065203
3183
一隻眼睛失明,另一隻也好不到哪兒去。
17:48
And I see the geometrical hallucinations.
333
1068410
4050
我會看到幾何圖形的幻視。
17:52
But they stop there.
334
1072484
1473
但僅此而已。
17:53
CA: And they don't disturb you?
335
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幻視不會讓你煩惱嗎?
17:55
Because you understand what's doing it,
it doesn't make you worried?
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因為你知道是怎麼回事,所以不會擔心嗎?
幻視讓我煩惱的程度不會超過耳鳴,
17:59
OS: Well, they don't disturb me
any more than my tinnitus,
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18:02
which I ignore.
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耳鳴我是不管的。
18:05
They occasionally interest me,
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有時候幻視會引起我的興趣,
18:07
and I have many pictures
of them in my notebooks.
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我的筆記本裡有很多幻視的影像。
18:10
I've gone and had an fMRI myself,
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我自己也做過 fMRI,
18:13
to see how my visual cortex
is ticking over.
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看到我的視覺皮質如何主導。
18:16
And when I see all these hexagons
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還有當我在偏頭痛時
18:20
and complex things, which I also have,
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看到六邊形
18:22
in visual migraine,
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跟複雜的圖形,
18:24
I wonder whether everyone
sees things like this
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我會想是不是人人都會看到這種東西,
18:26
and whether things
like cave art or ornamental art
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還有洞穴藝術、裝飾藝術
18:29
may have been derived from them a bit.
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是不是跟這有一點關係。
18:32
CA: That was an utterly,
utterly fascinating talk.
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真是非常引人入勝的演講。
18:34
Thank you so much for sharing.
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非常謝謝您的分享。
18:36
OS: Thank you. Thank you.
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謝謝,謝謝。
18:38
(Applause)
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(掌聲)
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