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The author describes a folie à trois involving three related colored people—mother, daughter and son-in-law—all three being diagnosed as dementia præcox paranoid type. The delusional system in which the three participate has a grandiose, religious character built on hallucinatory experiences of the daughter, the primary agent, who herself assumes the rôle of the 'Messenger of God' and attributes to her mother the rôle of the 'Keeper' and to her husband the rôle of the 'Power and Strength'. Mother and husband, though themselves not hallucinating, submit to the ascetic, religious ritual induced by the hallucinations of the primary agent, who is the youngest of the three. Husband and mother both have a positive blood Wassermann, but a negative spinal fluid Wassermann. In the family history dynamic important experiences of shame are noted: an incestuous relation between the patient, who is the primary agent, at the age of twelve with her father, and a sexual relation between her husband and her sister which produced an illegitimate son.
The author refers to several cases of multiple psychosis, folie à deux, à trois, à cinq, in the psychiatric literature and he compares the multiple psychosis with the spreading of religious beliefs and its illusionary, alleviating effects on poverty stricken and oppressed populations.