* * *
BEFORE very long I had met the rest of the staff, become acquainted with the layout of the sanatarium and familiar with its routine, and found myself "settling in" comfortably. For the most part, those patients to whom I was assigned were suffering from conditions depressingly common and ordinary. A lone exception was Uriah Horby: Even as my superior had predicted on the day of my arrival, Horby’s case was singular and curious.
Paranoia, of course, is a mental disorder characterized by systematized delusions and the projection of inner conflicts, which are ascribed to the supposed hostility of others. Such, at least, is the textbook definition: I have found such cases more richly various and less simple of explanation.
Sometimes, paranoid patients believe themselves hounded by imaginary enemies (which can be anything from foreign spies to the Jesuits or some secret brotherhood of mystics). They believe themselves followed wherever they go and that they are spied upon continuously, and they assign to the malignancy of these shadowy foes every accident or mishap that chances to befall them.
The outward symptoms of paranoia are remarkably easy to discern: a tendency toward careless, disorderly dress, a neglect of personal cleanliness, rapid and disconnected patterns of speech, eyes that wander to and fro fearfully searching the shadowy corners of the room, and a furtive lowering of the voice so that hidden ears cannot overhear what is being said.
It is particularly in the eyes that paranoia can be detected, even by the layman. The gaze of a paranoid is either dim, glazed, unfocused, the attention being turned within to ruminating over one's endless and pitiful persecution—or it is afire with the febrile gleam of the fanatic.
When I first entered the room assigned to Uriah Horby, I felt the shock of surprise. He was a small man in his mid-fifties, lean of build and going bald, clean-shaven and seemingly in good health. He was seated at a small folding desk studying sheafs of notepaper written (I noticed) in a clear, tight, legible hand ... very unlike the hysteric scrawl of most cases of acute paranoia I have studied.
His person was scrupulously neat and so was his room. The narrow bed was neatly made, the small bookcase tidy, and the personal effects on his dresser and washstand effectively organized. When he raised his eyes to meet mine I was in for another shock of surprise.
For Uriah Horby had the clearest, most candid gaze of any man I have ever met. His eyes were shrewd and thoughtful, but their innocence and candor were those of a small child.
Before the tranquil sanity in his eyes, I felt myself amazed. To cover my lack of composure, I hurried to introduce myself. He smiled politely.
"How do you do, Dr. Curtis? Pardon me if I do nor rise: To do so would disarrange these notes, and I have a passion for organization and deplore messiness. I have known you were about to join our little social circle here at Dunhill for some time, of course. I trust you have found your welcome adequate? As Menander said, 'The gentleman is at home in every circumstance,' but a madhouse is somewhat lacking in the amenities."
This was the man who went in mortal fear of lizards? A man whose chief and most deadly enemy lived in the moon? A paranoid who had been confined to Dunhill for over six years, and was believed incurable?
I could hardly believe it, yet it was indeed so ....
AT Dunhill, as I soon discovered, meetings between doctor and patient are informal and leisurely conversations, more like what my contemporaries call "rap sessions" than the usual clinical interrogations to which I had become accustomed. Uriah Horby was a deft and interesting conversationalist. His speech was coherent, his mind seemingly rational, his demeanor quiet and controlled.
He was an exceptionally intelligent man of obvious breeding and had enjoyed an excellent education. The son of a local merchant, he had studied abroad and traveled widely before settling in Santiago. He was of scholarly interests, learned in several abstruse fields, and, although absorbed by the nature of his peculiar fixation, able to converse easily upon a variety of subjects.
I conceived an intense curiosity concerning the man for several reasons, one of them being that he displayed in his manner and deportment and appearance none of the haunted, harried traits I had so often observed in other victims of paranoia. And his delusions of persecution were certainly novel.
"Why is it that you fear lizards. Mr. Horby?" I inquired bluntly on one of our first meetings. He considered his folded hands, lips pursed judiciously, as if carefully choosing his words.
“They ruled the earth before the earliest of our mammalian ancestors arose,” he replied soberly. “In time, our kind replaced theirs, and they hate us for it. As well, they are utterly alien to our species—vicious and coldblooded predators, devoid of emotion. That the highest order of sentience should reside in such loathsome reptiles is more than abhorrent, it is unholy."
Consistent with a formal, even pedantic, diction, as can be seen above, his speech was completely unemotional and lucid. Whatever fears tormented the man were obviously buried deeply within him.
"My understanding has always been that reptiles possess very little of what we should call intelligence, and operate on rudimentary instinct alone," I remarked. It is sometimes unwise to argue or to disagree with a mental patient, of course, but I meant to draw our man out, if possible.
He smiled dryly. “I gather. Dr. Curtis, that you have never encountered the Necronomicon in the range of your studies,” he said, changing the subject, or so I thought. I shook my head.
"I don't believe I have," I admitted frankly. "A Greek work, I assume? Theological?"
“Translated into Greek from the original Arabic." he answered. “Also into Latin and Elizabethan English. The author, a Yemenite poet of the eighth century of the Christian era, was named Alhazred; his work has been dismissed by your colleagues in the formal sciences as the ravings of a diseased intelligence. Had there been asylums for the insane in Alhazred’s day, as there are, unfortunately, in my own, I have no doubt he would have been locked up in one.”
“I gather that this Alhazred discusses the intelligence of reptiles?”
“To complete my reply to your first query, it is a work of demonology rather than of theology," he said somberly. "It presents a theory, drawn from documents and sources of the most fabulous antiquity, that this planet was first inhabited by entities from other worlds and galaxies and planes of existence, countless ages before the evolution of man. The nature of these beings is such that they would seem like gods or demons to lesser creatures like ourselves: Immortal, indestructible, not constructed from matter as we know it, they are incomprehensible intelligences of pure, devouring evil— older than the world, and desirous of possessing it ....”
These words, spoken in quiet, sober tones, sent a chill through the warm afternoon sunlight. Despite myself, I could not suppress a shudder: The nature of Horby’s paranoid delusions were, then, religious.
"In one section, during the first few chapters of Book IV," he continued, "Alhazred relates the history of a prehistoric town or settlement called 'Sarnath' which early men built in ominous proximity to ‘the grey stone city Ib’, where dwelt a race of aquatic nonhumans who worshiped the demon Bokrug in the form of a gigantic water lizard. Although Alhazred does not employ the term in the passages of which I speak, the aquatic beings are known as the Thunn'ha: They are green-skinned, batrachian, speechless. They worshiped their reptilian divinity with abominable rites—”
Recalling Dr. Colby’s words, I hazarded aloud the guess that this devilgod of Ib resided in the moon. Disconcertingly, Uriah Horby paled and bit his lip.