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Heraclitus said that when we are awake we live in a common world where everybody lives, but when we are asleep each one enters a world of his own. This is exactly what happens in psychosis. The process of introversion, the loss of contact with the external world, with the macrocosm in which we all live, plunging each one into his own internal world, into his individual microcosm, is a phenomenon common to madness and dream alike.
The analogy between madness and dreams has been emphasized since ancient times. As Henri Ey has pointed out, Moureau (of Tours) was the first to defend in a systematic way the thesis of the identity of both psychic manifestations. Jackson has also considered them both as effects of the functional dissolution of the nervous system.
In the first stages of psychosis in pellagra, the same psychic pictures are produced in dreams which the patient experiences later in more advanced psychotic states when he is awake. From the phenomenological point of view, ignoring psychomotor activity, which is inhibited during the state of sleep, there exists an exact parallelism between the physiological lowering and the pathological lowering of the level of consciousness. Actually, consciousness (the capacity of knowing) can be disturbed only by the diminution of its functions. It matters little whether the disturbance is provoked by abnormal pathological factors or by the normal action of physiological fatigue. The axial syndrome common to all psychosis, or the series of psychic states that constitute the unitary pattern, is therefore simply the same succession of states of consciousness through which we all pass in our daily transition from the state of wakefulness to the state of sleep.