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MEDICAL  JURISPRUDENCE





            OF





       INSANITY. 
 
TREATISE

     ON THE
MEDICAL JURISPRUDENCE
         OF

INSANITY.
By I. RAY, M. D.
        BOSTON:
CHARLES C. LITTLE AND JAMES BROWN.
         M.DCCC.XXXVIII. 
                         w
                         600
                          /?&

        Entered according to Act of Congress, in the year 1838,
           By Charles C. Little and James  Brown,
in the Clerk's Office of the District Court of the District of Massachusetts.
           BOSTO .\ :
PRINTED BY FREEMAN AND BOLLES,
       Washington-street. 
                      TO THE






             Hon. HORACE MANN ;






   TO  WHOSE  PERSEVERING  EXERTIONS,






           OUR  COUNTRY IS MAINLY INDEBTED






FOR ONE OF ITS NOBLEST INSTITUTIONS FOR  AMELIORATING





      THE CONDITION  OF THE  INSANE,





         THIS WORK IS RESPECTFULLY INSCRIBED





      AS A HUMBLE ACKNOWLEDGMENT OF ESTEEM,





                         BY





                                  I.  RAY.
■^rejfSflpi
 
 
PREFACE.
  Few, probably, whose attention has not been particularly-
directed to the subject, are aware, how far the condition of
the law relative to insanity is behind the present state of
our knowledge  concerning that disease.  While so much
has been done, within a comparatively short  period, to
promote the comfort of the insane, and  so much improve-
ment has been effected in the methods of treating their dis-
order, as to have deprived it of half  its terrors, it is both a
curious and a melancholy fact, that so little has been accom-
plished towards regulating their personal and social rights,
by more correct and enlightened principles of jurisprudence.
While nations are vying with one another in the excellence
of their  public  establishments  for the  accommodation of
this unfortunate class of  our fellow-men, and physicians
are every year publishing  some instance of an unexampled
proportion  of cures, we remain perfectly satisfied with the
wisdom of our predecessors in every thing relative to their
legal  relations.   This, no doubt,  is mainly  the fault of
medical men themselves, who have neglected to obtain for
the results  of their researches, that influence on the law of
insanity, which they have exerted  on  its pathology  and
therapeutics.  In general  treatises on legal medicine,  this
branch of it has always received a share of attention;  but 
Vlll
PREFACE.
the space allotted to it is altogether too limited to admit of
those details,  which can  alone be of any really  useful
service; and it is one of those branches on which the author
is  usually the least qualified  by his own experience,  to
throw any additional light.  Insanity itself is an affection
so obscure  and perplexing, and the occasions  have now
become so frequent and  important when its legal relations
should be properly understood, that  an ampler field of  il-
lustration and discussion is required for this purpose, than
is afforded by a solitary chapter in works of this description.
  Notwithstanding  the  great  prevalence  of insanity  in
Great Britain, and the vast amount of property affected
by  legal regulations and  decisions respecting  it, yet the
English language does not  furnish a single work, in which
the various forms and degrees of mental derangement are
treated in reference to their effect on the rights  and duties
of man.   Dr.  Haslam's tract on Medical Jurisprudence
as it Relates to Insanity, (1807), which was republished
in this country in 1819 by Dr. Cooper, in  a  volume  of
tracts  by  various English writers  on different subjects
of medical  jurisprudence, though  abounding in valu-
able reflections,  is altogether too  brief and general,  to
be  of  much practical  service  as  a book of  reference.
Among a few other works more or less directly concerned
with this subject, or in which  some points of it are par-
ticularly touched upon, the Inquiry  Concerning the Indi-
cations of Insanity, (1830), by Dr. Conolly, late Professor
in the  London University, is worthy  of especial notice  in
this connexion, for the remarkable ability and sound judg-
ment with which all its views are conceived and supported.
Though not entirely nor chiefly devoted to the legal re-
lations of the insane, yet the medico-legal student will find
his views  of insanity enlarged and improved by a careful
perusal of it; and every physician will do well to ponder 
PREFACE.
IX
the suggestions  contained in the chapter on the " Duties
of medical men when consulted concerning the state of a
patient's mind."   In the Judgments of Sir John Nicholl,
(contained in Haggard, Phillimore and Addams's Reports)
in the Ecclesiastical Courts, which, in their jurisdiction of
wills, have  frequent occasion to inquire into the effect of
mental diseases on the powers of the mind, are also  to be
found, not only some masterly analyses  of heterogeneous
and conflicting  evidence, but an acquaintance with  the
phenomena  of insanity in its various forms, that would be
creditable to the practical physician, and an application of
it to the case under consideration, that satisfies the most
cautious with the  correctness of the decision.
   In Germany this branch of legal medicine has received a
little more attention, and in a work entitled, Die Psycologie
in ihren Haupianwendungen auf die Rechtspjiege, {Psy-
chology  in its chief Applications to the Administration of
Justice)  by  J. C. Hoffbauer, a Doctor of Laws and Pro-
fessor in the University of Halle, and published in 1809,
we had, till quite recently, the only complete and method-
ical treatise on insanity in connexion with its legal relations.
It bears  the impress of a philosophical mind, accustomed
to observe the mental operations when under the influence
of disease;  it contains a happy analysis  of some states of
mental impairment,  and its doctrines are  generally correct,
and in many instances in  advance of his own, and even
our time.  Hoffbauer, however,  not being a practical phy-
sician, was  less disposed to consider insanity in its patho-
logical, than in its psychological relations, and consequently
has  attached too  little importance to its connexion with
physical causes, and to  the classification and description
of its different forms by means  of  which they may be re-
cognised  and distinguished from one another.   It is also
too deeply imbued with the peculiar metaphysical subtleties 
X
PREFACE.
in which his  countrymen are so fond of indulging, to suit
the taste or  convenience  of the English reader.  It has
been translated  into French by Dr. Chambeyron,  with
many valuable notes by Esquirol and Itard.
  In France,  M.  Georget has cultivated this field of inquiry
with a success proportioned to his  indefatigable zeal and
diligence; and his various  writings will ever be resorted to
by future inquirers, as they have been by the author of the
present work, as to a fund of original and interesting in-
formation.  Having long  been  devoted  to the  study of
insanity, and especially to the observation of the manners
and character of the insane, he was peculiarly well quali-
fied to treat  this  subject  in a spirit corresponding to the
present condition of the science.  His work entitled, Des
Maladies mentales, considerees dans leurs rapports avec la
legislation civile et criminelle, (1827), is an admirable man-
ual, and though but a humble  brochure, it yet  abounds
with valuable information and is pervaded  by sound and
philosophical views.  In  his Examen medical des  proces
criminels des nommes Leger, Feldtman, Lecoujfe, (1825),
and  his  Discussion medico-legale sur la Folie, (1826), as
well as a sequel to  the last, entitled, Nouvelle discussion
medico-legale sur la Folie, (1828), he has collected accounts
of numerous  criminal trials, in which insanity  was pleaded
in defence of the accused, and has taken  the occasion to
discuss the many important questions to which  they give
rise.   In the  course of these discussions  there is scarcely
a dark or disputed point in the whole range of the subject,
which he has not examined with great ability;  and if he
has  not always  settled them satisfactorily to  the unpreju-
diced inquirer, he has  at least afforded him the means of
forming more clear and definite views.
   On  becoming  aware of the deficiency, in  our medical
literature, of works on insanity considered  exclusively in 
PREFACE.                     XI
its legal relations, it was the author's first thought to make
a translation, either of Hoffbauer's or Georget's work, but
considering that the numerous notes which would be re-
quired in order to bring it up to the  present state of the
science, and adapt it to our own laws, would prove incon-
venient and embarrassing to the reader, besides not fully
accomplishing the object,  he was induced to abandon this
project, and, as  the only  means of fairly developing the
subject, to prepare  an original work,—original strictly in
plan and in many of its general views only, for the materials
have been necessarily drawn, in a great degree, from other
sources than the  author's  own experience.    The  main
object which he proposed to himself, was to establish the
legal relations of the insane in conformity to the present
state of our knowledge respecting their disease.  In fur-
therance of this  object, he has given a succinct description
of the different species of insanity, and the characters by
which they are distinguished from  one  another, so that
the professional student  may have some  means of recog-
nising them in practice, and thence  deducing, in regard to
each, such legal consequences as seem warranted  by a
humane and enlightened consideration of all the facts. He
is well aware that  he has presented some views that will
not,  at first  sight, meet with the cordial assent  of all his
readers.  He can only say in justification, that they have
appeared to him to be founded  on  well-observed,  well-
authenticated facts, and that as such, it was an imperative
duty required by the claims of humanity  and truth, to
present them  in the  strongest possible  aspect.  Before
being condemned for substituting visionary and speculative
fancies, in the place of those maxims and practices which
have come down to us on the  authority of our ancestors,
and  been sanctioned by  the  approval  of all succeeding
times, he hopes  that  the  ground  on  which those alleged 
xii
PREFACE.
 fancies have been built, will be- carefully, candidly, and
 dispassionately examined.   Of the manifold imperfections
 of his work, no one can be more sensible than the author
 himself; but if it succeed in directing attention to the sub-
ject, and putting others on the track of inquiry, it will, at
 the very least, have been followed by one beneficial result.

  Eastport, Me.,  March 20th, 1838. 
CONTENTS.
                                                   Page.
Preliminary Views      ......       1
                     CHAPTER I.
Mental Disease in General.....68
                    CHAPTER II.
Idiocy.........72
                    CHAPTER III.
Imbecility      ......••     77
                    CHAPTER IV.
Legal consequences of Mental Deficiency                96
                     CHAPTER V.
Pathology and symptoms of Mania   ....     134
                    CHAPTER VI.
Intellectual Mania.......152
Sec. I. General Intellectual Mania   ....     152
Sec. II. Partial Intellectual Mania                 •     161 
 xiv                   CONTENTS.
                                                    Page.
                    CHAPTER VII.
 Moral Mania........168
 Sec. I. General Moral Mania    .....     170
 Sec. II. Partial Moral Mania.....186
                    CHAPTER VIII.
 Legal consequences of Mania   .....     235
 Sec. I. Legal consequences of Intellectual Mania     .    236
 Sec. II. Legal  consequences of Moral Mania    .     .    258
                    CHAPTER IX.
 Dementia.......         279
                    CHAPTER X.
 Legal consequences of Dementia     ....    289
                    CHAPTER XL
 Febrile Delirium     .......    297
                   CHAPTER XII.
 Legal consequences of Delirium      .    ,         .    303
                   CHAPTER XIII.
 Duration and curability of Madness.  .             ,    310
                   CHAPTER XIV.
 Lucid Intervals      .......     319
                   CHAPTER  XV.
 Simulated Insanity    ......         333
                   CHAPTER XVI.
Concealed Insanity   .......     353 
CONTENTS.
                 CHAPTER XVII.
Suicide   ......
                 CHAPTER XVIII.
Legal consequences of Suicide  .
                  CHAPTER XIX.
Somnambulism      ....
                  CHAPTER XX.
Legal consequences of Somnambulism
                  CHAPTER XXI.
Simulated Somnambulism .
                  CHAPTER XXII.
Effect of insanity on Evidence  .
                 CHAPTER XXIII.
Drunkenness    .....
                 CHAPTER XXIV.
Legal consequences of Drunkenness  .
                  CHAPTER XXV.
Interdiction     ..... 
 
MEDICAL  JURISPRUDENCE
        OF


INSANITY.
              PRELIMINARY VIEWS.

   Statutes were framed and principles of law  laid
down, regulating the legal relations  of the Insane,
long before physicians had obtained any accurate no-
tions respecting their malady; and, as might naturally
be expected, error and injustice have been committed
to an incalculable extent under the sacred  name
of law.  The actual state of our knowledge of insa-
nity, as well as of other diseases, so far from  being
what  it has always heretofore been, is the accumula-
ted result of the observations, which,  with more or
less  accuracy and fidelity, have been prosecuted
through  many  centuries,  under  the  guidance of a
more  or less  inductive philosophy.  In addition to
the obstacles to the progress of knowledge respect-
ing other diseases, there has been this also in regard
to insanity, that, being considered  as  resulting from
a direct  exercise  of divine power, and not from the
operation of the ordinary laws of nature, and thus
associated with mysterious and supernatural pheno-
         A 
2      MEDICAL JURISPRUDENCE OF INSANITY.

mena confessedly  above our comprehension, inquiry
has been discouraged at the very threshold, by the fear
of presumption, or, at least, of fruitless labor.   To
this superstition, we may look as the parent of many
of the false and absurd  notions, that have prevailed
relative to this disease,  and  especially of the reck-
less  and  inhuman treatment,  once universally  be-
stowed on its  unfortunate subjects.  Instead of the
kindness and care, so usually manifested towards the
sick, as if it were a natural right for them to receive
it;  instead of the untiring vigilance, the soothing at-
tention, the lively solicitude of relatives and friends ;
the patient, afflicted with the  severest of diseases,
and most of all dependent for the issue of his fate on
others,  received nothing but looks of loathing, was
banished from  all that  was  ever dear to him, and
suffered to remain in his  seclusion uncared  for and
forgotten.  In those receptacles, where living beings,
bearing the image and superscription  of men, were
cut off from all the  sympathies of fellow-men, and
were rapidly completing the  ruin  of their  immortal
nature, there were  scenes  of  barbarity and moral
desolation, which no force of language can adequately
describe.   The  world  owes  an  immense  debt of
gratitude  to  the  celebrated  Pinel, who, with an ar-
dor of philanthropy,  that no discouragement could
quench, and a courage that no apprehension of dan-
ger could  daunt,  succeeded, at last,  in removing
the chains of the maniac, and establishing his claims
to all  the liberty and comfort, which his malady had
left him capable of enjoying.   With the new aspect,
thus presented, of the moral and intellectual condi-
tion of this portion of our race,  the medical jurispru- 
PRELIMINARY  VIEWS.
3
dence of insanity became invested with an interest,
that has led to its most important improvements.
  § 2. In all civilized communities, ancient or mod-
ern, insanity has been  regarded as exempting from
the punishment of crime,  and vitiating the civil acts
of those  who are  affected with it.   The only diffi-
culty, or diversity of opinion, consists  in determining
who are really  insane, in the meaning of the  law,
which  has been content  with  merely  laying down
some general principles,  and leaving  their  applica-
tion to the discretion ol the judicial authorities.  In-
asmuch,  as the greatest possible variety is presented
by the mental phenomena in a  state  of health, it is
obvious,  that profound study and extensive observa-
tion of the moral and intellectual nature of man can
alone prevent us, from sometimes confounding them
with the  effects of disease.  It would seem, there-
fore, an  almost self-evident  proposition, that a cer-
tain knowledge of the mind in its healthy state is an
essential preliminary, to  the attainment  of correct
ideas concerning its diseased manifestations.   If,  in
addition to this, it is considered, that opinions on the
nature of insanity,  viewed solely in  the  light  of a
disease—of a derangement of the physical structure,
■—have been constantly  changing for  the better, it
follows of course,  that  its  legal  relations, which
should be determined in some measure by our views
of its  nature, ought to be modified by the progress
of our  knowledge.  That  much of the jurisprudence
of insanity, in  times past, should bear marks of the
crude  and imperfect notions, that have been enter-
tained of  its  pathological character,  is  not to  be
wondered at; but, it is a matter of surprise, that it 
 4      MEDICAL JURISPRUDENCE OF  INSANITY.

 should be adhered  to, as  if consecrated by age, long
 after it has  ceased  to be suppoited by the results  of
 more  extensive and  better conducted inquiries.   It
 is to be feared, that the principles, laid down on this
 subject by legal authorities, have received too much
 of that reverence, which is  naturally felt  for the
 opinions and practices of our ancestors; and that in-
 novations have  been too much  regarded, rather as
 the  offspring  of new-fangled theories, than of the
 steady advancement  of medical science.  In  their
 zeal to uphold the  wisdom of the past, from  the fan-
 cied  desecrations  of reformers  and theorists,  the
 ministers of the law seem to have forgotten, that, in
 respect to this subject, the  real dignity and respect-
 ability of their profession is better upheld, by yield-
 ing to the improvements of the times and thankfully
 receiving the truth from whatever quarter  it  may
 come,  than  by turning away with blind obstinacy,
 from every thing that conflicts with long  established
 maxims.and decisions.  In the course of the review
 proposed  to be taken of the principles, that have
 regulated the civil and  criminal  responsibilities of
 the insane,  the reader  will have constant opportu-
 nity  to witness the influence of the spirit above con-
demned ; and be inclined, perhaps, to consider it as
the source of  that striking difference,  presented by
the sciences of law and medicine,  in the amount of
knowledge they respectively  evince  on the subject
of insanity.
  § 3. Legislators and jurists  have done little more,
 than merely to  indicate  some of the  most obvious
divisions  of  insanity,  without  undertaking any thing
like a systematic  classification of its  various forms. 
PRELIMINARY  VIEWS.
5
In the Roman law,  the  insane, or dementes, are divi-
ded into two classes ;  those whose understanding is
weak or null, mente capti, and those who are restless
and  furious, furiosi.    The French and Prussian
codes make use of the  terms, demence, fureur and
imbecillite,  without  pretending to define them.  The
English common law  originally recognised but two
kinds of insanity, idiocy  and  lunacy, the  subjects of
which were 'designated by the term, non compotes
mentis, which was used in a generic sense  and meant
to embrace all, who, from defect of understanding,
require  the protection  of  the  law.   An  occasional
attempt has been  made by jurists, to attach  some
definite  ideas to these  terms, and to point  out the
various descriptions of persons,  to whom they may
be applied.   Lord Coke says, there are four kinds of
men, who ma}'- be said to be  non compotes mentis:—
1. An idiot, who, from his  nativity,  by a perpetual
infirmity is non compos;  2.  He that by sickness, grief
or other accident, wholly loseth his memory and un-
derstanding ; 3. A  lunatic  that hath sometimes  his
understanding, and sometimes not, aliquando gaudet
lucidis intervallis;  and  therefore he  is  called non
compos mentis, so long as he hath not understanding;
4. He that  by his own vicious act for a time  depriv-
eth himself of his  memory and understanding,  as he
that is drunken.1
   § 4. That the above  classification  is exceedingly
defective, is sufficiently  proved, to go no  farther, by
the various attempts^  of law-writers  to  indicate the
1 Coke's Littleton, 247 a. 
6      MEDICAL  JURISPRUDENCE OF  INSANITY

precise  characters  by which they may  be distin-
guished.   An idiot  is defined to be a  person, who
cannot count or number twenty pence, or tell who
was  his father  or mother, or how old he is, so as it
may appear that he  hath no understanding of rea-
son,  what shall be for his profit or what shall be for
his loss ; but if he have  sufficient understanding to
know and  understand his letters,  and to  read  by
teaching  or information,  he is not an idiot.1   Now
the truth is,  that the proportion of idiots, capable
of attaining the kind of knowledge herein specified,
by means of the ordinary intercourse with men, or
of special teaching, is by no means small.   The en-
tire loss of memory and understanding,  attributed to
the second class,  is observed only as  a sequel to
madness  or some other  disease, or as  the result of
some powerful moral  causes ; so that if this is to be
considered an essential  character  of madness,  by
much the larger  proportion of madmen  will be alto-
gether excluded from this classification ; for, instead
of wholly losing their understanding,  they are  for
the most part perfectly rational on some topics, and
in some  relations of life; and a little  effort  is fre-
quently necessary,  in order to detect the fact of the
understanding being at all impaired.  Judging from
the almost exclusive use  of the term lunacy, and the
frequent  reference to  lucid intervals, the intermittent
character of madness was  either more  common,
some hundreds  of years since, or,  which is more
probable, in consequence of th# general belief in its
1 1 Fitzherbert, Natura Brevium, 583, ed. 1652. 
PRELIMINARY  VIEWS.
7
connexion  with lunar  influences,  this intermission
was imagined to occur far oftener than it really did.
This  certainly is  a more reasonable  explanation,
than the idea that the course of nature has changed,
so that lucid intervals, which were  once of the most
common occurrence in insanity, are now among its
rarest phenomena.
   § 5. Common sense and a tolerable share  of the
intelligence of the  time,  if fairly  exercised,  would
probably prevent,  in practice, any  grossly improper
application  of  these theoretical  principles;  but, in
civil cases,  the law, though  not disposed to guage
the exact measure of men's intellects, has sometimes
insisted  on  technical distinctions,  that  have  little
foundation in nature or  reason.   Originally,  com-
missions of  lunacy  wTere granted for  the  purpose of
inquiring whether  the individual were either an  idiot
ex nativitate, or a lunatic, in  Coke's meaning of the
term, and, in consequence thereof,  incapable of gov-
erning himself and managing  his  worldly  affairs.
The injustice of leaving beyond the protection of the
law, that larger class of insane, who, though neither
idiots, nor lunatics, labor  under more or less mental
derangement, led to a change  in the form of the
writ,  by which the phrase unsound mind was used
for the purpose of embracing  all others, who were
considered proper objects of a commission.   What
is  the precise meaning of  this term, it is not easy to
gather from the observations  of various  high  legal
authorities,  who  have attempted to fix its meaning.
It  seems to be agreed, that it  is not idiocy, nor lu-
nacy, nor imbecility, but  beyond this  all unanimity
is  at an end.  Lord Hardwicke held, that unsound- 
 8      MEDICAL JURISPRUDENCE OF  INSANITY.

 ness of mind did not mean mere weakness of mind,
 but a depravity of reason or a want of it.1  Lord El-
 don once referred to the case of a person  advanced in
 years, " whose mind was the mind of a  child," and
 observed, that,  " it was, therefore, in that sense, im-
 becility  and inability to manage  his affairs,  which
 constituted unsoundness of mind."2   The same  high
 authority had observed, on a previous occasion, that
 " the court had thought itself authorized  to issue the
 commission de lunatico inquirendo, provided it is made
 out, that  the party is unable to act with  any  proper
 and provident management;  liable to be robbed by
 any one; under that imbecility of mind,  not strictly
 insanity, but as to the mischief, calling  for as much
 protection  as  actual  insanity."3  Mr.  Amos,  late
 professor of Medical Jurisprudence in the  London
 University, has  said, that  "the term unsoundness of
 mind,  in  the legal sense, seems to involve the  idea
 of a morbid condition of intellect, or loss of reason,
 coupled with an incompetency of the person to man-
 age his own affairs." 4   Whatever  it may signify, it
 has always been insisted  on, that  the return of the
 commission must  state the incapacity or inability of
 the party to manage his affairs,  to  be evidence of its
 existence, in order that the party may have the pro-
 tection of the law.  If  the jury are unwilling from
what they see to infer the presence of a  mental
condition, to which the  highest dignitaries of the
law have declined fixing a precise, intelligible mean-
1 Ex parte Barnsley, 3 Atkyns's Reports, 168.
2 Haslam on the Medical Jurisprudence of Insanity, 336.
3 8 Vesey's Reports, 656.    4 London Medical Gazette, Vol. 8, p. 19. 
PRELIMINARY  VIEWS.
9
ing,  then  the inquisition is quashed.  The feelings
of dread and disgust, with which madness has been
generally contemplated, have often  deterred juries
acting  under a commission,  from  returning a ver-
dict of unsound mind, which  has become equivalent
to insanity;  either from a disinclination to embarrass
the family with an odious distinction, or because the
individual was not really unsound in the popular ac-
ceptation  of the  term,  though his  mental  faculties
might  have  been so far enfeebled  by old age, or
sickness, or  congenital causes, as to  render  him ab-
solutely incapable of conducting himself or his  af-
fairs,—a fact, which they have sometimes returned.
These attempts  to change the ordinary course have
never succeeded, the court having in every case re-
quired the verdict to be in the words of the inquisi-
tion, or in equipollent words.   "It is settled," says
Lord Eldon, " that if the jury find  merely the inca-
pacity  of the party  to manage his  affairs,  and will
not  infer  from  that  and other circumstances un-
soundness of mind, though the party may live where
he is exposed to ruin every  instant, yet upon that
finding the commission cannot go on." 2  The con-
sequence is, that the afflicted party must  either fore-
go the protection of the law, or fix upon his family a
sort of stigma of the  most  disagreeable and onerous
description.   When it is considered how many are
the cases, where individuals  are incapacitated from
managing their affairs, simply from  that  impairment
of the mind  so common in old age, or mere  defect of
1 19 Vesey's Reports, 286. 
 10    MEDICAL JURISPRUDENCE OF  INSANITY.

 memory, the other powers remaining sound, it is a
 little surprising, that no  effectual  measures have
 been taken, to render the operation  of the  law less
 imperfect and unequal.   It  is not  easy  to  see the
 ground of the extreme repugnance displayed by the
 English courts, towards any return that does not as-
 sert the  mental unsoundness of the affected party,
 unless it may be  some obstacle thereby thrown in
 the course of the subsequent proceedings.   The ob-
ject of the commission is, to ascertain whether or not
 the party in question is incapable, by reason of men-
 tal infirmities, of governing himself and managing his
 affairs; and if they so find him, it certainly is irrelevant
 to any useful purpose,  to connect this inability as an
 effect with any particular kind  of insanity,  whether
expressed in common or technical language.  Indeed,
to require a jury to infer  explicitly unsoundness of
mind from  inability  to manage affairs, which is  of
itself sufficient evidence of all  the mental unsound-
ness, that is required  for practical purposes, and re-
ject their return if they do not, would seem exceed-
ingly puerile, were it  not  strictly professional.  In
ex parte  Cranmer,1 where  the  jury  pronounced the
party in  their verdict, " so far debilitated in  his mind
 as to be incapable  of the general management of his
 affairs,"  Lord Chancellor  Erskine gives  some rea-
 sons for finding fault  with  the terms of the verdict,
 and directing the  inquisition to be quashed.   " The
 verdict," he says,  "does not state distinctly, that he
 is incapable ; but that he is so far debilitated in  his
1 12 Vesey's Reports, 406. 
PRELIMINARY VIEWS.
11
mind, that he is  not equal to the  general manage-
ment of his affairs."  The very word incapable, it is
true, is not used,  but the words "not equal" are
surely of  equivalent meaning ;  and  it is not easy  to
conceive,  how a clearer or stronger idea of a person's
incapacity can be conveyed, than to pronounce him
"not  equal  to  the  management  of his affairs."
"How  can I tell,"  he asks, "what  is 'so far debili-
tated in his mind that he is not equal to the general
management  of  his affairs V ':   He certainly could
not tell the precise quantity of mind left, but even if
the party had been returned non compos  and there-
fore  unequal to  the management of his affairs, it is
not quite  obvious,  how  any more definite notion on
this point would have been conveyed.1
   § 6.  The business of the  jury in  these cases  is,  to
ascertain  whether the individual is mentally capable
of managing his affairs; and this is a  duty, which,
generally speaking, they are^ able  to perform with
tolerable  correctness.  But what can be more  irrel-
evant to  the object in view, or more remote from
the ordinary circle  of their reflections,  than the ad-
ditional duty of  deciding whether his mental impair-
ment has  gone far enough, to bear being designated
by the  technical  phraseology, unsoundness of mind ?
When it is recollected, too, that the members of these
  1 In a recent case, the inquisition was quashed by Lord Lyndhurst,
because the verdict of the jury said too much, instead of too little, viz:
"that the party was not a lunatic, but partly from paralysis and partly
from old age, his memory was so  much impaired as to render him in-
competent to the management of his affairs, and consequently that he
was of unsound mind, and had been so for two years."  In Re Holmes,
4 Russel's Chancery Reports, 182. 
12     MEDICAL JURISPRUDENCE OF INSANITY.

juries  are  mostly uneducated  men, and but  few of
them at all  acquainted with  the force of legal  or
medical  distinctions, it  cannot  be supposed,  that
such a return is always the recorded opinion of un-
biassed,  understanding  minds.   Indeed, the  incon-
venience and injustice  of these  proceedings have
been so  strongly felt, as to have led to the repeated
expression of a wish, that its defects were remedied
by the action of the legislature.  That it should still
continue in a country, where  it is  linked  in  with a
system, whose foundations are in the very constitu-
tion of the government, is perhaps not strange ; but,
that it should be used in some of our own states,
which are untrammelled by such considerations, is
certainly an anomaly in legislation.
   § 7.  This  is  not  the only  instance, where  the
principles  of common  sense  and common justice,
which ought to  regulate  the legal  relations of the
insane, have, with  astonishing  inconsistency, been
strangely disregarded in the maxims of the common
law.   While it requires that contracts,  to be valid,
should spring from a free and  deliberate  consent, it
refuses to suffer the party  himself to avoid them on
the plea of lunacy,  in  accordance with an ancient
maxim, that  no man of full age shall  be allowed to
disable or  stultify himself; though, at the same time,
it does allow his heirs,  or  other persons interested,
to avail  themselves of this privilege.1   Thus, a per-
son, who recovers from a temporary insanity, before
the return of an inquisition,  has no remedy at law
1 Chitty on Contracts, 256. 
               PRELIMINARY  VIEWS.              13

or in equity for the most ruinous contracts,  that he
may have entered into while in that condition, except
on the ground of fraud, though,  after his death, his
heirs may have them set aside  by  establishing the
fact  of lunacy  alone.   Well  may a distinguished
jurist exclaim,  that,  "it is  matter of wonder and
humiliation, how so absurd and mischievous a maxim
could have found its  way into  any  system of juris-
prudence,  professing to act on  civilized  beings."1
It arose, no doubt, in part, from erroneous  notions
of the  nature of insanity, and partly from apprehen-
sions, not  well  founded, of  the  consequences, that
might follow the admission of the plea of lunacy in
avoidance of contracts.  The ends  of justice would
have been  better obtained, if no general rule at all
had been adopted, and  every  case decided on its
own merits.  Where the insanity of one of the par-
ties is perfectly well known  to  the  other, or  might
have been  so by the exercise of ordinary sagacity,  a
contract between them, except for the necessaries of
life or comforts and  luxuries suitable to his wealth
or station,  should obviously be held invalid,  because
the insane  party is deprived by the act of providence
of his  natural share  of discernment and  foresight.
It often happens, however, that a person's insanity is
not generally known and is not  very apparent, and,
in such cases, if it  can be  proved, that the contract
is a fair and reasonable  one  on  the face  of it, and
was entered into in  perfect honesty and good faith,
he certainly should not be permitted to stultify him-
1 1 Story's Commentaries on Equity Jurisprudence, § 225. 
14     MEDICAL JURISPRUDENCE OF INSANITY.
self, in order to  escape its  performance.1   Neither
does his death or interdiction so change the case, as
to render it proper for his heirs or guardians,  to do
that which he could not  do for  himself.   Much  as
the law is bound to protect  the  interests of the in-
sane, it is no less required to protect those who deal
with them,  unacquainted  with their  mental  condi-
tion.   It as often happens, that the sane party suffers
from the avoidance of the contract, as  that the insane
or his heirs do from its validity ;  and nothing can be
more clearly unjust, than the application of a maxim
or general rule, that favors only the  interests of the
unsound party.
   § 8. Though  little of this pertinacious adherence
to merely technical  distinctions is observed,  in  the
application  of the  law to criminal cases,  yet there
is  much of  the same respect  for antiquated maxims,
that have little  else to recommend  them  but their
antiquity, and are so much the more pernicious in their
application, as  the interests of property are of less
importance than reputation and life.  It by no means
follows, that a person, declared to be non compos by
due process of law, is to  be considered, on that
account, merely, to be  irresponsible for his criminal
acts.  This is  a question  entirely distinct,  and is
determined upon very different views of the nature
of insanity, and  of its  effects on the operations of
the mind ; and, here it is, that the lawyer encroaches
most on the domain of the physician.   The  first at-
  1 This principle has lately been adopted, where the contract was for
articles suitable to the means and condition of  the insane party.
Bagster v. Earl of Portsmouth.  Chitty on Contracts, 256. 
PRELIMINARY  VIEWS.
15
tempt to point out precisely those conditions of in-
sanity, in which the civil and criminal responsibilities
are unequally  affected,  was  made  by  Lord Hale.
" There is a partial insanity," says he,  " and a total
insanity.   The former is either in respect to things,
quoad hoc vel illud insanire.  Some persons that have
a competent use of reason,  in respect  of some sub-
jects, are yet under a particular dementia, in respect
of some particular discourses, subjects, or applica-
tions :  or else  it is  partial in respect  of degrees ;
and this is  the  condition of  very many, especially
melancholy persons, who for the  most  part discover
their defect in excessive fears and griefs, and yet  are
not wholly destitute of the  use of reason ; and this
partial insanity  seems not  to excuse  them, in  the
committing of  any offence  for  its matter  capital ;
for, doubtless, most persons that are felons of them-
selves  and others,  are under  a degree  of partial
insanity,  when  they  commit these offences.  It is
very difficult to define the invisible line that divides
perfect  and partial insanity ; but it must rest upon
circumstances duly to  be weighed and considered
both by judge and jury, lest on the one side  there
be a kind of inhumanity towards the defects of human
nature ;—or, on the other side, too great an indul-
gence given to  great crimes." J
  § 9. The doctrines, thus  dogmatically laid  down
by Lord Hale, have exerted  no inconsiderable influ-
ence on the judicial opinions of his successors ; and
his high authority has always been invoked against
1 Pleas of the Crown, 30. 
16     MEDICAL JURISPRUDENCE OF INSANITY.

the plea of insanity, whenever it has been urged by
the voice of philanthropy and true science.   If, too,
in consequence of the common tendency of indulg-
ing in forced and unwarrantable constructions, when-
ever a point is to be gained, his principles have been
made to mean far more  than he  ever designed, the
fact  impressively teaches  the  importance of clear
and well-defined terms, in the expression of scientific
truths, as well as of enlarged, practical information,
relative to the subjects  to  which they, belong.  In
the time of this eminent jurist, insanity was a much
less frequent disease than it now is,  and the popular
notions concerning it were  derived from the  obser-
vation of those wretched inmates of the mad-houses,
whom chains and stripes, cold and filth, had reduced
to the stupidity of the idiot, or  exasperated to the
fury of a demon.   Those nice shades of the disease,
in which the  mind,  without being  wholly  driven
from its  propriety, pertinaciously  clings  to some
absurd delusion, were either regarded as something
very different from real madness,  or  were  too few7,
too far removed from the  common gaze, and too
soon converted by bad  management into the more
active forms of the disease,  to enter much into the
general idea entertained of madness.   Could Lord
Hale  have  contemplated the scenes presented by
the lunatic  asylums  of our own times,  we  should
undoubtedly have received  from him  a very different
doctrine, for the regulation of the decisions of after
generations.
   § 10. Judging from the few cases that have been
reported, the course of practice in the English crimi-
nal courts has been strictly conformatory to the prin- 
PRELIMINARY VIEWS.
17
ciples laid down by Hale.  For instance, in the trial
of Arnold in 1723 for shooting at Lord Onslow, Mr.
Justice Tracy observed,  "that it is not every kind
of frantic humor, or something  unaccountable in a
man's actions, that points him out to be such a mad-
man, as is exempted from punishment: it must be
a man, that  is totally deprived of his understanding
and memory, and doth not know  what  he is doing,
no more than an infant, than a brute, or a wild beast,
such a one is  never the  object of punishment." 1
This is but  the  echo of Lord Hale's  doctrine, and
the circumstances  of the case show how faithfully
the principles were applied.   Arnold seems to have
been of weak understanding from his birth,  and to
have  led an  idle, irregular, and  disordered life,
sometimes unequivocally mad, and at all  times con-
sidered exceedingly strange and different from other
people ;  one witness describing him as  a strange,
sullen boy  at school,  such  as he  had  never seen
before.   It was  testified by his family and his neigh-
bors, that for several years previous, they had con-
sidered and  treated him as mad,  occasionally if not
always, although so little disposed  to  mischief, that
he was suffered to be  at large.   Contrary  to the
wishes of his friends, he persisted in living alone in
a house destitute of the ordinary conveniences  ; was
in the habit  of lying about in barns and  under hay-
ricks ; would curse and swear to himself for hours
together  ; laugh and throw things  about the house
without   any cause whatever, and  was  much dis-
1 8 Hargrave's State Trials, 322.
B 
 18     MEDICAL JURISPRUDENCE OF INSANITY.

 turbed in his sleep by fancied noises.   Among other
 unfounded notions, he believed that  Lord Onslow,
 who lived in his neighborhood,  was the cause of all
 the tumults, disturbances, and  wicked devices, that
 happened in the  country,  and his thoughts were
 greatly occupied with this person.  He was  in  the
 habit of declaring, that Lord Onslow  sent his devils
 and imps into his room at night to disturb his rest,
 and that he constantly plagued and bewitched him,
 by getting into  his belly or bosom, so  that he could
 neither eat, drink nor sleep, for  him.  He  talked
 much of being plagued by the Bollies and Bolleroys ;
 he declared in prison it was better to die  than live
 so miserably, and manifested  no  compunction  for
 what  he had done.   Under the influence of these
 delusions, he shot at  and wounded Lord Onslow.
 The proof of insanity was strong enough, but  not
 that degree of it, which the jury considered sufficient
 to save him from  the gallows,  and he was accord-
 ingly sentenced to be hung.  Lord Onslow himself,
 however,  thought differently ;  and, by means of his
 intercession,  the sentence was not  executed,  and
 Arnold was  continued in prison for life.  It is clear,
 that  the court   recognised  that  class of  madmen
 only, as exempted from the penal  consequences of
 crime,  whose reason is completely  dethroned from
 her empire, and who are reduced to the condition of
 an infant, a brute, or a wild beast.   If it be true,
 that such, as the  court said, are never the objects
 of punishment, though it neglected  to state that they
 are never the objects of prosecution,   the converse
 must be equally true, that those not exactly  in this
condition can never avoid punishment  on the plea of 
PRELIMINARY VIEWS.
19
insanity.   It  appears,  then,  that  the  law at  that
time did not consider an insane person irresponsible
for crime, in  whom  there  remained the slightest
vestige of rationality ;  though,  it did then and has
ever since deprived him of the management of him-
self and his affairs, and vitiates  his  civil  acts, even
wrhen  they  have no relation to the circumstances
that caused  his madness.   That  the  progress of
science and general  enlightenment has produced no
improvement  of the  law on  this subject, is  abun-
dantly shown  in the  strong  declarations  of Sir Vic-
ary Gibbs,  when  attorney-general of England, on
the trial of Bellingham,  in 1812.   "A man,"  says
he, " may be deranged in his mind,—his  intellects
may be insufficient for enabling  him  to conduct the
common affairs of  life, such  as disposing  of his pro-
perty,  or judging of the claims which his respective
relations have upon him; and  if he be so, the ad-
ministration of the country wall take his affairs into
their management, and appoint to him trustees ;  but,
at the same time, such a man is not discharged from
his responsibility for criminal acts." 1 Lord Erskine
had previously given the same doctrine the sanction
of his authority, in his celebrated speech  in defence
of Hadfield.   " I am bound," he says,  " to admit
that there is a wide  distinction between civil  and
criminal cases.  If,  in  the  former, a man appears,
upon the evidence, to be non compos  mentis, the law
avoids his act, though  it  cannot be  traced or con-
nected with the morbid  imagination which consti-
1 Collinson on Lunacy, 657. 
20      MEDICAL JURISPRUDENCE OF INSANITY.

tutes his disease, and which  may be  extremely par-
tial in its influence upon conduct ;  but, to deliver a
man from  responsibility for crimes, above  all, for
crimes of great atrocity and wickedness, I am by
no means prepared to apply  this rule, however  well
established, when property only is concerned."
  § 11. That a person, whom the law7 prevents  from
managing his own property, by  reason of his mental
impairment, should, in  respect  to criminal acts, be
considered  as possessing all the elements of respon-
sibility, and placed on the same footing with  men of
the  soundest  and strongest  minds, is a proposition
so strange and startling, that few, uninfluenced by
professional biases, can  yield to it  unhesitating as-
sent, or  look upon it in any  other  light, than  as
belonging to  that  class of doctrines, which, while
they may be the perfection of reason to the initiated,
appear to be  the  height of  absurdity  to every one
else.   Georget, an able French writer on the legal
relations of the  insane, in commenting on the speech
of de  Peyronnet,  who, in the  trial  of Papavoine,
had adduced the passage above  extracted from Lord
Hale, in support of his own   views, expresses his
astonishment  and indignation, that such  sentiments
should ever have been uttered,  least of all, quoted
with approbation, in  a  French  court of justice, by
the chief law-officer of the government.   " Can we
help wondering," he exclaims,  "at these sentiments
of Lord Hale, who seems to make more account of
property than life.   No excuse for the unfortunate
man, who,  in a paroxysm of madness,  commits a
criminal  offence, while civil  acts are to be annulled,
even when  they have  no relation to  the insane im- 
PRELIMINARY VIEWS.
21
 pressions, that might have influenced  his conduct." *
 The language of the law, virtually addressed to the
 insane man, is, your reason  is too much impaired to
 manage  your property ;  you are unable to distin-
 guish between those measures, which would conduce
 to your profit and such as would end in your  ruin,
 and therefore it is wisely taken altogether from your
 control ; but, if under the influence of  one  of those
 insane delusions, that have rendered this step neces-
 sary,  you  should kill your  neighbor,  you  will be
 supposed to  have acted  under  the  guidance  of  a
 sound reason;  you will.be tried,  convicted,  and
 executed like any common  criminal,  whose under-
 standing has never been touched by  madness.  As
 for any physiological or psychological ground, for this
 distinction  between the legal consequences of the
 civil and criminal acts of an insane person,  it is
 in vain to  look for it.  That the mind, when medi-
 tating a great crime, is  less under  the  influence of
 disease, and enjoys a more sound and vigorous exer-
 cise of its powers, than w7hen making a contract, or
 a  will, few,  probably, will  be hardy enough  to
 affirm; and  yet  the practice  of the law virtually
admits it.  The difference,  if there  be any, would
seem to be all  the other  way.  In the disposal of
property, the mind is engaged in what  has  perhaps
often exercised its thoughts;  the conditions and con-
sequences of the transaction require no great mental
exertion  to be comprehended ;  and  there  may be
nothing in it, to deprive the mind of all the calmness
1 Discussion medico-legale sur la Folie, p. 8. 
 22      MEDICAL JURISPRUDENCE OF INSANITY.

 aud rationality of which it is capable.  Now, crimi-
 nal acts, though abstractly wrong, may under certain
 circumstances become  right and  meritorious ;  and,
 if the strongest and acutest minds  have sometimes
 been perplexed on  this point,  what  shall we say of
 the crazy  and distorted perceptions  of him, whose
 reason shares a divided empire with the propensities
 and passions ?   Most maniacs have a firm conviction,
 that  all they feel  and think, is true, just, and rea-
 sonable ;  and nothing can  shake their  convictions.
 The contracts of the insane are, in many cases, de-
 clared to be invalid, and are set aside, in courts of
 law, as well  as equity, on  the  ground of fraud; in
 accordance with an established principle,  that  the
 parties to a contract must be capable of giving their
 deliberate and rational consent,  the power  of doing
 which is destroyed by  mental  derangement.1  In
 point of mental  soundness,  they must be equal, and
 common justice  requires, that the insane man, in his
 dealings with his fellow-men,  should be protected
 from the effect of his disorder.  Even in the  simplest
 transaction, it is supposed that the insane party may
 not be able to discern all the circumstances, that may
 conduce to his advantage, and may not act as if his
 mind  were perfectly sound.   But,  it remains to be
proved, that, in the  commission of a criminal offence,
he has more clearly apprehended its abstract nature,
its relations to the injured party,  and its consequen-
ces to himself, than he would all the circumstances
attending  a contract;  if,  therefore,  he  have  not
1 1 Story's Commentaries on Equity Jurisprudence, § 227. 
PRELIMINARY  VIEW'S.
23
acted rationally, but under the influence of a disor-
dered mind, he ought to be no  more responsible for
the former than for  the latter.
   § 12. A distinction is  also made between civil
and criminal cases,  in regard to evidence respecting
the state of the party's  mind.  In the former, proof
drawn from the nature of the act in question is para-
mount to all others, and,  in the absence  of others,
admitted to be alone conclusive ; while, in  the lat-
ter, to seek to prove the  existence of insanity, from
the character  of the act, w^ould be viewed as no-
thing less than a begging of the question.  "If a luna-
tic person," says Swinburne,1  "or one that is beside
himself at sometimes but not  continually, make his
testament, and it is not  known whether the same
were made while he was of sound mind and memory
or no, then in case  the  testament be so conceived,
as thereby no argument of phrensy  or folly  can be
gathered, it is  to be presumed that the  same was
made during the time  of his calm  and clear inter-
missions,  and so the testament shall  be  adjudged
good, yea, although it cannot be proved that the tes-
tator useth to have  any clear and quiet intermissions
at all, yet nevertheless I  suppose that if  the testa-
ment be wisely and  orderly framed, the same ought
to be accepted for a lawful testament."   Sir John
Nicholl  has observed, that where there is no direct
evidence of the time, or,  consequently,  of the de-
ceased's state of mind at the  time, of the act done,
recourse  must  be had  to the  usual mode of ascer.
taining  it in such cases—which is by looking at the
1 Of Testaments and Last Wills, Part II, Sec. 3. 
24     MEDICAL JURISPRUDENCE  OF INSANITY.

act  itself.   "The agent is to be inferred  rational, or
the  contrary,  in such  cases,  from  the  character
broadly taken of his  act." l   So, on the  other hand,
"in  the case of a person who is sometimes sane and
sometimes insane, if  there be in it a mixture of wis-
dom and folly, it is to  be presumed that  the  same
was  made during  the  testator's  phrensy,  even  if
there be but one word sounding to folly." 8  If, then,
testamentary dispositions that  conflict with  the  na-
tural distribution of property and the known  and ex-
pressed intentions of  the testator, yea, if  they  con-
tain  but one  word "sounding  to folly,"  are  to  be
held  as  sufficient evidence of  unsound  mind,  in
doubtful  cases, why, when an  atrocious crime is
shown to be  motiveless, unnatural, in opposition to
the habits, feelings, and principles of the whole past
life,  and unfollowed  by any consciousness of  guilt,
should not this act be considered as equally strong
proof of unsoundness of mind ?   Why is it,  that in-
stead of being thus considered, it actually  avails the
accused nothing; the  character  of the act, in  the last
resort, being too often explained,  on the supposition
of an inherent ferocity and thirst for blood, which no
considerations can restrain; even in the face of totally
different dispositions,  indicated by  the whole  tenor of
his life.
  §  13.  Notwithstanding  that  Lord Hale's   doc-
trine was cited with  approbation  by  de  Peyronnet,
(§ 11),  yet,  by the  French penal code,  madness,
  1 1 Addams's Ecclesiastical Reports, 74, Scruby and Finch v. Ford-
ham and others.  See also I Phillimore's Reports, 90; 1 Dow's Reports,
178, for a recognition of the same principle.
  2 Swinburne, Part II, § 3, pi. 16. 
PRELIMINARY VIEWS.
25
without limit or condition, exempts from the punish-
ment of criminal acts.   The language of the law is,
that "there is no crime nor offence when the accus-
ed was in a state of madness at the  time of the ac-
tion."1  The existence of insanity once established,
the accused is, by the  spirit of the  law, acquitted.
This  intention  has sometimes  been  near being de-
feated, in consequence of the great liberty allowed to
French juries,  in the construction of the phraseology
of their  verdict, in which they may  declare, if they
choose, not whether the  accused was guilty or not
guilty, sane or insane, but  whether  or not the act
was committed voluntarily.2  A verdict of this kind,
in an instance  mentioned  by Georget,  led to a curi-
ous result, in the hands of men who were not indoc-
trinated in the subtleties of metaphysics.  The fact of
insanity having been given to the jury  for  decision,
they returned that the accused acted  voluntarily and
with premeditation ; and, secondly, that he  was in-
sane at the time of committing the act.3  This ver-
dict, so consistent in  reality, but so  utterly contra-
dictory in a legal sense, was received  by  the court
and understood to mean, that the  accused possessed
the will of a  madman, a merely animal will which
excludes legal culpability.   Had  not the  last ques-
tion  been  raised, the accused,  though mad, would
have been condemned to death.4  It  seems evident,
  1 II n'y a ni crime ni debt lorsque le prevenu etait en etat de de-
mence au temps de Taction.  Art. 64.
  2 Special verdicts in criminal cases are quite common in France.
  3 Des maladies mentales, 100.
  4 It is one of those metaphysical subtleties, so prevalent on the sub-
ject of insanity, that the acts of an insane mind are involuntary.  It 
26     MEDICAL  JURISPRUDENCE OF INSANITY.
that the legislator, in framing that law7, was impress-
ed  with the difficulty  of drawing the  line between
general  and partial  insanity,  and of estimating the
quantity of  reason  left  after the invasion of this dis-
ease, and therefore determined to avoid it altogether
by  recognising but one kind  of insanity.    Though not
prepared  to acquiesce entirely  in the dispositions of
this enactment,  yet  it  is infinitely  preferable, with
all  its faults, to the  English practice of requiring  a
number of  men, w7ho may  have had very  little edu-
certainly can be of little practical consequence, what epithet is applied
to the acts of a mind admitted to  be insane ; though it seems to be an
abuse of language, to call any act involuntary, which proceeds from a
person's own free will.  The exercise of the will may be greatly influ-
enced by the condition of the mind, even to such an extent as to de-
prive a  person of all criminal responsibility.  But this does not neces-
sarily prove insanity, unless, for instance, every man, who commits a
criminal act under the influence of strong passions, is considered as in-
sane.  The objection to this distinction is, that it is used as a test in the
decision of doubtful cases, every one being left to decide, as he pleases,
what acts are voluntary, and what involuntary.  A curious application
of the distinction is made by Mr. Shelford in his work on Lunatics
(Introduction,  p.  xlix.) when  speaking of suicide.   "The art with
which the means are often prepared, and the time occupied in  plan-
ning them, seem to mark it [suicide] as an act  of deliberate volition ;
but the acts of an  insane mind are involuntary, and not voluntary;
therefore, the question must always revert to, what was the real condi-
tion of the mind  when suicide was committed."  If the preparation for
the suicidal act be  so indicative of that volition which is exercised by
sound minds only, it is not very clear by what process of logic, from these
two propositions would be drawn  the  conclusion, that the " question
must always revert to what  was the real condition of the mind when
suicide was committed."  This calls to mind a character, commemora-
ted in a work  which appeared a few years since, called the " Clubs of
London," who was remarkably addicted in his discourse to that species
of reasoning, denominated  by  logicians the non sequitur.   "The wea-
ther is uncommonly fine, this  morning," he would  say, " therefore,  I
shall go home and not stir out of my house the whole day." 
PRELIMINARY  VIEWS.
27
cation of any kind, and  least of  all, any very accu-
rate notions of the influence of insanity on the oper-
tions of the mind,  to sit  in judgment on the measure
of a man's understanding, and decide whether or not
he had enough of  reason left to discern the nature of
the  act he  committed.   Mental unsoundness is not
necessarily incompatible with crime,, for we can con-
ceive of cases, where the criminal act is beyond the
sphere of the influence of the reigning delusion, and
therefore,  as far as that is  concerned, the offspring
of a  sound  mind, yet we must acknowledge the ex-
treme difficulty of establishing this fact, and the cau-
tion with which we should proceed to a decision.
   § 14. On the trial of Hadfield, for shooting at the
king in Drury Lane theatre, in 1800, there occurred
for the first  time,  in an  English  criminal court, any
thing like  a thorough  and enlightened  discussion  of
insanity as connected with crime; and the result was,
that a fatal blow was given to the doctrines of Lord
Hale by Mr. Erskine, who brought all the energies
of his great  mind  to bear upon the elucidation of this
subject.1   In  accordance with  these  doctrines,  the
  1 One reason,  why the criminal law of insanity has undergone so
little improvement in England, is, probably, that the accused, not being
allowed counsel to speak in their defence,  except in trials for high
treason, the officers of government have always been at liberty to put
their own construction on the law, and urge it on the jury as the only
correct one, without fear of being contradicted or gainsay ed.  Thus, the
old maxims have been repeated, year after year, and not being ques-
tioned, their correctness  has remained undoubted, both in and out of
the legal profession.  Can any one doubt, that had those insane crimi-
nals, who have been condemned within the last half century, been de-
fended by an Erskine, many of them would have been acquitted, and a
great advance made in the law of insanity, that would have prevented 
28    MEDICAL JURISPRUDENCE OF  INSANITY.

attorney-general had told the jury, that to protect a
person from criminal responsibility,  there  must be a
total deprivation of memory and understanding.  To
this Mr. Erskine very justly replied,  that if these
expressions were  meant to  be taken in the literal
sense of the words—which however he did not deny
—"then no such madness ever existed in the world."
This condition of mind is observed only in idiocy and
fatuity,  and  its unhappy subjects  are never  made
accountable to the laws.  In proper madness, on the
contrary, so  far was there from being a total depri-
vation of memory  and  understanding,  that  "in all
the cases that have filled Westminster Hall," said he,
"with the most complicated considerations, the luna-
tics and other  insane persons, who have been the
subjects of them, have not only had memory in my
sense  of the expression—they have  not  only had  the
most  perfect knowledge and recollection  of all the
relations they stood in  towards others, and of the
acts  and circumstances of their lives,  but have, in
general, been remarkable for subtlety and acuteness.
Defects in their reasonings have seldom been trace-
able—the disease consisting in the delusive sources
of thought:—all their deductions, within  the  scope
of their malady, being founded on the immovable as-
sumptions of matters as realities, either without any
foundation whatever, or  so  distorted and  disfigured
by fancy, as  to  be nearly the  same thing as their
creation."   Instead  therefore of making that kind of
some of those exhibitions of presumptuous ignorance, which will one
day be universally regarded with feelings of disgust and pity ? 
PRELIMINARY VIEWS.
29
insanity which  would exempt from punishment to
consist in the absence of any of the intellectual facul-
ties, he lays down delusion as  its true character, of
which the criminal act in question must be its imme-
diate  unqualified offspring.1   Here was a great step
made in this branch of medical jurisprudence,  and it
might have been expected,  that the  victory, thus
gained over professional prejudices and time-honored
errors, would  be  felt in  all  subsequent  decisions.
But, though the day has gone  by, when such insanity
only, as is  attended by total deprivation of  memory
and understanding, can be admitted  in  excuse  for
crime,  the  test  offered  by  Erskine was  altogether
too simple  and too philosophical,  to be readily adopt-
ed by minds that delighted in subtleties and techni-
calities.
   § 15. In the  case  of Bellingham,  for  instance,2
tried for the murder of the Hon.  Spencer Percival in
1812, it appeared  from  the history of the accused,
from his own account of the transactions,  that led to
  1 It is surprising and perfectly unaccountable, that Mr. Erskine, in
adverting to the case of Arnold (§ 10), should have declared, "that his
counsel could not show, that any morbid delusion had overshadowed
his understanding."!  If it were no delusion in Arnold to believe that
Lord Onslow was the cause  of all  the turmoils and troubles in the
country—that he bewitched him in particular by getting into his belly
and bosom, and sending his devils and  imps into his room to prevent
his rest, it surely was none for Hadfield to imagine that he had con-
stant intercourse with God—that the world was about to come to an
end—and that he was to sacrifice himself for its salvation, by taking
away the life of another.   Either the able advocate, in his zeal  for his
client,  must have egregiously deceived himself respecting the facts of
Arnold's case, or have attached some ideas to delusion, which have
never entered into the ordinary conceptions of that kind of belief.
  s 1 Collinson on Lunacy, 650. 
 30     MEDICAL  JURISPRUDENCE OF  INSANITY.

 the fatal act, and from the testimony of several wit-
 nesses, that he labored under many  of those strange
 delusions, that find  a place only  in the brain  of a
 madman.  His  fixed  belief,  that his own  private
 grievances were national  wrongs;   that his coun-
 try's diplomatic agents in a foreign land neglected
 to hear his complaints and assist him in his troubles,
 though they had in reality done more than could have
 reasonably been expected of them  ; his conviction,
 in  which he was firm  almost to  the last,  that his
 losses  would be made good by the government, even
 after he had been repeatedly told,  in consequence of
 repeated applications  in various quarters, that the
 government would not interfere in  his affairs ;  and
 his determination, on the failure of  all other means
 to bring his affairs before the country, to effect this
 purpose by assasinating the head of the government,
 by which he would have an opportunity of making a
 public  statement of his grievances  and  obtaining a
 triumph, which he never  doubted,  over  the  attor-
 ney-general ; these were all delusions, as wild  and
 strange, as those of seven eighths of the inmates of
 any lunatic asylum in the land.   And  so obvious were
 they, that though he had not  the aid of an Erskine
 to,press them  upon  the attention of the jury,  and
 though he himself denied the imputation of insanity,
 the government, as if virtually acknowledging their
existence, contended for his  responsibility on  very
different  grounds.  As the various tests of this con-
dition,  commonly urged  on such occasions, were
dwelt upon with unusual earnestness and force,  and
with strong expressions of confidence in their value,
it may  be well to examine them critically, in order 
PRELIMINARY VIEWS.
31
to ascertain how7  much weight they are really enti-
tled to, in settling the question of criminal responsi-
bility.
   § 16.  In  the  trial  of  Arnold,  already  noticed,
(§ 10) the jury were directed to  settle it  in their
own minds, whether the accused  was capable of dis-
tinguishing right from wrong, good from  evil, and if
they concluded that he was,  that they  must return
a  verdict of guilty.   In Bellingham's case, the at-
torney-general  declared,  "upon  the  authority  of
the first  sages in the country, and upon the authority
of the established law  in  all  times,  which  law has
never been  questioned, that although a man may  be
incapable of conducting his own affairs,  he  may still
be answerable for his criminal acts,  if he possess a
mind capable of distinguishing right  from wrong."  2
Lord Chief Justice  Mansfield, who tried the case,
echoed the same doctrine  in his charge to the jury.
In speaking of a  species  of insanity,  in which  the
patient fancies the existence of injury, and  seeks an
opportunity of gratifying  revenge by  some  hostile
act, he says,  "if such a person were capable, in
other respects, of distinguishing  right  from wrong,
there was no excuse for any  act  of atrocity, which
he might commit under this  description  of derange-
ment." 2  Mr. Russell, in  his work on  criminal law,
includes  inability to  distinguish  right from wrong
  1 1 Collinson on Lunacy, 657.
  2 This opinion was delived scarcely a dozen years after the absur-
dity of its principles had been so happily exposed in a few words, by
Mr. Erskine, on the trial of Hadfield.  What a comment on the pro-
gress of improvement in the medical jurisprudence of insanity ! 
32     MEDICAL JURISPRUDENCE OF INSANITY

among  the characters  of that  grade  of  insanity,
which exempts from the punishment of crime.1
   §  17. That the insane  mind is not entirely  de-
prived of this power of moral discernment,  but on
many subjects is perfectly rational, and  displays the
exercise of a sound and well balanced  mind, is one
of those facts now so well established, that to ques-
it  would only  betray  the height of  ignorance  and
presumption.   The first  result,  therefore,  to which
the doctrine leads, is, that no man can ever success-
fully plead insanity in  defence  of crime, because it
can be said  of  no one, who would have occasion for
such a defence, that he was unable  in any  case to
distinguish right  from  wrong.   To  show the  full
merits of the question, however,  it is necessary to
examine more particularly, how far this  moral senti-
ment is  affected by, and  what relation it  bears to
insanity.  By that partial  possession  of the reason-
ing powers,  which  has  been  spoken  of  as  being
enjoyed by maniacs  generally,  is  meant to  be im-
plied the undiminished power  of  the  mind, to con-
template some objects  or  ideas in their customary
relations, among which are those  pertaining to their
right or wrong, their good or evil, tendency ;   and it
must comprise the whole of these relations, else the
individual is  not sane on these  points.  A  person
may regard his child with the feelings natural to the
paternal bosom,  at  the  very moment  he  believes
himself commanded by a voice from heaven to sacri-
fice this child, in order to  secure  its  eternal  happi-
1 Russell, on Crimes and Misdemeanors, 12. 
PRELIMINARY VIEWS.              33
ness, than which, of course, he could not accomplish
a  greater good.   The conviction of a  maniac's
soundness, on certain subjects,  is based in  part on
the moral aspect, in which he views those  subjects ;
for, it w7ould be folly to consider  a person rational,
in reference to his parents and children, while he
labors under an  idea, that it would  be doing God's
service to kill  them ; though he may talk  rationally
of their characters,  dispositions  and habits  of life,
their chances of success in their  occupations, their
past circumstances, and of the feelings of affection,
which he  has always cherished towards them.  Be-
fore, therefore, an individual can be accounted sane
on a particular subject, it  must appear that he re-
gards it correctly, in  all  its  relations  to  right and
wrong.   The  slightest acquaintance w7ith  the insane
will convince any one  of the  truth of this position.
In no school of logic,  in no  assembly of the just,
can we listen to  closer and shrewder argumentation,
to warmer exhortations to  duty,  to more glowing
descriptions of the beauty of virtue, or more indig-
nant denunciations of evil-doing, than in the hospi-
tals and asylums for the insane.   And yet many  of
these very people may make no secret of entertain-
ing notions utterly subversive of all moral propriety ;
and, perhaps,  are only waiting a favorable opportu-
nity, to execute  some project  of wild and cruel vio-
lence.   The purest minds  cannot express  greater
horror and loathing of various crimes, than madmen
often do, and from precisely the same causes. Their
abstract conceptions of crime, not being perverted
by the influence  of disease,  present  its hideous out-
lines as strongly defined,  as they ever were in the
             c 
34     MEDICAL JURISPRUDENCE OF INSANITY.

healthiest condition ;  and the  disapprobation  they
express at the sight arises from  sincere  and honest
convictions.  The particular criminal  act, however,
becomes divorced in their minds from its relations to
crime in the abstract; and, being  regarded only in
connexion with some favorite  object, wdiich it  may
help to obtain,  and which they see no reason to re-
frain from pursuing, is viewed, in fact, as of a highly
laudable and meritorious nature. Herein, then, con-
sists their insanity, not in preferring vice to virtue,
in applauding  crime and  ridiculing justice,  but  in
being  unable  to  discern  the  essential  identity of
nature, between a  particular crime  and all  other
crimes, whereby they are led to approve, what, in
general terms,  they have  already condemned.   It is
a fact, not calculated to  increase  our faith in  the
march of intellect,  that  the very trait peculiarly
characteristic of insanity  has  been  seized  upon  as
conclusive proof of sanity, in  doubtful cases ;  and,
thus, the infirmity that entitles one  to  protection is
tortured into a  good and sufficient  reason for  com-
pleting his ruin.
   § 18. If this  power  of distinguishing  right from
wrong do  really indicate soundness  of mind, it may
be justly complained, that  the question of its exist-
ence is never agitated in any but criminal cases,
while it certainly should be whenever the rights and
liberties of the  insane  are to be  invaded.   If it  is
proper to make those who possess this power respon-
sible for their criminal acts, how unjust and absurd
is  it to deprive them of their liberty, and  seclude
them from their  customary scenes  and enjoyments,
before they have violated a single human  law.   Un- 
PRELIMINARY  VIEWS.
35
doubtedly, this measure will be conducive  to their
good, by taking from them effectually the opportu-
nity of injuring the persons  or property of them-
selves or others ; and so it would be for every other
unprincipled and reckless individual, who bids fair to
be a pest to society.  But  if it  is alleged,  that  the
latter are  morally free,  and,  therefore, are  person-
ally free, till the commission  of some external act,
it may be replied, that the former, on the hypothesis
of the law, which  makes  moral freedom consist in
the power  of distinguishing right from wrong, have
the same claim to immunity from personal constraint.
This  preposterous   distinction,  between  civil  and
criminal cases, gives rise in practice, to  one of  the
most curious  and startling  inconsistencies, that
human legislation ever presented. While the mental
impairment is  yet  slight,  comparatively,  and  the
patient is quiet and peaceable, the law considers him
incapable  of managing himself or his worldly affairs,
and provides him with a guardian and a place in  the
wards of a hospital ;  but, when the disorder  has
proceeded  to such a height as to deprive  the maniac
of all moral restraint, and  precipitate him on  some
deed of violence,  he is to be  considered as  most
capable of perceiving moral distinctions, and, conse-
quently, most responsible for his actions !
  § 19. The qualifications, with which some of  the
latest writers have  promulgated this test of responsi-
bility, encourage the hope, that it  will ere  long be
viewed in  a very different  aspect.   A disposition to
disregard the old landmarks on  this point was mani-
fested, not  long  since,  by Lord Lyndhurst, in  the
case  of the King v. Orford, when  he directed  the 
36      MEDICAL JURISPRUDENCE OF  INSANITY.

jury to acquit the prisoner, if satisfied,  "that he did
not know, when he committed the act, what the ef-
fect of it, if fatal,  would  be,  with  reference  to  the
crime of  murder;"1  in other words, they  were to
satisfy themselves,  before acquitting him, that he did
not know, that the act  would be essentially murder,
that crime, which in the abstract is equally abhorred
by the sane  and the  insane.   Still, however, this is
not sufficient, for he  might, like many  others, have
loathed the act and been perfectly conscious of its
consequences to himself, while he felt impelled to its
execution by  a voice  from heaven, or by a strong
conviction of certain great ends which it was to pro-
mote, and thus have acted the part, if the expression
may be allowed, of an insane  Abraham or  Brutus.
This principle, therefore,  is  far  from  being univer-
sally applicable, though if it had been admitted in the
case of Bellingham, it would have produced the ac-
quittal of that unfortunate man.   The criminal act
w7hich he committed was not  viewed by him at all as
one of murder, any more  than  the killing of a brute
for the same purpose, but merely as a  disagreeable
though justifiable method  of bringing his  affairs be-
  1 5 Carrington and Payne, 168.  The defendant, in this case, was
tried for murder.  It appeared, that he entertained the notion, that the
person whom he shot and many others were desirous of depriving him
of his liberty, and had accordingly  conspired together, to accomplish
their purpose, and, under the influence of this delusion, he would
abuse people whom he met in the streets, though wholly unacquainted
with them.  In his pocket was fouud a paper purporting to be " a List
of Hadleigh Conspirators against my Life," in which he had enrolled
the names of the deceased and his family.  Several medical witnesses,
who heard the evidence, deposed that the  prisoner  was affected with
monomania. 
PRELIMINARY  VIEWS.
37
 fore the country, and obtaining redress for his mani-
 fold wrongs and sufferings.   And yet Lord Lynd-
 hurst, in this very case, expressed his approbation of
 the doctrines laid down by Lord Chief Justice Mans-
 field on the trial of Bellingham,—doctrines which he
 had found it necessary here to modify, in order that
 they might afford to an innocent man  the protection
 to which he was entitled!  Mr. Chitty seems inclin-
 ed to proceed a step farther  on  this point.  "The
 substantial question presented  to  the  jury," he ob-
 serves, "is, whether, at the time  the alleged crimi-
 nal act was committed,  the prisoner  was incapable
 of judging between  right  and wrong,  and did not
 then know he was committing  an  offence against the
 law of God and  of nature."1   By  some late Scotch
 writers on criminal  law, this  test of responsibility
 has been disapproved of, in still more explicit terms.
 Baron Hume disposes of it in the following language :
 "Would he have answered on the question, that it is
 wrong to kill a fellow creature ? this is hardly  to be
 considered a just criterion of such  a state of mind, as
 ought to make  him  answer to the law for his acts.
 Because a person may happen to answer in this  way,
 who is yet so absolutely  insane as to  have lost all
 power of observation of facts,  all discernment of the
 good or bad intentions of those who are about  him,
 or even the  knowledge  of their persons.   Besides,
 the question is put in another and  a more special
sense, as relative to the act done by  the panel, and
his knowledge of the place in  which he did it.   Did
1 Medical Jurisprudence, 354. 
38     MEDICAL  JURISPRUDENCE  OF INSANITY.

he  at  that moment understand the evil of what he
did ?   Was he  impressed with the consciousness of
guilt and fear of punishment ?—it is then a pertinent
and a material  question, but one which cannot be
rightly answered, without taking  into consideration
the whole circumstances of the  situation.   Every
judgment  in the matter of right  and wrong supposes
a case, or  state of facts  to  which it  applies.  And
though the person may have that vestige  of reason,
which may enable him to answer in the general, that
murder is  a  crime, yet if  he  cannot distinguish a
friend from an enemy, or  a  benefit from  an injury,
but conceives every thing about him  to be  the  re-
verse of what it really is, and mistakes the ideas of
his  fancy in that respect, for realities, those remains
of intellect are  of  no sort  of service to him in the
government of his actions, in enabling him to form a
judgment as to  what is right or  wrong  on any par-
ticular occasion." 1   From all this, Hume draws the
broad conclusion, that the  judgment of right  and
wrong has nothing  to do with the  question of re-
sponsibility.  This  view of the subject is certainly
liberal enough,  and  increases  our  regret,  that  it
should be contrasted in a subsequent stage of his re-
marks, by one of those vague and senseless notions,
that seem  to have obtained a prescriptive place  in
the books  on criminal law.   "It is not  to be un-
derstood," he continues,  "that there is any privilege
of mere  weakness  of intellect, or of a strange and
  1 Commentaries on the Law of Scotland respecting Crimes, Vol. I,
p. 36. 
PRELIMINARY  VIEWS.
39
moody humor, or of a crazy and capricious, or irreg-
ular temper and habit.  None of these things either
are, or ought to be law."   When all these traits are
observed in an undividual,  or any one of them in a
remarkable degree, there is great reason to suspect
the existence of insanity, and  the most faithful means
should be resorted to, in order to determine this fact.
In the great majority of cases, the suspicion  will
prove to be well founded, and the judgment of right
and  wrong on  "particular occasions" to be com-
pletely  perverted.   These traits of character must
not be considered, as they  too  generally are, in and
by themselves exclusively, and unconnected with the
previous moral and intellectual habits of the individ-
ual, but as symptoms of a deviation from the normal
condition—of pathological  changes  in the action of
the cerebral organism.  When viewed in this light,
they will be examined with the patience and intelli-
gence, necessary to establish, beyond doubt, the ex-
istence of that insanity, of which they are the almost
certain signs, instead of being hastily dismissed, as
only the words of an ill-governed, malicious, temper.
  § 20. Mr. Alison  lays  down the principle,  that
"to amount to a complete bar to punishment, the
insanity, either at the time of committing the crime,
or of the trial, must have been of such a kind as en-
tirely deprived the accused of the use of reason, as
applied to the act in question, and the knowledge  that
he was doing wrong  in committing it." l   This is all
very clear and rational, but a subsequent remark
1 Criminal Law of Scotland, p. 645. 
 40     MEDICAL JURISPRUDENCE OF  INSANITY.

 shows, that in his struggle  with  the  errors  of the
 law, he had not completely  emancipated  his  mind
 from their binding  influence.   "Any thing," he ob-
 serves, "short of this complete alienation of reason,
 will be no defence  ; and  mere oddity of  manner, or
 half-craziness  of disposition,  if unaccompanied  by
 such an obscuring of the conscience,  will not avail
 the prisoner."   The idea that "any thing short of
 complete alienation of reason  will  be no defence,"
 is not only  at  variance with  his previous qualifica-
 tion, that this  loss of reason  must be in reference
 "to the act in question,"  but is identically the doc-
 trine of the last century, the fallacy of which was
 clearly exposed by  Erskine  in  Hadfield's  case.
 What is precisely meant by such vague phraseology,
 as "half-craziness of disposition," it would be hardly
 worth while to inquire;  it is enough  to say,  that,
 taking the language in  its most natural and obvious
 signification, the mental condition expressed by it is
 one  utterly unknown  in  metaphysics or  medicine.
 Mr.  Alison very justly disapproves  of the  law, as
 laid down by Chief Justice Mansfield, in Bellingham's
 case, viz. ;  that  the prisoner  was  accountable, be-
 cause he could  distinguish good from  evil, and  knew
 that  murder was a crime ; but his remark respecting
 it  betrays an ignorance of insanity,  that would be
 surprising were it not so common in discussions upon
 this subject.  "On  this  case,"  says he,  "it may be
 observed,  that  unquestionably  the  mere fancying a
 series of injuries to have been received will not
 serve as an excuse for murder,  for this plain  reason,
 that, supposing it true, that such injuries had been
received, they would have furnished  no excuse for 
PRELIMINARY VIEWS.
41
the shedding of blood ; but, on the other hand, such
an illusion, as deprives the  panel  of the  sense that
what he did was wrong,  amounts  to  legal insanity,
though he was perfectly  aware that  murder in gen-
eral was a crime; and, therefore, the law appears to
have been more correctly laid  down, in the cases of
Hadfield and Bowler, than in this instance."   If this
be the law  by which maniacs are to be tried, few
will escape punishment for  criminal acts; for, in by
far the greater proportion, such acts  have been com-
mitted in consequence of a fancying of injuries re-
ceived.   One man  kills  his neighbor, whom he fan-
cies to have joined a conspiracy to defraud him of his
property or his liberty;  or  for having  insulted and
exposed him  to scorn and derision ;  or for standing
in the way of his attaining certain honors or estates;
yet the insanity  is not to excuse  him,  unless it de-
prived him of the consciousness, that he was doing a
wrong act.    The existence of the  illusion is obvious
and cannot be mistaken ; but what may  be the views
of the maniac, respecting the moral character  of the
criminal acts which he commits  under its influence,
can  never  be exactly known;  and,  therefore, they
ought not to be made the criterion of responsibility.
But it is known, that  one of the most  striking and
characteristic effects of insanity in  the mental opera-
tions is, to  destroy  the  relations  between end and
means—between  the object in  view and the course
necessary to  pursue in order to obtain it.   It was in
accordance with these views, that Lord  Erskine pro-
nounced delusion to  be the true test of such insanity
as exempts from punishment,  and  that  the correct-
ness of the principle was  recognised by the Court. 
 42     MEDICAL JURISPRUDENCE  OF INSANITY.

 It is impossible, therefore, to divine why Mr. Alison
 should say,  that  the  law  was more correctly  laid
 down  in Hadfield's case, when it is in direct conflict
 with  his own opinions.   Thus,  as if frightened by
 their own temerity in overthrowing one ancient land-
 mark  on  the domain  of error, it would seem  as if
 these writers were anxious  to compound with  their
 fears, by adhering with unusual pertinacity to all the
 rest.   The radical fault of this test of responsibility
 lies  in the metaphysical error of always looking on
 right and wrong in the abstract,—as things having a
 positive and  independent existence, and not as they
 really are, mere terms expressing the relations, that
 exist  between actions and certain faculties of our
 moral nature.  That they express the same relations
 in nearly all  men, is because  nearly all  men possess
 the same faculties; but  when these faculties are ab-
 sent, as in idiots,  or when  their  action  is perverted
 by disease, as in  the  insane, the relations  of right
 and wrong are widely  different.
  § 21. Another trait, which has been greatly relied
 on as a criterion in doubtful cases,  is  the design, or
 contrivance,  that  has  been manifested  in the com-
 mission of the criminal  act.   That  it should ever
 have  been viewed in this  light,  is  an additional
 proof, if more were wanting, of the deplorable igno-
 rance, that characterizes the jurisprudence of insan-
 ity ; for the slightest practical acquaintance with  the
 disease would have prevented this  pernicious mis-
 take.   The source of this error is probably to be
found in the fact,  " that,  among the vulgar, some are
for reckoning madmen, those only who  are  frantic, 
PRELIMINARY  VIEWS.
43
or  violent to  some  degree ; "1 the  violence  being
supposed to preclude every attempt at  design,  or
plan of operations.  In the trial of Bellingham,  the
attorney-general declared, that,  "if even insanity
in all his other acts  had been  manifest, yet the sys-
tematic correctness, with which the prisoner contrived
the murder, showed that he possessed a mind, at the
time, capable of distinguishing  right from wrong."2
In Arnold's case (§  10). great'stress was  laid on the
circumstances of  his  having  purchased  shot of  a
much larger size,  than he  usually did when he went
out to shoot, with the  design  then formed of com-
mitting the murder  he afterwards attempted.  Mr.
Russell3 recognises  the correctness of the principle,
and lays it down as  part of the law of the land.   If,
however, the power of design is really not incompa-
tible with the existence of insanity,  this pretended
test must be as  fallacious  as that  already adverted
to.   What must be thought of the  attainments  of
those learned authorities,  in the study of madness,
who see in the power of systematic design a disproof
of the existence  of insanity, when, from the humblest
menial in the service of a lunatic asylum,  they might
have  heard of  the  ingenuity  of  contrivance and
adroitness  of  execution, that preeminently charac-
terize the plans  of the insane  ?   If  the  mind con-
tinues rational on some subjects, it is no  more than
might be expected, that this rationality should em-
» Sir John Nicholl, in Dew v. Clark, 3 Addams's Reports, 441.
2 Collinson on Lunacy, 657.
s 1 Russell, on Crimes and Misdemeanors, 13. 
 44     MEDICAL JURISPRUDENCE OF  INSANITY.

 brace the power of design, since a person could not
 properly be called rational on any point,  in  regard
 to which he had lost  his  customary ability  to  form
 his plans and designs  for  the future.   These views
 are abundantly confirmed  by every  day's  observa-
 tion.   The  sentiment of  cunning,  too,  which is
 necessary to  the  successful execution of one's pro-
 jects,  holds  but  a low place in the scale  of  the
 mental faculties—being a  merely  animal instinct—
 and is oftentimes observed to be rendered more  ac-
 tive by insanity, so as to require the utmost vigilance
 to detect  and  defeat its  wiles.  One,  who is  not
 practically acquainted with the habits of the insane,
 can  scarcely  conceive of the cunning  which  they
 will practise, when bent on accomplishing a favorite
 object.   Indeed, it may be said, without greatly dis-
 torting the truth, that the combined  cunning of two
 maniacs, bent on accomplishing  a  certain  object, is
 always a match for the sagacity of any  sound indi-
 vidual.   Those, for instance, whose  madness takes
 a suicidal direction, are known to  employ wonderful
 address,  in procuring  and  concealing  the  means of
 self-destruction ; pretending to have seen the folly
 of their  designs, and  to have renounced them en-
 tirely,  sending away  their  keepers  after thus,  lul-
 ling  them  into security, and, when least  expected
renewing their  suicidal  attempts.   When desirous
of leaving their  confinement also, the consummate
 tact, with  which  they will set  suspicion at rest,
 the forecast with  which they make their  prepara-
 tions for escape,  and the sagacity  with which they
choose the time and place of action,  would  do infi-
nite credit to the conceptions of the most sound and 
               PRELIMINARY  VIEWS.             45

intelligent minds.  Mr. Haslam  has  related a  case
so strikingly illustrative of this trait, that it is well
worth extracting in this connexion.  An Essex farmer,
after having  so well counterfeited  recovery  as to
produce his liberation, and being  sent  back again,
immediately became tranquil, and remonstrated on
the injustice of  his  confinement.   "Having  once
deceived me,  he wished  much,  that  my opinion
should be taken respecting the state of his intellects,
and assured his friends that  he would  submit  to my
determination.  I had taken care to be well prepared
for this interview, by obtaining an accurate account of
the manner, in which he had  conducted himself.  At
this examination, he managed himself with admira-
ble address.   He spoke  of  the treatment he  had
received, from  the persons under whose care he was
then placed,  as most kind and fatherly :  he also ex-
pressed himself as particularly fortunate  in  being
under my care, and bestowed many handsome com-
pliments on my skill  in treating this  disorder, and
expatiated on my sagacity in perceiving the slightest
tinges of insanity.  When I  wdshed  him to explain
certain parts of his conduct,  and  particularly some
extravagant opinions, respecting certain persons and
circumstances,  he disclaimed all knowledge of such
circumstances,  and felt himself hurt that  my mind
should have been poisoned so much  to his prejudice.
He displayed equal subtlety on three  other occasions,
when I  visited  him ; although,  by  protracting the
conversation, he let fall sufficient to  satisfy my mind
that he w7as a madman.   In a short time he was re-
moved to the  hospital, where  he expressed great
satisfaction in being under my inspection.  The pri- 
46     MEDICAL  JURISPRUDENCE OF  INSANITY.

vate madhouse, which he had formerly so much com-
mended, now became the subject of severe animad-
version ; he said  that he had there been treated with
extreme cruelty  ; that he had been nearly starved,
and eaten up by  vermin of various descriptions.   On
inquiring of some convalescent patients, I found (as
I had suspected) that I was as much the  subject of
abuse, when absent, as any of his supposed enemies,
although to my face, he was  courteous and respect-
ful.  More than  a month had elapsed  since his ad-
mission into the hospital, before  he pressed me for
my opinion ;  probably confiding  in  his  address and
hoping to deceive me.  At length he appealed to my
decision, and urged the correctness of his conduct
during confinement, as  an argument for his libera-
tion.  But, when I informed him  of circumstances
he supposed me unacquainted with, and assured him,
that he was a proper subject  for  the asylum  which
he then inhabited, he suddenly poured forth a torrent
of abuse ; talked in  the most incoherent manner;
insisted on the truth  of what he formerly denied ;
breathed vengeance against  his family and friends ;
and became so outrageous that it was  necessary to
order him to be strictly  confined.  He continued in
a  state of  unceasing  fury  for more  than  fifteen
months." x  But the  purely intellectual  power  of
combining a series of acts, that shall accomplish  or
eventuate in certain results,  when properly carried
into execution, seems to be not only less frequently
involved in  the  mental  derangement,  but often  to
1 Observations on Madness, 53. 
PRELIMINARY  VIEWS.
47
have received a preternatural degree of .strength and
activity.   Pinel speaks of a maniac, who endeavored
to discover the perpetual motion, and, in the course
of his attempts, constructed some very curious ma-
chines.   The plans,  which the brain of a  maniac,
who  imagines himself a  monarch,  is  perpetually
hatching for  the management  of his kingdom, will
bear  to be compared with the  political  schemes of
some rulers,  who are supposed to have the advantage
of sanity on  their side.
   § 22. If then, the knowledge  of good and evil, of
right and w7rong, and the power of design, are  to be
considered as  fallacious tests of responsibility, not-
withstanding they  have proved  the death-warrant of
many a  wretched  maniac,  let us come back to that
proposed by  Erskine—delusion—and see if that will
bear  a more  rigid scrutiny, when viewed by the light
of modern discovery.1  Now, if it  were a fact, that
the reason, or, to  speak more  definitely, the intel-
lectual powers, are exclusively liable  to derange-
ment, this test would be unobjectionable, and would
  1 The use of this test of insanity has been sanctioned by the high
authority of Sir John Nicholl, in the case of Dew v. Clark, 3 Addarns,
79.  "The true criterion," says he, "the true test, of the absence or
presence of insanity, I take to  be the absence or presence of what,
used in a certain sense of it, is comprisable in a single term, namely—
delusion."  " In short I look upon delusion in  this sense of it, and
insanity to be, almost if not altogether, convertible terms."  "On the
contrary, in the absence of any  such delusion, with whatever extrava-
gances a supposed lunatic may be justly chargeable, and  how like
soever to a real madman he may either think or act on some one, or on
all subjects; still, in the absence, I repeat, of any thing in the nature
of delusion, so understood as above, the supposed lunatic is in my judg-
ment, not properly, or essentially insane." 
48      MEDICAL JURISPRUDENCE OF  INSANITY
furnish an easy and satisfactory clew to the elucida-
tion of doubtful cases.1   But it must not be forgotten,
that  the author of our being has also  endowed us
with certain moral  faculties, comprising the various
sentiments,  propensities  and affections, which, like
the  intellect,  being  connected  with  the brain,  are
necessarily affected  by  pathological actions  in that
organism.   The  abnormal  condition  thus produced
may  exert an  astonishing  influence on the conduct,
changing the peaceable and retiring individual into a
demon of fury,  or, at the least,  turning him from, the
calm and quiet of his lawful and innocent occupa-
tions, into a career of shameless dissipation and de-
bauchery, while the intellectual  perceptions seem to
have lost none of their  ordinary soundness and vigor.
The existence  of this form of insanity is now too well
  1 Even Mr. Erskine himself has furnished an exception to his own
rule, in a case he has related of a young woman indicted for murder,
who was acquitted on the ground  of insanity, though it was not pre-
tended, that she labored under any delusion whatever.  " It must be a
consolation," he  says, "to those who prosecuted her, that she was ac-
quitted, as she is at this time in a most undoubted and deplorable state
of insanity; but I confess, if I had been upon the jury who tried her,
I should  have entertained great doubts and difficulties; for, although
this unhappy  woman had before exhibited strong marks of insanity
arising from grief and disappointment; yet she acted upon facts and
circumstances, which had an  existence, and  which  were calculated,
upon the ordinary principles of human action, to produce the most
violent resentment. Mr. Errington having just cast her off, and married
another woman, or taken her under his protection,  her jealousy was
excited to such a pitch, as occasionally to overpower her understand-
ing; but when she went to Mr. Errington's house where she shot him,
she went with the express and  deliberate purpose of shooting him."
"She did not act under a delusion, that he had deserted her when he
had not, but took revenge upon him for an actual desertion." Erskine's
Speeches. 
PRELIMINARY  VIEWS.              49
 established, to be questioned by those who have any
 scientific reputation to lose; and though the proofs of
 this will be furnished in  their  proper place, it will,
 for the present, be supposed that  the  assent of the
 reader has been  obtained  without them.   In this,
 the most deplorable condition,  to which a human be-
 ing can be reduced, where the  wretched patient finds
 himself urged, perhaps, to the  commission of every
 outrage, and though perfectly conscious of what he
 is doing, unable  to offer the slightest resistance to
 the overwhelming  power that  impels  him, the re-
 sponsibility is to be considered not affected, because
 no delusion is  present to disturb and distort the men-
 tal vision !  In short, the very  character, that ren-
 ders  this  mental disorder  more  terrible  than all
 others, is also  that which is made to steel the heart
 against the claims of humanity  in behalf of its miser-
 able victim.
   §  23.  The doctrine of moral insanity has been as
 yet unfavorably received  by judicial authorities, not
 certainly for want of sufficient facts to support it, but
 probably from that common tendency of the mind, to
 resist  innovations upon  old and generally received
 views.  If, a  quarter of a  century ago, one of the
 highest law-officers of Great Britain pronounced the
 manifestation of "systematic correctness" of an ac-
 tion, a proof of sanity sufficient to render all others
 unnecessary, it is  not  surprising, that the idea of
 moral insanity has been considered by the legal pro-
fession, as  having sprung from  the  teeming brains of
medical  theorists.  In the fulness of this spirit, Mr.
Chitty declares, that,  "unless a jury should be satis-
fied that the mental faculties have been perverted, or,
            d                                  _____


                                       ( JfW* 
50     MEDICAL JURISPRUDENCE OF  INSANITY.
at least, the faculties of reason and judgment, it is
believed, that  the party subject to such  a moral in-
sanity, as it is termed,  would not be protected from
criminal punishment";1 and, in the trial of Howison
for the murder of the widow Geddes at King's Cra-
mond, Scotland, two  or three years since, moral in-
sanity, which  was pleaded in his  defence, was de-
clared by the court to  be  a  "groundless theory."
Such opinions, from quarters, where a modest teach-
ableness  would  have been more  becoming than an
arrogant contempt for  the results of other men's in-
quiries, involuntarily suggest to the  mind a compari-
son of their authors  with the saintly persecutors of
Galileo, who resolved,  by solemn  statutes, that na-
ture always had operated and always should operate
in accordance  with their views of propriety and truth.
  § 24.  It appears,  then, that,  in  cases of doubtful
insanity,  delusion is a test  no better  than  those
before mentioned ; and, indeed, there  is no  single
character which is  not equally liable to objection.
Jurists, who have been so anxious to  obtain some
definition of insanity,  which shall embrace  every
possible case,  should understand, that such a wish is
chimerical, from the very nature of things.  Insanity
is a disease, and, as is  the case with all other dis-
eases, the fact of its existence is never established by
a single diagnostic  symptom, but by the whole body
of symptoms, no particular  one of which is present
in every case.   To distinguish the  manifestations of
  1 1 Chitty, Medical Jurisprudence, 352.
  2 Simpson on Homicidal Insanity, in a Treatise on Popular Educa-
tion.  Boston, 1834. 
PRELIMINARY  VIEWS.
51
 health from those of disease requires the exercise of
 learning and judgment; and, if no one doubts this
 proposition, when stated in reference to the bowels,
 the lungs, the heart, the  liver, the kidneys, &c,
 what sufficient  or even plausible  reason is  there,
 why  it should be doubted when predicated  of the
 brain ?   The functions of those organs proceed with
 the regularity and sameness of clock-work, compared
 with  the ever-varying and  unequal phenomena  of
 this; and yet there are persons, who assume a magis-
 terial tone  in  writing  or  talking of the latter, who
 w^ould defer to a tyro's judgment, in whatever con-
 cerns the others.  If, when anxious to know all w7e
 can, respecting a disease of the lungs or stomach, we
 repair to those who have a high  and well-founded
 reputation,  in  the pathology of these  parts, why
 adopt the converse of this  rule in regard to diseases
 of the brain 1   No  reasonable  person would desire
 to set up an insuperable barrier, between the domain
 of professional knowledge, and that  of common sense
 and common information ;  but, it is not too much to
 insist, that facts, established  by men of undoubted
 competence and good faith, should be rejected for bet-
 ter reasons, than the charge of "groundless theory."
  § 25.  In the passage taken from Lord Hale  (§ 8),
 it will be observed, that he considers all crime to  be
 the offspring of partial insanity, and the inference he
 meant should be drawn from  it is, that partial insan-
 ity furnishes no excuse for crime.   It is a curious
fact, that many  benevolent people  in their desire to
palliate  the sins of criminals  have inculcated the
same principle, for the purpose of drawing from it a
very different inference.  The logic, by which such 
 52     MEDICAL JURISPRUDENCE OF INSANITY.

 opposite conclusions are arrived at, is certainly not
 unworthy the days of Duns Scotus or Thomas Aqui-
 nas. Says the former : crime must be punished ; but
 all crime proceeds from madness, therefore madness
 furnishes no exemption from punishment.  Say the
 latter : madmen are not responsible for their criminal
 acts ; but madness is  the  source of all crime,  there-
 fore madmen and criminals are equally irresponsible
 and exempt from  punishment.  Which of these two
 precious specimens of human subtlety can claim the
 triumph  of absurdity, it would not be easy to deter-
 mine.   Crime is not necessarily the  result of mad-
 ness, not even when perpetrated under  the  excite-
 ment of fierce and  violent passions; in the true sense
 of the word, it is never so, but is always actuated by
 motives ; insufficient  it may be,  but  still  rational
 motives, having reference to definite and real ob-
jects.  The misfortune  which  the criminal is going
 to avert, the interest which he is going to subserve,
 the revenge he is  about to gratify, the insult  or in-
jury he is about to  repay, are real injuries and insults
 and interests, however much they may be exaggerated,
 or however disproportionately small they may be to
 the crime they provoke; and, the ends, to be obtain-
 ed by the criminal act, are real and have an appre-
 ciable value.   In the most violent transports of pas-
 sion, he never loses his knowledge of  the  true rela-
 tions of things.  The person whom he considers his
 enemy, or the author of the insult, is really such, or
 at least,  he has some ground for believing him such;
 and, with the absence of the object  of his passion,
 disappears the intention to offend.  Violent passions
 may weaken the judgment, and diminish its power of 
PRELIMINARY  VIEWS.
53
control,  but  they do not vitiate the perceptions, nor
deprive the mind of its powers of comparison.  All
this is very different in mental derangement.   The
causes, which urge  the insane to deeds of violence,
are  generally illusory—the hallucinations of a dis-
eased  brain—or  they may act  from no motive at all,
solely  in obedience to a blind  impulse,  with no end
to obtain, nor wish to gratify.   Madness too is more
or less independent of the exciting causes, that have
given rise to it,  and exists long after those  causes
have been removed, and after the paramount wish  or
object  has been obtained.    In short, madness  is the
result of a certain pathological  condition of the brain,
while  the criminal effects of violent passions merely
indicate  unusual strength  of those passions, or a de-
ficient education of those higher and nobler faculties,
that furnish the necessary restraint upon their power.
It is admitted, that strong passions do deprive the
individual of  the  power of calmly deliberating, and
perceiving the terrible consequences of his fury; and
legislators have wisely distinguished it from deliber-
ate, premeditated mischief, by uniting it with a minor
degree of punishment.  In drunkenness the  same
effect is produced to such a degree as to amount  to
temporary insanity;  but neither does this any  more
than strong  passions exempt from all  punishment;
for the plain  reason, that,  in each case, the impair-
ment of moral liberty is the voluntary act of the in-
dividual  himself.   The fact of mental unsoundness
admitted, it always remains to be determined, whether
it is  of the person's own  immediate  procuring, or  is
the result of circumstances, over which he had no
control.   If the   remarks on this point may seem  to 
54     MEDICAL JURISPRUDENCE OF  INSANITY.

be unnecessarily prolix, it can only be observed, by
way of excuse, that, where opinions are handed down,
as they are in law, from one  generation to another,
they attain much the same kind of value, that is pos-
sessed by established  facts in natural science,  and
exert an influence that demands for them a degree
of consideration, which  their  intrinsic merits do not
deserve.
  § 26. Enough has been said,  it is believed, to
convince every unprejudiced  reader, that, in Great
Britain, the law of insanity, especially that relative
to criminal  cases,  is  still loose,  vacillating,  and
greatly  behind the  present state  of the  knowledge
of that disease.  That  it is no better in this country,
may  be  readily inferred, when it  is considered, that,
in the  absence of any provisions  by  statute,  the
practice of our courts  is  completely  regulated by
that  of  England.  Criminal trials, in which insan-
ity is pleaded  in  defence,  are generally  so  little
known,  beyond the place  of  their occurrence,  that
it is  difficult  to ascertain  on  what  particular  prin-
ciples  of  the  common  law,  the decisions of  the
courts have been founded, though from all that  can
be gathered,  their practice, like that of the  British,
has been diverse and  fluctuating.   In  one  or two
instances,  the jury have been  permitted to found
their  verdict on the  principles laid down in Had-
field's case ;  in some others, they have imitated the
conduct of the English  courts,  which, as if blinded by
the little light struck out in the discussions connected
with that trial,  turned back to  the old maxims and
again rejoiced in the wisdom of their ancestors.  The
frequency with which insanity is pleaded in defence 
PRELIMINARY  VIEWS.
55
of crime, the magnitude  of its  consequences to the
parties concerned, and the perplexity in which the
discussions it occasions involve the minds of judges
and jurors, are ample reasons why the law  relative
to insanity should be simple and easily understood—
a result that can only be obtained  by direct legisla-
tive  enactments.   It is time for  the legislature to
determine,  what,  amid the mass of conflicting opin-
ions on this subject,  shall be  the  law of the land ;
and thus no longer permit the lives  and liberties of
our citizens to be suspended on the dicta  of men,
whose knowledge of insanity was exceedingly  im-
perfect, and which have not  even  the merit of uni-
formity and consistency.  It may be doubted, whether
a  less general provision, than that  of the French
penal code would better promote the purposes of jus-
tice.  Under this law, when  strictly  applied, if the
existence of insanity is once established, the respon-
sibility of the party is taken away; and all nice discus-
sions concerning  the effect  of this  or that kind or
degree of mental derangement, and  the exact meas-
ure of reason that has been  left or taken away, are
thus effectually precluded.   It is  not certain,  that
insanity, under every form or  circumstance whatever,
ought to annul a person's criminal  or civil liabilities  ;
and, to allow the  court or jury any latitude on this
point, would be equivalent to having no law at all
on the subject.  If the mental unsoundness, neces-
sary to exempt from punishment,  were required by
the law to  have embraced the criminal act within
the sphere of its influence, as much perhaps would
then be accomplished as is practicable  in a specific
enactment.  True, the fact of insanity would be left, 
 56     MEDICAL JURISPRUDENCE  OF INSANITY.

 as it now is, with the jury to  decide ;  but,  as they
 would no longer be puzzled with metaphysical dis-
 tinctions  between total and  partial  insanity,  and
 engaged in nice estimates of the knowledge  of good
 and evil, of right  and  wrong,  and of the power of
 design possessed by the accused, their inquiries would
 be narrowed down to the  single fact of mental im-
 pairment  on a certain point—a duty much less re-
 mote from the train of their ordinary habits and pur-
 suits.   Thus a great  object would be gained, for the
 more that is provided by statute and the less that is
 left to judicial discretion, the greater is the benefit
 afforded by law.1
   § 27. As the conclusions of the  jury,  relative to
 the existence of insanity, must necessarily be  based
 on the testimony offered by the parties,  it is a sub-
ject of the utmost importance,  by whom and in what
 manner, this testimony shall be given.   If the decis-
 ion of this point were purely a matter of facts, the
 only duty of the jury would be to see that they were
 sufficient for the purpose and proceeded from authen-
 tic sources;  but, on  the contrary, it is  a  matter of
 inference  to be drawn from certain data, and this is
 a duty for which our juries, as at present  constituted,
 are manifestly unfit.   That a  body of  men, taken
 promiscuously from the common walks of life, should
 be required to decide, whether or  not  certain  opin-
  1 The state of New York has adopted the principle of the French
law, in reference to this point.  " No act done  by a  person in a
state of insanity can be punished as an offence, and no insane person
can be tried, sentenced to any punishment, or punished, for any crime
or offence which he commits in that state." 2 Revised Statutes, 697. 
PRELIMINARY  VIEWS.
57
ions and  facts in evidence  prove derangement  of
mind, or,  in other words,  to decide  a professional
question  of a most delicate nature  and involving
some of the highest interests of man, is  an  idea  so
preposterous,  that one finds it difficult, at first sight,
to believe that  it  ever was seriously entertained.
Such, however, is made their business,  and, in the
performance of it, there is  but  one  alternative for
them to follow ;—either to  receive with  the utmost
deference the  opinions of those, who have a profes-
sional  acquaintance with the  subject,  or to slight
them altogether, and rely solely on their  own judg-
ment of the facts.  The latter course has sometimes
been adopted, though  no one, probably,  personally
concerned in the issue of the case,  would congratu-
late himself on their choice,  unless specially  anxious
to become a victim of ignorance and obstinacy.  But,
in the larger proportion of cases, the medical  testi-
mony, which is given in the shape of opinions, though
rather an anomaly in evidence, that courts have been
sorely puzzled at times whether  to admit or reject,
is mostly  relied  on, and determines the verdict of the
jury.  It  is,  perhaps, of  little  consequence, who
testifies to a simple fact, that  it requires only eyes
to see, or ears to hear ; but it is all very different
with the delivery of opinions, that  are  to shape the
final decision.   As this requires an exercise  of judg-
ment as well as observation, there ought  to be some
kind of qualification, on the part of those who render
such opinions,  not  required of one  who testifies to
mere facts.   The  understanding certainly  is,  that
their habits,  pursuits,  and  talents,  have rendered
them peculiarly competent for this  high  duty,  for in 
58      MEDICAL JURISPRUDENCE OF INSANITY.

the absence of the power of cross-examination, these
constitute the only pledge that can  be had of its  cor-
rect and faithful performance.  But as the law makes
no exclusion, and the witnesses' stand is open to any
one, whom the parties  may  choose to call, it fre-
quently happens, that  the  witness  has nothing but
his  professional character  to rely  on, to give his
opinions the authority they ought to possess.  And
even  when he  may have  been preceded  by  the
shadow of  a great reputation,  the jury  may  not
know,  nor be able  to discover,  how  much  of  that
reputation is a factitious one; and,  in  consequence,
may be induced  to confide in  opinions, which,  from
a different quarter, they would have listened  to with
feelings of doubt and distrust.
  § 23. It is  not  enough,  that the standing of the
medical witness  is deservedly high in his profession,
unless  it  is  founded on  extraordinary  knowledge
and skill relative to the particular disease,  insanity.
Lunatic asylums and retreats for  the insane have
so multiplied  in our country, that  patients  of  this
class are almost entirely taken away from  the man-
agement of the private physician, and consigned to
the more skilful  conductors of these institutions; so
that many a medical man may spend  a life of full
practice, without having been  intrusted   with  the
care of a dozen insane persons.  To such, therefore,
a practical knowledge  of the disease  is out of the
question, and thus the principal inducement is want-
ing, to become acquainted with the  labors  of those,
who have enjoyed better opportunities.  If a partic-
ular class of men only are thought  capable of man-
aging the treatment of the insane, it would seem to 
PRELIMINARY  VIEWS.
59
follow,  as a  matter of course, that  such only are
capable  of giving opinions  in judicial proceedings
relative to insanity.   True,  in important cases, the
testimony of  one or more of this class is generally
given ;  but it may be contradicted by that of  others
utterly guiltless of any knowledge of the subject, on
which they tender their opinions  with arrogant con-
fidence—for ignorance is always  confident—and the
jury is seldom  a proper tribunal for distinguishing
the true from the false,  and fixing on each its right-
ful value.  An  enlightened  and conscientious jury,
when required to decide in a case of doubtful insan-
ity,  which is to determine  the weal  or w7oe of a
fellow-being, fully alive to the delicacy and respon-
sibility of their situation, and of  their own incompe-
tence unaided by the  counsels  of  others, will be
satisfied with nothing less  than the opinions of those,
who have possessed unusual  opportunities for study-
ing  the  character  and  conduct  of the insane, and
have the qualities of mind  necessary  to enable them
to profit by their observations.  If they are obliged
to decide on  professional subjects, it would seem but
just and the  dictate of common sense,  that they
should have the benefit of the best  professional ad-
vice.  This,  however,  they do  not always  have ;
and, consequently,  the ends  of justice are too often
defeated by the high-sounding assumptions of igno-
rance and vanity.
   §29.  It may at first  sight be  thought impossible
to remedy this defect, without what  would seem to
be  an engraftment upon our judicial  system, of prac-
tices not in perfect harmony with it; but the difficulty,
after all, may  not be  found utterly  intractable, if 
60       MEDICAL JURISPRUDENCE  OF INSANITY.
names  are not allowed  to  usurp  in  our  minds the
place of things.   Instead of the unqualified and  irre-
sponsible witnesses, now too  often  brought forward
to enlighten the minds of jurymen  on medical  sub-
jects, it would  be  far better, if we had a class of men,
more or less like  that  of the  experts l  of the French,
peculiarly fitted for the duty by a  course of  studies
expressly directed to  this  end.   They might be ap-
pointed  by the government, in numbers adapted to
the wants  and circumstances  of the population, and
should  be  always ready at  the  call of  courts,  to
examine  the  health  of  criminals,  draw up reports
touching the same, and deliver opinions.   When the
  1 The term experts is used in the French law, to designate certain
persons, appointed in the course of a judicial proceeding, either by the
court or by the agreement of the parties, to make inquiry UDder oath,
in reference to certain facts and to report thereon to the court.  They
are not examined as witnesses; nor have they the  power of deciding
the cause, like arbitrators; their functions are more analogous to those
of a master in chancery, according to  our laws.  The following ex-
tract from  Pothier's Treatise on Civil Procedure  (Part I, chap. Ill,
art III, § I,) will give an idea of the functions of these officers.
  "The decision of a cause frequently depends on some fact, contested
between the parties, which can only be established by a visit to the
thing, which makes the ohject of the contestation; for example, the
buyer of a horse brings a redhibitory action against the seller, to compel
the latter to take back the horse, on account of some pretended defect,
which the former alleges  entitles  him to a return ;  if the seller denies
the existence of the defect, this fact, upon which the decision of the
cause depends, can only be ascertained by an examination of the horse
by experts; and the judge, therefore, before rendering a definitive judg-
ment, must order the animal to be examined by experts, who shall report
whether he labors under the said defect or not.  In like manner, if I
make a bargain with a workman, to do certain work upon a house, and
when the latter demands the agreed price of me, I object that the work
is badly done and therefore not receivable, there must be an order for
an examination by experts." 
PRELIMINARY VIEWS.
61
courts  see the minds  of jurors perplexed and  con-
founded by the  contradictory  opinions  of medical
witnesses, and with no means of satisfying themselves
as to what is really  true, it should be  their  duty to
submit  the accused to the examination of experts, who
should  report  at a  subsequent period.  Something
like this is often  done  in France,  which is  much be-
fore our  own  country, or  even England,  in every
thing relative  to the  judicial  relations  of medical
men.1 Thus, in the case of Henriette Cornier, in Paris,
for murdering a neighbor's child, November 4, 1825,
the court, at the request of the prisoner's counsel,
made shortly before the trial, which was ordered to
take place February 27,1826, appointed a committee
of three distinguished physicians, to report, after due
examination, whether or not she was a fit subject for
trial.   Their reports not  being  satisfactory to the
avocat-general (attorney-general), the trial, at his
request, was postponed  to another session, and the
prisoner  was  again  subjected to the examination of
the  committee,  who reported  three  months after-
  1 Fodere (De medicine legale, Tome I, Introd. p. xlii.) relates with
the most naive astonishment, that, in a question of survivorship, aris-
ing out of the accouchement of Mrs. Fischer in England, the opinion
of the celebrated Denman was rejected by a jury, that yielded implicit
belief in the testimony of one Dallas who was not a physician, and of
two ignorant women, who spoke only from memory, after the expira-
tion of fourteen years. Many readers may recollect, that, in the case of
Donellan, tried in  1781 (see 2 Beck's Medical Jurisprudence, fifth
edition,  page 563), for the murder of Sir Theodosius Boughton, by
poisoning, the opinions of three or four physicians, as unknown to
fame, as the science they professed to understand seems to have been
unknown to them, far outweighed with the court, that of John Hunter,
though' illustrated by  his various learning, and supported by his repu-
tation for unrivalled talents and original research. 
62     MEDICAL JURISPRUDENCE OF INSANITY.

wards.1  What a contrast, does this calm and delib-
erate inquiry present to  the  indecent haste, with
which the legal proceedings were precipitated against
Bellinsjham, who committed his offence, was indicted,
tried and hung, all within the space of eight days.
In this case,  there  was a strong disinclination mani-
fested by the court, to listen to the plea of insanity;
as if it were a fiction set  up by counsel, in the ab-
sence of any other  ground of defence; and the earn-
est request of his counsel  for a little delay, that he
might obtain witnesses from  the part of the country,
where the accused  had lived and  was  well-known,
who would  substantiate the fact  of his insanity,  of
which  there  was  already  more than  suspicion,  was
disregarded.  Few, it  is  believed,  at  this period,
unbiassed by the  political prejudices of  the  times,
and examining the event as a point of history,  will
read the report of Bellingham's trial, without being
forced to the conclusion, that he was really mad, or,
at the  very  least, that the  little evidence, which did
appear relative to  his state of mind,  wras  strong
enough to  have  entitled  him to  a  deliberate  and
thorough  investigation  of his  case.   Mr. Simpson,2
after mentioning the case of  Howison, who was tried
and executed for the murder of the widow Geddes,
in which the evidence  of his insanity was so strong,
that it is  almost impossible  to conceive what addi-
tional evidence could make  it stronger, states,  that
"application was made without success  to the  secre-
1 Georget, Discussion medico-legale sur la Folie, p. 71.
2 Homicidal Insanity, p. 222. 
PRELIMINARY  VIEWS.
63
tary of state, by Howison's law-agent, for time to
obtain further evidence of his insanity.   To this that
gentleman  was emboldened, by receiving  the  con-
curring opinions of some of the first medical men in
Edinburgh, who had not been cited, that  even the
evidence adduced on the trial was sufficient;  but,
that,  when several post-judicial  facts were added,
there could be no doubt that the  unhappy  man was
not a fit subject for punishment."   Cases like these
ought to convince us, that the  feelings of horror and
vengeance, excited by the  bloody deeds of the in-
sane, completely unfit the popular mind for a careful
and  impartial investigation  of the plea of insanity,
and that the mental condition  of the accused should
be examined by  men, who have  become  fitted for
such duties, by a peculiar course of study and expe-
rience.  Is it necessary,  to  go into  a  labored argu-
ment to prove,  that this  method  of  determining the
grave and delicate question of insanity must be infi-
nitely more  satisfactory,  than that of summoning
medical witnesses to the trial—most of whom  have
but very imperfect notions of the disease, and proba-
bly have not had the  least communication  with the
accused,—and  forcing out  their  evidence,  amid the
embarrassment produced by the queries of  ingenious
counsel, bent on puzzling and distracting their minds?
If a  physician, after listening  to  divers vague  and
rambling details, concerning  a  person's ill-health,
and  looking  at  him across the  apartment, without
being permitted  to address to him  a single word,
or lay a finger on his person, should then be required
to say on his oath, whether  or not the individual in
question were  laboring  under inflammation of the 
64    MEDICAL  JURISPRUDENCE  OF INSANITY.

lungs, bowels, or kidneys, he would scarcely restrain
a smile at the stupidity, which should expect a satis-
factory answer.  And yet, absurd and foolish as such
a  course w7ould  be considered,  in the abstract, it is
the only one recognised by  our  laws, when the dis-
ease, whose  existence is to  be established, happens
to be insanity.   Besides, where mental derangement
is  suspected, there are many physical symptoms and
numerous other circumstances, that cannot be inves-
tigated in an hour  or  a day, but require a course of
diligent observation,   that  may occupy  weeks or
months, before  the suspicion can be  confirmed or
disproved.   From these considerations, the general
conclusion is, that, in  criminal cases, where insanity
is  pleaded in defence,  the ends of justice will be best
promoted, by the appointment of a special commis-
sion, consisting of men who possess a well-earned
reputation  in the knowledge  and  management  of
mental derangement,  who shall  proceed to  the ex-
amination of the accused, with the coolness and im-
partiality proper to scientific inquiries.
   § 30. If the above  hasty review of the judicial
opinions  and practices, that have hitherto prevailed
relative to insanity, have left  the impression, that this
disease is as yet but imperfectly understood, as well in
the medical profession as out of it, an explanation of
this fact may perhaps be demanded; but, as it would
be hardly relevant to the present purpose, to  enter
largely into a discussion of this point,  nothing more
will be attempted than merely to indicate what seems
to have had the principal share in producing it.   To
explain the  little progress, comparatively speaking,
that has been made by medical men in the knowledge 
PRELIMINARY VIEWS.
65
of insanity, it is too much the fashion to allege, that
they have neglected the study of mental philosophy,
or that of mind in the healthy state,  which  is indis-
pensable to correct notions on the  disordered condi-
tion of mind.   So far, however, is  the fact  here in-
dicated from  being  true, generally,  that  one can
not hesitate to say, that the result in question has
been owing to the undue account, that physicians
have  made of the popular philosophy of mind,  in
explaining the phenomena of insanity, and that they
have failed, in consequence of studying metaphysics
too much instead of too little.  While it is admitted,
that the knowledge of healthy  structure and func-
tions  is necessary  to a thorough  understanding of
diseased structure  and functions, there is every rea-
son to believe  that the converse of the proposition
is equally true ; neither can be successfully studied
independently of the other.   In the  prosecution of
psychological  science, this latter truth has  been al-
most entirely  disregarded, and  therefore it is, that
we  see the metaphysician  looking  for  his  facts and
his  theories in  the  healthy  manifestations  of the
mind, and directed in his  course  solely by his own
self-consciousness,  while  the student of  insanity,
after collecting his facts with commendable diligence
and discrimination, amid the disorder  and irregular-
ity of disease, resorts to the theories of the former,
for the purpose of generalizing his results,  instead of
building upon  them a philosophy of his own.  Meta-
physics, in its  present condition, is utterly incompe-
tent to furnish a satisfactory explanation of the phe-
nomena of insanity, and a more deplorable waste of
ingenuity can  hardly  be imagined, than is witnessed
              E 
 66     MEDICAL JURISPRUDENCE OF INSANITY.

 in the modern attempts to reconcile the facts of the
 one with the speculations of the other.   In proof of
 the truth of these assertions, it is  enough  barely to
 mention, that the existence of monomania, as a dis-
 tinct form of mental derangement, was  denied, and
 declared to be  a fiction of medical men,  long after
 it had taken its place among the established truths
 of science ;  because, probably, it was a condition of
 mind not described by metaphysical writers.  All
 this, howrever, is in  accordance  with a  well-known
 law of the  human  mind,  which  resists  important
 innovations  upon the  common  modes  of thinking,
 till long after they shall have  been required by the
 general progress of knowledge.  The dominant phi-
 losophy has prevailed  so  long and so  extensively,
 and has become so  firmly  rooted  in men's minds,
 that they who refuse to take it on trust and seriously
 inquire into  its foundations, and after finding them
 too narrow  and imperfect,   are  bold  enough  to
 endeavor to remedy  its defects by laying foundations
 of their own,  are  stigmatized  as visionaries and
 overwhelmed with ridicule  and censure.  The only
 metaphysical system of modern times,  which  pro-
 fesses to be  founded on the observation of nature,
 and which really does explain the phenomena of
 insanity, with a  clearness  and  verisimilitude,  that
 strongly corroborate  its proofs, was so far from being
joyfully welcomed, that it is still confined to a  sect,
 and is regarded  by  the world at  large,  as one of
 those  strange vagaries, in  which  the human  mind
 has sometimes loved  to indulge.   So true it is,  that,
 in theory, all mankind are agreed in  encouraging
 and applauding  the humblest attempt to enlarge the 
PRELIMINARY VIEWS.             67
sphere of our ideas, while, in practice, it often seems,
as if they were no less  agreed to crush them, by
means of every weapon,  that  wit, argument, and
calumny, can furnish.  In the course  of this work,
the reader will have frequent  occasions to see how
the popular misconceptions,—which are too  much
adopted by professional men—of the nature of vari-
ous forms of mental  derangement,  have  been pro-
duced  and fostered by  the  current  metaphysical
doctrines, and thus may have some means of judging
for himself, how far the imperfect notions of insanity,
that are  yet  prevalent,  may be  attributed  to the
cause  above assigned. 
68    MEDICAL JURISPRUDENCE  OF INSANITY.   [CH. I.
                  CHAPTER I.

          MENTAL DISEASES IN GENERAL.

  § 31. Correct ideas of the pathology of insanity
are not unessential  to  the progress of enlightened
views respecting its legal relations.   If it be consid-
ered as withdrawn from the influence of the common
laws of nature, in  the production of disease,  and
attributed to the direct visitation of God;  if the exist-
ence of physical changes  be  overlooked or denied,
and we are referred exclusively to some mysterious
affection of the immaterial spirit, for its cause; then
is it in vain to hope,  that  such a  condition can ever
be the object of discriminating, salutary legislation.
In the prevalence of such views in past times, howr-
ever, we may look for the cause of much of the error
and absurdity, that pervade the law of insanity, and
that  are equally  at  variance  with the  principles of
science and the dictates of humanity.   It is an un-
doubted truth, that the manifestations of the intel-
lect, and those of the sentiments, propensities  and
passions, or generally, of  the intellectual and affec-
tive powers, are connected with and dependent upon
the brain.   It follows, then, as a  corollary, that ab-
normal conditions of these powers are  equally con-
nected with abnormal conditions of the brain; but
this is  not merely a  matter of inference.  The dis-
sections of many eminent observers, among whom it 
CH. I.]      MENTAL DISEASES IN  GENERAL.        69

is enough to mention the names of Greding, Gall and
Spurzheim, Calmet, Foville, Fabret, Bayle, Esquirol,
and Georget, have placed it beyond a doubt; and no
pathological fact  is  better established—though its
correctness was for a long while doubted—than that
deviations from the healthy structure are generally
presented  in the  brains of insane subjects.   In the
few  cases,  where such appearances have not been
observed, it is justly concluded that death took place
before the deviation was sufficiently great to be per-
ceptible,—a phenomenon, not rare  in affections  of
other organs.
   § 32.  These  pathological changes are not  suffi-
ciently definite to admit of classification, or of prac-
tical application in the treatment of the various kinds
of insanity.  To  us  they are chiefly  valuable, as
showing  the frequent liability to disease, either from
excessive exertion or disuse of its own  powers, or
from its proneness  to be  affected by morbid irrita-
tions, that radiate from other parts of the body.  We
learn from them, also, that changes of structure may
proceed in the brain, as in other organs, to an incur-
able degree, without giving rise to much, if any, very
perceptible  disturbance of  its  functions,  until  some
striking and unexpected  act  leads the  enlightened
physician to suspect  its existence, and draws down
upon the unfortunate  subject the restraints and pen-
alties of  the law.
   §  33.  A natural classification of the various forms
of insanity, though of secondary importance  in re-
gard to  its medical  treatment, will be of eminent
service to the legal inquirer, by enlarging his notions
of its phenomena, and enabling him to discriminate,, 
 70    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. I.

 where discrimination is  necessary to the attainment
 of important ends.   The deplorable  consequences of
 knowing but  one kind of insanity,  and of erecting
 that into a standard, whereby every other is to be
 compared and tested, are too common in the  records
 of criminal jurisprudence; and it is time that it were
 well understood, that the philosophy of such a method
 is no better than would be that of the physician, who
 should recognise no diseases of the  stomach, for in-
 stance, but  such as proceed from inflammation,  and
 reject all others as anomalous and  unworthy of at-
 tention.   The  various diseases, included in the gen-
 eral term insanity, or mental derangement, may be
 conveniently arranged under two divisions, founded
 on two very different conditions of the brain;  the
 first being a want of its ordinary developement,  and
 the second,  some lesion  of its  structure subsequent
 to its developement.  In the former of these divis-
 ions,  we have idiocy and imbecility, differing from
 each other only in degree.   The various affections,
 embraced in the latter general division,  may  be  ar-
 ranged under two subdivisions, mania and dementia,
 distinguished by  the  contrast they  present  in  the
 energy and tone of the mental manifestations.  Mania
 is  characterized by an exaltation of the faculties,  and
may be confined  to the intellectual,  or  to the affec-
tive powers, or it may involve them  both, and these
powers  may be  generally  or  partially deranged.
Dementia depends on a more or less complete  en-
feeblement of the faculties,  and may be consecutive
to injury of the brain, to mania, or  to  some other
disease;  or it may be connected with the decay of 
CH. 1]      MENTAL DISEASES IN GENERAL.         71
old age.   These divisions will be more conveniently
exhibited in the following tabular view.
INSANITY.
Defective
develope-
ment of<
the facul-
ties.
Idiocy.
Imbecility.
Lesion of
the facul-
ties  sub-
sequent
to their
develope-
ment.
Mania.
Dementia.
f 1. Resulting from congenital defect.
J 2. Resulting from an obstacle to the
|     developement of the faculties,
[^    supervening in infancy.

 {1. Resulting from congenital defect.
 2. Resulting from an obstacle to the
     developement of the faculties,
     supervening in infancy.
Intellectual.
Affective.
1. General.
  Partial.
{i
1. General.
  Partial.
'1. Consecutive to mania, or inju-
    ries of the brain.
 2. Senile, peculiar to old age.
   § 34. It is not  pretended, that any classification
can be  rigorously correct;  for  such  divisions have
not been made by  nature, and cannot  be  observed in
practice.   Diseases  are naturally  associated into
some general groups only; but if these be ascertained
and brought into view, the great end of classification
is accomplished.    We shall often find them running
into one another,  and be puzzled to assign to a par-
ticular disease its  proper place; but since such is the
order of nature, w7e must make the most  of the good
it presents, and remedy its evils in the best manner
we can.   The above arrangement, with the exception
of  some slight modifications, is that adopted by Es-
quirol,  and has  this  advantage  over  some  others,
that it preserves the  divisions  made by  nature, and
will thus  be serviceable to our present purpose, by
dissipating some of the false notions, that prevail re-
lative to the nature of insanity. 
72     MEDICAL JURISPRUDENCE OF INSANITY.  [CH. 11.
                 CHAPTER  II.

                     IDIOCY.

   § 35. Idiocy is that condition  of mind, in which
the reflective, and all or a part of the affective pow-
ers, are either entirely wanting, or are manifested to
the slightest  possible extent.   As the organic  de-
fects,  on which idiocy depends, are various in kind
and degree, and also  as it regards the  parts of the
brain  affected, we should be led to expect, what  ob-
servation  shows is  actually  the  case, considerable
variety in  the manifestations of this condition.  The
individual  may hardly rise to the level of some of the
brutes, his movements being confined to the necessi-
ties of the automatic life; or he  may be capable of
performing some useful  services, of exercising  some
talent, or of displaying some of the higher moral sen-
timents.   In short,  there is even  more diversity, in
the characters  of the idiotic and imbecile, than in
those  of the sound, and  this  truth must not be for-
gotten, if  we would avoid the flagrant error of  regu-
lating judicial decisions  by rules, which, though per-
fectly correct in regard to one case or set of cases,
may be wholly  incorrect in regard to others.
   The most striking physical trait of idiocy, and  one
seldom wanting, is the diminutive  size of the  head,
particularly of the anterior-superior portions, indica-
ting a deficiency of the anterior  lobes of the brain. 
CH. II.]
IDIOCY.
73
Its  circumference, measured immediately  over the
orbitar arch and the  most prominent  part of the oc-
cipital bone, is fixed  by Gall, whose observations on
this subject are entitled to great confidence, at be-
tween Hit and 14? inches.1  The brain consequently
equals that of a new-born infant ;  that  is,  about
one fourth,  one fifth,  or  one sixth of the cerebral
mass  of an adult's, in the full enjoyment of his facul-
ties.  The above is  the only constant character ob-
served in the heads of idiots;—their forms are as
various as those of heads of the ordinary size.  When
idiocy supervenes in  early infancy, the head is some-
times as  remarkable  for immense size, as in the for-
mer  case, it is for its diminutiveness.   The cause of
this  enlargement  is some  kind of morbid  action,
preventing the developement of the  cerebral  mass
and producing serous cysts,  immense  dropsical  effu-
sions, &c.   In idiocy the  features  are irregular; the
forehead low, retreating and narrowed to  a point;
the eyes  are unsteady and often squint;  the lips are
thick, and the mouth being kept open, the saliva is
suffered to escape, and their spongy gums and defec-
tive teeth are displayed; the limbs are crooked, and
feeble and limited in their motions.   The senses are
very imperfect at best, and often  entirely  wanting.
Many are deaf and dumb, or blind.  Many are  inca-
pable of  perceiving odors, and have so little taste as
to show  no  discrimination  in their choice of  food,
swallowing whatever comes to hand.   Their move-
ments are constrained and awkward; they walk badly,
1 Sur les Fonctions, p. 329. 
 74    MEDICAL JURISPRUDENCE OF INSANITY.   [CH. 11.

 easily falling down;  and are constantly dropping
 whatever is placed in  their hands.  None are  able
 to articulate more than a few words, to which  they
 seem to attach no meaning; while the most of them
 utter only cries  or muttered sounds.   Some make
 known their most important wrants by means of signs
 or sounds, that are intelligible to those who have the
 care  of  them.  Idiots  are generally  affected  with
 rickets, epilepsy, scrofula, or paralysis, and their
 whole physical  economy indicates a depraved and
 defective  constitution.   Idiocy, as above described,
 is congenital, or begins at a very early period, and
 is incurable.   Its  wretched subjects seldom live be-
yond their twenty-fifth year, continuing all their lives
in the same brutish condition,  utterly unchanged by
external  circumstances, and scarcely indicating  the
species to which they belong,  in their stupid,  brute-
like  countenance, in their dull or glaring eyes, gap-
ing mouth, their wild and hideous laugh, their inar-
ticulate sounds,  their  obtuse  sensations, and utter
unconsciousness of social and domestic relations.
  §  36. In reasoning  power,  idiots are below the
brute.  Unable to compare two ideas  together, no-
thing leads them to act but the faint impressions of
the moment, and these  are often insufficient to induce
them to   gratify  even   their instinctive wants.  It
frequently happens, however, that  some one or more
of the intellectual faculties, always excepting the
reflective, are manifested in more or less perfection.
Among the moral sentiments,  it is not uncommon to
find  self-esteem, love of approbation, religious ven-
eration,  and  benevolence,  bearing  a prominent
part, if not constituting  the entire character,  and 
CH. IL]
IDIOCY.
75
 thus producing a slight approximation to humanity.
 Rush'  speaks of one who was remarkable for kind-
 ness and affection, and spent his life in acts of benev-
 olence, though he showed no one  mark of reason.
 Dr. Combe2 saw two,  who, though differing much,
 in other respects, agreed in evincing a strong predi-
 lection  for  religious  worship,  and  for  listening  to
 sermons and prayers.  Some can  recollect  names,
 numbers,  or  historical facts; some are capable  of
 repeating what they have  frequently heard;  others
 are able to sing a few airs, and  even to  play on
 musical instruments.   Gall3 saw one at Hamburgh,
 sixteen  years  old,  who learned names,  dates,  num-
 bers,  history,  and repeated  them all mechanically,
 but  was destitute of all  power of combining and
 comparing  his  ideas, and was incapable of being
 engaged in any employment.  Various propensities,
 such as the  sexual feelings, cunning, and  destruc-
 tiveness, they often manifest in an inordinate degree
 of vigor and activity.
  § 37. In  that form of  idiocy,  called cretinism,
which is endemic in the Alps and some other moun-
tainous  countries, opportunities of observing its phe-
nomena are  offered on a grand scale.  The difference
in the degrees of this affection has led to its division
into  three classes, viz.,  cretinism, semi-cretinism,
and cretinism of the third degree.   In the first, life
seems to be  almost  entirely automatic;  most of its
subjects are  unable to speak, their  senses are  dull,
1 Medical Inquiries.
8 Observations on Mental Derangement, 243.
s Sur les Fonctions I, p. 193. 
 76     MEDICAL JURISPRUDENCE OF INSANITY.  [CH. II.

 if not altogether wanting, and  nothing  but the most
 urgent calls  of nature excite their attention.   The
 semi-cretins   show  some  glimmering  of a higher
 nature ; they note what passes  around;  they remem-
 ber simple events ;  and make  use  of language to
 express their wants.   They are capable of  little
 else, however, for they have  no idea  of numbers,
 and, though taught to repeat certain  passages, they
 learn  nothing  of  their  meaning.  The  actions of
 those of the third  kind indicate a still higher  degree
 of intellect; they have a stronger memory of events,
 and they  learn to  read and  write,  though  with
 scarcely any  conception of the purposes of either.
 Particular talents are often  displayed by them in a
 very respectable degree.  Music, drawing, painting,
 machinery, &c, have each had its  followers, in a
 humble way,  among  these cretins.  In the construc-
 tion of some parts of a watch,  they  are  often em-
 ployed in Geneva, and their work is characterized
 by  neatness.   Others  have executed  drawings of
 some  merit,  and  some have  even studied  several
 languages,  in which their acquisitions  were by no
 means  insignificant;  while others have even  at-
 tempted poetry, though succeeding  in  nothing  but
 the rhyme.  Though, in all degrees of idiocy,  the
 intellectual powers are so deficient as hardly to be
recognised, and therefore these distinctions can be
of little practical importance, yet they may serve to
teach us how independent  of one another are  the
 various moral and  intellectual faculties,  and lead us
 to be cautious how we  infer the soundness or capa-
city of the whole mind, from the perfection manifested
by one or two of its faculties. 
CH. Ill]             IMBECILITY.                 77
                 CHAPTER III.

                    IMBECILITY.

   § 38.  By imbecility is meant  an abnormal defi-
ciency either in those faculties that acquaint us with
the qualities and ordinary relations of things,  or in
those which furnish us with  the moral motives that
regulate  our  relations  and conduct  towards our
fellow-men ; and frequently attended with excessive
activity of one or more of the  animal propensities.
In imbecility the developement of the moral and in-
tellectual powers is arrested at  an early period of
existence.  It differs from idiocy, in the circumstance,
that while in the latter, there is an utter destitution
of every thing like reason,  the subjects of the for-
mer possess some intellectual  capacity, though in-
finitely less  than is possessed by  the great  mass of
mankind.  Imbeciles can never attain that degree of
knowledge which is common among  people  of their
own rank and opportunities, though it is very certain
that they are not entirely unsusceptible of the influ-
ences of education.   They are capable of forming a
few  simple  ideas  and of expressing them  in lan-
guage ; they have some memory  and a sense of the
conveniences and proprieties of life.   Many  of them
learn to read,  write,  and  count, and  make  some
progress in  music, though for the most part, they 
78    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. III.

are  untaught and employed in  the  coarsest  and
rudest labors.  Their moral and intellectual charac-
ter presents  the same infinite variety  that  is  wit-
nessed in the normal state of the mind.  While some
are changing their plans and resolutions with the
fickleness of  the winds,  others  have some favorite
project which they are bent on accomplishing; while
nothing  can arrest the attention of some  for a  mo-
ment,  others pertinaciously  retain some crotchet
that  occupies nearly all their thoughts.  Some engage
in certain occupations, and manage  to take  care  of
themselves and  their  property,  though  frequently
obliged  to resort to others for  advice and assistance.
They talk but little, and will answer questions  cor-
rectly, provided  they are not without  the circle of
their customary thoughts and habits, and are not
required to follow a conversation.   They are par-
ticularly deficient in forethought,  and in strong and
durable affections, and they generally labor under a
certain  uneasiness and  restlessness of disposition
that  unfit them for steady  employment.   It is  also
worthy of notice  that the  same  physical  imperfec-
tions and a tendency to  the same diseases which ac-
company idiocy,  are generally observed, though  in a
less degree, in imbecility.
  § 39. Much as the moral and intellectual powers
vary in the different cases, but little has been done
towards distinguishing the various degrees  of imbe-
cility, by a system of classification,  though it must
be obvious  at first  sight, that  something of this kind
is absolutely  necessary before  its legal  relations  can
be determined with much  correctness, or  consis- 
CH. III.]
IMBECILITY.
79
tency.   Hoffbauer1 alone has made  an attempt to
supply this want,  and though perhaps not perfectly
satisfactory, as might have been expected from the
nature of the subject,  yet it  evinces  such a correct
appreciation of mental diversities, and so much abil-
ity in the analysis  of deficient  understandings, that
it would be doing injustice to the subject,  to neglect
giving some account of his views, in this place.
   § 40.  Mental deficiency is  manifested under two
different forms, which  Hoffbauer  designates by the
terms imbecility (blodsinn), and stupidity (dummheit).
The former  consists in a defect of the intensity, the
latter, in a defect of the extensity, necessary  to  a
sound and healthy mind.   By  intensity is  meant the
power of the mind to examine the data presented to
it by the senses and  therefrom to deduce correct
judgments; by its extensity, the mind perceives and
embraces these data, and suffers  none to  escape,—
one, it may be added, is  the reflective;  the  other, the
perceptive power.
   "In reference to  the  faculty of judgment, it may
be observed,  that the  stupid  person is  more  liable
than the imbecile  to form erroneous  decisions; the
latter experiences great difficulty in bringing himself
to  any  conclusion.   Secondly, the stupid person
sometimes judges very correctly on subjects to which
his attention has been strongly applied; occasionally
he surpasses, in this respect, those of superior  intel-
ligence.   When he  judges wrongly,  it is through
  1 Die psychologie in ihren hauptanwendungen auf  die rechts-
pflege, ft 26—46. 
 80    MEDICAL JURISPRUDENCE OF INSANITY. [CH. III.

 neglect of some of the considerations which ought to
 have formed the  groundwork of his judgment, and
 he will  say, in order  to  excuse himself,  that 'he
 never should have dreamt of this or that circum-
 stance.'   To the imbecile,  on the contrary,  the most
 simple act of judgment  is difficult.   A lady, for  in-
 stance, who said she was  twenty-five years of age,
 and had  been  married six years,  could not,  after
 many efforts, tell how old she was at the period of
 her wedding;  at one time, calling it twenty, at an-
 other, twenty-two.  Thirdly, the stupid man may
 often be  induced to correct his mistake; some simple
 reason, or particular  circumstance being suggested
 to him which leads to its  detection.  The imbecile
 man  can scarcely  rectify  his errors, being unable
 sufficiently to concentrate his attention on any parti-
 cular subject.  Fourthly, the stupid man, in recov-
 ering from his error, frequently falls into the oppo-
 site extreme, passing from the blindest confidence to
 the most  jealous distrust,  because he views every
 subject  on one side  only,  and is embarrassed  by
 every complex  idea.
   § 41.  "In relation also to memory, there is a de-
 cided difference between the stupid and the imbecile.
 The latter appear to be almost entirely  deficient in
 this faculty,  while  the former recollect after a long
 interval of time, and  with  tolerable accuracy, some
 insulated  circumstances.
   § 42.  "Weakness of intellect is displayed in both
 these classes,  when their  defect  is  excessive, by a
propensity to  talk to themselves.   This is  mostly
observable when the individual is alone, or supposes
himself alone.  In  reality, we employ words,  not 
CH. HI.]
IMBECILITY.
81
 merely for purposes of intercourse, but as an instru-
 ment of thought; and when  the  mind is morbidly
 enfeebled, the silent and  unperceived, or mental em-
 ployment of words is  insufficient;  they must be re-
 peated  more or less audibly.  This practice is not
 uncommon  with imbecile and stupid people, but
 when in company, they generally perceive its incon-
 gruity and  abstain from it.   If, however, such indi-
 viduals  talk to themselves, knowing  that they are  in
 the presence of  company, it is a proof of greater de-
 ficiency.
   § 43.  "Another distinction between the imbecile
 and the stupid  person is, that the  latter imagines
 himself equal, if not superior, to other men in intel-
 ligence; whereas the former is sensible of his defect,
 and even exaggerates it.   Hence results another dif-
 ference between the stupid and the imbecile person.
 The former acts precipitately  and without reflection;
 the latter never  can make up his mind, even on the
 simplest affair, from the  fear that there may be con-
 sequences which he is incapable of foreseeing.   The
 imbecile is frequently timid, and even  misanthropic;
 not only because he is conscious  of his deficiency,
 but because he has had a disagreeable  experience  of
 the superiority of others.   When this is the cause  of
 his jealous distrust, we observe, first, that he reposes
 unlimited confidence in those  whose benevolence he
 has experienced;  secondly, that when his condition
 in society places him beyond the reach of  injury, he
 has none of this misanthropy of which we speak,
 and is at peace with all the world.  The pusillanim-
 ity and  misanthropy of  the imbecile lead them to a
species of devotion, if such it  may be called;  for  it
F 
82   MEDICAL JURISPRUDENCE OF  INSANITY.  [CH. III.

is natural  that,  on seeing themselves repulsed, or
ill-treated by men, they  should apply  to  the  deity
for support.  The stupid, more confident  in  them-
selves, fancy that they acquire merit by their devo-
tions, or confer an honor on the divinity."
  § 44. Hoffbauer, while he  acknowledges the vari-
ous and almost  imperceptible  shades of  difference
between one case of imbecility and another, has re-
duced its numberless gradations to five degrees, and
those of stupidity to three.   To  these as  described
and explained by him,  he looks for  the means of a
consistent and rational application of the legal prin-
ciples that  should regulate  their civil and criminal
relations.
  "The first degree of imbecility manifests itself in
the inability to form a judgment respecting any new
object, even when the necessary data are furnished,
and the question is one  which in itself, presents no
difficulties.  In this degree of the affection, the indi-
vidual  can  very well  judge respecting objects to
which he is daily accustomed, and in familiarity with
which he may be said to have  grown up.   In the
pursuit of his daily concerns, he often shews a minute
exactness that appears to him a matter of absolute
necessity.   His memory is very limited; not that he
loses absolutely the remembrance of things, but be-
cause he cannot  apply his recollections according to
his wishes.  He scrupulously observes whatever he
thinks becoming in his situation, because he fears to
offend by neglecting it.   When he gives himself up
to avarice,  there is  observed in him rather an ap-
prehension of  losing than a  desire of accumulating.
The  propensity to talk to himself,  and the  species of 
CH. Ill]
IMBECILITY.
83
 devotion  to which we have alluded, is seldom  to
 be met with in this instance; the former, because the
 routine of daily  occupations, above which the indi-
 vidual seldom  raises himself, makes but small de-
 mands  on his  intelligence;  the latter,  because his
 infirmity is not so remarkable in ordinary society  as
 to render it a subject of general observation, and
 entail upon  him frequent  annoyance, and thus make
 him feel the necessity of seeking support elsewhere.
 He is very subject to gusts of passion, which  never-
 theless are as easily appeased as they are excited."
   The description of the  second degree of imbecility
 applies to the subjects of dementia, which will  be
 considered in another place;  and it may therefore  be
 omitted here.
   § 45.  "A person affected with imbecility in the
 third degree, is unfitted for all  matters that require
 more than a mechanical mode of action; but he pre-
 serves sufficient intelligence to be aware of his weak-
 ness and of the intellectual superiority of others.
 We may  likewise remark in him that  propensity  to
 devotion and misanthropy of which we have spoken
 above.  His mind is not completely inactive,  although
 it cannot raise  itself to any elevated views; hence  he
has the propensity to talk to himself.  He has not the
power of seizing an idea so clearly as to impress it on
his mind; hence a very marked defect of memory and
 a great propensity to pass rapidly  from one topic  to
 another.   He  is very irritable and suspicious, fancies
a design  to insult him where it is impossible, because
his state yet permits him to feel and resent injuries
—of which susceptibility those about him often take
advantage in order to annoy  him. 
84   MEDICAL JURISPRUDENCE OF  INSANITY.  [CH. III.

  § 46.  "The fourth degree of imbecility is marked
by a clouded state of the understanding and memory,
with a great insensibility,  which nevertheless leaves
the patient  a confused idea of his  weakness.   He
eagerly seeks excitement  by various stimuli."
  § 47.  The fifth degree of imbecility as described
by Hoffbauer, corresponds  to the last  stage of  de-
mentia, or the fatuity which results from some cere-
bral diseases, and therefore does  not belong to this
condition of mind according  to  the arrangement
above  adopted.
  § 48.  Stupidity, generally speaking,  is  a defect
less severe than imbecility, according to the defini-
tion given of each.  The slightest degree of imbecil-
ity, however, indicates an imperfection of the  intel-
lectual  powers,  less severe  than the greatest degree
of stupidity.
  "In the first degree of stupidity, the individual is
only incapable  of judging,  and  deciding, when it is
necessary to weigh  opposing  motives.   Then  he
feels his  incapacity, and resorts to the intelligence of
others, unless too proud, which often happens.   If
he acts absurdly, it is often because he applies to his
actions a rule  good in itself, but  the application of
which requires other considerations.
  § 49.  "The subject of the second degree of stupid-
ity judges accurately  and  sometimes even promptly,
respecting things by which he is habitually surround-
ed; but he commits  serious errors whenever it is
necessary to exert a certain vigor of judgment.   He
is embarrassed  in any  train of reasoning  however
simple it may be.  His  memory is perhaps faithful,
but it  is slow;  he cannot, without  great difficulty, 
CH. III.]
IMBECILITY.
85
 express a complex idea, if it is the result of his own
 reflections, and has not been received from  another.
 When his faculties have been  somewhat developed
 by education, he is an obstinate partisan of any thing
 which is, as we say, good in  theory but useless  in
 practice; because he cannot observe the circumstan-
 ces that distinguish  particular  cases, and appreciate
 them  according  to  their just value.   These two
 conditions are indispensable, however, to the proper
 application of general rules.
   § 50.  "In the highest degree of stupidity the in-
 dividual cannot go beyond  one single  idea; and he
 must completely lose that one before he can pass  to
 another.  Hence  he is  less capable of judging than
 the imbecile, because the comparison of several ideas
 is necessary to form a judgment.  Individuals who
 are affected with stupidity in the third degree, often
 express themselves in half-uttered  words, return in-
 cessantly  to  the same subject, make  known  their
 ideas by sentences, short, incoherent, and unfinished,
 like children who can retain  words but do not  know
 how to connect  them  together; they often express
 the subject and the attribute, without connecting the
 one to the other by the affirmative or negative.  If
 they wish  to say, 'the  rose  is beautiful,' they will
 say,  'rose  beautiful,' or only 'rose,' or 'beautiful,'
 according as  the subject or attribute strikes  them
 most. Often they reverse the natural order of words,
 and say, for example,  'rose beautiful is;' and  when
 they perceive an omission which they wish to repair,
 they become still more perplexed."
   § 51. It does not need the  high authority of Es-
quirol  to  convince us,  that these distinctions are 
86   MEDICAL  JURISPRUDENCE OF INSANITY.  [CH. III.

drawn with a minuteness and show of accuracy that
savor more  of the labors  of the  closet than of the
rigid and faithful observation of nature.  This objec-
tion, however, which might not have been unsuspect-
ed by the author himself, does not entirely destroy
the utility of his attempt, so  long as it is admitted to
be an approximation  to  the  truth;  for, with all  its'
defects, it establishes the important fact that mental
deficiency  is distinguished by various grades of in-
tensity, instead of being invariably the same condition,
and therefore that it  is properly subject to precisely
the same legal regulations.   It is a material defect
in the above descriptions, that the state of the moral
faculties is  seldom adverted  to, though their devia-
tions from  the  normal condition are no less striking
than those  which the intellectual  powers  exhibit.
Whatever may  be  their  character, it is obvious that
their  ordinary  relations  to the intellect must be af-
fected, and  thus the  idea  is forced upon us, that as
accountable beings, the subjects of mental  deficiency
must be viewed in a very different light from that  in
w7hich we are accustomed  to  regard  those of sound
and  well-developed  minds.    The  observations  of
Georget on  the moral faculties of imbeciles, partially
supply  this defect in  Hoffbauer's descriptions, and
therefore are worthy of notice in this connexion.
   ^52.  "In hospitals  for  the  insane,"  says  he,
" there  is always  a certain number of  imbeciles who
do the coarser work of the  house, or serve  as domes-
tics and assistants  to the regular officers.   They be-
come sufficiently intelligent at last, to perform their
duties well,  to sweep the courts, carry burdens, move
machines, execute  simple commissions, know the use 
CH. III.]
IMBECILITY.
87
of  money, and procure various enjoyments.  But
they have no idea, or a very imperfect one, of society,
laws, morality, courts and trials; and  though they
may have the idea  of property, they have  no con-
ception of the consequences  of theft.   They  may
have been taught to refrain from injuring others, but
they are ignorant of what would be done to them if
guilty of incendiarism or murder.  Indeed, it is well
known  how common theft is  among  imbeciles and
idiots,  and for a very obvious reason.  Some of them
have no conception of property, nor of the  distinc-
tions of meum  and tuum;  their  conduct  is actuated
solely by the fear of punishment when capable of ex-
periencing this sentiment,  and by their own  desires.
Others have some notions of property, but neither a
sense of morality, nor a fear of punishment  furnish
motives  sufficiently powerful  to prevent them from
stealing.   The sentiment  of cunning, too,  may be
very much developed, while the other faculties are
more or less deficient.  Among the lower orders  of
society,  are  many  imbeciles  a little  more  intel-
ligent  than  these,  and not  considered as  utterly
devoid of understanding, who,  nevertheless have but
vague and imperfect  notions of social duties  and  of
justice.   They engage  in occupations that  require
no great extent of intellect, and even in  the simplest
of the mechanic arts.  If they do not  pass among
their acquaintances  for  imbeciles, they  are at least,
regarded as singular beings, with feeble  understand-
ings, and are  teazed and  tormented in innumerable
ways.   Many  of them, for want  of some powerfully
restraining motive, indulge in  drinking, and  become
lazy, drunken, and  dissipated, and finally fall into 
88    MEDICAL  JURISPRUDENCE  OF INSANITY.   [CH. III.

the hands of justice in greater  numbers than is gen-
erally  suspected.   They steal adroitly, and  hence
are considered  as very intelligent; they recommence
their  offences the moment they  are  released from
confinement, and thus are believed to be obstinately
perverse; they are violent  and passionate, and the
slightest motive  is sufficient  to  plunge them into
deeds of incendiarism and murder.  Those who have
strong sexual  propensities,  soon  become  guilty of
outrages on female chastity.  I have had occasion to
see many examples of this class in prisons,  who had
been judicially decided  to be  rational,  but  whose
demi-imbecility was manifest enough to me." *
  If this  is  a  correct representation  of the  moral
character of the lesser grades of imbecility—and the
ability and good-faith of Georget are not to be doubt-
ed—it may  be  easily imagined, without the help of
further description, what  it must be in the higher
degrees.
  § 53. The prevalent  error  of looking at mind in
the abstract, as a unique principle endowed  with a
certain appreciable measure of strength  and activity,
has been the cause  of much dispute and discrepancy
of opinion, in cases where the  acts of persons  affect-
ed with Hoffbauer's first degree of imbecility, have
been made the  object of judicial investigation.  One
witness has observed a range and tenacity of mem-
ory wdiich he could not square with his notions of
mental weakness;  another, perhaps,  has  seen the
  1 Discussion medico-legale sur la Folie. p. 140; and Des maladies
mentales, considerees dans leurs rapports avec la legislation civile et
criminelle, p. 8. 
CH. III.]
IMBECILITY.
89
party whose acts are in question conducting himself
with the utmost propriety, and  observing  the  social
usages proper to his station, and this he has deemed
incompatible  with  imbecility of mind; and  another
has heard him replying to questions on common-place
subjects, readily and appropriately, and he also draws
similar conclusions.  On  the other hand,  he is  seen
engaging in occupations and amusements, and asso-
ciating with company seemingly below the dignity of
his age, or station, by one  who  desires no further
proof of an imbecile mind; or he may be so extrava-
gantly vain of some personal accomplishments, as to
impress another with the idea,  that his  understand-
ing has scarcely the strength of a child's.   And it is
worthy of  notice that oftentimes the very fact  which
furnishes undoubted  proof of imbecility to one ob-
server, conveys an unshaken conviction  of mental
soundness, to another.  Few, indeed, are capable of
sounding the  depths of another's intelligence, because
few are aware of the  necessity, or have the ability if
they  were, of scrutinizing,  not one act or trait of
character alone, but  every  intellectual manifestation
as it appears  in the conduct, conversation and man-
ners, as the only means of obtaining an  insight into
his real, mental capacity.  Scarcely a case comes up
in which the  understanding  of an imbecile is  judi-
cially  investigated, that does  not furnish  striking
illustrations of this fact,  as  might be shown by nu-
merous instances in point.   The following, however,
which occured in 1832, may serve as examples.
   § 54. " MissBagster was a young lady of fortune,
and perpetrated a runaway-match  with Mr. Newton.
An application was made by her  family  to dissolve 
 90    MEDICAL JURISPRUDENCE OF INSANITY. [CH. III.

 the marriage, on the ground that she w7as of unsound
 mind.  The facts urged against her before the com-
 missioners,  were, that she had been a  violent, self-
 w7illed, and  passionate child ;  that this continued till
 she grew up ; that she was totally ignorant  of arith-
 metic, and therefore incapable of taking care of her
 property; that she had evinced a great fondness for
 matrimony,  having  engaged herself to  several per-
 sons ; and that, in many respects, she evinced little
 of the delicacy becoming her sex.  Dr. Sutherland
 had visited her four times, and came to the conclu-
 sion that she was incapable of taking care of herself
 or of her property.   She  had memory,  but neither
judgment nor reasoning power.  Dr. Gordon did not
 consider  her capacity  to  exceed that of a child of
 seven years of age.  Several non-medical witnesses
 who had known her  from infancy, spoke of her ex-
 tremely passionate, and occasionally indelicate con-
 duct.   On her  examination,  however,  before  the
 commissioners, her answers were pertinent and in a
 proper manner.  No indelicate remark escaped from
 her.   Drs. Morrison and Haslam had  both visited
 her, and were not disposed to  consider  her imbecile
or idiotic.  She  confessed and lamented her  igno-
rance of arithmetic,  but said  that  her grandfather
sent excuses when she w7as at  school, and begged
that she  might not be  pressed.  Her conversation
generally impressed  these gentlemen  in a favorable
manner as to  her sanity.  The jury  brought  in  a
verdict, that Miss Bagster had been of unsound mind
since November 1, 1830, and the marriage was con-
sequently dissolved." *
1 1 Beck, Medical Jurisprudence, 579. 
CH. III.]             IMBECILITY.                  91

   § 55. There would seem to have  been no doubt
as to the existence  of some degree of mental defi-
ciency in this young lady; the question was, whether
it was constitutional, or  merely the result of a neg-
lected  education and misplaced  indulgences.   In
proof of its constitutional nature, we  have the opin-
ion of a respectable physician, that she was incapa-
ble of taking  care  of herself or  of her  property  ;
and of another, that her capacity did not exceed that
of a child seven years old, which opinion is corrobo-
rated by the  facts  in evidence, that she was ex-
tremely passionate, and often  indelicate in her con-
duct ;  that her mind ran greatly upon matrimony  ;
and that she had not made  the most ordinary attain-
ments in knowledge.  On the other hand, it appears
that  her education was unquestionably neglected;
that,  before  the commissioners, her answers were
pertinent and in a proper  manner ;  and that  two
eminent physicians were not disposed  to consider
her idiotic or imbecile.   It is  obvious, that in cases
like this, the opinions of the medical  witnesses will
depend, very much, if not  altogether, on the extent
of their previous acquaintance  with  the manifesta-
tions of the mind, both  in its  normal  and abnormal
conditions.  Hence it is that a trait by no  means in-
compatible with imbecility was considered,  in this
case, as indicative  of a  proper soundness of mind.
Persons  laboring  under far  more imbecility than
Miss  Bagster are  capable,  on  occasions,  of con-
trolling themselves and concealing their more promi-
nent faults, to such a degree that a stranger finds it
difficult to believe, that in point  of understanding,
they are much below the level of ordinary  people. 
 92    MEDICAL JURISPRUDENCE OF INSANITY.   [CH. III.

 It should be recollected that imbecility is manifested
 in the conduct and manners, as well as the thoughts
 and language ; and when it is considered,  that per-
 sons like Miss Bagster, are  confessedly of narrow
 understandings, and often  of defective education, it
 could not be expected that strong indications of im-
 becility  would be  observed  in  their  conversation
 alone.   Her answers,  it  seems,  were  pertinent,
 and properly delivered, as  they might  well have
 been, if they related to things,  in  which  she w7as
 particularly  interested  and  were  not beyond  her
 powers of comprehension,  and  she  still  have been
 imbecile or  stupid.  In  the description  of the first
 degree of imbecility,  already  quoted (§  44),  Hoff-
 bauer expressly says that " the individual can very
 well judge respecting objects  to which he is daily
 accustomed,  and in familiarity with which  he may be
 said to have  grown up."  It may be also added, that
 their answers are sometimes not  only pertinent,  but
 characterized by considerable  pith and shrewdness.
  Miss Bagster's education was, no  doubt, grossly
 neglected, but this circumstance could  not have pi»o-
 duced  so much mental deficiency as to have im-
 pressed a careful  and  intelligent observer,  with  the
 conviction that her capacity did not exceed that of a
 child seven years old.   Neglected or  vicious educa-
 tion is  a  cause of ignorance, but can never degrade
 the mind into a state of imbecility or stupidity, which
 are always congenital,  or the effect of  disease.  Dr.
 Morrison indeed stated under  oath, that  he  would
 undertake to teach her, in six months,  arithmetic
 and the use  of money,  but his success would have
been far from disproving the existence  of  imbecility. 
CH. Ill]
IMBECILITY.
93
It is not doubted that in this condition of mind, there
is some susceptibility of education, and the cases are
not unfrequent, where, in regard  to one or two par-
ticular powers, the individual is quite on a level with
his  more happily-endowed fellow-men.
  § 56. In the case of Portsmouth v.  Portsmouth,
which was a suit of nullity of marriage, on the ground
of the mental unsoundness (which  was, in fact, im-
becility in the first degree) of the husband, the earl
of Portsmouth, numerous  facts  were  deposed to by
witnesses, in proof  that he possessed  a  capacity and
understanding fully  equal to the ordinary  transac-
tions of life.   It appeared that when at school, he
evinced a very good memory, and made a respecta-
ble proficiency in arithmetic and the languages ; and
that, after coming of age, he settled accounts with
his  agents,—attended public  meetings  and  commit-
tees,—prosecuted an offender and was examined as a
witness,—and that his friends  had  failed  in making
him the object of a commission  of lunacy.  In regard
to these circumstances, the court, Sir John  Nicholl,
observed in substance, that the capacity for instruc-
tion and improvement is possessed even by the brute
creation, and therefore did not  of itself disprove the
fact of imbecility ; that when he  appeared as a wit-
ness in a court of justice, it was only a simple fact
he had to  state,  requiring little,  if any thing,  more
than memory, and that  his  cross-examination could
require nothing more than the recollection of facts—
not any considerable exercise of  the  understanding
and of the reasoning powers ;  that his  behavior in
company, and his  few observations on the state of 
94     MEDICAL JURISPRUDENCE OF INSANITY.  [CH. III.

the weather, horses, and  farming,  were not incom-
patible with great imbecility of mind, because, under
the restraint produced by formal company  and by
the sense  of being observed,  the  more prominent
features of imbecility would be shaded, and  the in-
dividual  might pass  as  possessing a considerable
degree of understanding.   On  the  contrary, it  was
satisfactorily proved that he had always been treated
by his family as  one  of feeble capacity, and by a
family-arrangement, he was married,  when  thirty-
two years of age, to a lady of forty-seven, evidently
for the purpose of saving  him  from improper con-
nexions, and obtaining for him suitable care and pro-
tection.  It appeared  that his servants were   his
play-fellows, and that he  played  all sorts  of tricks
with them ; that he was fond of driving a team,  and
that his wife so far indulged him,  as to have a team
of horses  kept for  his amusement  as a toy  and a
plaything, with which he  carted  dung, timber,  and
hay;  that he had a propensity  for bell-ringing, was
fond of slaughtering cattle, and indulged  in  wanton
cruelty towards man and beast, never  expressing
regret, but merely observing,  "serves him right,"
on his own acts of cruelty.  It also  appeared that a
medical man was taken into the family,  to assist in
superintending the earl, and that he obtained com-
plete  ascendancy over him, the mention of his name
being sufficient  to intimidate  him  and  exact   his
obedience.   This gentleman at last  thought prudent
to deliver up his charge  to the earl's  trustees in
London, one of whom, within one week after, mar-
ried him to his  own daughter.   This marriage  was 
CH. III.]
IMBECILITY.
95
declared by the court null  and  void.1   In the above
statement a few facts only have been  selected from
a mass of evidence given by one hundred and twenty-
four witnesses ; but  this is  sufficient to  illustrate the
general principle  that proof of imbecility is not to be
found in a few insulated facts, but in an investigation
of the whole  character and conduct of  the party.
  1 1 Haggard, 359.  The reader who wishes to extend his inquiries
farther, will find in the judgment of Sir John Nicholl, in Ingraham v.
Wyatt, 1 Haggard, 384, some excellent observations on the characters
of imbecility, besides a masterly  analysis of evidence relative to this
condition, ranging through a life of seventy-four years. 
96   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. IV.
                 CHAPTER  IV.

    LEGAL CONSEQUENCES OF MENTAL DEFICIENCY.

   § 57.  The  general  principles that  determine the
legal relations of idiocy are so obvious, and the fact
of its existence so easily established that little occa-
sion has been afforded for doubt or diversity of opinion.
The maxims of the  law have  sprung from the sug-
gestions  of common sense,  and its provisions have
equal reference to the  best interests of its wretched
subjects and of those  who are about them.   It may
be mentioned  as a curious fact however, that while
the idiot is denied the  enjoyment of most  of the civil
rights, he is quietly left  by the constitutions of the
several states of the union, in  possession of  one  of
those political rights, that of suffrage,  the  very es-
sence of which is the deliberate and unbiassed exer-
cise of a rational will.   How this anomaly has arisen,
it is not easy to conceive.  A natural jealousy of any
attempt  to  encroach upon the popular right, might
apprehend evils  to  this institution  in  allowing the
mental qualifications of voters to be too closely scru-
tinized, but such fears could hardly have been ex-
pected in view of the  unlimited control maintained
by the law over the property and  personal liberty of
idiots.
  §  58. The little indulgence showm to imbecility in
criminal courts, sufficiently indicate that either the 
CH. IV.]         LEGAL  CONSEQUENCES.            97

psychological nature of this condition of mind is very
imperfectly understood, or the true ground on which
the idea of responsibility  reposes is not clearly per-
ceived.  Whichever it may be, it may no doubt be at-
tributed to the  prevalent habit  of studying the moral
and  intellectual phenomena in sound  and healthy
minds only, without a suspicion, apparently, of  the
great modifications they present, when the develope-
ment of the cerebral organism  is interrupted by dis-
ease.  It will be necessary, therefore, before coming
to any positive conclusions relative to the legal  ac-
countability of imbeciles, to bring  into view some
considerations  on  this point,  which have  been  too
much, if not altogether, overlooked.
   §  59. Our moral  and intellectual constitution is
constructed in harmony with the external world on
which it acts and by which it is acted upon;  the  re-
sult  of this mutual action being  the happiness  and
spiritual advancement  of an immortal  being.  Thus
endowed with the powers of performing the part al-
lotted us, and placed in a situation suitable for exer-
cising and developing them, we become accountable
for the  manner in  which they are used,—to  our
Maker, under all circumstances,  to our fellow-men,
when the institutions  of  society are  injured.  All
legal responsibility, therefore, is  founded  on  this
principle of adaptation and ceases whenever  either
of its elements is taken away.   The intellect must
not  only be sufficiently developed, to acquaint the
individual with  the existence of external objects, and
with some of their  relations to him, but the moral
powers must be sound  enough  and strong enough to
furnish, each its specific incentives, to pursue that
            G 
 98   MEDICAL JURISPRUDENCE OF  INSANITY.  [CH. IV.

 course  of conduct which the intellect has already
 approved.  It is nothing that the mind is competent
 to  discern  some  of the  most ordinary relations of
 things,  and is sensible of  the  impropriety  of  certain
 actions;—so long as  the individual is incapable by
 defect of constitution of feeling the  influence of those
 hopes and fears and of all those sentiments and affec-
 tions that man  naturally  possesses, an essential  ele-
 ment of legal responsibility is wanting, and he is not
 fully accountable for his actions.
   § 60. In  the normal mind the idea of crime is as-
 sociated with those of injury and wrrong; can we then
 impute  crime where  there is  neither  intention  nor
 consciousness of injury ?    For want of  the  higher
 and nobler faculties, the actions of the imbecile are
 contemplated by  him  solely  in relation to himself;
 not a thought enters his mind respecting their con-
 sequences to others.   For the same reason that  he
 puts to  death a brute,  that of mere  personal gratifi-
 cation,  he murders a  fellow-being, and is  constitu-
 tionally unable  to appreciate  any  difference in the
 moral character  of the  two  actions.  In the latter
 case, as in the former, he has a selfish object in view,
 and  is restrained from pursuing his purpose by none
 of the considerations that actuate the sound and well-
 developed mind.   The natural right of every  one to
 the undisturbed possession of his  own life,  and  the
 sentiment of wrong awakened by the infliction of in-
jury, are things as far beyond the sphere of his con-
 templations, as the most  difficult  problem in mathe-
 matics,  and  he merely  feels the animal  impulse—
 which to him has the strength of a natural right,—
 to appropriate to himself  whatever will conduce to 
CH. IV.]          LEGAL CONSEQUENCES.           99

his momentary  gratification.   The  thought of  the
wounds inflicted on the friends and connexions of his
victim by his decease, could not restrain him, because
the feelings of benevolence and sympathy which they
suppose, are utter strangers to his own bosom; and
it would be preposterous to expect him to be influ-
enced by  a regard to feelings  which he never  expe-
rienced himself.  The sense of future accountability
could not restrain him, for the idea of an  Almighty,
All-seeing Being, ever witnessing his actions, is  too
confused and too limited in his mind, to present  the
slightest check to the indulgence of his caprices and
passions.   The fear of punishment could not restrain
him, because his intellect can discern no  necessary
connexion between  his crime and the penalty attach-
ed to it.   To make such a person responsible for his
actions to the same degree as one enjoying the  full
vigor and soundness of the higher faculties, is there-
fore manifestly  unjust; because an essential element
of responsibility is a power to refrain from evil-doing,
which power is  furnished by the exercise of  those
faculties, that are but imperfectly, if at all, developed
in the imbecile.   The  law  looks only to  the inten-
tion, not  to  the  amount  of injury  committed; and
since  there can be no criminal  intention where there
is no consciousness  of  wrong,  it consequently cannot
reach those  wretched objects, who, to use  the  ex-
pression of one  of them, whose case will be shortly
noticed,  "can see no difference between  killing an
ox, and killing a man."
  § 61. Many, it is true, find it hard to be convinced
that one who labors under no  delusion, and enjoys a
certain degree,  at least, of  moral liberty,  may still 
100   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IV.

not be responsible for his criminal acts.   They see
perhaps that he has intelligence enough  to  perform
the inferior kinds  of employment, and feel assured
that  observation  must have made him  acquainted
with the consequences  of such acts, even though a
stranger to that high moral power which instinctively
teaches the distinctions of right  and wrong.   "He
knew better," is their language,  "and therefore jus-
tice  requires his punishment."   The error of this
reasoning arises  in the vulgar  habit of estimating the
strength  and extent of the moral faculties  by the
ability to go through certain mechanical duties, and
provide for the wants and exigencies of the present
moment.   Not  only has  this  ability no  connexion
with the  moral  sentiments, but it is not even an in-
dex of the measure of  intelligence;  any more than
the skill of the bee or beaver in erecting their struc-
tures,* is  indicative of great intellectual  resources.
These degraded specimens of  our race are not with-
out the capacity of being educated in a limited de-
gree ; and thus like those inferior animals which man
has made conducive to his comfort, they are trained
to perform some kinds of service with tolerable merit.
This, however, no more proceeds from  the kind of
intelligence that  discerns  moral  truth,  than the
isolated talent for  music  or construction not  unfre-
quently met with in the complete idiot.
   §  62. For the purpose of illustrating and  confirm-
ing the above views, some account will now be given
of a few criminal trials, the  subjects of which seem
to have been affected with mental imbecility,  stating
very briefly the facts as they are found recorded, and
accompanying them with such reflections as the par- 
CH. IV.]         LEGAL CONSEQUENCES.          101

ticular circumstances of the case require.   They are
wrell worth the consideration of every honest and un-
prejudiced  inquirer, for he will  find in them a kind
of information which  he can obtain from no  other
quarter, and  will be able to see for himself, how lit-
tle of true philosophy  has presided over the depart-
ment of criminal jurisprudence.
  §  63. I.  In November, 1821, John Schmidt, aged
17, was tried at Metz for parricide.   He had  mani-
fested from an early age, a proneness to mischief and
even cruelty.  As soon as he was old enough to run
in the streets, he would amuse himself by throwing
stones  into the rivulet, that ran  through the village,
in order to spatter and hurt the people who were
passing by, many of  whom  were injured  by  him.
They contented  themselves, however, with  charging
his parents to take care of him, for he was even con-
sidered to be mad.
  The first count in the indictment charged him with
wounding on the  head his sister-in-law, in one  of
their domestic  quarrels.  The second charged him
with an attempt on the life of one of his cousins, whom
he pushed into the water while fishing by the side of
a pond, and then  laughed  at his struggles to  extri-
cate  himself.  When  he finally succeeded, Schmidt
approached him  and asked if he were wet, and if the
water had reached his skin; the  boy, to show that it
had, opened his shirt when Schmidt plunged a knife
in his bosom.  Happily, the wound was not severe.
  On the night of the parricide, the father was boil-
ing potashes.   At four o'clock  in  the morning he
called  to his wife to come and  assist  him in  lifting
the kettle from the fire, but she  refused and ordered 
 102   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IV.

 John to go.   John went in his shirt, and set the ket-
 tle on  the floor,  and  while his  father was bending
 over to stir the potashes, he  struck him a blow with
 a hatchet lying near,  that felled  him senseless to the
 ground.   He  then  ascended to  the  garret,  where
 his  brother  and sister  were sleeping, and severely
 wounded the latter  with  the  hatchet.   On being
 seized by his brother  soon  after, he asked to see his
 father, who had just  expired; and when gratified in
 this wish,  he uttered these remarkable  words:—
 "Ah, my dear father, where are you now  ?   What
 will become  of me 1   You and my mother are the
 cause of my  misfortunes.  I predicted  it long ago,
 and if you had brought me up better,  this would not
 have happened."   When asked  what had induced
 him to commit such an atrocious  crime, he  replied
 that the devil  undoubtedly instigated him.  He also
 declared that the  itch which he had  taken from his
 sister-in-law,  was   repelled,  and, in  consequence,
frequently occasioned  a mental derangement and fits
 of fury  which impelled him to sacrifice every thing.
Several witnesses  testified that  he had always been
remarkable for profound piety  and religious habits.
He confessed to his counsel that whenever  he saw a
cutting instrument,  such  as  a hatchet, a knife, &c,
he felt  the strongest desire to seize  it, and  wound
the first person that came in his way.  His counsel
unsuccessfully pleaded in his defence mental  derange-
ment, though Schmidt interrupted him by declaring
that he was not mad.   Shortly before  the fatal hour,
iood was brought to him, but observing it to  be meat,
he refused to  eat it,  saying that in a  few minutes it
would be Friday.   As he walked barefooted  to  the 
CH. IV.]         LEGAL  CONSEQUENCES.          103

place of execution,  his confessor  asked him if the
pavement did  not hurt him?   " I wish," he replied,
" they had  made  me  walk on thorns."  When he
arrived at the  scaffold,  they cut off his hand, but he
uttered  not a word or a cry, and  remained firm  to
the last.
   §  64. Dr. Marechal, of Metz, who communicated
this  case, observes  that  he  was struck  with  the
smallness of the head,  and its singular shape, and
that  on carefully examining his skull, he found the
forehead very narrow and retreating,  the  sinciput
tolerably high, and a  marked prominence over the
ears.  He said it had  the same shape as those of all
the idiots mentioned by Pinel.
   In Schmidt we have  ample confirmation of the
other indications of imbecility, in the physical struc-
ture, which speaks a language  that cannot deceive.
If his cranium were shaped like those of the idiots
described by  Pinel, what better  manifestations of
mind or morals could have been expected from one
thus stamped  by nature  with  the impress of infe-
riority ?   This furnishes an explanation of his early
indulgence in brutal propensities,   to  such a degree,
as to be regarded mad  ; and gives us a clew to the
cause of his attempts on life, solely for the moment-
ary  gratification  they afforded;  of  the  motiveless
and  cold-blooded murder of his father ;  and of that
regard of religious observances which had no better
foundation than the merest superstition. His inclina-
tion  to kill  on seeing  a cutting  instrument, shows
some morbid action in the  brain  not  uncommon in
imbecility, which is also indicated  by  the  paroxysms
of fury in which he felt himself urged  on to indis- 
104   MEDICAL JURISPRUDENCE OF INSANITY. [CH. IV.

criminate slaughter.    These  vehement  impulses,
even the slight consciousness of wrong, denoted by
his exclamation on  seeing  the  corpse  of his father,
was totally unable  to restrain ;  and,  by a  process
unknown to himself,  and which he could  only ex-
plain on the popular notion  of  the instigation of the
devil,  they  would  burst  forth  with  fatal violence.
His extraordinary proneness to mischief and  cruelty,
and the early age at which it began to appear, point
distinctly to an original defect of constitution, which,
though not attended by  what  is  properly called
mania,  furnishes  no  controlling influence over  the
purely animal propensities.   Ferocity of disposition
in imbeciles no more  implies responsibility for crimi-
nal acts, than  it does in the brutes;  and affords but
an  indifferent reason for  ridding  the  world  of their
presence.  To conclude then, we cannot hesitate to
believe with Dr. Marechal and Georget, that Schmidt
was one of those  wretched beings who are disgraced
by  nature from their  very  birth, and  whose vicious
propensities are counterbalanced neither by a  sense
of justice and  morality, nor a fear of punishment.
   § 65.  II.  Pierre  Joseph Delepine,  aged  sixteen,
was tried at Paris for eight different incendiary acts,
committed  in  the Faubourg St. Antoine, in  1825.
The first time,  a  bird with  burning  tow dipped in
spirits  attached to its tail, was  let loose in a garden
adjoining that  of the accused.  At another  time,
August 17th, a fire  broke out in  the  adjoining  gar-
den, two heaps of straw being  burnt and a part of
the wall destroyed.  Three days afterwards, a grange
belonging to  Delepine's  garden was  burned, and
three days after this, a cousin of his was awakened 
CH. IV.]-         LEGAL CONSEQUENCES.          105

by a dense smoke, and soon discovered  that a chest
containing his effects was on  fire.   The next night,
a person passing through the street, observed a heap
of straw in flames at the farther end  of the garden
which laid on the street.  He sprang over  into the
garden to render assistance, when Delepine and his
family rose and finally extinguished the fire.  While
this was being done, a bucket-full  of burning  char-
coal was discovMfed in the garret,  in  time however
to be  extinguished.   In the  morning of the  7th
September, a piece of burning  canvass was found in
a wood-closet under  the stair-case ;  and Delepine,
who expressed his astonishment,   helped  to  extin-
guish  the flames.  Soon  after, there  was  found
under  the  two  mattresses in his  sister's room, a
handful of burning flax by which  the bed-furniture
had been already set on  fire, and some was  also
discovered in  his  own  chamber,  placed under  his
pillow,  and  an hour or  two  afterwards,  a heap  of
straw in  a neighboring garden was observed  to be
on  fire.   He  was also charged with having  com-
mitted  several thefts.
   § 66. On  the trial, his father stated that the pris-
 oner's  intellectual faculties were  not what might
have been expected  from one of  his age ; and,  in
 support of his assertion, he adduced the nature of
 the criminal acts themselves, and  the  absence of
 sufficient motives to excite him to so many attempts,
 both against his own family and  people who were
 indifferent to him.   He also produced a certificate
 signed by nine of his neighbors,  which  purported
 that Delepine's thoughts and feelings were frequently
 in  a  disordered  condition;   that  he would often 
 106   MEDICAL JURISPRUDENCE OF INSANITY  [CH. IV.

 wander  in his conduct  and conversation ; that he
 wrould sometimes strip himself  naked and run like a
 madman  through his father's  garden ;  that they
 heard his- parents say that  in the  January previous,
 he attempted to hang himself,  and  sometime after,
 to  jump into a well.   It appears from the evidence
 that  he  led  an  irregular  life, was jealous  of his
 brothers  and sisters,  and  caused  his father much
 uneasiness.   At various times he h^l stolen from his
 parents,  and it was for having stolen a horse that he
 met in the street, without  its  owner, that he  was
 first arrested by the police.
   § 67.  On his trial,  Delepine replied to the ques-
 tions put to him with  calmness ;  his countenance
 was devoid of expression and presented a picture of
 stupidity.  He denied the facts charged  in  the in-
 dictment, and could  not  conceive  how  they  hap-
 pened.   The newspapers described him as having a
 low forehead ; and all the witnesses who had an
 opportunity  of knowing,  agreed  in  believing that
 there was some singular defect  in his mental organi-
 zation.   His  mother testified that for  sometime pre-
 vious, his parents had had occasion to reprove  him
 for his conduct,  and that they  had intended  to
 seclude him.   She said he was  odd,  addicted to the
 strangest tricks, and,  in short,  showed that " there
 was something wrong about his head,"  though  he
 was not  mad nor  idiotic.  This  testimony  of the
 mother was confirmed by that of eight or nine other
witnesses, who agreed in representing him as  having
been always very  odd and strange in his conduct,
and addicted  to mischief, though not mad, nor  pro-
perly speaking, idiotic.   He was, notwithstanding, 
CH. IV.]         LEGAL CONSEQUENCES.          107

convicted,  and condemned to death ; but he heard
the sentence as  unmoved as he had continued to be
during the trial.
   §  68. In a  memoir  addressed  to the  king by his
counsel, M. Claveau, he is described as being  " weak
in body, his face pale, his eye dull,  and his mind
infirm ; as  manifesting  no  disposition for employ-
ment, wrapped in silence, and subject to convulsive
agitations.   He was  in  the  habit  of shunning his
companions, and when he did incline to  join them,
he proposed only the  most  frightful  sports.  Once,
in the middle  of the night, he placed baskets on his
head, wrapped himself in the bed-clothes, and  ran
through the garden, uttering the most fearful bowl-
ings.  On one occasion he kindled  a  fire in  a stove
with thirty crackers, and though covered  with the
ruins, he was  not astonished at  the result.   After
the  trial, while in prison and in irons, and under the
eyes of his keepers, he  contrived to place  burning
coals in his bed,  and then laid down upon it while
actually on fire.  It cannot  be  doubted that he  is
enslaved by a passion  for conflagrations, incessantly
haunted by images of flames, cinders, and ruins, and
would not mind perishing himself, provided he could
enjoy the sight of them,  in the act.  He belongs to
that class of wretched beings who are doomed  from
the cradle ; who live  without motives, and  are cut
off without understanding why."  In consequence
of this memorial, his punishment was commuted for
that of imprisonment for life.
   §  69.   While  in prison he amused himself with
scribbling  his  name in every variety of  form on the
copy of the indictment  that was left with him;  by 
 108   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IV.

 wTriting on  it unmeaning or disconnected words, or
 words formed by letters put together at random; by
 drawing on it grotesque figures, and  changing  the
 letters in such a manner  that  some parts of it could
 scarcely be read.   Thus, the words, " Acte d'accu-
 sation centre  Joseph Delepine," were  changed in
 the following manner ;—Dade deaccusationiss contre
 Josephu Delapine;  and the first page is filled  with
 ink-spots, and detached and insignificant words, such
 as, Marieux, meche,  a mosire  non, dacculer, mosieur
je  dit, bonjour a monsieur leru,"  &c.   "Can it be
 conceived," says  Georget, "that a person who is
 conscious of the enormity of his crime, and who can-
 not be without some anxiety respecting the result of
 his trial,  should  be absorbed in such  puerilities 1
 that he should read such grave  charges,  not  only
 without a  single  emotion of horror, but even with
 the most perfect indifference, and  use the paper con-
 taining them for his amusement ?   Such conduct not
 only displays insensibility, which  is not rare in har-
 dened criminals, but betokens the mind  of a child;
 and in a lad of sixteen, indicates  stupidity, silliness
 and imbecility."   The physical characters attributed
to Delepine, and his manners  as  described by those
who were  in  the  habit  of frequently  seeing  him,
clearly indicate a  natural deficiency of his moral
powers; but though  his crimes were the acts  of a
child five or six years old, his imbecility alone may
not be sufficient to account for the particular form
his offences  assumed.   It  must be  borne in mind,
that in imbecility,  as  in other  abnormal  conditions,
there is not  only deficiency and irregularity, but also
a great tendency to diseased cerebral action, mani- 
CH. IV.]        LEGAL CONSEQUENCES.           109

festing itself in excessive, uncontrollable indulgence
of some one or more propensities.  In Delepine, it
assumed the form of that monomania which consists
in a morbid impulse, which the higher powers can-
not restrain,  to acts of incendiarism.  That  the  in-
cendiary acts of Delepine arose from diseased action
in the brain,  and not from mere love of mischief, is
abundantly proved by the slightest examination of
their nature.  To let loose a bird with burning tow
attached to it, without knowing or caring where it
would alight, is what,  perhaps, might have been  ex-
pected from a low and simple,  though  sound  mind,
deliberately bent on mischief;  but certainly,  nothing
less than genuine, unequivocal insanity, can  account
for his setting his own bed on fire, and then calmly
lying down upon it.   If too he had been actuated by
malice or a pure love of mischief,  it is absurd to sup-
pose that he would have chosen his own home for
its objects, and thus deliberately endeavored  to  de-
prive himself of a shelter, as well as those on  whom
he depended.   In short, the fact of imbecility, com-
bined with mania, is so plainly written on the history
of this singular  case,  that  it would be hopeless, to
attempt, by  any additional  comments, to make it
more clear to those who cannot  read  it  for  them-
selves.1
   § 70.  III.   Abraham Prescott was tried  at Con-
cord, New Hampshire,  in September  1834,  for the
  1 The facts in the above cases are taken from Georget's work, al-
ready referred to, entitled, Discussion medico-legale sur la Folie, pp.
130, 144. 
 110    MEDICAL JURISPRUDENCE OF INSANITY. [CH. IV.

 murder of Mrs. Sally Cochran.1  On the morning of
 June 23,  1833, he left home with the deceased, who
 was the wife of his employer, for the purpose of pick-
 ing strawberries in a neighboring pasture.  An hour
 and a half afterwards,  the  family heard  a whining,
 moaning sound in  the barn, which was found to pro-
 ceed from Prescott, who, on  being asked what was
 the matter with him, said that  "he had struck Sally
 [Mrs. Cochran] with a stake  and killed  her."   He
 then went with them and  showed them  the body,
 which they found  had been  dragged a little distance
 from the  place where the  murder was  committed
 and  concealed among  some  bushes.   On his  way
 thither  he asked the husband if he would hang him ;
 he showed no  disposition to escape,  though  not ar-
 rested till several hours afterwards, and slept soundly
 the succeeding night.   He  wTas eighteen years old,
 had  lived three years  in Mr. Cochran's family, by
 which he had  been  always  kindly  treated,  and his
 conduct had been  uniformly correct and satisfactory.
 No misunderstanding had occurred between him and
 any  other member of the family, and they reposed
 unlimited  confidence  in his  fidelity and attachment,
 though  on one occasion it  was strongly  tried.   On
 the 6th  of January 1833,  that  is, about six  months
 previously, he  arose  in the night,  procured  an axe
from the shed,  went  to the bed where  Mr. and Mrs.
Cochran were sleeping and struck each of them some
severe blows on the side of the  head which left them
  1 The facts of this case are derived from the report of the trial, pub-
lished at Concord, in 1834, and Irom an article in the Boston States-
man of January 9th, 1836, entitled "Execution of Abraham Prescott." 
CH. IV.]         LEGAL CONSEQUENCES.           Ill

senseless.   He then went to an  adjoining room
where Mr. Cochran's  mother slept, and told her, he
"believed  he  had killed Mr. and  Mrs.  Cochran."
They recovered however, and warmly repelled every
suspicion of the truth of his own  statement  that he
committed  the act in his sleep, unconsciously, though
he had never been known to walk  in his sleep before.
For several months after the murder,  he continued
to explain his conduct in regard to it, by saying that
while in the pasture  he  had the toothache, that he
sat down on a stump, and  fell asleep,  and  that was
the last he knew, until he found he had killed Mrs.
Cochran.   On being  much  pressed by the  coroner
and warden to confess the whole  truth, for they did
not believe that he acted without  a motive, and as-
sured by them that he would stand a better chance
of being pardoned  if he confessed, he told these offi-
cers,  that  he  made an insulting proposal to Mrs.
Cochran which she resented, and threatened to tell
her husband of and get him punished ;  that he  sup-
posed he should have to  go to prison, and thinking
he would rather be hung than go there, he caught
up a stake  and killed her.   Subsequently, he stated
that he did not make such proposals to Mrs. Coch-
ran, and uniformly denied  that he had ever so  con-
fessed;  but declared  that the coroner and  warden
had troubled him so much that he  did not know what
he told them.   To  the keeper of the jail,  and the
clergymen  who visited him, he  invariably stated,
" trfat he attempted to kill Mr. Cochran and his wife,
in  January, 1833,  in order  to get  possession of their
property; and that wdien he found  he had not de-
spatched them, he feigned  that he  had been asleep 
 112    MEDICAL  JURISPRUDENCE OF INSANITY. [CH. IV.

 when he did it.  In June, he said, that his intentions
 were, first  to  kill  Mrs. Cochran  in the hollow, and
 then call down Mr. Cochran and kill him."
   § 71. His counsel  set  up in  defence the plea of
 homicidal insanity, which  they supported by quoting
 numerous cases of this disorder, and citing the opin-
 ions of high medical authorities  and witnesses;  and
 in  short, nothing was omitted by them that could
 help to render the defence satisfactory to the jury.
 Chief Justice Richardson, in his charge, strongly in-
 clined to the belief of his insanity, and observed  that
 if the  prisoner  "had been all  the  time sane, his
 conduct had certainly been most extraordinary.  And
 on the other hand, if he  had been otherwise  than
 sane, it was a most extraordinary case of insanity."
   § 12. There certainly are strong reasons for be-
 lieving that Prescott was utterly unconscious of what
 he was doing when he murdered Mrs. Cochran, but,
 on the contrary,  a careful examination of all the cir-
 cumstances  of the case presents us with still stronger
 reasons for  thinking that  he did  know well enough
 what he was doing.  It appears perfectly  evident
 that he  belonged to that wretched class of  men, in
 whom mental imbecility is accompanied by more or
 less perversion of  the moral faculties.  Upon  any
 other  than  this  view  of  his  mental  condition, it
 is impossible to furnish  a  satisfactory explanation of
 his conduct  and the circumstances attending it.   His
 original statement that  he  was unconscious when he
 committed the murder, is opposed by his subsequent
 confessions that he  was actuated by motives; so that
 we are  presented in the outset, with the very unu-
sual case of a  criminal  defended on the ground of 
 CH. IV.]        LEGAL CONSEQUENCES.           113

 insanity,  who denies that he was insane,  and fur-
 nishes rational motives for his conduct.  There is good
 ground for believing that his last confession was the
 true one,  first,  because he could have had no reason
 then for inculpating  himself falsely, while, on the
 other hand, the hope of escaping  punishment was a
 sufficient  reason for his fabricating  the  story which
 he told at  first; and  secondly, because  it furnished
 the same  motive for the attempt to kill in  January,
 and this  establishes  a  consistent and  satisfactory
 relation between these two acts.   To remove as he
 did the only doubt in his favor founded on the suspi-
 cion of his madness, and confess  a rational motive for
 his conduct, when  none  really existed, strikingly
 indicates—not  mania, for  such  a trait is never wit-
 nessed in mania,  or at  least, not in the partial form
 of that disease—but imbecility.   We  are obliged
 therefore  to believe that he was actuated  by  a motive
 and that this motive was  a desire of gain;  and no-
 thing can more strongly show the  imbecility  of his
 mind  than the means which he took to obtain his
 object.   It seems that the  idea haunted his  mind
 that the death of the Cochrans would put  him in  pos-
 session of their property; and with this view,  "he
 thought,"  as he said, "a  thousand  times of killing
 them  along through the fall before the attempt on
 their lives in January."   When  asked if he did not
know that  the  property would descend to the child-
ren, he replied  " that he knew it would  so descend,
but he did not think of it at that moment."   In fact
he was not even the most distantly related to the
Cochrans, and had no reason whatever  for supposing
that they had made testamentary dispositions  in his
             H 
114   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IV.

favor.   His imbecility is  also strikingly manifested
in the feebleness  of  spirit  and  want of resolution
which characterized his criminal attempts.   He kills
both husband and wife in  their bed, as he supposes;
but when he returns  to  their  room  and finds them
still living, instead of  completing his work by an ad-
ditional blow, as the cool assassin would have done,
he goes and arouses the rest  of the family and the
neighbors, and tells them what he has done.   Again,
instead of taking  an opportunity when  both his vic-
tims might  be finished together, with some shade
of secrecy, he despatches one  in open day, almost
within call of help, intending to trust to his chance
of overpowering the other under  similar circumstan-
ces.   The latter  part of  this plan—that of calling
Mr. Cochran and killing him—he abandons the  mo-
ment he  has murdered the wife;  and seems then for
the first time to have thought of concealing the body
and his own share in the bloody act.  This purpose
too, he but half performs, and finally goes  and  dis-
closes the whole transaction to  the very person most
interested in knowing it.  Such conduct is perfectly
inexplicable on  the  supposition of his  possessing a
soundly-acting mind;  but  it is a fair specimen of that
vacillation of purpose, feebleness of resolution,  and
capriciousness of  design, which are  among the most
common features  of  imbecility.    Had he belong-
ed to the class of ordinary criminals, he certainly,
after obtaining the object he  had  in view in com-
mitting the murder, would either have fled, or taken
some  means of turning suspicion from himself and
provided for his escape in this last resort.  But he
was an imbecile, and because he was an imbecile, he 
CH. IV.]         LEGAL CONSEQUENCES.          115

immediately proclaims his own agency in the act,
relying for  his safety  on  the very suspicious excuse
of being unconscious of what he was doing,—an ex-
cuse which at best, would not have  saved him from
much tedious, perhaps perpetual confinement, and
the ineffaceable stigma of having  murdered a fellow
being.   Even the motive he assigned to the coroner
and  warden  and  on which  the attorney-general
rested the burden of his argument against him, sup-
posing it were actually  the  true  one, would only
strengthen  this view of his  mental condition;  for
none but an  imbecile or  an  idiot would ever have
imagined that he would be sent to jail for offering an
insulting proposal to a woman, or would have pre-
ferred hanging to temporary imprisonment, and then
added murder to  insult for the purpose of obtaining
his preference.   Nothing that appears  in what  is
said of him during his confinement gives  any higher
idea of his  moral  and intellectual powers.  The ut-
most efforts of zealous and judicious  clergymen failed
to impress him with a sense of his awful situation, or
inspire him, in the least degree, with those cheering
hopes which even the most abandoned criminals often
entertain.  This did  not  arise from a  spirit of bra-
vado, nor  from the  utter recklessness  sometimes
manifested  by the hardened victims of  the law ; but
from stupid indifference,  or sheer  inability to com-
prehend  the  simple  truths of  religion,  or imagine
any thing beyond the  present worse than the annoy-
ances to which he was  subjected.   In short, so ob-
vious was his imbecility, that the writer, from whose
statement the foregoing account is in part taken, ob-
serves that "no one  who has had any  intercourse 
116   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. IV.

with Prescott has come to the  conclusion that he is
or has been insane, but they all consider him to have
been deficient  in  intellect  or  common sense.1   The
signs  of imbecility were not  wanting even  in his
physical constitution.   A  medical witness who  had
been physician of a  private asylum for  the  insane, for
fifteen years, speaking of his appearance at the bar,
said, " the  motion  of  his  eye is  idiotic,  dull, lazy,
indifferent;  no appearance of fear or  anxiety in his
countenance.  I noticed no agitation,  nor anxiety in
the prisoner during the  examination of the first two
government witnesses."  It is also worthy of notice,
that insanity had been a common disease in the Pres-
cott family;  that his mother was fifty-six  years old
when he was born and  his  father   but   one  year
younger  ; and that  the prisoner, when a child,  had
a scrofulous or rickety affection, for which  they used
cold bathing and some external remedies.   Stronger
predisposing causes of imbecility  than these  when
combined, do not exist.2
  1 It is true, that one witness with whom the accused lived a year and
a half previous to living with the Cochrans, described him as " intelli-
gent," and another who had  been acquainted with him from a child
said, " he was as intelligent as boys in general;" but when we bear in
mind how ill-qualified most persons are to estimate the intellectual ca-
pacity of others, and that with them intelligence generally means only
manual skill, or a tolerable aptness in performing the coarser labors of
the farm and the work-shop, we shall place little reliance on these rep-
resentations, more especially too, as they are not  sustained by  other
testimony.  The keeper of the jail and his wife  who seem  to have
been particularly interested in him and to have had considerable inter-
course with him, both testified that they considered him "not as intel-
ligent as boys in general."
  * Before dismissing this case, it is gratifying to be able to add, that
the knowledge of  the phenomena of insanity in its various forms, 
CH. IV.]          LEGAL CONSEQUENCES.           117

   Such are the reasons that induce the belief, that
Prescott was a subject of imbecility, not mania—that
he belonged  to that  unfortunate  class described by
Georget (§ 52) who know no  other incentive than
the gratification of animal passion ; and who are re-
strained from evil doing by no higher sentiment than
the fear of punishment.  This  consequence he cer-
tainly should have been made to suffer in  a limited
degree ; but to mete it out to him in the same meas-
ure that is bestowed on ordinary criminals, was man-
ifestly contrary to the principles of natural justice.
   § 73. IV.    On  the  14th of May, 1833,  a  young
man,  John Barclay, was  executed at Glasgow, for
the murder of Samuel Neilson, for whom he had pre-
viously showed some  affection.  He  took  from him
three one pound notes and a watch, to obtain posses-
sion of  which seems  to have been  the cause of the
murder.   So  little sense  had he  of having  done
wrong,  or of his own situation, that he hovered about
almost without  disguise, and, while going  to  spend
part of  the money with the first person he  spoke to,
he dropped first  one and  then another note  at  his
feet, as  a child would have done.  When questioned,
he could see no difference between killing a man and
killing an  ox, except  that he  "would never hear
him fiddle again ; " and so little did he know of the
nature of the  watch, that he regarded it as an ani-
evinced by the court and by the counsel for the prisoner, and the gen-
eral correctness of their notions, were exceedingly creditable to them,
and furnish a remarkable contrast to the crude and narrow views so
commonly taken by men in similar situations, who yet have had far
ampler means of obtaining information on this branch of medical juris-
prudence. 
  118  MEDICAL JURISPRUDENCE OF INSANITY. [CH. IV.

  mal,  and  when  it stopped  from not  having  been
  w7ound up, believed it had died 'of cold from the glass
  being broken.  So obvious was Barclay's mental de-
  ficiency, that the court of justiciary,  before whom
  he was brought,  declined proceeding to his trial till
  it was decided by medical evidence, that he was a
  fit subject  for trial.  In his parish, he was familiarly
  known  as  " daft Jock  Barclay ; "  and the  clergy-
  man  who knew him well,  "  always regarded him as
  imbecile,  and had never been able  to give  him
  any religious instruction,  and did not consider him a
  responsible being."  Notwithstanding  the fact  that
  Barclay's  weakness of mind  was recognised by all
  parties from the judge downwards, and that the jury
  strongly recommended him to mercy on that account,
  he was condemned and executed.   It  appears  that
  much stress was laid  on Barclay's knowing  right
  from  wrong, as  affording indisputable  proof of his
  being a moral agent.  The  reader  is  left to judge
  for himself, how extensive and  accurate must  have
  been  the notions on this point, of one who thought a
  watch was a live creature, and could see no differ-
  ence  between killing an ox, and killing  a man.
    In  the above cases  the  imbecility was congenital,
.  and resulted from an imperfect developement of the
  cerebral organism.   In  the  following, it was the
  effect of disease,  by means of which the normal ac-
  tion of the brain was perverted.
    § 74. V. Louis Lecouffe aged twenty-four years,
  was tried  at Paris, 11th  December, 1823,  for the
  murder of a woman, whom he robbed of a quantity
  of plate.   It appears that he was an epileptic from
  infancy; and those who were in the habit of associ- 
CH. IV.]         LEGAL CONSEQUENCES.           119

ating with him always regarded  him as an idiot or
fool.   He had some disease of the head when very
young.   At fifteen, he showed manifest signs  of in-
sanity ; and affirmed that God,  from time to time,
came to visit him.  His mother,  whom he strongly
accused, and seriously compromised by his  disclo-
sures, declared, even while she stigmatised him as a
monster and a  villain, that he had always been in
bad  health,  and hardly  ever in possession  of his
senses.   At his first examination  he denied  the
charge, but subsequently  he confessed, for  the  fol-
lowing reason.   He  stated that on the  preceding
night, while still awake,  the spirit of his father ap-
peared to him, with an angel at  his  right  hand,  and
commanded him to confess his  crime ;  that God
immediately after, placed his hand  upon  his  heart,
and said to him,  "I pardon thee,"  and ordered him
to confess every thing within three days.  It appears
that his mother,  of whom he stood  greatly in awe,
had refused her consent to a marriage  he was anx-
ious to contract;  that  she refused him again on
another occasion, and, according to his confession,
she long teased him to commit the murder and rob-
bery,  and  decided  his resolution by promising no
longer to  oppose  his marriage.   The plate was
pawned for two hundred and thirty francs, of  which
his mother gave him only forty to defray the expen-
ses of his marriage.  He declared  that his  victim
was fond of him, and that he deserved her good will
by  having rendered her many little services.  On
being confronted with his mother, he did not retract
his assertions, but only showed some hesitation, say-
ing he was not himself, and experienced a violent 
 120  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IV.

 nervous attack.  He said, next  day, that if placed
 again in the presence  of his mother,  he  would be
 unable to answer for  himself;  that  she would give
 him the lie, and he would not have firmness enough
 to maintain the truth.  Her unbounded influence and
 authority over him, which were deposed to by seve-
 ral witnesses,  were such,  that he did whatever she
 ordered  him,  and absolutely  deprived  himself of
 every thing to support her,  giving her  all his earn-
 ings without daring to retain a  single sous.   The
 keeper of the  prison testified that he talked incohe-
 rently,  and that  he  seemed idiotical  and weak-
 minded.   The chief keeper  said,  that  he  had often
 seen the accused with haggard looks, and eyes filled
 with tears, complaining of headache,  but without
 manifesting any true derangement of mind.  During
 the trial he had very frequent violent attacks of con-
 vulsions, and he stated  that  when he felt vexed, a
 kind of flame or flash passed before his eyes.
   § 75. The facts  here related  may  seem  to some,
 to  establish the imbecility,  or mania,  or both, of
 Lecouffe,  beyond  a reasonable doubt; but not  so
thought the court or jury, and, accordingly, he was
condemned  and executed with  his  mother.  Cer-
tainly, nothing short of great weakness  of mind can
account for the entire  submission  of  a  man twenty-
four years old  to the despotic rule of his mother, to
whom he yielded the last sous of his earnings, sacri-
ficed his matrimonial  schemes,  on  which  he  was
strongly bent,  and  from whom he received only forty
of the two  hundred and thirty francs,  for which, at
her instigation, he   had murdered  his  benefactress.
That this mental weakness amounted to imbecility, 
CH. IV.]         LEGAL CONSEQUENCES.           121

is  satisfactorily proved by  the fear and  convulsive
agitations which he experienced  when brought into
her presence ;  by the common opinion of those who
were in the habit of associating  with him ; and by
the well-known effects of his disease on the under-
standing of its subjects.   Epilepsy, the seat of which
is  in the head, seldom  continues for any length  of
time without destroying the natural tone and sound-
ness of the mind, rendering the patient listless and
forgetful,  indisposed and unable  to  think for him-
self, yielding without any  will of his own, to every
external influence, and finally sinking into  hopeless
fatuity, or becoming incurably mad. It appears from
a  table published by  Esquirol,  that out  of  three
hundred and thirty-nine epileptics in the Salpetriere
of Paris, in 1822, two were monomaniacs ; sixty-
four maniacs, of whom thirty-four were furious; one
hundred and forty-five were imbecile, of whom one
hundred and twenty-nine were so  only immediately
after the attack ; eight were idiots ; fifty were habit-
ually rational,  but with loss  of  memory,  exaltation
of the  ideas, sometimes a temporary delirium and a
tendency  to idiocy ; sixty were without any derange-
ment of intellect, but very irritable, irascible, obsti-
nate, capricious, and eccentric.1   In these cases, the
disease probably occurred at various periods of life;
when it appears in infancy,  as it did in Lecouffe, the
proportion of those, whose minds are affected, is still
greater. If now, Lecouffe, after suffering the disease
his whole life, had still  possessed  a  sound mind, it
1 Dictionnaire de Medecine, Art. Epilepsie. 
 122   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IV.

 would have been  a fact  almost,  if not altogether,
 without  a parallel ; but that he did  not escape its
 deteriorating effects,  is abundantly proved by  the
 evidence adduced.  Occasionally,  his  mental affec-
 tion took the form of proper mania, as was indicated
 by the wildness and disorder of his looks, by talking
 incoherently to himself, by his groanings and mourn-
 ful cries in the  night, observed by one of  the wit-
 nesses,  by  his nocturnal apparitions, and by  the
 testimony of his  own  mother, that  he was almost
 never in possession of his senses.
   § 76.  Against all this  array of evidence, the ad-
 vocate-general  had  nothing to offer but  the idle
 declamation usually resorted to on  such occasions.
 The attempts of the prisoner's counsel to  establish
 the existence of imbecility and mania, he reprobated
 in the severest terms, as dangerous  to society, sub-
 versive of social order,  destructive of morality and
 religion,  and affording a direct encouragement  to
 crime.   It forms no part of  the  plan of this  work,
 to show the utter groundlessness of these assertions;
 and they are mentioned here, merely that the reader
 may see  what powerful considerations  succeeded in
 invalidating the evidence  in  favor of  Lecouffe, and
 consigning him to an ignominious end.
   § 77.  By  imbecility is  ordinarily  understood a
 deficiency of intellect;  but it has  been seen above
 (§ 56) that its signification is here extended, in order
 to include that class of subjects in whom the mental
 defect consists in a great deficiency, if not utter des-
 titution of the higher moral faculties, the intellectual,
perhaps,  not being sensibly affected.   The following
case will illustrate this form of the  disorder. 
CH. IV.]        LEGAL CONSEQUENCES.           123

  VI.  E. S.,  aged thirty-four, who had been ten
years an inmate  of the Richmond  Lunatic Asylum,
in Dublin, was brought before  Mr. George Combe,
during a  visit to  that institution,  on the 20th  of
April,  1829, to be subjected with several others,  to
a phrenological examination.  A few months after,
Dr. Crawford, the physician of the asylum, addressed
a letter to Mr. Combe  respecting this patient, from
which  the following  description is taken.   " You
observe in your notes, I am surprised he was not
executed before  he became  insane."  This  would
lead to the  supposition that  he had been afflicted
with some form of insanity, in addition to  a naturally
depraved character.  Such, however, is by no  means
the case ; he never was different from what he now
is ; he has never evinced the  slightest mental inco-
herence on any one point, nor any kind of hallucina-
tion.   It is one of those cases where there is great
difficulty in drawing the line between extreme moral
depravity and insanity, and in deciding at what point
an individual should cease to  be considered as a re-
sponsible moral  agent, and amenable to the  laws.
The governors and medical gentlemen of the asylum
have often had doubts whether they were justified
in keeping E. S,  as a  lunatic, thinking him a more
fit subject for a  Bridewell.  He appears, however,
so totally callous with regard to every moral princi-
ple and feeling—so thoroughly  unconscious  of ever
having done any thing wrong—so  completely desti-
tute of all sense  of shame or remorse when reproved
for his vices  or crimes—and  has  proved  himself
utterly incorrigible throughout life, that  it is  almost
certain that  any jury before  whom he might  be 
124  MEDICAL JURISPRUDENCE  OF INSANITY.   [CH. IV.

brought would satisfy their doubts  by returning him
insane, which, in such a case, is  the most humane
line  to pursue.   He  was  dismissed several times
from the asylum,  and sent there  the  last  time for
attempting to poison his father ;  and it  seems fit he
should be kept there for life as  a moral lunatic; but
there has never been the least  symptom of diseased
action of the  brain, which is the general concomitant
of what is usually understood as insanity." *
   § 78.  Nothing can be more  certain than that this
individual was denied by  nature  the possession  of
those moral  faculties,  the due developement  and
exercise  of which constitute an essential element  of
responsibility.   By the aid of kind  and intelligent
friends, he was secluded from  scenes,  in  which he
was unfitted  to mingle ; but if on the  contrary, he
had been suffered  to go at large, with his animal
propensities  uncontrolled  by  the  higher  powers  of
our moral nature, and constantly meeting with oppor-
tunities for indulgence,  what  else could  have been
expecyri. but some deed of violence, that would have
brought upon him  the  tender  mercies  of the law 1
Dr. Crawford, is altogether too  sanguine, in believ-
ing that a jury would have pronounced E. S. insane;
for the melancholy termination  of the  cases  above
given, teaches how little we can  here rely on the
intelligence  of courts and juries.  Had  he  com-
mitted a capital crime, he would probably have been
  1 The particulars of the last three cases are taken respectively from
the Edinburgh Phrenological Journal, No. 49; from Georget's Examen
des proces criminels, &c.; and from the Edinburgh Phrenologi-
cal Journal, vol. 6, p. 147. 
CH. IV.]        LEGAL CONSEQUENCES.           125

condemned and executed,  while  the intelligent and
the educated,  the philosopher and  the  man  of the
world,  would, for the most  part,  have joined the
unthinking populace, in thanking God, that a  mon-
ster of wickedness had  fallen beneath  the arm  of
the law.
   § 79. This  form of insanity which is above de-
nominated moral  imbecility, in order to distinguish
it from that in which the intellect  is affected,  is not
very rare in receptacles for the insane,  and is more
common in society than is  generally suspected.  Dr.
Rush says that in the course of his life, he had been
consulted in three cases of it; and nothing can bet-
ter express the true characters of their  physiology,
than  his  remark  respecting them.   "In  all  these
cases," he observes, " there  is probably an original
defective  organization in  those  parts of  the  body
which are occupied by  the moral  faculties of the
mind," 1—an explanation that will receive but little
countenance in an age, that derives  its  ideas  of the
mental phenomena from  the exclusive observation  of
mind  in a state of acknowledged  health and  vigor.
To understand  these cases  properly,  requires  a
knowledge of our moral  and intellectual constitu-
tion, to be obtained only by a  practical acquaintance
with the innumerable  phases  of the mind, as pre-
sented in its various degrees  of strength and  weak-
ness,  of health and disease, amid all  its transitions
from  brutish  idiocy to the most  commanding intel-
lect.
1 Diseases of the Mind, p. 357. 
 126   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IV.

   § 80. If the  principles above  laid  down (§§ 55,
 56,  57,) are not entirely incorrect, it follows that
 the  persons whose cases have been related, were
 not fit  subjects for criminal  punishment—at least,
 not  that of death.  The usual treatment of  such
 offenders, it is  to  be feared,  is prompted more by
 prejudice and excited feelings than by enlarged views
 of human nature and of the objects of criminal juris-
 prudence.   While  the public feeling has become too
 refined to tolerate  the infliction of blows and stripes
 on the imbecile and the mad in the institutions where
 they are confined, and is  inclined  to  discountenance
 altogether  the idea of punishment as applied  to  the
 insane, it can still be gratified by gazing on the dying
 agonies of  a being  unable to  comprehend the con-
 nexion between his crime  and the penalty attached
 to it, and utterly insensible of the nature of his awful
 situation.  The voice of reason and humanity which
 speaks successfully in the first instance is in the last
 drowned by the more imperious tones  of prejudice
 and  passion.  When imbeciles are  convicted on a
 charge of great  criminal offences, the  only rational
 course to be pursued with them, is that of perpetual
 confinement, which  at once secures society from their
 future  aggressions,  and is most conducive to their
 mental and bodily welfare.
  § 81. It  has been already mentioned (§ 51), as an
 essential defect in Hoffbauer's  descripton of the va-
rious grades of imbecility  and stupidity, that he has
almost entirely left out of view the state of the moral
faculties—an omission that is fatal to the value of the
principles which he lays  down relative to the legal
consequences of this mental condition in connexion 
CH. IV.]         LEGAL CONSEQUENCES.           127

with crime.   The ground above  taken (§§ 55, 56)
leads to the view, that the principle he has adopted, of
graduating criminal responsibility by  the  strength
and extent of the intellect alone, is exceedingly par-
tial and unjust  in  its operation.   The only condi-
tions of culpability which he recognises, are, first, a
knowledge that  the  act is  contrary  to law ; and
secondly, that the act is precisely the one prohibited
by the  law.  In the first degree of imbecility—for in
the third,  all legal culpability is  annulled—the ab-
sence of these conditions may be alleged in excuse  ;
but only, first, when  the violated  law neither forms
a part  of those general relations which  concern him-
self in common  with'  other  members of society, nor
belongs  to his  own  particular condition or circum-
stances ;  and secondly, when the action forbidden
by the law  is not contrary to the law of nature.
Accordingly,  he considers  "that inattention or ab-
sence of mind, want  of foresight, &c. are not to  be
received in excuse when they have regard to objects
universally known, as to fire, or to those which are
familiarly used by the imbecile,  as  the tools &c. of
his profession.   In all  other instances his fault loses
the degree of culpability that belongs to it, according
to the expression of jurists, in  abstracto.   This is
also the  case when the  act  is the result of sudden
anger or fear, to which weak persons are prone."  1
  § 82.  In settling the civil responsibilities  and re-
lations of the imbecile, Hoffbauer's descriptions are
not so  unsuitable for practical application ;  as these
1 Op. cit. sup. § 55. 
 128  MEDICAL JURISPRUDENCE OF  INSANITY.  [CH. IV.

 must be chiefly determined  by the condition of the
 intellect alone.   As his observations, however, have
 reference in a great measure, to the legal regulations
 of his own  country,  they will be  noticed no farther
 than merely to state his opinion that when imbecility
 reaches, or approaches the  third degree, the party
 can no longer be considered capable of taking care
 of his property,  or of bequeathing it by will.
   § 83.  No cases subjected to legal  inquiry  are
 more  calculated  to  puzzle  the understandings of
 courts and juries, to mock the wisdom of the learned,
 and baffle the acuteness of the shrewd, than those
 connected  with  questions of imbecility.   Much of
 the difficulty consists,  no doubt, in a want of  that
 practical tact which  is obtained by  experience, in
 unravelling their  intricacies, and of that knowledge
 of the psychological nature of this condition of mind,
 which directs the attention  exclusively to the  real
 question at issue, and abstracts whatever is extrane-
 ous, or without any direct bearing on its merits.  It
 is  impossible to specify any particular rules for as-
 certaining the mental capacity of imbecile persons;
 for circumstances always proper to be taken into the
 account, are constantly varying with each individual
 case.   The education of the  party, the sphere of life
 in  which he has  moved, his capacity of acquirement,
his exposure to improper influences, and  especially
 the nature of the act in question,—are points which
require a  close  and  thorough  consideration.    In
 questions of interdiction which present the greatest
 difficulty, some overt  acts of extravagance, or indis-
 cretion generally appear in evidence, when the party
is  really incapable of  managing  his  affairs,  which 
CH. IV.]         LEGAL CONSEQUENCES.           129

will remove the doubts that  a  direct investigation of
his intelligence and capacity may have left behind.
It ought  to  be considered as a general rule,  that
when no acts of this kind have been committed, not-
withstanding the  management  of his  property has
been entirely in his own hands, beyond the control
of others,  the  party cannot be  interdicted on the
score of imbecility.  In  all cases it will be indispen-
sably necessary, as  Mr. Haslam advises, to investi-
gate his comprehension of numbers,  without which
the nature of property cannot be understood.  But
the assertion of this writer,  that  " if a person were
capable of enumerating  progressively to the number
ten, and  knew the force and value of the  separate
units, he  would be fully competent  to  the  manage-
ment of property," 1 is  by no means to be  admitted
as true ;  for it is  very certain  that  a  large propor-
tion of those whose  mental capacity is  unquestiona-
bly inadequate to  the management of property, have
nevertheless these arithmetical acquirements. Cases,
even, are  occasionally met  with of imbeciles who
possess  surprising  powers of calculation, but have not
the  competency  of children to  manage pecuniary
affairs of  any extent.   No doubt, the converse of
the proposition, in reference to  people of  doubtful
capacity, comes nearer the truth.   When there ex-
ists this inability of comprehending the value of num-
bers, the individual ought to be considered as legally
non compos mentis,  notwithstanding we might hesitate
to adopt this conclusion,  after an investigation of his
1 Medical Jurisprudence, as it relates to Insanity, 347
      I 
 130    MEDICAL JURISPRUDENCE OF INSANITY. [CH. IV.

 intellectual capacity in regard to the general nature
 and relations of property and business transactions.
   § 84. Imbeciles in the third degree are  evidently
 incapable  of making wills ; but not necessarily  so,
 Hoffbauer thinks,1 are  imbeciles in the  first degree,
 even when subjected to a  curator.   The purpose of
 this guardianship is to protect them from the damage
 they might do themselves if left with the administra-
 tion of their affairs, and to prevent them from enter-
 ing into engagements which  they would find it im-
 possible to perform.    But as testamentary disposi-
 tions depend on a single arrangement and one which
 the testator may have taken time to  think  upon and
 mature, they do not  require the same degree of  in-
 telligence  as  the administration  of property, and
 therefore the validity of a will ought not  to be incom-
 patible with the  guardianship or interdiction of the
 testator.   As  a  general  principle,  its  correctness
 may be admitted, because  it places no arbitrary re-
 striction on the exercise of a  natural right, the abuse
 of which  can be sufficiently prevented by judicial
 interference ;  and because, if it be rejected, we may
 have the curious  spectacle  of a person debarred  from
 having  any voice in the final disposition of his pro-
 perty—in an act which really comes within the reach
 of his understanding,—while in the continued  man-
 agement of his  property,  a  judicious committee is
paying  all the  deference  to  his wishes  and sugges-
tions which their reasonableness  deserves.   It  can-
not be denied that the nature and consequences of a
1 Op. cit. sup. § 73. 
CH. IV.]        LEGAL CONSEQUENCES.           131

testament may be sufficiently understood by many
an imbecile who is  utterly incapable of discerning
the complicated relations  that are involved in  the
management of property.   Nothing can be more
natural than that he should be attached to those who
have rendered him important services, and  perhaps
have well-founded claims on his bounty ; and if anx-
ious to leave some substantial  token of his  regard,
no legal impediment ought to prevent  him from be-
queathing them  a reasonable portion of his property.
The danger anticipated from such an exercise of the
testamentary power, is probably  more imaginary
than real ; for it can hardly be  conceived that tes-
tamentary  dispositions  which turn  the  descent of
property altogether from  its  natural  channels, to
heap it up in the lap of a stranger or a favorite, would
not be attended  by appearances of fraud or circum-
vention, that would inevitably destroy their  validity.
All that is required to  establish the wills of people
of weak understandings is that they should have been
capable of comprehending their nature and effect1—a
point entirely independent  of the accidental  circum-
stance of interdiction.   The propriety of the  practice
here advocated  was  recognised on the  14th  of Feb-
ruary,  1808, by the Royal Court of Aix  who con-
firmed the will of  the Sieur Beauquaire, a person of
weak  understanding (though at the  time of making
it he was  under  the surveillance of a curator); for
the reasons that the dispositions  of the will were
rational, and that the mind of the testator was capa-
1 Shelford on Lunacy, 275. 
132   MEDICAL JURISPRUDENCE  OF INSANITY.  [CH. IV.

ble of understanding  them,  though  too weak to be
intrusted  with the management  of his  property.1
The French  tribunals, according  to  Georget, have
ever shown themselves the protectors of the right of
making wills,  taking into  consideration the  mental
condition of the testator and  the dispositions of the
will itself.  Much injustice, therefore, might be com-
mitted  by depriving all  interdicted imbeciles  of the
testamentary power, compared  with which the tem-
porary inconvenience  that would arise  from  the ab-
sence of any statutory provisions  on the  subject, is
hardly  to be  mentioned.  Of course,  the slightest
appearance  of interference,   or improper  influence
should be closely scrutinized, and  as much less evi-
dence  required to substantiate its existence, as the
party is  more likely to have been affected by  it.
   § 85.  Imbeciles in the third degree,  and others of
whatever grade under  interdiction, are  legally inca-
pable of contracting marriage,  for  since  they are
presumed to be incapable of  transacting  business of
the smallest  amount,   they must  be equally  so,  of
becoming  a party  to a  contract which is not only to
  1 Sirey, Recueil gen. des lois et des arrets. Tome 8, p. 315.  In
coming to this decision, the Court  considered  the testator to be one of
those persons whose case is contemplated in the following article (499)
of the Civil Code, in which the power of making a will is not men-
tioned  among the civil acts, which they are  rendered unable to per-
form.  " In rejecting a petition for interdiction, the court may, never-
theless, if circumstances require,  decree that the defendant is hence-
forth incapable of appearing in suits, of making contracts, of borrow-
ing, receiving payment for debts  or giving a discharge, alienating or
pledging his  property, without  the aid of a  council which  shall be
appointed in the same judgment." 
CH. IV.]         LEGAL CONSEQUENCES.          133

affect their pecuniary interests, but their whole future
happiness and comfort.   When, however, the mental
deficiency has not been sufficient to provoke inter-
diction, though plain enough to be generally recog-
nised, it, very properly, constitutes no legal impedi-
ment to marriage, but  on proof of fraud or circum-
vention the marriage has  been pronounced by  the
courts, null and void.1   It is obvious  that no general
rule  can be applied to all such cases, for while mar-
riage might conduce to  the interests of each party in
one  case;  in another,  it  might be  equally ruinous
to the interests of one or both parties.   Every case
should be judged on its own merits, and only annulled
when the mind of either party is proved to have been
operated on by improper influences.
  1 1 Haggard Ecc. Rep. 355.  Portsmouth v. Portsmouth ; Miss Bag-
ster's case, Ante, § 54. 
134    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. V.
                 CHAPTER  V.

       PATHOLOGY AND SYMPTOMS OF MANIA.

  § 86. While medical literature is far from being
deficient in works on  Insanity considered  as  one of
the most serious maladies to which man is liable, the
popular notions respecting it  are peculiarly loose
and incorrect.  As these,  however, are  the source
of many of the faults in the jurisprudence relating
to this affection, it is necessary to enter  somewhat
into its medical history, and to discuss points  which
might seem, at first  sight, to be of an exclusively
professional nature, but a  proper understanding  of
which is absolutely necessary to save us from gross
mistakes on this subject.   Certainly no greater ab-
surdity can be imagined than that of fixing the legal
relations of persons  in  a particular state of mind,
while entertaining the most imperfect notions of what
that state  really is,—unless it may be  that of perti-
naciously  clinging  to those notions and  discouraging
every attempt to correct them,  after the progress of
scientific knowledge has shown them to be erroneous.
Before describing the phenomena of mania, it  should
be distinctly understood that it is, first, a  disease of
the brain; and secondly, that in its various grades
and forms, it observes the  same  laws  as  diseases of
other organs.   The importance of these propositions
makes it proper to state the grounds on which  they 
CH. V.]  PATHOLOGY AND SYMPTOMS OF MANIA.   135

rest; for until they are  clearly recognised  and ap-
preciated, it will be in vain to expect any improve-
ments in the medical  jurisprudence of insanity.
   § 87.  I.  Mania  arises from a  morbid  affection J
of  the brain.   The progress  of pathological  anat-
omy during the present century, has established this
fact beyond the reach of a reasonable doubt.   It can
hardly be necessary at the present time, to prove
the fact of the dependence of the mind on the brain
for its external manifestations—that,  in  short, the
brain is the material  organ  of the  intellectual and
affective powers.  Whatever  opinion may be enter-
tained of the nature of the mind, it  is generally ad-
mitted—at  least by all  enlightened physiologists—
that it must of necessity  be put in connexion with
matter, and that the brain is the part of the body by
means of which this connexion is effected. Little as
we know beyond this single fact, it  is  enough to
warrant the inference that derangement of the struc-
ture, or of the vital actions of the  brain, must be
followed by abnormal manifestations of  the mind ;
and consequently,  that  the presence  of the effect
indicates  the existence  of the cause.  If it be an
organic law, that derangement of structure is fol-
lowed and indicated by derangement of  function, it
cannot for an instant be doubted that insanity is the
result of cerebral derangement, since the  manifesta-
tion of the mind  may be considered  as one of the
functions of the brain.   Whether the morbid action
arises in the digestive, or some  other system, and is
reflected thence to the brain by means of the ner-
vous  sympathies,  or  arises primarily in  the brain,
the soundness of the above principle is equally un- 
136   MEDICAL JURISPRUDENCE OF  INSANITY.  [CH. V.

touched.  This leads us to the source of the hesita-
tion that has been evinced by pathologists to consider
the brain as the seat of insanity.
   § 88.  From the fact  that organic lesions are not
always discoverable after death in  the  brains of the
subjects of  insanity,  it  has  been  inferred that the
brain is not  the seat of  this disease ; though, if this
fact were true—it being also true that no other organ
in the  body  invariably  presents  marks  of organic
derangement  in  insanity—the only  legitimate  infe-
rence would have been,  that,  in  some cases, it is
impossible to discover such lesions by any means in
our power.  Besides,  if insanity is produced by  some
obscure affection  of the  nervous  influence, or vital
principle, as has been seriously imagined, with wdiat
consistency could the believers  in this  speculation
look  for change of structure  any  where  ?   But
the strangest  theoretical error which  this apparent
soundness of the brain in  some cases, has  occasioned,
is that of denying the existence of any material  affec-
tion at  all, and attributing the disease  entirely  to  an
affection of the immaterial principle.  If the  same
pathological principles  had guided men's reasoning
respecting this disease, that they have applied to the
investigation  of  others,  these errors  would  never
have been committed.  It will scarcely be contended,
at the present day at least, that the structural  chan-
ges, found after death from any disease,  are the pri-
mary cause of the disturbances manifested by symp-
toms during life ; or that if the  interior could  be
inspected at  the beginning of the  disease,  any of
these structural changes  would be discovered.   It is
now a well-recognised  principle, that  such changes 
CH. V.]   PATHOLOGY  AND SYMPTOMS OF MANIA.   137

must be preceded by some  change  in  the  vital ac-
tions of the part where they occur.  This vital change
is now generally expressed by  the term irritation,
and nothing is implied by it relative to the nature of
this  change, more  than an  exaltation  of action.
Irritation then  is the  initial stage of disease,—the
first in the  chain of events, of which disorganization
is  the  last—and,  of course, nothing  can  be  more
unphilosophical than  to attribute  disturbances of
function, exclusively to any structural changes  that
may take place during the progress of these succes-
sive stages.  The  departure from the normal course
of vital action,  which is probably as unexceptionable
a definition of irritation as can be given, is  sufficient
to derange  the functions of the part in  which it
occurs, without producing any  visible  change in its
appearance; and hence, we may oftentimes explore
the dead body with the utmost minuteness and skill,
without being  enabled to infer from any  thing we
find, an adequate cause  of death.   Before  this  can
be found, the initial  stage must have continued more
or less time; and  though it always tends to  pass
into the subsequent stages, yet death may take place
from various causes, before they are developed  and
before  a trace of their existence can be detected.
  § 89. There is this peculiarity in the pathology of
insanity, that while the irritation deranges  the men-
tal functions so as  to be  manifest to every observer,
its sympathetic effects upon the rest  of the system
are so  slight that they contribute but little compara-
tively, by  their reaction, to  develope the stage of
inflammation. The consequence is, that'cerebral irri-
tation, sufficient to produce insanity, may endure for 
 138    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. V.

 years,  and death occur  at  last from  other  causes,
 without our being  able  to discover any morbid ap-
 pearances.   Thus  their existence,  instead of being
 essential to the disease,  is entirely the  result  of acci-
 dental  circumstances.   The probability  of  finding
 inflammation or any of its products, will depend on
 the duration of the disease,  and the share which it
 had in causing the death of the patient.  If it have
 existed for a short time  only,  or death  have been
 occasioned by some other cause, examination  will be
 likely to disclose no traces of morbid action ;  but on
 the contrary, if it have  been of long  standing  and
 have killed the patient by the constitutional  distur-
 bances it has produced, they will generally be found
 more or less abundantly.  From not properly attend-
 ing to these considerations,  pathologists have been
 led into  an egregious error by  the  absence of mor-
 bid changes,—no less  a  one than  that of denying
 the disease  to be an affection of matter, and jumping
 at the absurd conclusion, that it is the spiritual prin-
 ciple alone that suffers.
   § 90.  It has never been denied, however, that the
 traces of  disease, when they do  occur,  are oftener
 found in the brain than in any other organ ; nor that,
 in a  very large proportion of the whole number of
 cases, the brain actually  does show evident marks of
 having been diseased.  And when we  bear in mind
 the limited knowledge  of  the  cerebral  structure
 which pathologists have  possessed till  quite  lately,
 and consequently, the difficulty they must  have  ex-
perienced, in  detecting  changes from the healthy
 condition, it may well be concluded that the absence
of these changes might be attributed,  in  not a few 
CH. V.]   PATHOLOGY  AND SYMPTOMS OF MANIA.   139

instances, to the fault of the  inquirer rather than to
the nature of the disease.  Certain it is,  that as we
have become better  acquainted with the anatomy of
the brain  and with  its sensible qualities, and been
more thorough  and persevering in our examinations,
the rarer  it  has become to find  a case  of insanity
presenting no  organic  changes after  death.    The
very same observers who once could  find nothing
satisfactory  in  their  pathological  researches  in the
brains of  the insane, have changed their views, as
their field of observation has enlarged, and  their ac-
quaintance with the  whole subject has been increased
with time and practice, so that some have examined
hundreds  of subjects without finding one entirely free
from some appreciable change.
   § 91.  II. Insanity observes the  same pathological
laws as other diseases.   Notwithstanding the air of
mystery   which  ignorance  and   superstition  have
thrown around this disease, it cannot be said to pre-
sent any thing  very strange or peculiar; nor are the
discussions concerning it  involved in  the obscurity
which is generally imagined.  It   arises from a mor-
bid affection of organic matter, and is just as much,
and  no more,  an event of special providence, as
other diseases ; and to attribute  it to the visitation
of God in a peculiar sense,  is a  questionable proof
of true  piety as well  as  of sound philosophy. It
follows the same course of incubation, developement,
and termination in cure or death,  as other diseases  ;
sometimes lying dormant for months  or even years,
obscure to others, and  perhaps unsuspected  by the
patient  himself;  at others,  suddenly breaking out
with  no  premonition of its approach;  and  again, 
 140   MEDICAL  JURISPRUDENCE OF INSANITY.   [CH. V.

 after being repeatedly warded off by precautions and
 remedies,  finally  establishing itself in its  clearest
 forms; just as consumption, for instance, sometimes
 begins its ravages so slowly and insidiously as to be
 perceptible only to the  most practised observer, for
 years together,  while in  another class of patients,
 it proceeds from the  beginning with  a progress as
 rapid as it is painfully manifest. But its presence no
 one thinks  of denying  in the  former  case,  merely
 because its victim enjoys a certain degree of health
 and activity,  though  it would be no  greater error
 than to- deny the  existence  of insanity while  the
 operations of the mind are not  so  deeply disturbed
 as to be perceptible to the casual  observer.   When
 fully developed too, it may, like other  diseases, give
 rise to  severe constitutional  disturbance, or it may
 scarcely affect the system at large ; as inflammation of
 the digestive organs may occasion fever and intolera-
 ble pain, or lead  its  victim slowly to the  grave,
 hardly aware of  its presence, and in the  enjoyment
 of comparative health.  Like other diseases, insanity
 is made the object of remedial  treatment and  often
yields to judicious  administration of medicines,—a
 sufficient proof of its material origin, for though  the
rationale of the operation of bathing,   bleeding, and
digitalis, is perfectly obvious  in cerebral disease, it
is not so clear how they restore the spiritual princi-
ple to its natural vigor.  It may proceed through its
successive stages with  a severity ever increasing to
the end,  or  like many  other affections of the nervous
system, its progress may be  interrupted by periods
more or less long, of relaxation of its ordinary force,
—from a mere abatement of the constitutional ex- 
CH. V]   PATHOLOGY AND SYMPTOMS OF MANIA.   141

citement and mental extravagance,  to  complete in-
termission of the disease, when  the  patient is appa-
rently restored to all his original soundness.  In its
causes also,  insanity is under  the  dominion of no
extraordinary pathological laws.  It never arises in
a mysterious way, as if abstracted from the ordinary
relations of cause and effect, as  it would do, were it
an affection of an immaterial principle ; but its origin
may be readily  accounted for in  the same way as
that  of other diseases.   Whether proceeding from
hereditary  predisposition, or  maternal  influences
during gestation; from  the cerebral irritation pro-
duced by disease in other parts,  or by external inju-
ries  ;  from  excessive or deficient  exercise  of  the
mind ; from great predominance or indulgence of
some faculties with a small endowment or neglect of
the rest; from improper or insufficient nourishment
or air; from the unbridled license of the passions; or
the habitual use  of intoxicating  drinks ; we see  the
influence of causes precisely analogous to those which
give rise to other diseases.  Mania also furnishes an
illustration of a well known pathological law7,  in its
tendency to be confirmed and influenced by remedies,
in proportion to the length  of its  continuance—a
fact which  is totally inexplicable on  the supposition
of the  mind itself being idiopathically diseased.  In
common with other diseases it evinces the   remedial
powers, of proper air and exercise, of cheerful con-
versation, of friendly  sympathy and attention, and
of employments which furnish a  healthful play to  the
actions of the whole system, and abstract the patient
from the contemplation  of his  own condition.  In
short, throughout the whole history  of mania,  in its 
142   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. V.

various forms, we clearly discover the evidence of a
bodily disease—of a suffering  organ ; and in not a
fact respecting it  can we discover any thing anoma-
lous or at variance with the principles  of diseased
action.   If this  truth  be steadily borne in mind, it
will be a faithful  light  to our steps  ; and  no one at
all acquainted with the subject, can question the im-
portance of the influence, which it will exert on judi-
cial investigations.
   § 92. Mania then being  a disease and  governed
by the same  pathological laws as other diseases, it
will be incumbent on  us to give some account of its
symptoms;   and, since  we  consider a  well-settled
conviction  of the above views as having  an  impor-
tant bearing on  the course of legal  decisions, no
farther  reason will be necessary for going more fully
into this part of the  subject,  than at  first  blush,
might seem proper for our purpose.   So closely are
soundness and unsoundness of mind allied, that we
are met at the outset by  the difficulty already hinted
at, of discriminating in some cases  between mental
functions modified by disease, and those that are pe-
culiar though natural to  the individual.   Madness is
not indicated so much by any particular extravagance
of thought or feeling, as by a well-marked  change of
character, or  departure  from  the ordinary habits of
thinking, feeling  and  acting, without any  adequate
external cause.   To lay  down,  therefore,  any par-
ticular definition of mania founded on symptoms,  and
to consider  every person mad who  may happen to
come within the range of its application, would in-
duce the ridiculous consequence  of  making a large
portion  of mankind of unsound mind.  Some  men's 
CH. V.]   PATHOLOGY AND SYMPTOMS OF MANIA.    143

ordinary habits so closely resemble  the behavior of
the mad, that a stranger would be easily deceived ;
as in the opposite case, where the confirmed mono-
maniac  by carefully abstaining  from the mention of
his hallucinations,  has the semblance of a perfectly
rational man.   Hence, when the sanity of an individ-
ual is in question,  instead of comparing him with a
fancied standard of mental soundness, as is too com-
monly the  custom, his  natural character should be
diligently investigated, in order to determine whether
the apparent  indication  of madness, is not merely
the result of the ordinary and healthy constitution of
the faculties.  In a word, he is to be compared with
himself, not with others,  and if there have been no
departure  from  his ordinary manifestations,  he is to
be judged  sane ; although it cannot be denied that
striking peculiarities of character, such  as amount to
eccentricity, furnish strong ground of suspicion of pre-
disposition to madness.
   § 93. For the  first announcement  of this  great
principle,   that,  in doubtful cases,  the mind of  the
supposed  lunatic should be compared with his own
when in its natural, habitual state, we are indebted,
to the late Dr. Gooch,1  though it has been  since
developed  and illustrated with an  ability worthy of
its importance, by Dr. Combe in his Observations on
Mental Derangement.   If the  truths  contained in  the
following  extract  are faithfully  considered  by  the
medical student, he may be spared many an awkward
mistake which he might otherwise have committed,
1 London Quarterly Review, v. 42, p. 355. 
  144   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. V-

  and may save many a sound  and worthy individual
  from incalculable pain and annoyance.   " In investi-
  gating the nature of insanity,  the  first caution to  be
  observed is not to confound disorders of mental func-
  tions with natural qualities which sometimes strongly
  resemble them.   Many men in the full enjoyment of
  health are remarkable for peculiarities and idiosyn-
  crasies of thought and feeling, which contrast strongly
 with the general  tone and usages of society ; but
 they are not  on that account  to be  held as insane,
 because  the  singularity for which they  are distin-
 guished is with them  a natural quality, and not the
 product of disease  ; and, from  the very unlikeness  of
 their manifestations to the modes of feeling and act-
 ing of other men, such persons are, in common lan-
 guage, said to be eccentric.  It is  true that, on the
 principle already explained, of excess in size of some
 organs over the rest being favorable  to the  produc-
 tion of insanity, eccentricity involves, all other things
 being equal,  a greater than usual susceptibility to
 mental derangement ; but still it is not mere strange-
 ness of conduct or singularity of mind which consti-
 tutes its presence.   // is  the prolonged  departure,
 without an  adequate external cause, from the state of
feeling and modes of thinking usual to  the individual
 when in health, that is the true  feature of  disorder in
 mind; and the degree at which this disorder ought
 to be held as constituting  insanity, is  a question of
 another  kind,  on which we  can scarcely hope for
 unanimity of sentiment and opinion.   Let the disor-
 der, however, be ascertained to be morbid in its na-
 ture, and the chief point is secured, viz. a firm basis
 for an  accurate diagnosis ; because it  is impossible 
CH. V.]  PATHOLOGY AND SYMPTOMS OF MANIA.    145

that such  derangement can occur unless in conse-
quence of, or in connexion with,  a morbid condition
of the organ of mind ;  and thus the abstract mental
states,  which  are justly held  to  indicate lunacy in
one, may, in another,  speaking relatively to health,
be the strongest proofs of perfect soundness of mind.
A brusque, rough manner, which is natural to one
person, indicates nothing but mental  health in him ;
but if another individual who  has always been  re-
markable for a deferential  deportment and habitual
politeness, lays these qualities aside,  and  without
provocation or  other  adequate cause,  assumes  the
unpolished forwardness of the former, we may justly
infer, that his  mind is either already deranged, or on
the point of becoming so.  Or, if a person who has
been noted all his life, for prudence, steadiness, reg-
ularity and sobriety, suddenly becomes, without any
adequate change in his external situation, rash, un-
settled,  and dissipated in his  habits, or vice versa,
every one recognises at once these changes, accom-
panied as they then are by bodily symptoms, as evi-
dences of the presence of disease affecting the mind,
through  the  instrumentality of  its organs.   It is
therefore, I repeat,  not the abstract act or feeling
which constitutes a symptom ; it is the departure from
the natural and healthy character, temper and habits,
that gives it this meaning ; and  in judging of a man's
sanity, it is consequently as essential  to know what
his habitual manifestations were, as what his  present
symptoms are."
   § 94.  Mania,  under whatever form  it may  appear,
is  generally preceded, except when produced by
injuries or moral shocks, by a  change in the natural
            K 
146   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. V.

conditions designated by writers  as the period of in-
cubation.  In  the  following paragraphs by Georget,
we have a most accurate  and graphic description of
this state.   "Sometimes,"  says  he,  "the  action of
the cause is strong and rapid ; at other times, more
moderate and slow.   In  the first  case,  madness
breaks out at  the end of some hours or some days,
after a state of anxiety and uneasiness, with headache,
sleeplessness, agitation or depression, and threaten-
ing of cerebral congestion;  the patient  begins  to
babble, cry, sing,  and becomes  agitated  and wild.
He is then often taken  for a person in a state of in-
toxication,  and the mistake becomes apparent only
after examining the previous  circumstances and the
duration of the malady.   In the  other case, thought
only  becomes affected gradually,  and often  very
slowly;  the patient is  generally conscious of some
disorder in his intellectual  faculties ; he is beset by
new and odd notions,  and by unusual  inclinations;
he feels himself changing in his  affections ;  but, at
the same time, he  preserves  a consciousness of his
condition, is vexed at  it, and  tries  to conceal it; he
continues his  occupations as  much as he can ; and
lastly, as many people do in the first stage of intoxi-
cation, he makes every effort  to  appear reasonable.
Meantime,  his health continues to give way, and he
either sleeps  less  or  loses sleep  altogether ;  the
appetite diminishes or disappears ;  sometimes diges-
tion is difficult, and constipation supervenes ; embon-
point decreases, the features alter, the monthly dis-
charge becomes irregular, weak,  and at last is sus-
pended.  At the same time, there is  observed some-
thing unusual  and even extraordinary, in  the tastes 
CH. V.]   PATHOLOGY AND SYMPTOMS OF MANIA.    147

of the patient, in his habits, his affections, his char-
acter and aptitude for business ;  if he was gay and
communicative, he becomes sad, morose, and averse
to society ;  if he was  orderly and economical, he be-
comes confused and  prodigal ; if he had long ab-
stained from the pleasures of love,  he  becomes the
victim of insatiable desires, and either seeks to asso-
ciate with the other sex, or has recourse to disgrace-
ful practices ; if he was moderate  in his political and
religious opinions, he passes to an extreme exagger-
ation in both ; if he was open and candid, he becomes
suspicious  and jealous; if a  wife, she regards her
husband and  children with  indifference;  the mer-
chant neglects his business ;  tears and laughter suc-
ceed each other without  apparent  motive ;  the exte-
rior of candor and modesty gives place to an air of
conceit and assurance, which, especially in women,
astonishes  us.   But  all  these phenomena  are less
prominent than they may appear to be here, and un-
less the individual have  been insane before, no one
may suspect the nature of the ailment which torments
him ; all the questions put to him lead to no results,
except that of fatiguing and giving him pain, for the
ignorance  that prevails relative  to madness  leads
the friends to indulge in offensive insinuations, and
to charge him with frivolous  accusations,  from not
perceiving that he is  under the influence of disease
and not of reason.  Sometimes the  appetite  either
remains entire, or  is speedily recovered, as well  as
digestion, nutrition, &c.  and  it is in these circum-
stances that the conduct of the patient gives rise  to
a host of interpretations  on the part of his  relatives
and the public." 
 148   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. V.

   § 95.  " This period of incubation of mental alien-
 ation,  during which the true  state of the patient is
 generally misunderstood, or  not appreciated, may
 last a long time.   Pinel  relates,  that a man who be-
 lieved his wife to have been ill only six months, the
 period of the invasion of furious  delirium, admitted,
 after a multiplicity of questions, that the disease
 must have been going on fifteen  years.  The same
 author mentions elsewhere, that  in several instances
 the maniacal  or  melancholic  state, has begun four,
 six, ten,  or even fifteen  or  twenty years previously.
 It is often easy to go  back months, or years, in  this
 way ;  and we  finally discover  that  circumstances
 taken for causes by the friends,  are frequently only
 the consequences of unobserved  disease.   In fact, it
 often happens at that period of the  malady,  that a
 slight contradiction, or paroxysm of anger, or some
 cause equally insignificant to a person in good health,
 provokes the immediate  and complete subversion of
 reason, and gives rise to mistakes as to its true cause
 and duration." i
   § 96.  Sooner or later  this disorder of the cerebral
 functions  becomes  of a  more  obvious and positive
 character.  The struggle between the convictions of
 his sounder reason, and the impulses of this new con-
 dition,  ceases, and the patient, instead of contending
 any longer against the approaches of disease, or of
 concealing his thoughts, now believes in their reality
 and openly and strenuously avows them, except when
induced by powerful  reasons  to  pursue  a  contrary
1 Dictionnaire de Medecine, art. Folie. 
CH. V.]   PATHOLOGY AND SYMPTOMS OF MANIA.    149

course.   The symptoms of physical derangement are
also more striking and numerous.   A  febrile excite-
ment  pervades the system.  The pulse  is acceler-
ated, the eye has a wild and glassy look, the sensa-
tions have become either more acute or more ob-
scure, and the patient complains of pain in the head,
sense of weight, giddiness,  ringing in the ears.   A
singular insensibility to external impressions is often
witnessed in this stage of mania, by means of which,
exposure to intense cold, heat,  hunger and thirst, is
borne  to  a wonderful  degree, without  producing
uneasiness, or even consciousness of the  fact.   The
muscular power is sometimes inordinately developed,
the waking moments being a scene of almost con-
stant  restlessness  and agitation;  while at others,
there is an equally unnatural sluggishness and indis-
position to move about.   Hunger and thirst are sel-
dom unaffected, the patient either taking immense
quantities of food, or scarcely sufficient to supply the
wants of nature.   The maniacal patient sleeps less,
and his  slumbers  are disturbed by frightful dreams.
Such are  the more prominent symptoms  of physical
disorder which in  various  degrees  of intensity and
forms of combination, mark,the invasion of mania.
The mental disorders are of course as numerous and
various  as the mental  constitutions  of  the  insane
themselves ; and to consider any particular associa-
tion of  them as characteristic  of the state  of mind
called mania, would be only to blend things together
that have no uniform  nor necessary relations to one
another ;  and would convey no more really valuable
information, than  it would to  marshal forth  every
symptom  that has at any time  been observed in the 
 150    MEDICAL JURISPRUDENCE OF INSANITY.   [CH. V.

 countless disorders of digestion, as the symptoms of
 diseased stomach.   The  only use which the physi-
 cian makes of the latter is  to refer them as they
 occur, to some particular  derangement of that organ,
 and thus establish the ground for an appropriate and
 efficient treatment.   There  is  no  reason, why the
 same process should not  be  pursued in mania ; and
 it is because a different one has been followed, that
 the common notions of this disease are so loose and
 incorrect, as not only to be of little service in judicial
 discussions, but  absolutely in the way of arriving at
just and philosophical conclusions.   To furnish any
 light on the subject, it would be our duty to analyze
 the various  phenomena of mania, associate them by
 some natural relations,  and refer them, as far as our
 knowledge will permit, to particular faculties.   It is
 proposed therefore,  following this idea as closely as
possible, to consider mania as  affecting either the
intellectual, or  the affective faculties;  meaning by
 the former, those which make us acquainted with the
existence and qualities of external objects and the
relations of cause  and effect, and conduct us to the
knowledge of general truths ; and by the latter, those
sentiments,  propensities and  passions necessary  to
man as a social and  accountable being.   It is not
intended to convey the  idea that mania is invariably
confined to one or the other of these two divisions of
our faculties ; for though they may sometimes be
separately  affected,  the one presenting  a  chaos  of
tumult and disorder, while the other apparently re-
tains its wonted  soundness and vigor, yet more fre-
quently, they are  both  involved  in  the  general de-
rangement.   But  unless  we  study  these disorders 
CH. V.]   PATHOLOGY AND SYMPTOMS OF MANIA.    151

separately,  and recognise their independent exist-
ence—and this effect it is the tendency of the above
classification to produce,—we never shall be able to
refer them to  their true source, nor discover  their
respective influence over the mental manifestations. 
152   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. VI
                 CHAPTER  VI.

               INTELLECTUAL MANIA.

   § 97. Intellectual mania is characterized by
certain  hallucinations, in which  the patient  is im-
pressed with the  reality of facts or events that have
never occurred, and acts more or less in accordance
with such belief;  or having adopted some notion not
altogether unfounded,  carries it  to an extravagant
and absurd extent.   It may be general,  involving all
or the most of the operations of the understanding  ;
or partial, being confined to  a  particular idea, or
train of ideas.
                    Section  I.

            General Intellectual Mania.

   § 98.  This form of the disease  not only presents
the most chaotic confusion into which it is possible
for the mind to be involved, but it is  also  attended
by greater disturbance of the rest  of the functions of
the body, then any other.  " The patient sometimes
keeps his head elevated and his looks fixed on high ;
he speaks in a low voice, or utters cries and vocifera-
tions without any apparent motive ; he walks to and
fro, and sometimes arrests his  steps as  if excited by 
SEC. I.]     GENERAL INTELLECTUAL MANIA.      153

the sentiment of admiration, or wrapt up in profound
reverie.   Some insane persons display wild excesses
of merriment, with immoderate bursts of laughter.
Sometimes also, as if nature delighted  in contrasts,
gloom and  taciturnity  prevail,  with  involuntary
showers  of tears, or  the  anguish of deep sorrow,
with all the external signs of acute mental suffering.
In certain cases a sudden reddening of the eyes and
excessive loquacity give  presage of a  speedy  explo-
sion of violent madness and the urgent necessity of
a strict confinement.   One lunatic, after long inter-
vals of  calmness,  spoke  at  first  with volubility,
uttered frequent shouts of laughter,  and then  shed a
torrent of tears; experience had  taught the  neces-
sity  of shutting him up immediately, for his  parox-
ysms were at such times of the greatest violence." '
It must not be understood  that no glimpse of natural
soundness can be discerned amid all this intellectual
disorder.   Questions on  indifferent subjects may be
appropriately answered ; many of the patient's rela-
tions to surrounding circumstances may still be per-
ceived ;  and no  little acuteness  and ingenuity are
often manifested in accommodating the real and true
to the delusions under which  he labors.  The diffi-
culty is to fix the attention on a particular point, the
mind constantly running  from  one idea to another,
or absorbed in the thoughts which  happen, for the
moment, to predominate over  every  other.
  § 99. In the present state of our knowledge of the
mental constitution, it  is  not strange to find consid-
1 Pinel, Traite de alienation mentale, p. 03. 
154   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. VI

erable diversity of opinion respecting the nature or
cause of maniacal hallucinations; yet in a  medico-
legal point of view it is  important that they should
be correctly understood.  Hoffbauer * says that they
consist in a vicious relation between the imagination
and the senses by  which  the  patient  mistakes the
creations of the one for  objects really perceived by
the others.   Esquirol, not entirely satisfied with this
explanation,  divides them into two  classes, termed
by him, illusive sensations, and hallucinations.2  The
first arise in the senses,  as when  a maniac mistakes
a window for a door, passes through it  and is pre-
cipitated to the ground ;  or takes the  clouds which
he sees in the sky for contending armies ; or believes
his legs are made of glass ; or his head turned round.
In all these instances, the error refers  to  the real
impression which is ill-perceived ; there  is  an error
of sensation, a vicious relation  between the sense
which actually perceives and the  intellect  which
judges falsely of the external object.   In  the second,
on the contrary,  the senses have  no  share ; the im-
agination alone is exalted ; the  brain  is exclusively
the seat of the disturbance ;  the patient mistaking
the creations of his imagination, for  objects actually
present to his senses.  He sees  images and appari-
tions amid the thickest darkness ; hears  sounds and
voices in the most  perfect silence ; and smells odors
in the absence of all odorous  bodies.  This distinc-
tion does not seem to be well  supported.   That the
functions of  the senses  are sometimes greatly  per-
1 Op. cit. sup., § 84.          2 idem, § 82, note. 
SEC. I.]     GENERAL INTELLECTUAL MANIA.      155

verted, there can be no question ;  but it needs more
evidence than we yet have, to prove  that such per-
versions bear any part in producing these illusions  ;
more especially as Esquirol admits, that,  in what
he  terms  hallucinations,  an exalted imagination is
sufficient of itself to produce a  very similar effect.
In  senile  dementia  where, in consequence of the
decay of the senses, wrong impressions  are being
constantly received, they nevertheless give rise to
none of these delusions.   When the hero of Cervan-
tes did battle with the sheep and the windmills, it will
not be contended that  he was  laboring  under any
special optical infirmity which conveyed false impres-
sions of outward objects, because on most occasions,
the  action of his  senses was  unequivocally sound.
Ready as he was to mistake a company of peaceable
shepherds for the creations of his  disordered intel-
lect, he never imagined Sancho to be any other than
his faithful squire, for the reason  that  his reflective
faculties were not so far subverted as to be incapable
of any healthy action.   Besides, if erroneous sensa-
tion has any thing to do  with  producing these illu-
sions, we must go the length of asserting, that at such
times all the senses are disordered, or deny that the
errors of one may be corrected by the others.   It is
not so strange that vision should  sometimes be so
affected as to deceive a person with the idea that his
legs are made of glass or butter, but  it certainly is
very strange, that on such occasions, the other senses
should  all  return  equally  false  impressions;  the
touch being unable to  distinguish the feel of flesh
and blood, and the hearing the sound produced by
striking them, while they retain this power in regard 
156  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VI.

to  every other part of the body.   These  illusions
appear  to  result from a  morbid excitement  of the
perceptive faculties, whereby they are stimulated to
involuntary and irresistible activity, reproducing their
former impressions with unwonted  rapidity and dis-
tinctness, while a coexistent impairment of the re-
flective faculties prevents them from being considered
as illusions and not outward realities.   The  physi-
cian will not  unfrequently hear a patient complain-
ing of seeing  colors of the  utmost beauty and variety
of combination passing and repassing before his eyes,
or  forms  of objects of every possible  description,
whether his eyes  be open or shut, the  room dark or
light.  His understanding being sound,  he  is not
deceived, but believes them to be what they actually
are, merely  illusions; but,  if, on  the contrary,  it
were unsound, then these illusions would be taken
for realities, and he would conduct accordingly. Ben
Johnson would keep awake an  entire night, gazing
at armies of Turks and Tartars, Carthaginians and
Romans contending around his great toe ; in which
amusement there is no evidence of mania, but merely
of a morbid activity of the internal perceptive organs.
The apparitions of Nicolai of Berlin, and others of a
similar kind, arose, no doubt, from the same cause.
Indeed unnatural excitement of these organs in insan-
ity is sometimes  so  obvious and well-marked, as to
be immediately recognised and properly  understood.
Rush gives the case of a young woman who delighted
her visiters with her  efforts  in  singing  and poetry,
though  previously she had never  manifested  any
talent for either ;  and  the  author  once  attended an
insane patient of feeble intellect and defective educa- 
SEC. 1.]     GENERAL INTELLECTUAL MANIA.      157

tion, who occupied much  of her time in  making
verses, though she had not shown the slightest trace
of such a power before  the  invasion of her disease.
The faculty  of construction too  is  occasionally
heightened to a wonderful degree.  Pinel speaks of
a maniac who believed he  had discovered the per-
petual motion ;  and in the course of his researches,
he constructed some very ingenious machines.  The
only real difference, then, between hallucinations and
illusions of the senses, is, that in the latter, the mor-
bid activity of the  perceptive  faculties,  which is a
common element in the production of both, requires
to be excited by outward impressions, while  in the
former,  this effect is produced by the  remembrance
of past impressions,—a distinction that can be of but
little if  any  importance, in judicial investigations.
We have been thus particular in showing the true ori-
gin of hallucinations, that any  mistake  arising from
wrong views  of  their nature might be avoided,—an
event not altogether beyond the limits of possibility,
for one instance has come  to  our own knowledge,
where it wras  attempted  in  a court of justice, in a
neighboring state, to measure the extent of the in-
sanity by the comparative number of the senses sup-
posed to be deranged in the hallucination.
  §  100.  To determine exactly what mental impair-
ment it is which is essential to insanity,  metaphysi-
cians and  physiologists have long and anxiously
labored  with hardly  the shadow of success.  The
various definitions and  explanations to which their
inquiries have given rise, display some  ingenuity,
but  would scarcely  be worth considering  in this
place, were they not capable of an injurious applica- 
158  MEDICAL JURISPRUDENCE OF INSANITY.   [CH. VI.

tion in judicial investigations.  It has been said that
insanity consists essentially in diseased perception;
that this is the common attribute of its various kinds
and decrees.  We have seen above, however, that
in a state  of perfect mental soundness, the percep-
tions may be deeply disordered, insomuch as to give
rise to strange and  most extraordinary impressions,
while many a madman may be found  who evinces no
one single error of perception.   The doctrine that
insanity consists in false judgments, conveys no more
satisfactory  notion  of  its  essential  characters, for
though there most  certainly  is  false judgment in
every case of insanity,  it is far from being confined
to this condition of the mind.  Every  one is occa-
sionally guilty of some gross error  of judgment on
which  he  may reason accurately and arrive at spe-
cious conclusions,  without  being  considered at the
time  madder than  his neighbors.    Locke, as  if
strongly impressed with the curious fact of the coex-
istence of absurd fancies with the power of reasoning
smartly and pertinently to  a certain extent, which
is occasionally observed in the insane, remarked that
they did not seem to  have lost the faculty of reason-
ing,  " but  having joined  together some  ideas very
wrongly,  they mistake them for truths, and they err
as men do that argue right  from wrong principles."'
If Locke  had possessed any practical  acquaintance
with insanity, if he had even spent an hour in a well-
managed  hospital  for  the  insane, he  never would
have adopted this opinion, for nothing can be farther
1 On the Human Understanding, Book II. ch. xi. § 13. 
SEC. I.]    GENERAL INTELLECTUAL MANIA.       159

from the truth, than the idea that generally madmen
reason correctly from wrong  premises.   The  lady
who imagined that a tooth which a dentist had re-
moved, had slipped from his fingers and stuck in her
throat, and  insisted that she  could not swallow  a
morsel,  while she  ate and  drank heartily, was  as
wrong in her conclusion as she was in her premises;
and the man who,  like  Bellingham,  imagines that
the government has been culpably negligent of his
private interests,  and  thence  proceeds to take the
life of a person whom he believes to be perfectly
innocent, in order that he may have an opportunity
of bringing his affairs before the country, errs  in
every stage of his reasoning.  Indeed,  it is matter
of common observation,  that  maniacs display  their
insanity, not more in the delusions which they enter-
tain, than in the course they pursue in order to ac-
complish  their objects.  The last and  most  ably-
supported speculation on this subject is that of Dr.
Conolly, who makes insanity to consist in " the im-
pairment of any one or more of  the  faculties of the
mind, accompanied with, or  inducing, a defect in the
comparing faculty." '   There can be no doubt that
this power of comparison is often, perhaps, generally,
affected in  insanity ; but  it  may be  questioned
whether this  author has not referred many pheno-
mena to this faculty of the mind, which more properly
belong to some other.   And even when  the mental
disturbance does unquestionably  flow from  defect in
the comparing power, it would seem as if this defect
1 Indications of Insanity, p. 300. 
160  MEDICAL JURISPRUDENCE OF INSANITY.   [CH. VI.

were but  the consequence of one  affecting more
deeply the secret springs of thought.   It is said that
the  celebrated Pascal  sometimes  believed  that  he
was near the  brink of a fearful precipice,  and that
his attendants, to allay his apprehension of falling
down it, were accustomed to place a  chair near him,
in the direction of the supposed  precipice.  " He
then compared what was done with  what appeared
to him," says Dr. Conolly,  " and drew the just con-
clusion, that a chair could not stand upon air, beyond
the brink  of a precipice, and that he was not there-
fore in real danger."   "Whenever the  comparison
could not  be made," he adds, " the delusion yet re-
maining, he was not sane on the subject of the preci-
pice."1  Now7 it  cannot be denied that  in  both in-
stances, Pascal saw the chair, and  wras sensible that
it was in the direction of the precipice, and that the
real difference between them was, that in the former,
he could, in the latter, he could not, draw the just con-
clusion that a chair could not stand upon air. It is evi-
dent that, in this case at least, and there is much rea-
son to believe the fact is a general one—the faculty of
the mind primitively affected was that which recog-
nises the relations of cause and  effect.   We might
multiply examples of this fondness for definitions, but
enough  has been  said on this point, to  convince  the
student of legal medicine how barren of all practical
benefit, such speculations are, and to place him on
his guard  against their admission in judicial  investi-
gations, as tests, or criteria of insanity.
Idem, p. 316. 
 SEC. II]     PARTIAL INTELLECTUAL MANIA.        161

   § 101. It is not to be understood that, in this form
 of mania, the derangement is  confined to the intel-
 lectual faculties, the moral continuing to  be exer-
 cised with  their ordinary soundness.   On  the con-
 trary, the moral faculties seldom escape its influence ;
 and one of the earliest symptoms of the disease is an
 unaccountable change in  the patient's social and do-
 mestic feelings.   He becomes indifferent  to those
 whom he  loved the most ;  the  mother  thinks no
 longer of her children, or regards  them with  loath-
 ing ;  the child forgets his parents ;  the husband is
 insensible to the endearments of his w7ife ;  and love,
 attachment and friendship are replaced by hatred,
 jealousy and indifference.   These traits,  however,
 are  not  so  prominent as the intellectual  disorders,
 (except in the earliest stage of the disease)  and be-
 sides,  are very different  from those which  charac-
 terize that  form of mental derangement to be pres-
 ently described under the title of moral mania.


                    Section II.

            Partial Intellectual Mania.

   § 102. By  the ancients this form of the disease
was  called  melancholia on the supposition  that it
was always attended by dejection of mind and gloomy
ideas.  This term was used and so  understood by
modern writers, till Esquirol proved its improper ap-
plication by showing that the ideas  are not always
gloomy, but frequently of a gay and cheerful nature.
He substituted the term monomania, which  is now in
            L 
162   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VI.

general use ;  and though possessing a more correct
and definite  signification,  it. embraces, besides the
cases which come under the present division,  a class
that will be treated of under a different head.   Still,
for  convenience's  sake, the use of the term will  be
continued,  with the understanding that it always re-
fers to that form  of insanity which is the immediate
subject of discussion.
  § 103.  Monomania is often described  as  a de-
rangement  of  one or a few of the  intellectual  facul-
ties, but incorrectly, upon our views of the constitu-
tion of those faculties, many of which may be simul-
taneously deranged by the action of disease, without
necessarily producing insanity.   This point has been
already established, when  speaking  of those  affec-
tions of the perceptive faculties which give rise  to
apparitions, and change, to appearance, the outward
qualities  of objects.   A  multitude  of cases are re-
corded, in which  the  faculty of language too has
been wholly or partially lost, while the soundness of
the reasoning powers remained unimpaired ;  indeed
there is not a single perceptive faculty, whose func-
tions have not been sometimes obliterated  or dimin-
ished, without being accompanied by insane  delusion.
It is evident that  before a person can be insane, par-
tially or generally, the mental faculty or faculties
must be deranged, by which we discern the relations
of things, and arrive at the knowledge of general
truths.
  § 104. The most simple form of this disorder is
that in which the patient has  imbibed some single
notion contradictory to common sense and to his own
experience, and  which  seems,  and sometimes no 
SEC. II]     PARTIAL INTELLECTUAL MANIA.       163

doubt really is,  dependent on  errors of sensation.
Thus, thousands have believed their legs were made
of glass, or that  snakes, fish, or eels  had taken up
their abode in  their stomach or bowels.  In many
such cases the hallucination is excited and maintained
by impressions  propagated .from diseased parts, the
presence of which has  been revealed by dissection
after death.  Esquirol,  in a memoir read before the
institute,1 a few  years  since,  has related numerous
cases in proof of this  proposition,  among which  is
that of a woman who insisted she was pregnant with
the devil,  in whose womb, there  was  found after
death, a mass of hydatids ; of another, in the Salpe-
triere,  who imagined that a regiment of soldiers lay
concealed in her  belly,  and that she could feel them
struggling  and fighting with each other;   and  of
another, who believed that the apostles and evangel-
ists had taken up their abode in her bowels  and
were occasionally visited by the pope and the patri-
archs of the old testament,  in  both of  whom,  the
intestines were  found agglutinated together in conse-
quence of chronic peritonitis.  That these hallucina-
tions are not always connected with corporeal  im-
pressions of this  kind,  seems to  be proved by the
fact, that they are sometimes dissipated by the skil-
ful application of arguments, or manoeuvres, by which
the patients are made to believe themselves cured  of
their complaint.  The story of the " Turned Head,"
in the "Diary of a Physician,"  ludicrous as it is,  is
scarcely a  caricature of the  truth ; and one of M.
1 Medico-Chirurgical Review, N. S. vol. 21, p. 524. 
164   MEDICAL JURISPRUDENCE OF INSANITY. [CH. VI.

Manry's patients, who, after  thinking himself cured
of a serpent in his bowels by means of a pretended
surgical operation,  suddenly took up the idea, that
the creature had  left its ova behind  ready  to  be
hatched into a brood of young ones, was again re-
stored by  the  dexterous reply of his physician, that
the snake was a male.1   In this class of cases, the
mind  is  not observed to have  lost any of its original
vigor, and its soundness on every other topic remains
unimpaired, though there unquestionably does exist
some  derangement in the  reflective faculties.
   § 105.  In another class of cases,  the monomania
takes a  little wider range, involving a train of mor-
bid ideas, instead of being limited  to a  single  point.
The patient imbibes some notion connected with the
various  relations of persons, events, time, space, re-
sistance &c. of the  most  absurd and unfounded na-
ture,  and endeavors, in some measure,  to regulate
his conduct accordingly;  though, in most respects,
it is grossly inconsistent with his delusion.  It is cer-
tainly not one of the least curious phenomena  of our
mental  constitution, that these hallucinations will
sometimes continue  for years  together, unaffected by
time, and proceeding parallel, as it were, with the
most sound and healthy operations of the mind, though
more often,  the predominant idea instead of enduring
in this  manner is frequently changing, one insane
notion  disappearing  to give  place  to  another  and
another.  Rush says that  he knew one clergyman
and had heard of another, who were deranged at all
1 Medico-Chirurgical Review, N. S. vol. 21, p. 524. 
 SEC. II]    PARTIAL INTELLECTUAL MANIA.       165

 times, except when they ascended the pulpit, where
 they discovered,  in their prayers and sermons, all
 the  usual marks of a sound and correct mind ; and
 he speaks of a judge who was rational and sensible
 upon the bench, but constantly insane when off it.1
 The celebrated case of the Rev. Simon Browne is
 another  remarkable  instance  of this  kind.    For
 many  years before his death, he entertained the be-
 lief that "he had  lost  his  rational  soul,"  though
 during that time  he evinced great ability both in his
 ordinary conversation and  in his writings.  Having
 discontinued all  public  or  private worship, he ex-
 plained to his friends, that " he had fallen under the
 sensible  displeasure of God, who had  caused his ra-
 tional soul gradually  to perish, and left him  only an
 animal  life  in common  with brutes ;  that  it  was
 therefore profane in him  to pray, and incongruous  to
 be present at the prayers of others."   In a  book  of
 some  merit  which he dedicated to  the  queen he
 speaks of himself as "once  a man ;  and of some lit-
 tle name;  but of no  worth, as his  present unparal-
 leled case makes but  too manifest ; for by the imme-
 diate hand of an avenging  God,  his  very thinking
 substance has for more  than seventeen years been
 wasting away, till it is wholly perished out of him, if
 it be not utterly come to nothing." 2
   §  106. The operations of the understanding, even
on subjects connected with the insane belief,  are
sometimes  not impaired  in  an appreciable degree ;
  1 On Diseases of the Mind, p. 204.
  2 An account of this case may be found in the Gentleman's Maga-
zine, 1762. 
 166  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VI.

 on the contrary, we are occasionally struck with the
 acuteness of the reasoning power displayed by mono-
 maniacs.    Muratori relates  the  case of a  Jesuit,
 named  Sgambari who believed himself a cardinal,
 and claimed to be addressed by the title of eminence.
 A friend was  anxious  to convince him of his error,
 and obtained a patient hearing to his remarks.  When
 he had  finished, the madman replied ;  " either you
 consider me insane or rational; on the latter sup-
 position, you do me injustice by your remonstrances;
 on the former, I hardly know which is most mad, I,
 for believing myself a  cardinal, or you, for thinking
 to cure  a madman by such reasonings." x
   § 107.  Though monomaniacs are generally ready
 enough  to declare their predominant idea,  yet when
 sufficient inducement exists, such  as interest,  fear of
 ridicule &c. they will occasionally conceal it ;  and
 this too without the occurrence of a  lucid interval,
 and while they believe in its reality as firmly as ever.
 Chambeyron,  the French translator  of Hoffbauer's
 treatise, speaks of "a woman who on her admission
 to the Salpetriere  told one of the overseers, ' that
 she was an  apostle, and that  Louis XVIII. had re-
 membered her in his will.'   "The next day," says
he, " at my  visit, I asked her reasons for entering the
hospital.  'If I tell you,' said she, 'you  will think
me mad/   On my protesting to the contrary how-
ever,  she replied,   'well I am remembered in the
will of Louis  XVIII.'  Of the other  notion whose
absurdity was more  palpable, she said not a word.
1 Hoffbauer, Op. cit. sup. § 86, note. 
SEC. II.]     PARTIAL INTELLECTUAL MANIA.       167

Now  [a few days after] she denies that she ever en-
tertained either notion, though her conduct and con-
versation prove that she still believes  them both."
Some cases of a similar kind are also related in Ers-
kine's speech in the defence of Hadfield.
   § 108.  In the simplest form of monomania, the
understanding appears to be, and  probably is, per-
fectly sound, on all subjects but those connected with
the hallucination.   When, how7ever,  the disorder is
more  complicated, involving a longer train of morbid
ideas, we have the high authority  of Georget for be-
lieving, that though the patient may reason on  many
subjects unconnected with the particular illusion on
which the insanity turns,  the understanding is more
extensively deranged,  than  is generally suspected.
If we could  follow  these  people  to the privacy  of
their  own  dwellings,  narrowly observe their  inter-
course with their friends and neighbors, and converse
with them on the subjects nearest  t^o their thoughts,
we should generally detect some perversity of feeling
or action,  altogether foreign to their ordinary  char-
acter.   Cases  illustrative of this  remark  will fre-
quently occur  to  the reader in the course of this
work ; and it is not necessary to insist on the impor-
tance  of this fact in estimating the  degree of criminal
responsibility remaining in monomaniacs.  It  is  a
fact that must  never be forgotten, that the pheno-
mena  of insanity do not lie on the  surface, any  more
than those of other diseases, but can  be discovered
only by means of close and patient examination. 
168    MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII.
                 CHAPTER  VII.

                   MORAL MANIA.

  § 109.  Thus far mania  has been  considered as
affecting the intellectual faculties  only;  but a more
serious error on  this  subject  can scarcely be com-
mitted,  than that of limiting its influence to  them.
It will not be denied that the propensities and senti-
ments are also integral portions of our  mental con-
stitution ; and no enlightened physiologist can doubt
that their manifestations are dependent  on the cere-
bral organism.  Here then we have the  only essen-
tial conditions  of  insanity,—a  material  structure
connected with jnental  manifestations;  and until it
is satisfactorily proved that this structure  enjoys a
perfect immunity from morbid  action, we are  bound
to believe that  it  is liable  to disease,  and conse-
quently, that  the affective, as well  as  intellectual fa-
culties are subject to derangement. To moral mania,
as a distinct form of the disease,  the attention of the
profession was first directed by the celebrated Pinel
in the beginning of the present century.   Previously
to that time it was  a matter of universal  belief,  that
insanity is always  accompanied  by derangement  of
the reasoning  powers, and a recognition of this fact
entered into every  definition of the disease.  Partici-
pating in  the common belief, he  found, to his great
surprise, on resuming his researches  at the Bicetre, 
CH. VII.]            MORAL MANIA.               169

that  there were many  maniacs who betrayed  no
lesion  whatever  of the  understanding,  but were
under the dominion of instinctive and  abstract fury,
as if the affective faculties alone had sustained injury.
This form of mental disorder, he designated as manie
sans  delire.   The  examples  which he gives, being
chiefly characterized by violent anger and unbounded
fury, by no means furnish suitable illustrations of the
affection now styled moral insanity, though they do
illustrate a particular  form of that disorder.  This
defect however has been  amply supplied by the re-
searches of others, which have made us acquainted
with a great number and variety  of cases, in which
the affective faculties,  either  singly  or collectively,
were deranged, independently  of any appreciable
lesion of the intellect.  The  reality and importance
of this distinction which thus establishes two classes
of mania, is now generally acknowledged by practi-
cal observers, among whom it is sufficient to mention
Esquirol, Georget,  Gall, Marc, Rush, Reil,  Andrew
Combe, Conolly and Pritchard, though some of them
are inclined to doubt  whether the integrity  of the
understanding is so fully  preserved in moral mania,
as Pinel believed.  Still, the apparent soundness, and
the difficulty,  at least, of establishing  the existence
of any intellectual derangement, while the intellect-
ual powers are  unequivocally and deeply deranged,
render it no less important in its legal relations, than
if the understanding  were  wholly  and  absolutely
unaffected.   It  is  defined by Pritchard,  who  has
strongly insisted on the necessity  of  assigning it a
more distinct and conspicuous place, than  it has
hitherto received, as " consisting in a  morbid per- 
 170   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

 version  of the  natural  feelings,  affections,  inclina-
 tions, temper, habits, and moral dispositions, without
 any notable  lesion of the intellect or knowing and
 reasoning faculties,  and particularly  without  any
 maniacal hallucination." x   We shall distinguish it
 into, first, general,  where the whole moral  nature
 presents a scene  of  chaotic disturbance ;  secondly,
partial, where one or two only of the moral powers
 are perverted.


                    Section I.

               General  Moral Mania.

   § 110. This condition is thus vividly described by
 Pritchard.  " There are many individuals living at
 large, and not entirely separated from  society, who
 are affected in a certain degree by  this modification
of insanity.    They are reputed persons of singular,
wayward,  and  eccentric  character.  An  attentive
observer may often recognise something remarkable
in their  manner of existence,  which leads  him to
entertain doubts of their entire sanity, and circum-
stances are sometimes discovered on inquiry which
assist in determining his opinion.  In many  instances
it is found that there is  an  hereditary  tendency to
madness  in the family,   or  that several  relatives of
the person affected have labored under diseases of
the brain.  The individual himself is discovered in
1 Cyclopaedia of Practical Medicine, art. Insanity, p. 825. 
SECT]         GENERAL MORAL MANIA.         171

a former period of life to have  sustained an attack
of madness of a decided character.  His temper and
dispositions are found on inquiry to have undergone
a change ;  to be not  what they were previously to
a certain time ; he has become an altered man ; and
this difference  has perhaps been  noted from  the
period when he sustained some  reverse of fortune,
which deeply affected him, or  since the  loss of some
beloved relative.   In  other instances, the alteration
in his character has  ensued immediately  on some
severe shock which his bodily constitution has under-
gone.   This  has either been a disorder  affecting the
head, a slight attack of paralysis,  a fit  of epilepsy,
or some fever or inflammatory  disorder,  which has
produced a  perceptible change in the habitual state
of the constitution.  In some  cases the  alteration in
temper and habits has been gradual and impercepti-
ble, and it seems only to have consisted in an exalt-
ation or increase of peculiarities which  were always
more or less natural or  habitual."   "Individuals
laboring under this disorder are  capable of reasoning
or supporting an argument,  on any  subject within
their sphere of knowledge that may be  presented to
them, and they often display great ingenuity in giving
reasons for their eccentric conduct, and in accounting
for and  justifying the state of moral  feeling, under
which they appear  to  exist.   In one sense indeed,
their intellectual faculties may be termed unsound,
but it is the same sense in which persons under the
influence of strong passions may be generally said
to have their judgment  warped, and  the sane or
healthy exercise of their understandings  impeded.
They think and act under the influence of strongly 
172   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

excited feelings and a person sane is under such cir-
cumstances proverbially liable to error both in judg-
ment and conduct." l   It  was this class  of  persons
undoubtedly, that suggested the following descrip-
tion in a work published in the beginning of  the
present century.   " Among the varieties  of maniacs
met with  in  medical  pactice,  there  is one, which,
though, by no means rare, has been little noticed by
WTiters on this subject :  I  refer  to  those cases  in
which the individuals perform most of  the common
duties of life  with propriety,  and  some of them, in-
deed,  with  scrupulous exactness, who  exhibit  no
strongly marked features of either temperament, no
traits of superior or  defective mental  endowment,
but yet take  violent antipathies,  harbor unjust sus-
picions, indulge strong propensities, affect  singularity
in dress,  gait, and  phraseology; are  proud, con-
ceited and ostentatious ;  easily  excited  and with
difficulty  appeased ;  dead  to sensibility, delicacy,
and refinement ;  obstinately riveted to  the most ab-
surd opinions ; prone to  controversy, and yet inca-
pable of reasoning ; always  the hero of their own
tale, using hyperbolic, high-flown language to ex-
press the  most simple ideas, accompanied by unna-
tural gesticulation, inordinate action,  and frequently
by  the most  alarming expression of countenance.
On some occasions they  suspect sinister intentions
on the most trivial grounds ;  on others are a prey to
fear and dread from the most ridiculous  and imagi-
nary sources;  now embracing  every opportunity of
1 Op. cit. sup., p. 826. 
SEC. I.]        GENERAL MORAL MANIA.          173

exhibiting romantic courage and  feats of hardihood,
then indulging themselves in all manner of excesses.
Persons of this description,  to the casual observer,
might appear actuated by a bad heart,  but the ex-
perienced physician  knows  it is the head which is
defective.  They seem as if constantly affected by a
greater or less degree of stimulation from intoxicating
liquors,  while the  expression  of countenance fur-
nishes an infallible proof  of mental disease.   If sub-
jected to moral restraint, or a medical regimen, they
yield with  reluctance  to  the  means proposed, and
generally refuse and resist, on the ground that such
means are unnecessary where no disease exists; and
when, by the  system adopted, they are so far recov-
ered, as to be enabled to suppress the exhibition of
the former peculiarities,  and are again fit to be re-
stored to society, the physician, and those  friends
who put them under the physician's care, are gener-
ally ever after objects of enmity and frequently of
revenge."1
   § 111.  There is unquestionably a great tendency
in this affection to pass into intellectual mania, which
we have seen  is  no less  strongly  characterized  by
moral perversities than by hallucinations; and Esqui-
rol and Georget  actually describe  it as belonging
to the initiatory  stage or incubation of  the  latter
disorder.  Without discussing the point whether any
stage of a disease should under any circumstances be
erected into a distinct  affection, the  fact  that it may
continue for an indefinite  length of time and become
1 Cox, J. M., Practical Observations on Insanity.  London, 1804. 
 174  MEDICAL JURISPRUDENCE OF  INSANITY.  [CH. VII.

 the object of judicial investigation, gives it incalcula-
 ble importance in a medico-legal point of view, and
 entitles it  to a prominent place in a w7ork like the
 present.   Heinroth and Hoffbauer both  recognise
 a form of. mental alienation consisting  exclusively of
 morbid excitement of the passions and feelings.  " It
 is clear, says the latter, that mania may exist uncom-
 plicated with mental delusion ;  it is in  fact only a
 kind of mental exaltation, (tollheit) a state  in which
 the reason has lost its empire over the passions and
 the actions by which they are manifested, to such a
 degree that the individual can neither repass the for-
 mer, nor abstain from the latter.   It does not follow
 that he may not be  in  possession  of his senses and
 even his usual intelligence, since,  in order to resist
 the impulses of the  passions, it is not  sufficient that
 the reason should  impart  its counsels ; we must have
 the necessary power  to  obey  them.  The maniac
 may judge correctly of his actions  without being
 in a condition to repress his passions, and to abstain
 from the acts of violence to which they impel him."1
 Subsequently he observes, that when mania proceeds
 from inordinate passions,  " its more immediate cause
 lies in the  physical temperament, or in  certain moral
 affections which induce frequent occasions of anger.
 In every other respect, the maniac may be master of
 his propensities and the actions to  which  they lead ;
 he  may judge and act  rationally.  He is irrational
 only in his paroxysms of  fury, and then his errors of
judgment are rather the effect than the cause of his
 furious transports."2
1 Op. cit. sup. § 122.
s Ibid. § 126. 
SEC. 1.]       GENERAL MORAL MANIA.           175

  § 112. The form of mental disorder which we are
now considering,  has  been so little noticed by wri-
ters, while an ample -knowledge of its phenomena is
essential to the correct administration of justice, that
no farther apology is  needed for  illustrating it with
several  examples collected from  the observations of
others.   The first is  related by Pinel as belonging
to his manie sans delire.   "An only son  of a weak
and indulgent mother was encouraged in the gratifi-
cation of every caprice and  passion of which an un-
tutored  and violent temper was  susceptible.   The
impetuosity of his disposition increased with his years.
The money with which he was lavishly supplied re-
moved every* obstacle to the indulgence of his wild
desires.  Every instance of opposition or resistance
roused him to acts of fury.   He assaulted his adver-
saries with the audacity of a savage ;  sought to reign
by force and was perpetually embroiled  in disputes
and quarrels.   If a dog,  a  horse, or  any other ani-
mal offended him, he instantly put it to death.  If
ever he went to a fete or any other public meeting,
he was sure to excite such tumults and  quarrels as
terminated in actual  pugilistic encounters, and he
generally left  the scene  with  a bloody nose.   This
wayward youth,  however, when unmoved by pas-
sions, possessed a perfectly sound judgment.  When
he became of age, he succeeded to the possession of
an extensive domain.   He proved himself fully com-
petent to the management of his estate, as well as to
the discharge of his relative duties, and he even dis-
tinguished himself  by acts of beneficence and  com-
passion.   Wounds, law-suits,  and pecuniary  com-
pensations were  generally  the consequences  of his 
176   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

unhappy propensity to quarrel.   But an act of noto-
riety put an end to his career of violence.  Enraged
with a woman who had used offensive language to
him, he  precipitated her into a  well.   Prosecution
was commenced against him  ; and on the deposition
of a great many witnesses who gave evidence to his
furious deportment, he was condemned to perpetual
confinement in the Bicetre." 1  In this instance there
was something more than  the unrestrained indul-
gence of strong passions, though, no doubt, the pas-
sions  of this  person  were  naturally   remarkably
strong and active ; the understanding, though sound,
was incapable  of restraining their impulses, for  the
reason that they were  excited by disease and there-
fore beyond its control.   The constant excitement of
passions already too  much developed by means of a
vicious education, led to that condition of mind in
which the healthy balance of the  affective and intel-
lectual faculties,  is destroyed,—in other words,  to
moral mania.   A case of a very similar character to
this, and to which the  rank  of the person and  the
disastrous results of the affection have given a melan-
choly preeminence over all  others  in  the medico-
legal history of the disease,  is that of earl Ferrers,
who was  executed in  1760, for  the murder of  his
steward.   It differs from the above in  exhibiting a
more  advanced stage  of the disease, and in  more
distinctly revealing its approximation to intellectual
mania by the  unfounded notions  which  the  patient
had imbibed.   Though his  reasoning powers  were
1 Sur PAlienation Mentale, p. 156, § 159. 
 SEC. I.]        GENERAL MORAL MANIA.           177

 sound and his conversation rational,  he  imagined
 that his  relatives had  formed  a  conspiracy against
 him in which his  victim was an accomplice  ; and his
 conduct  in many respects was  so wild  and strange,
 as to excite in those who were in the habit  of  meet-
 ing him, a suspicion, and even conviction of his in-
 sanity.1
   § 113.  The following  case from  Metzger is cited
 by Hoffbauer, who observes that the patient labored
 under no delusion, properly speaking,  but  was only
 not master of his  actions.
   A Russian colonel came to Konigsberg to receive
 an inheritance, and committed there so many acts of
 violence, that he was summoned  before the tribunal
 of justice.  His conduct  before the magistrates  was
 equally unreasonable.   He had become so  much an
 object of  dread at Konigsberg, that  nobody would
 execute any commission for him—the very chimney-
 sweepers required a guard if sent to sweep his  chim-
 neys.  At last, after several complaints made against
 him, he was arrested because he had threatened to
stab his landlord  with a pitchfork  for  demanding his
 rent, and pursued him with that intent.   "In  going
 into the prison,"  says Metzger,  " I saw an  old man
 with white hair,  of a respectable appearance,  who
  1 A report of Earl Ferrers's trial may be found in Hargrave's State
Trials, and it is noticed at considerable length in Smollet's Continua-
tion of Hume's History of England.  Some valuable comments on this
case, are contained in Combe's Observations on Mental Derangement, p.
204, to which every reader is referred, who is more anxious to en-
lighten his mind by correct facts and philosophical views, than to con-
firm his errors and gratify his prejudices by obstinately shutting his
eyes agaiust the progress of scientific improvement.
              M 
178    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

received, me politely.   I first inquired concerning
his health.   'I am ill, through old age,' he replied,
' and tormented with gout, with the stone, and with
the scurvy,  evils for which I  can  have no remedy.'
He desired to know who had sent me to see  him ;  I
told him it was the tribunal.   ' I ought to be judged,'
he replied,  ' by a French  tribunal,'  and he pretend-
ed that I should find proof of what he said in a writ-
ing which he forced me  to take.  At last I informed
him of the reason of his  arrest.  His eyes then spar-
kled,  and he said in French, with much volubility,
that M. M.-----and-----were his mortal enemies ;
that  they had several times tried to ruin him ;  that
he had experienced much injustice  and oppression
on the part of the tribunal; and that  they had dis-
posed, as  they pleased of his  brother's inheritance.
Being asked what were his  occupations, he replied,
' that he was,  as  every  honest man  should be,  free
and content, even in prison ; that he amused himself
with poetry, and copied verses relating to  his situa-
tion.' " 1
  § 114.  The following cases are taken from Pritch-
ard.   "I.  K., a farmer, several  of  whose relatives
had been the subjects of mental derangement, was a
man of sober and domestic habits,  and frugal  and
steady in his conduct, until about his forty-fifth year,
when his disposition appeared to have become sud-
denly changed in a manner which  excited the  sur-
prise of his friends  and neighbors,  and occasioned
grief and vexation in his  family.   He  became wild,
1 Op. cit. sup. $ 126. 
SEC. I.]        GENERAL MORAL MANIA.           179

excitable, thoughtless,  full of schemes and absurd
projects.  He would set out and make long journeys
into distant  parts of the country to  purchase cattle
and farming-stock, of which he had no means of dis-
posing ;  he  bought a number of carriages, hired an
expensive house  ready furnished, which  had  been
inhabited by a person much above his rank,  and was
unsuitable to  his  condition ;  he was  irascible and
impetuous,  quarreled with his neighbors, and  com-
mitted an assault upon the clergyman of the parish,
for which he was indicted and bound to take his trial.
At length his wife  became convinced  that  he was
mad,  and made application for his confinement in a
lunatic asylum,  which was consequently  effected.
The medical  practitioners who  examined him were
convinced of his insanity7, by comparing his late wild
habits and  unaccountable  conduct with the former
tenor of his  life,  taking  into consideration the  ten-
dency to disease which was known  to prevail in his
family.  The change in his character alone had pro-
duced a full  conviction of his  madness in  his friends
and relatives.   When  questioned as to the motives
which had induced him to some of his late proceed-
ings, he gave clear and distinct replies, and assigned
with great ingenuity some  plausible reason for  al-
most every part of his conduct."
   § 115.  " Abraham B., a working tradesman of in-
dustrious  and  sober habits, conducted himself with
propriety until about forty-six years of age,  and had
accumulated a considerable  property from the  fruits
of his exertions.  About that period  he lost his wife,
and after her death became more and  more penurious.
At length, he  denied himself  the comforts,  and in a 
 180   MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII

 great measure, the necessaries of life,  and became
 half-starved and diseased ; his body was emaciated
 and beset with scaly eruptions.  Mr. S., a gentleman
 who had long known him, hearing of the condition
 into which  he had sunk,  sent a medical practitioner
 to visit him, by whose  advice B. was  removed from
 a miserable dirty lodging to a lunatic asylum.   Mr.
 S., who was present on the  occasion, observed that
 Abraham B., previously to his  quitting  the room in
 which he had immured himself, kept his eyes fixed
 on  an  old trunk  in the  corner  of the apartment.
 This was afterwards emptied of its contents, and in
 it were found, in  the midst of various articles, dirty
 bank-notes, which had been thrown into it apparently
 at different times,  to the value  of more than a thou-
 sand pounds.  Abraham B., after his removal to an
 asylum where he had wholesome food and exercise,
 soon began to recover from his bodily infirmities, and
 at length became anxious to be at large.   The writer
 of this article visited him and conversed with him for
 some time, in order to ascertain his mental condition.
 He betrayed no sign of intellectual delusion, nor did
 it appear that any thing of that description had ever
 been a part of his complaint.   His replies to ques-
 tions were rational according  to the extent  of his
 natural  capacity.   He was  determined to go  and
 manage his property,  and get a wife  who should
 take care of him.   In a few days after his release he
was married  to a servant belonging  to  the  lunatic
 asylum where he  had been confined.  His  new wife
found after some  months that it was impossible to
endure the  strange conduct of her husband,  and after
 various expedients, brought him back to the asylum, 
SEC. I]        GENERAL MORAL MANIA.          181

with a certificate from a medical man, who had ex-
amined him and declared him to be insane.   He still
remains in confinement, and his derangement is now
more  complete than formerly, as it plainly involves
his intellect." J
   § 116.  These are no uncommon instances of that
condition  of  mind so often mistaken for  any thing
rather than what it really  is—mental derangement.
Its true nature  was here  recognised by  intelligent
practitioners  who looked beyond the circle of a defi-
nition, and might have been recognised, perhaps,  by
others of narrower views, in a calm investigation  for
therapeutical purposes ; but, amid  the  excitement
produced  by great criminal acts, and the  struggles
between knowledge and ignorance,  truth and preju-
dice,  that spring  up  in  judicial investigations, how
seldom, alas, has it been discerned.   The  following
cases, in which this perversion of the  moral faculties
was accompanied by a single insane belief, will serve
to complete our proofs of the intimate connexion of
moral with intellectual mania.
   117. "Mr. H. P. had been for many years con-
fined  in  a lunatic asylum, when, an estate having
devolved upon him by inheritance, it became neces-
sary to subject  him anew7 to an investigation.   He
was examined by several physicians who were unani-
mous  in the  opinion  that  he was a  lunatic; but a
jury considered him to be of sound  understanding,
attributing his  peculiarities to  eccentricity,  and  he
was consequently set at liberty.
Op. cit. sup. p. 831. 
182    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

  "The conduct  of  this individual  was  the most
eccentric  that can be  imagined : he  scarcely per-
formed any action in the same manner as other men ;
and some  of his habits,  in which he obstinately per-
sisted, were singularly filthy and disgusting.   For
every peculiar custom he had a quaint and often lu-
dicrous reason  to  allege, which indicated a strange
mixture of shrewdness and absurdity.   It might have
been barely possible to  attribute all these  peculiari-
ties,  as well as the morbid state of temper and affec-
tions, to singularity in natural  character  and to  the
peculiar circumstances under which this person had
been placed.   But there was one conviction deeply
fixed on his mind, which, though it might likewise be
explained  by the  circumstances of his previous his-
tory, seemed  to constitute  an  instance of maniacal
delusion.   Whenever any  person whom  he under-
stood to be a physician attempted  to feel his pulse,
he recoiled with an  expression of horror, and  ex-
claimed, ' If you were to feel  my pulse,  you would
be lord paramount over me  for the rest of my life.'
The result has proved that confinement is not always
necessary in  cases of this description.  Mr. H. P.
has remained at liberty for many years, and his con-
duct,  though extremely singular, has been  without
injury to himself or others." 1
  § 118.  A very  common  feature  of moral mania
is a deep  perversion  of the social affections, where-
by the feelings of kindness  and attachment  that
flow from  the relations of father, husband, and child
1 Pritchard, Op. cit. sup. p. 834. 
SEC. I]         GENERAL  MORAL MANIA.          183

are replaced  by a perpetual inclination  to  tease,
worry  and embitter the existence  of others.  The
ordinary scene of its  manifestations is  the patient's
own  domestic  circle,  the peace  and  happiness of
which are effectually destroyed by the outbreakings
of his  ungovernable temper,  and  even by  acts of
brutal ferocity.  Frederic William of Prussia, father
of Frederic the  Great,  undoubtedly  labored  under
this form of moral mania ;  and it furnishes a satis-
factory explanation of his brutal treatment  of his son
and his utter disregard of the feelings or  comfort of
any other  member of his  family.  About a  dozen
years before his death,  his health  gave way under
his constant  debauches in drunkenness, he became
hypochondriacal, and redoubled  his  usual religious
austerities.   He forbade his family to talk of any
subject but religion, read  them  daily sermons, and
compelled  them to sing, punishing with the utmost
severity any  inattention  to  these  exercises.  The
prince and his eldest sister soon  began to attract a
disproportionate share  of his hostility.  He  obliged
them  to eat and  drink unwholesome  or  nauseous
articles, and would even  spit in their dishes, address-
ing them only in the  language of invective, and at
times endeavoring to strike  them  with his  crutch.
About this time he attempted to strangle himself and
would have accomplished  his design,  had not  the
queen come to his assistance.  His brutality towards
the prince  at last arrived to  such a  pitch, that  he,
one morning, seized him by the collar as he entered
his bed-chamber, and began beating him with a cane
in the crudest manner,  till obliged  to desist from
pure exhaustion.  On another occasion,  shortly after, 
 184  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

 he seized his son by the hair and threw him on the
 ground,  beating him  till he was  tired,  when he
 dragged him to a window apparently for the purpose
 of throwing him out.   A  servant  hearing the cries
 of the prince, came to his assistance,  and delivered
 him from  his hands.  Not satisfied with treating him
 in this barbarous manner,  he endeavored,  though
 unsuccessfully, by  a  similar course  of conduct, to
 make him sign an  act  renouncing  his claim to the
 succession of the Prussian throne,  in favor of his
 brother.   To obtain this  end, though in  a different
 manner,  he  connived at  the prince's attempts to
 escape from his tyranny, in order that he might pro-
 cure from a court-martial, a sentence  of death, and
 this even  he was anxious to anticipate, by endeavor-
 ing to run him through the body with his sword.  Not
 succeeding in procuring his death  by judicial pro-
 ceedings,  he kept him in confinement, and turned all
 his thoughts towards converting him to  Christianity.
 At this time, we first find mention of any delusion
 connected with his  son, though  it probably  existed
 before.  In his correspondence with the chaplain to
 whom he had  entrusted the charge of converting the
 prince, he speaks of him as one who had committed
 many and heinous sins against God and the king, as
having a heardened heart  and being in the fangs of
Satan.   Even after  he became satisfied  with  the re-
pentance of the  prince, he showed no  disposition to
relax  the severities of his confinement.   He  was
kept in a miserable  room,  deprived of all  the com-
forts and many of the necessaries of life, denied the
use of pens, ink, and paper, and  allowed scarcely
food enough to prevent starvation.   His treatment of 
SEC. 1.]
GENERAL MORAL MANIA.
185
the princess was no less barbarous.  She  was also
confined, and  every effort used to make her situation
thoroughly wretched,—and though, after a few years,
he relaxed his persecution of his children,  the gen-
eral tenor  of his conduct  towards  his  family and
others, evinced little improvement  in his  disorder,
till the day of his death.1
   §. 119.  There can be  little doubt  that the affec-
tion above  described,  is far more  common  in  the
ordinary walks of society, than is generally imagined.
It is so imperfectly understood, however, that those
singular  freaks  of conduct  and  whimsical notions
which would unquestionably subject a person to the
imputation of insanity, were there  the slightest ab-
erration of reason, are set  down to  eccentricity of
temper,  or inherently  vicious dispositions.    The
suspicion that they spring from insanity, is immedi-
ately dispelled by calling to mind the general cor-
rectness of his views, and the steadiness and sagacity
with wrhich he pursues his daily avocations.  And so
intimately  connected are the  ideas  of  insanity and
delusion in the common  mind, that it  requires no
little courage  and confidence on the  part of the prac-
titioner who ventures,  in a given case, to declare the
existence of the former,  independently of the latter.
The consequences of these erroneous views are often
strikingly  and painfully  exhibited,  when a person
thus affected becomes the object of a legal procedure.
While he  may be described  by one,  as acute and
  1 Lord Dover's Life of Frederic II. King of Prussia, vol. 1. B. 1.
chap. 2, 3,4, 5, 6, 7. 
186   MEDICAL JURISPRUDENCE  OF INSANITY.  [CH. VII.

methodical in his business, and  rational  in his dis-
course, and believed to be perfectly sane ;  another
will testify to the strangest freaks  that ever a mad-
man played, and thence deduce the conviction of his
insanity ;  while one represents  him  as  social and
kindly in his disposition, ready to assist and  oblige,
and to accommodate himself to the varying humors
of those about him, it will be testified by another, that
in his domestic relations, his former cheerfulness has
given way to gloom and moroseness, that equanimity
of temper  has been replaced  by frequent gusts of
passion, and that the warm affections,  which spring
from the relations of parent and  child, husband and
wife, have been transformed into indifference or hate.
These are the cases that confound  the w7ise and defy
the scrutiny of the skilful,  while  they  tempt  the
superficial and conceited to  betray their ignorance,
under the  delusion of superior penetration ; which
tarnish many a professional  reputation,  and expose
even  the  pretentions  of  true science  to  popular
mockery and derision.


                   Section II.

               Partial Moral  Mania.

   § 120. In this form of insanity, the derangement
is confined to one or a few of the affective faculties,
the rest  of the moral  and  intellectual  constitution
preserving its  ordinary integrity.  An exaltation of
the vital forces  in any part of the cerebral organism,
must necessarily be followed  by  increased  activity 
SEC. II.]        PARTIAL MORAL MANIA.           187

and energy in the manifestations of the faculty con-
nected with it, and which  may  even  be  carried to
such a pitch as to be beyond the control of any other
power, like  the working  of a  blind, instinctive  im-
pulse.   Accordingly, we see the faculty thus  affect-
ed, prompting the individual  to  action by a kind of
instinctive  irresistibility, and while he  retains the
most  perfect  consciousness of the impropriety  and
even enormity of his conduct, he  deliberately  and
perseveringly pursues  it.   With  no  extraordinary
temptations to sin, but on  the  contrary, with every
inducement to refrain from it, and apparently in the
full possession of his reason, he  commits  a crime
whose motives are equally inexplicable  to  himself
and to others.   The ends of justice require  that this
class of cases should be viewed in their true light;
and while  it  is not denied that their similarity to
other cases  in which mental unsoundness  is never
supposed to have existed, renders such a view diffi-
cult, yet this very difficulty is a fresh  reason for ex-
tending our inquiries and increasing our information.
In the  account now about  to  be given of partial
moral mania, those forms of it only will  be noticed
which have the  most important legal relations.
   § 121. Instances  of an  irresistible  propensity to
steal, unaccompanied by any intellectual alienation,
are related on good authority and are by no means
rare.   " There  are persons," says Dr. Rush, "  who
are moral to the highest degree as to  certain duties,
but who,  nevertheless,  live under  the influence of
some one vice.  In one instance,  a woman was ex-
emplary in  her  obedience  to every command of the
moral  law except  one,—she could not refrain  from 
188  MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII.

stealing.  What  made this  vice  more remarkable
was, that she was in easy circumstances, and not
addicted to  extravagance  in  any thing.   Such was
the propensity to this vice, that when  she could lay
her hands on nothing  more valuable, she would often
at the table  of a friend, fill her pockets secretly with
bread.  She both confessed and lamented her crime." !
Cases like this are so common, that they  must have
come within the personal  knowledge of every reader
who has seen much of the world, so that it will be
unnecessary to mention them more particularly.2  It
would be difficult to prove directly, that this propen-
sity, continuing as it does during a whole life, and in
a state of apparently perfect health, is, notwithstand-
ing, a consequence of diseased or abnormal action in
the brain, but the  presumptive evidence  in favor of
this explanation is certainly strong.  First, it is very
often observed in  abnormal  conformations  of the
head, and accompanied by an imbecile condition of
the understanding.    Gall and Spurzheim saw in the
prison of  Berne a boy twelve years old, who could
never refrain from stealing.  He is described as " ill-
organized and rickety."  At Haina they were shown
an  obstinate robber,  whom no corporal punishment
could correct.  He appeared  about sixteen years of
age, though  he was in fact twenty-six ;  his head was
round, and about the size of a child's one year old.
He was also deaf and dumb,  a common accompani-
  1 Medical Inquiries and Observations, v. 1.
  2 In Gall's great work, On the Functions of the Brain, Vol. 4, p. 131,
Boston edition, the reader will find a considerable number of these
cases related. 
SEC. II.]       PARTIAL MORAL MANIA.           189

ment  of mental  imbecility.   Secondly, this propen-
sity to steal is  not  unfrequently  observed in un-
doubted mania.  Pinel says  it is a matter of common
observation, that persons who, in  their lucid inter-
vals, are justly considered models of probity, cannot
refrain from  stealing and  cheating during the pa-
roxysm.   Gall mentions the case of two citizens of
Vienna, who, on becoming insane, were distinguished
in the hospital, for  an  extraordinary propensity to
steal,  though previously  they had lived irreproacha-
ble lives.   They wandered over  the house  from
morning  to night,  picking  up whatever  they  could
lay their  hands upon,—straw, rags, clothes,  wood
&c. which they  carefully concealed in  their room.1
A propensity to theft is  recognised by Pritchard, as
being often a feature of moral mania, and sometimes,
the leading if not the sole  character of the disease,
and he mentions  a lunatic who would  never eat his
food, unless he had previously stolen it, and accord-
ingly  his  keeper was obliged to put  it  into  some
corner within  his reach,  in order that he  might dis-
cover and take it  furtively.2   Thirdly, it has been
known to follow diseases or  injuries of the brain, and
therefore to be dependent on morbid action.   Acrel
mentions the case of a young man,  who after receiv-
ing a severe wound on the temple  for which he was
trepanned, manifested an   invincible propensity  to
steal,  which wras quite contrary to  his  ordinary dis-
position.   After committing  several  larcenies, he was
imprisoned and would have  been punished according
1 Op. cit. sup. vol. 4, p. 131.      2 Op. cit. sup. p. 829. 
 190   MEDICAL JURISPRUDENCE OF INSANITY.. [CH. VII.

 to  law,  had  not  Acrel declared  him  insane, and
 attributed his unfortunate propensity to a disorder of
 the  brain.   In the  Journal  de  Paris,  March  29th,
 1816, appeared the following paragraph : "An ex-
 commissary of police,  at  Toulouse, Beau-Conseil,
 has just been  condemned to eight years confinement
 and hard labor, and to the  pillory, for  having  while
 in office, stolen some pieces of plate from  an inn.
 The accused persisted to the last in an odd kind of
 defence ; he did not deny the crime, but attributed
 it  to mental  derangement  produced by wounds he
 had received at Marseilles in 1815." *   The late Dr.
 Smith of New Haven,  Connecticut,  once observed a
 similar effect consecutive to an attack of typhus fever.
 "One patient in particular, who had been extremely
 sick with this disease, after his recovery, had a strong
 propensity to steal, and did  in effect take some  arti-
 cles of clothing from a  young man to whom  he was
 under great obligations for the care which he had taken
 of him during his sickness. He at length stole a horse
 and  some money,  was  detected and punished.  I
 took  some  pains to inquire into  the young man's
former character,  and found  it good, and  that his
 family were  respectable." 2   Fourthly,  this propen-
 sity to steal  is sometimes followed by general mania.
Fodere relates the case of a  female servant in his
own family, who  could  not help stealing  secretly
from  himself  and  others, articles, even of trifling
value ; though she was intelligent,  modest and  reli-
1 Quoted by Gall in Op. cit. sup. vol. 4, p. 141.
5 Medical and Surgical Memoirs, p. 62. 
SEC. II]        PARTIAL MORAL MANIA.           191

gious, and was all the  while conscious of and admit-
ted the turpitude of her actions.   He placed her in a
hospital, considering her insane, and after apparent
restoration and a long trial, he again  took her  into
his service.   Gradually, in  spite of herself, the in-
stinct again mastered her, and in the midst of an in-
cessant struggle between her vicious  propensity on
the one hand  and a conscientious horror of her con-
dition on the other, she  was suddenly attacked with
mania, and died in one  of its paroxysms.1  Fifthly,
this propensity is  sometimes  produced by  certain
physiological  changes  in the animal economy.  Gall
met with  four examples  of women  who, when preg-
nant, were violently impelled to steal, though per-
fectly upright at other  times.
   § 122.  An inordinate  propensity to  lying is  also
of no uncommon occurrence in society ; and most of
the  readers  of this work  have  probably met with
instances of it in people, whose  morals in other re-
spects were irreproachable,  and whose education had
not  been neglected.   The maxim  of Jeremy  Ben-
tham,  that it is natural  for men to  speak the truth,
and therefore easier to  do so  than to utter falsehood,
seems,  in them, to be  completely reversed, for they
find nothing more difficult than to tell the truth.  In
repeating a story which they have heard from others,
they are sure  to embellish it with exaggerations and
additions,  till it can scarcely be recognised, and are
never known  to tell the same story twice alike.   Not
even is the slightest groundwork of truth necessary,
1 Traite de medicine legale, T. 1, p. 237. 
 192   MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII.

 in order to call forth the inventions of their perverted
 minds ;  for they as often flow spontaneously and in
 the greatest profusion as when based on some  little
 foundation in fact.   This propensity seems to result
 from  an inability to tell the truth, rather than from
 any other cause ;  as it can  be traced to no adequate
 motive, and is often indulged when truth would serve
 the interests of the individual better.  Like that last
 mentioned,  it is  liable to degenerate into unequivocal
 mania,  and is also quite a common feature  in this
 disease—a  circumstance which  Rush considers as
 proof of its physical origin.
   § 123. We are  not  prepared to go  the  length of
 referring all the instances of these two propensities
 thus manifested, to the  influence of disease, but they
 cannot all be attributed to faults of education, to evil
 example, or to innate  depravity, without doing vio-
 lence to the  testimony of  every  day's experience.
 It may be  difficult  no doubt, in many cases, to dis-
 tinguish them in respect to their  physical or  moral
 origin,  but the  distinction  is no  less  real  on  that
 account  ; the same principles are to guide us  that
 regulate our decision in questions touching any other
 form of insanity;  and if common  sense and profes-
 sional intelligence preside over our deliberations, the
 final judgment will not  often be wrong.
   § 124. Morbid activity of the sexual propensity is
 unfortunately of such common occurrence, that it has
 been generally noticed by medical  writers, though its
 medico-legal importance has never been so strongly
 felt as it deserves.   This affection,  in a state of the
 most  unbridled  excitement,  filling the mind with  a
crowd of voluptuous images,  and ever hurrying its 
 SEC. II.]       PARTIAL MORAL MANIA.           193

 victim to acts of the  grossest licentiousness,  in the
 absence of any lesion of the intellectual powers,  is
 now universally known and described by the name
 of erotic mania.  We cannot convey a better notion
 of the phenomena of this disorder, than by referring
 to a few examples  mentioned by Gall, by whom  it
 was first extensively  observed and  its true  nature
 discovered.  Its milder forms and early stages, when
 not  beyond the control of medical and moral treat-
 ment, are  illustrated in the following cases.  "A
 robust  and plethoric  young  man came to  reside in
 Vienna.  Having no liaisons, he was  unusually con-
 tinent, and was soon attacked with erotic mania."
 Gall pursuing the treatment indicated  by his peculiar
 views of the origin of the disease, succeeded in re-
 storing him in a few days to perfect health.
   § 125.  "A well-educated,  clever young man,
 who, from his  infancy almost, had felt strong  erotic
 impulses, succeeded in controlling them to a certain
 extent, by  means of equally strong devotional feel-
 ings.  After his  situation  permitted  him to  indulge
 without  constraint in the pleasures of love, he soon
 made the fearful  discovery, that it was often difficult
 for him  to withdraw his  mind from  the voluptuous
 images that haunted it, and fix it on  the important
 and  even urgent concerns  of his  business.   His
 whole  being was absorbed in sensuality."   He ob-
 tained relief by an assiduous pursuit of scientific ob-
jects, and by finding out new occupations.
   §  126. "A very intelligent lady was tormented,
 like  the subject of the last-mentioned case,  from in-
fancy, with the most inordinate desires.  Her excel-
lent  education  alone saved her from the rash indul-
               N 
194   MEDICAL JURISPRUDENCE  OF INSANITY.  [CH. VII,

gences to which her temperament so violently urged
her.   Arrived at maturity, she abandoned herself to
the gratification  of her  desires,  but  this only  in-
creased their intensity.  Frequently, she saw herself
on the verge of madness, and in despair, she  left her
house and the city, and took refuge with her mother
who  resided in the country, where the  absence of
objects to excite desire, the greater severity of man-
ners  and the culture of a garden,  prevented  the ex-
plosion  of the  disease.  After having  changed her
residence for that of a large city, she was,  after a
while, threatened with a relapse, and again she took
refuge  with  her mother.   On  her return to Paris,
she came to me,  and complained like a woman in
perfect  despair.   'Every  where,' she exclaimed,
' I see nothing  but the most lascivious  images  ; the
demon of lust unremittedly pursues me, at the table,
and even in  my sleep.  I am an object of disgust to
myself,  and feel that I can no  longer  escape either
madness or death.'"
  § 127. In the following cases, the mind was finally
overwhelmed by the force of this frightful propensity,
and sunk into complete and violent madness.  "A
man had lived many  years  in  a happy and fruitful
union, and had acquired by his  industry a respecta-
ble fortune.   After having retired from business and
led an idle life,  his predominant  propensity gradu-
ally obtained the mastery over  him, and he  yielded
to his desires, to such a degree, that,  though still in
possession of his reason, he looked on  every  woman
as a victim destined to gratify  his sensual appetite.
The moment he perceived a female from his window,
he announced to his wife and daughters, with an  air 
 SEC. II.]        PARTIAL MORAL MANIA.           195

 of the utmost  delight,  the bliss  that  awaited him.
 Finally, this partial mania degenerated into general
 mania,  and shortly after, he died in an  insane hospi-
 tal at Vienna."1
   §  128. Pinel has related a very similar case.  "A
 man had creditably  filled his place in society till his
 fiftieth  year.   He was then smitten  with  an immo-
 derate passion for venereal pleasures  ; he frequented
 places of debauchery, where he gave  himself up to
 the utmost excesses ; and then returned to the soci-
 ety of his friends, to paint the charms of pure and
 spotless love."   His disorder  gradually increased ;
 his seclusion became necessary; and he soon became
 a victim of furious mania.
   Many more cases like these  might  be quoted, but
 the above are sufficient to illustrate a truth as gener-
 ally  recognised as  any other  in  pathology, and to
 convince the most skeptical mind,  that if insanity—
 or, in  more explicit terms, if  morbid  action  in the
 brain inducing a deprivation  of moral  liberty—ever
 exists, it does in what is called erotic mania.
  § 129. A morbid propensity to incendiarism, where
the  mind  though otherwise  sound,  is  borne on
by an  invisible power,  to the  commission of this
crime has been so frequently observed,  that it is now
generally recognised as a distinct form of insanity.
A few cases,  taken  from  a multitude  at hand, will
give the reader a better  idea  of it than  a general
description.  Gall has quoted from a German journal
an account of Maria Franck,  who was executed for
1 Sur les Fonctions du cerveau, T. 3, p. 318. 
196   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

house-burning.  Within five years,  she fired twelve
houses, and was arrested on the  thirteenth attempt.
She was a peasant's daughter of little education, and
in consequence of an unhappy marriage,  had aban-
doned herself to  habits  of  intemperance.  In  this
state, a fire occurred  in which  she had  no share.
"From the moment she witnessed this fearful sight,
she felt a desire to fire houses, which, whenever she
had drank a few  coppers' worth of spirit, was con-
verted into  an irresistible impulse.   She  could give
no  other  reason,  nor show7  any other motive, for
firing so many houses, than this impulse which drove
her to it.   Notwithstanding  the fear, the terror, and
the repentance she felt, in every instance, she  went
and did it afresh."   In other respects her mind was
sound.1
   § 130. Several German medical jurists have lately
noticed this form of moral  mania,  and related nu-
merous cases, among which are the following.  " A
young girl  of a  quiet,  inoffensive  disposition, and
whose character had been hitherto exemplary, made
seven different attempts  at incendiarism in a village
near Cologne.  When interrogated as to the motives
which  had  prompted  her to act so wickedly, she
burst  into tears, confessing  that, at certain periods,
she felt her  reason  forsake  her, and that then she
was irresistibly impelled to the commission of a deed
of which,  when done,  she bitterly repented.  She
was acquitted by a jury  of all criminal  intentions."2
1 On the Functions of the Brain, vol. iv. p. 104.
2 Medico-Chirurgical Review, July, 1836, p. 216. 
SEC. II.]         PARTIAL MORAL MANIA.           197

   § 131.  " A girl  seventeen years of age became
a servant  to a Mr. Becker on the seventh of Febru-
ary.  Strange to say,  her master's house  was dis-
covered to be on fire  several times in the course of
a few days after  she  began  to  reside  there.   The
girl  was  dismissed, in consequence of her master
supposing that she was bewitched.   Soon afterwards
she got a  place in another  family,  and  it  was not
long  before  she again resorted to her  incendiary
practices.   When charged  with the offence, she at
once confessed it, and bitterly grieved at the damage
and distress she had caused.  The judge before whom
she was tried, very properly decided that  she  was
the victim of an instinctive monomania." ]
   § 132.  One case has already been related (§  61),
in which this propensity was connected  with mental
deficiency.  Gall says that such a conjunction is not
very  uncommon.2  In  the  prison at Freyburg,  in
Brisgau,  there  was  a half-imbecile youth,  fifteen
years old, who had set fire to nine houses in succes-
sion.   When the fire  was over he  thought  no more
of it; which proves that he was  governed solely by
an animal instinct.
  § 133.  The last and most  important form of moral
mania that will be noticed consists in  a morbid ac-
tivity of the propensity to destroy; where the  indi-
vidual without  provocation  or  any other  rational
motive, apparently in the  full possession of his  rea-
son, and oftentimes, in  spite of his  most strenuous
efforts to resist,  imbrues  his hands  in  the  blood of
1 Medico-Chirurgical Review, July 1836, p. 216.
2 Op. cit. sup. vol. 4, p. 104. 
 198  MEDICAL JURISPRUDENCE OF INSANITY.   [CH. VII.

 others ;  oftener than otherwise, of the partner of his
 bosom, of the children of his affections, of those, in
 short, who are most dear and cherished around him.
 The facts here alluded to  are of painful  frequency,
 and the  gross misunderstanding of their true nature
 almost  universally  prevalent,  excepting  among  a
 few in the higher walks of the professions, leads to
 equally painful results. In the absence of any patho-
 logical  explanation  of this horrid phenomenon,  the
 mind seeks in vain,  among  secondary  causes, for a
 rational mode of accounting for it, and  is  content to
 resort to that time-honored solution,  of all the mys-
 teries of human delinquency,  the  instigation of the
 devil.  Of the double homicide to which  this affec-
 tion gives rise, there  can  be  no question which is
 most to be deplored, for  shocking as  it  is,  for  one
 bearing the image of his Maker to  take the life of  a
 fellow-being  with brutal  ferocity,  how  shall  we
 characterize  the deliberate perpetration of the same
 deed, under the sanction of law  and of the popular
 approbation ?  We  trust, however, that  the ample
 researches of writers of unquestionable veracity  and
 ability, which are now just reaching the attention of
 the legal profession, will be soon followed by a con-
 viction of past errors, and a more  rational adminis-
 tration  of the  criminal law.  For the purpose of
 contributing to this  object,  it will  be  necessary to
 bring fully before the reader the  results of these re-
 searches,  and, in view of the importance of the sub-
ject, to risk the charge of prolixity by  the number
 and length of the quotations.
   § 134.  The form  of disease now under  considera-
 tion  was   first distinctly  described by Pinel;  and 
SEC. 11.]         PARTIAL MORAL MANIA.           199

though its existence as a distinct form of monomania
was for a long  time after doubted, it has  subse-
quently been admitted by  the principal  writers on
insanity ;  by Gall and-Spurzheim, Esquirol,1 Georget,
Marc,  Andral, Orfila, and  Broussais  in France ;  by
Burrows,  Conolly, Combe and Pritchard in England;
by  Hoffbauer, Platner,  Ethmuller,  and  Henke in
Germany; by Otto  of  Copenhagen ; and  by Rush
in this country.  It has received the various appella-
tions  of  monomanie-homicide,  monomanie-meurtriere,
melancholie-homicide,  homicidal  insanity,  instinctive
monomanie.   Esquirol, in  his  valuable  memoir pub-
lished in  the shape of a note in the  French transla-
tion of Hoffbauer's work,  observers that homicidal
insanity,  or  monomanie-homicide,  as he  terms  it,
presents  two distinct forms, in the former  of which
the monomaniac  is  always  influenced by avowed
motives more or less  irrational, and is  generally re-
garded as mad;  in the latter, there  are no motives
acknowledged, nor to be  discerned, the  individual
being  impelled by a blind, irresistible impulse.  It
is with the latter only that  we are concerned, for the
other is clearly a form of partial intellectual mania;
but as this division has not been strictly  made  by
nature, cases often  occurring that  do not  clearly
come  under either   category,  the subject will  be
better elucidated  by noticing all  the  forms of this
  1 It is worthy of mention that though Esquirol, in his article Manie
in the Diet. Med. Sci. expressed his disbelief in the existence of homi-
cidal insanity unconnected with other mental alienation, he has since
not only retracted his opinion, but has published the very best contri-
bution to our knowledge of the subject. 
200   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. Wl.

affection, and seeing how intimately they are  con-
nected together.
  § 135. In the following cases  we  have the  sim-
plest form of homicidal insanity,—that  in which the
desire to destroy life is prompted by no  motive what-
ever,  but solely by an irresistible  impulse,  without
any appreciable disorder of  mind or body.
  " In a respectable house in Germany, the  mother
of the family returning home one  day, met a servant,
against whom she had no cause of complaint, in the
greatest  agitation; she  begged  to speak with her
mistress alone, threw  herself upon her  knees, and
entreated that she might be sent out  of the house.
Her  mistress astonished,  inquired the reason, and
learned that whenever  this  unhappy  servant un-
dressed the  lady's child,   she  was  struck  by the
wdiiteness of its flesh  and  experienced the almost
irresistible desire to tear it in pieces. She felt afraid
that she could not resist the impulse, and preferred
to leave the house."   "This circumstance,"  says
the narrator,  " occurred in the family of Baron Hum-
boldt, and  this  illustrious person permitted me to
add his testimony."
  § 136. " A young lady who had been placed in a
maison de sante, experienced  homicidal desires, for
which she could assign no motive.  She was rational
on every subject and whenever she felt  the approach
of this dreadful propensity, she shed tears, entreated
to have the straight-waistcoat put on and to be care-
fully guarded, till the paroxysm, which sometimes
lasted several days, had passed." 1
1 Marc, consultation medico-legale. 
SEC. II]        PARTIAL MORAL MANIA.           201

  § 137.  "Mr.  R.,  a distinguished chemist and a
poet,  of a naturally mild and  sociable disposition,
committed himself a prisoner in one of the maisons
de sante of the  faubourg St.  Antoine.  Tormented
by the desire of  killing, he prostrated himself at the
foot of the altar, and implored the divine  assistance
to deliver  him from such an atrocious propensity, of
the cause  of which he could <nve no account. When
he felt that he w7as likely to yield to the violence of
this inclination, he hastened to the head of the estab-
lishment,  and requested him to tie his  thumbs to-
gether with a ribbon.  This slight ligature was suffi-
cient  to calm the unhappy R. ;  who  subsequently
endeavored to kill one of his friends and finally per-
ished  in a fit  of maniacal fury." J
  § 138.  The following case is recorded by  Gall,
who derived it from a German paper of April 13th,
1820.   "  A  carrier belonging to  the bailiwick of
Frendenstadt, who had quitted  his family in perfect
health,  was  suddenly  attacked  by a  paroxysm of
furious madness, on the route  between  Aalen and
Gemunde. His  first insane act was to shut himself
up in  the  stable  with  his three horses to which he
gave no fodder ;  and when departing he  harnessed
only two of his horses,  accompanying  the carriage
mounted on the other.   At Moglengen he abused a
woman ; at Unterbobingen, he alighted, and walked
before his  horses with a hatchet  in his  hand.   On
the route  between the last place  and Hussenhofen,
the first person he met with was a woman whom he
1 Marc, op. cit. 
202   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

struck several  times  with  his  hatchet, and  left her
lying in a ditch by the road-side. Next, he encount-
ered a lad thirteen years  old  whose  head  he split
open ; and shortly after, he split the skull of a man,
thirty years old, and scattered his brains in the road;
and after hacking the body, he  left his hatchet  and
carriage, and thus unarmed proceeded towards Hus-
senhofen.   He  met two Jews on the road, whom he
attacked, but who,  after a  short struggle,  escaped
him.   Near Hussenhofen,  he assaulted  a peasant,
who screamed till several persons came  to  his aid,
who secured the maniac and carried him to Gemunde.
They afterwards led him to the bodies of his victims,
when he observed,  ' It is not I,  but  my  bad spirit,
that has committed  these murders.' " 1
  § 139. William Brown  was   executed  at   Maid-
stone, England, in 1812, for strangling a child whom
he accidentally met one morning while walking in
the country. On the trial, he said he had never seen
the child before, had no malice  against it,  and could
assign no motive for the dreadful  act.  He took up
the body and laid it on  some steps,  and  then went
and told what he had done, requesting to be taken
into custody.  He bore an exemplary character, and
had never been suspected of being insane.2
  140. A country gentleman enjoying good health
and easy circumstances, consulted Esquirol in regard
to his singular and  unhappy condition.   He  related
that he had read  the  indictment of Henriette Cor-
1 Sur lcs Fonctions, &c, vol. 4, p. 103.
8 Newgate Calendar, vol. 4, p. 80. 
SEC. II.]         PARTIAL MORAL MANIA.         203

nier, which however did not very strongly excite his
attention.  In the  course of the night he  suddenly
awoke with the thought of killing  his wife who was
lying beside him.   He left his wife's bed for a time,
but within  three weeks  the  same idea  seized upon
his mind three  times, and always  in  the night.
During the day, considerable exercise  and occupa-
tion preserved him  from this fearful inclination.   He
evinced not the slightest mental disorder ;  his busi-
ness was prosperous ; he had never experienced any
domestic chagrins ; and he had no cause of com-
plaint  or jealousy  in  regard to his wife  whom  he
loved and with whom he never had had the least disa-
greement.   With the  exception of a light headache
occasionally, he had always  been well and free from
pain.   He  is sad and troubled  about his  condition,
and has quitted his  wife for  fear lest he might yield
to the force of his desire.1
   § 141. In  most  cases  of homicidal  insanity  the
presence of some physical or moral disorder may be
detected  ;  and though none is mentioned  in  those
above  related,  there is reason to suppose that it
might  have  been  ascertained  by proper examina-
tion.  In the following group of cases  the homici-
dal fit was  accompanied or  preceded by disease or
physical disorder of some  kind.
   § 142. The following case is related by Gall, who
obtained  it from Dr.  Zimmermann  of Krumback.
"A peasant,  born at Krumback, Swabia, who never
enjoyed very good  health,  twenty-seven years old,
1 Note in Hoffbauer, p. 346. 
204   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. VII

and unmarried, had been subject from his ninth year
to frequent epileptic fits.   Two years ago, his disease
changed its character  without any  apparent cause,
and ever since, this man, instead of a fit of epilepsy,
has been attacked with an irresistible inclination to
commit murder.   He felt the approach of the fit
many hours, and sometimes a whole day, before its
invasion, and  from  the commencement  of this pre-
sentiment, he  begged to be secured and chained  that
he might not commit some dreadful deed.   ' When
the fit comes on,' says he, ' I feel under a necessity
to kill, even it were a child.'   His parents whom he
tenderly  loved,  would be the first victims of this
murderous propensity.  ' My  mother,'  he cries out
with a frightful voice, ' save  yourself,  or I must kill
you.'  Before  the fit he complains  of being exceed-
ingly sleepy, without  being able  to sleep ; he feels
depressed, and experiences slight twitchings of the
limbs.  During the fit, he preserves  his conscious-
ness, and knows perfectly well that in committing a
murder, he is  guilty of an  atrocious crime.  When
he is disabled  from doing injury, he makes the most
frightful contortions and grimaces, singing or talking
in rhyme.  The  fit lasts from  one  to twro days.
When it  is  over,  he cries  out,  ' Now unbind  me.
Alas! I have  cruelly suffered, but I rejoice that  I
have killed nobody." *
  §  143.  On  the  15th  February, 1826,  Jacques
Mounin,   after many  acts of violence and  fury,
1 Gall, op. cit. T. 4, p. 104. 
SEC. II]        PARTIAL MORAL MANIA.           205

escaped from his family who wished to restrain him,
scaled the walls of several adjoining properties, and
took to the fields without shoes,  hat, or weapons of
any  kind.  His  flight having excited  considerable
alarm,  as  after some  epileptic attacks he  had for-
merly given many  signs of a blind fury,  the  local
authorities were informed,  and several persons des-
patched after him as quickly as possible.   On arriv-
ing at a field where many laborers were at work at a
distance from one another,  Mounin  first threatened
a man who was driving a cart, and immediately after
pursued Joseph Faucher and  pelted him with stones.
The latter having escaped, he then made up to an old
man almost blind,  named Mayet, whom he knocked
down and killed by beating him on  the head with a
large stone.  He  next attacked a man  who  was
digging at a little  distance, and  killed him with a
spade.   A few minutes afterwards he met Propheti
on horseback, whom he struck dowrn with stones, but
was  obliged to leave  him in consequence of the cries
of his victim.  He then chased some children, who
saved themselves by hard running, but he overtook
a man at work and slew him.  On being questioned
during  his confinement, Mounin said he well recol-
lected having  killed the  three men, and especially
one, a relative of his own, whom he greatly regretted;
he added  that in his  paroxysms  of phrensy he saw
nothing but flames, and that blood was  then  most
delightful  to his  sight.  At  the  end of a few days'
imprisonment, he seemed to have entirely recovered
his reason, but subsequently he relapsed.  The court
declined trying  him,  under  the  conviction that he 
206    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

was  insane while  committing the murders above
mentioned.1
  § 144.  " Frederick  Jensen, a workman,  thirty-
seven years old, had for some time suffered from fits
of giddiness which always obliged him to seize hold
of the nearest objects.   In the spring of 1828, he
lost  a beloved daughter, which afflicted him  very
much.  The state of his health was nevertheless per-
fect  in  mind as well  as in  body, when  he one day
(Sunday 28th September, 1828) after dinner, told his
wife that he would take a walk with his  son, a boy
ten years old. He did so, and went with him to the
green which  encircles  the citadel.  When he came
there,—he now  relates,  ' a strange confusion came
over me ; ' it appeared like  a  matter of absolute ne-
cessity to him to drown his son and  himself in the
waters at the citadel.   Quite unconscious of what he
was doing, he ran  towards the water with the boy
in his hand.  A man surprised at his behavior, stop-
ped him there, took the boy from  him, and tried to
persuade him to leave the water ;  but  he became
angry, and answered that he intended to take a walk,
and asked,  ' whether any body had a right  to forbid
him to do so 1'   The man left him, but took the boy
along with him.  An hour afterwards  he was taken
out of the water into which he  had thrown himself,
and taken to prison.   As he still showed symptoms
of insanity, he was bled and purged,  and two days
after, was brought into the  hospital, and committed
to  the  care of my friend Dr. Wendt who has per-
1 Georget, Discussion medico-legale, &c. p. 153. 
SEC. II.]        PARTIAL MORAL MANIA.           207

fectly cured him, and who kindly afforded  me the
opportunity to see and to speak with him.  He now
very quietly tells the whole event himself, but is not
able to  explain the cause of the suddenly rising de-
sire to kill himself and the boy whom he loved heart-
ily.   This  cause is  only to be sought in congestion
of blood to the brain,  the same which  before had
caused his  giddiness ; and whether we  adopt an or-
gan of  destructiveness  in the  brain  or  not, it is  to
be  assumed that the propensity to kill himself and
the son  arose from a morbid excitation of a certain
part  of the brain.   The  disposition to  congestion
originated  from a  fall  he  suffered on  the head  in
1820."  2
   § 145.  Another curious form of homicidal insanity
occurs  in women, and  seems to be connected with
those changes in the system produced by parturition,
menstruation and lactation.  It is a little remarkable
that with  scarcely an exception,  the victim selected
by  the  patient is always  her  own,  or  some  other
young child.  Among several  cases which Esquirol
has related at length,  are the two following which
are abridged from his memoir.
  § 146. Madam N., whom Esquirol received into
his  hospital, and whom he describes as  being per-
fectly rational in her conversation and conduct, and
of a mild,  affable and  industrious disposition, very
calmly related  to him the circumstances connected
with a strong inclination she felt to kill her child.
After her last accouchement, fourteen months before,
1 Dr. Otto, in the Edinburgh Phrenological Journal, vol. 6, p. 611. 
 208   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

 she had several hysterical fits and was much troubled
 with pains in the head, stomach and bowels ;  with
 vertigo and ringing in the ears.  These mostly dis-
 appeared,  but she  then became exceedingly capri-
 cious in her temper and affections,  being alternately
 gay and sad,  confiding and jealous,  resolute and
 weak.  In this condition, she heard of the  murder
 committed by Henriette Cornier, w7hen  she was im-
 mediately seized with  the idea of killing her infant,
 and one  day wdien her child entered the room, she
 felt the most violent desire to assassinate it.   ' I re-
 pelled the idea, said she,  and coolly inquired of my-
 self, why I should conceive such cruel designs—what
 could put them into my imagination  ?   I could find
 no  answer.   The same desire returned;  I  feebly
 resisted it,  was overcome, and proceeded to consum-
 mate the crime.   A new effort arrested my steps, I
 raised the knife to my  own throat,  saying to myself,
 better perish  yourself, bad  woman.'  When  asked
 the cause of these evil thoughts, she replied,  that
 something behind her  back  urged  her on.  During
 the first fortnight of her stay  in the  hospital, she was
 afflicted by a return  of the physical disturbances with
 which she was first attacked, but  at the end of six
 weeks was so much better, in  consequence of a proper
 medical treatment, that she received her husband and
child with joy, and  lavished  on the latter the  ten-
 derest caresses.  Suddenly she perceived a cutting
 instrument, and was seized with the desire of snatch-
 ing it up and  committing  two murders at  once,—a
 thought which she suppressed only by  flying  from
 the room.   The  symptoms of physical  disturbance
now again made their appearance, during which she 
SEC. II.]
PARTIAL MORAL MANIA.
209
 was informed that her child was sick, and while ex-
 tremely distressed and weeping at the news,  ' she
 felt a violent desire,'  to use her  own  expression,
 ' to stab or stifle it in her arms.'  After about three
 months residence at  the hospital, she went away re-
 stored, and continued well.
   § 147.  A girl fourteen years old, of strong consti-
 tution and difficult temper, enjoyed apparently good
 health, though she  had not menstruated.  Once a
 month she complained of pain in the head, her eyes
 were red, she was  irascible,  gloomy and restless  ;
 every thing went w7rong with her  and she was par-
 ticularly inclined to dispute with  her mother,  who
 was always the object of her threats and abuse ; and
 finally she became most violently angry,  sometimes
 attempting her own life and sometimes her mother's.
 When the fit arrived to this degree, the blood escaped
 from her mouth, nose or eyes ; she wept  and trem-
 bled ;  the extremities became cold and affected with
 convulsive pains ; and her  mind was filled with dis-
 tress.   The fit which altogether  continued one  or
 two days,  being over, she recovered her affection for
 her mother, and asked her forgiveness.  She did not
 recollect all the circumstances of these fits, and de-
 nied with  feelings of surprise and regret some of the
 particulars which were  related  to  her.  At the age
 of sixteen years, these fits of anger were often re-
 placed by hysteric convulsions ; the disease dimin-
 ished progressively,  but did not cease till she was
seventeen years old, when her courses  appeared.
She  afterwards married and became an  excellent
mother.
  ^ 148.  Esquirol relates  another case  communi-
           o 
210   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

cated  to him by Dr. Barbier of Amiens, which will
be briefly noticed.  This  lady, Marguerite Molliens,
twenty-four years old, had suffered for three  years
past pains in the epigastrium, and right side of  the
abdomen;  headache, vertigo, noise in the ears, dis-
turbance of vision, palpitation of the heart,  constric-
tions of the throat and trembling of the limbs.  Her
first child, which lived but three months, she  loved
and  deeply regretted.  Nine  months ago  she had
another child.   On the fifth day of her confinement
she heard  of Cornier's case, and wTas  so deeply im-
pressed with  the story that her  thoughts dwelt upon
it, and from  that moment she  feared lest  she also
might  be  similarly tempted.    In spite of  all her
efforts,  she gradually  familiarized herself with the
idea of killing her  child.   One day while  dressing
it, the  thought of murdering it seized upon her mind
and became a violent desire.   She  turned  around,
and perceiving  a kitchen-knife on a table near her,
her arm was involuntarily carried towards  it.  She
saw that she could no longer  control herself, and
cried out for assistance.  The neighbors came in and
she soon became calm.  Shortly after  she was sep-
arated from her child  and sent to a hospital where
she finally recovered.   It is  worthy of note that
when the pains  in the head and  epigastrium, from
which she suffered greatly in the hospital, were worst,
then the bad thoughts appeared to  be most impe-
rious.
  § 149.  Dr. Otto, of Copenhagen, relates that a
female, who was received into a lying-in-hospital of
which he was physician, requested a private confer-
ence with him previously to her accouchement.  She 
SEC. II]        PARTIAL MORAL MANIA.           211

appeared to be in great agitation and embarrassment,
and earnestly begged of him that she might not be
left  in  the same chamber with  other  women and
their infants, as it would be utterly  impossible for
her to resist the propensity she  felt  to destroy the
latter.  Her  request was granted and she was care-
fully watched.  Her  delivery was easy, and the child
was kept from her and afterwards sent to her mother.
The young woman on leaving the hospital went into
service, and  would  not  return to her mother's, lest
she might  be tempted  to destroy her  infant.  She
declared that the sight of a very young infant kindled
up an irresistible propensity to destroy its life.  This
woman was a peasant who had been seduced, but had
never led a dissolute life nor was in any way of cor-
rupt manners.  She  had not been reproached, nor
ill-treated  by her parents,  during pregnancy, nor
was there the least  cause for anxiety on  account of
the child, as  her mother had engaged to provide for
it.  She entered into the service of a clergyman, and
enjoyed good health.   Sometime afterwards she in-
formed the doctor that  she had lost  nearly all pro-
pensity to infanticide.1
  § 150. The next  case is recorded by Dr. Michu
in his Memoire  sur la  monomanie-homicide.   " A
country woman, twenty-four years of age, of a bilious
sanguine temperament,  of simple and regular habits,
but reserved  and sullen manners, had been ten days
confined with her first child, when suddenly, having
her eyes fixed upon it, she was seized with the desire
1 Medico-Chirurgical Review, O. S. Vol. 13, p. 441. 
 212    MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII-

 of strangling it.   This idea made her shudder ; she
 carried the infant to its cradle, and went out in order
 to get rid of so horrid a thought.  The cries of the
 little being who required nourishment,  recalled her
 to the house  ; she experienced still more strongly the
 impulse to destroy it.  She  hastened away again,
 haunted by the  dread  of committing a crime so hor-
 rible ;  she raised  her  eyes to heaven, went  to the
 church  and prayed.  The whole  day was passed by
 this unhappy mother in a constant struggle between
 the  desire of taking away the  life of her infant and
 the dread of yielding to the impulse.  She concealed
 her agitations,  until evening, w7hen  her confessor, a
 respectable old man, was the first to receive her con-
 fidence.   He soothed her feelings,  and counselled
 her to have medical assistance.   ' When we arrived
 at her  house,'  says Michu,  ' she appeared gloomy
 and depressed, and ashamed of her situation.'  Being
 reminded of the  tenderness due from  a mother to her
 child, she  replied;  ' I know how much a mother
 ought to love her child ; but if I do not love mine,
 it  does  not depend  upon me.'  She  soon after re-
 covered, the  infant,  in the  meantime,  having been
 removed from her sight."
   §  151. Gall says he knew a woman, then twenty-
 six years old, who  experienced,  especially at the
 menstrual  periods,  inexpressible  torture,  and the
fearful temptation to destroy herself, and to kill her
husband and children, who were exceedingly dear to
her.   She  shuddered with  terror, as she described
the struggle that took place within her  between her
sense of duty and of religion,  and the  impulse that
urged her to  this atrocious act.   For a long  time, 
SEC. H]        PARTIAL MORAL MANIA.           213

she dared not bathe her youngest child,  because an
internal voice constantly said to her,  ' let him slip,
let him slip.'  Frequently she had hardly the strength
and  time  to throw  away a  knife  which she  was
tempted to plunge into her own breast and her child-
ren's.  Whenever she entered  the  chamber of her
children,  or husband, and  found  them  asleep,  she
was  instantly  possessed with the desire of killing
them.  Sometimes she precipitately shut behind her
the door of their chamber and threw away the key,
to remove the possibility of returning to them during
the night, if she  should  fail  to resist this infernal
temptation." J
  § 152.  In another class of cases, the exciting cause
of the homicidal propensity is  of a moral nature,
operating upon some peculiar physical predisposition,
and sometimes followed by more or less physical dis-
turbance.   Instead of being urged  on by a  blind,
imperious impulse to kill,  the subjects  of this form of
the affection,  after  suffering for  a certain period
much gloom of mind and depression of spirits, feel as
if bound by a sense of necessity to destroy life;  and
proceed to the  fulfilment of their destiny with  the
utmost calmness and deliberation.  So reluctant have
courts and juries usually been to receive the plea of
insanity in defence of crime, deliberately planned and
executed by a mind  in which no derangement of in-
tellect has  ever been  perceived, that  it  is of  the
greatest  importance that the nature of these cases
should not be misunderstood.   They are of not  un-
1 Op. cit. sup. T. 4, p. no. 
 214   MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII.

 frequent occurrence, and are often  attended by such
 horrid, heart-rending circumstances, that nothing but
 the  plainest and strongest conviction  of  their true
 character can ever save their subjects  from the last
 penalty of the law.   The near affinity of this form of
 the  affection  to those  already  described will be
 manifest,  upon  a careful  consideration of the few
 cases that will now be given.
   §  153.  The following is related by Dr. Otto of a
 surgeon who had served in several campaigns against
 the French.   " He always appeared of a  lively and
 cheerful  disposition, till  certain  pecuniary matters
 ruffled his temper and made him thoughtful and mel-
 ancholy.  He was  now  frequently observed  to be
 studying the scriptures, and reciting passages from
 the  bible.   He  was happily married  and had four
 children.  One  morning he summoned  his wife and
 children  into  the court of the house, and there in-
 formed them that it was his  intention to  kill  them
 all, and afterwards himself.  He descanted coolly on
 the propriety of homicide, and told his wife she must
 first  be a spectator of the destruction of her children,
 and  then  her own  turn would come.   The woman
 appears to  have possessed great presence of mind,
 and  acted with  great  prudence on such  a trying
 occasion.  She  entirely coincided in the justness of
 her husband's sentiments,  and cheerfully agreed to
 the proposed tragedy.  But she appeared  suddenly
 to recollect  that it  would be  proper for herself as
 well as the  children, to confess and take the sacra-
 ment previous to their  appearing before their final
judge,—a ceremony which would  necessarily require
several days' preparation.  The monomaniac replied 
SEC. II.]        PARTIAL MORAL MANIA.          215

that  this was a reasonable and proper procedure;
but,  in the meantime, it would be absolutely neces-
sary that he took some person's life that day.  With
this  purpose in view, he instantly set off for Salz-
bourg.  His wife having placed the children in secu-
rity,  made the best  of her way to the above-men-
tioned town, and went directly to professor 0., the
friend of her husband, for advice.  The monomaniac
had already been there, and not finding the profes-
sor at home, had gone  away.   The  woman now
recollected and told the professor, that her husband
had  threatened his life for some imaginary slight  ;
but at that time she thought he was in jest,  About
mid-day the monomaniac  came back to the profes-
sor's residence, and appeared quite calm and peace-
able.  The professor invited  him to go and see the
hospital of the town, where he had a curious dissec-
tion  to make, and they sat down to eat some refresh-
ments before proceeding thither.   At this repast, the
monomaniac informed  his  host  that he  had lately
been most immoderately disposed to commit homi-
cide, and that he had  actually murdered a peasant
that  morning  on his way to  town.   He  confessed
also  that he had entered  a coffee-house for the pur-
pose of committing a second act of this kind, but had
been diverted from his  purpose.  The murder of the
peasant was a fiction,  as was  afterwards proved.
The professor now turned the discourse to other sub-
jects, and on all other topics the monomaniac was
perfectly rational.  They now set off for the hospital
and  in their way thither the monomaniac met with
an old acquaintance and fellow-campaigner.  While
they were greeting each other, the monomaniac sud- 
216    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

denly struck  his friend  a violent  blow on the pit of
the stomach,  exclaiming in a burst of laughter, that
he had done it  for him, as  he had hit the coeliac
plexus.  The professor reprimanded him in strong
terms  for this dishonorable and cruel act, at which
the monomaniac was much surprised, and informed
his preceptor that he was irresistibly led to commit
homicide, and cared not who was  the victim of this
propensity.   The  professor  now asked  him some-
what  tauntingly, if he had not a design  against his
life.   The monomaniac acknowledged it;  but added
that he had sufficient control over himself to prevent
the destruction  of his  benefactor.   The professor
took his arm and  they proceeded to  the hospital,
where the monomaniac was immediately confined.
He almost instantly became furiously maniacal, and
in a few months after died." !
   Gall quotes  from the  Psychological Magazine,
vol. hi., an account of Catherine Hansterin, who, in
consequence of being detected in a petty theft which
was reported to  her husband, a man  of harsh and
austere manners,  of whom she stood greatly in fear
on account of his cruel treatment of her,  became
exceedingly melancholy and depressed.  After suf-
fering much and long from her cruel  husband, she
determined to leave him, and  accordingly departed,
taking her infant two and a half months  old, and her
little  girl who  had declared  she  would  rather die
than be left behind with her father.  " The thought
which this reply brought to  her mind,  the  distress
' Medico-Chirurgical Review, Vol. 13. 
SEC. II.].        PARTIAL MORAL MANIA.         217

that afflicted her, the fear of what would happen  to
her children in case of her  death, and at the same
time,  her ardent desire to  terminate her own exist-
ence ;—all these united, gave  rise  to  the barbarous
design of drowning her two children. Having arrived
at the bank of the Danube, she made her little girl
kneel down and  pray God  for a good death.  She
then placed the  infant  in  the hands of her  sister,
blessed them both, and making the  sign of the cross,
pushed them into the river. This done, she returned
to the village and told what had passed." x
   § 154.  Dr. Otto has published the  case  of Peter
Nielsen, a joiner, aged forty-seven years, who drown-
ed four of his seven children.  He appears to have ex-
perienced  some  misfortunes, but was  not in positive
want of the necessaries of  life at the moment when
he committed the horrid deed.  Many persons, who
conversed  with him on the same day both before and
after the  transaction,  testified that he  was not in-
toxicated,  nor the least agitated in mind.  He was,
on the contrary, placid and tranquil.   No  domestic
altercations, of  any  moment, had  occurred,  but he
was disconcerted at not readily getting  a new lodg-
ing on being turned out of that which he previously
occupied.   His  love to his children was testified to
by all.  He  confessed that  the idea of killing  his
children came into his head  on the  morning of the
 day that he put  the idea into  execution, and that the
 impulse was quite  irresistible.  He determined to
 drown the three younger boys and spare the  daugh-
Op. cit. T. 4, p. 152. 
218    MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII.

ter wrho was  older.   But she  insisted on accom-
panying her father and brothers  in the walk he pro-
posed, and though he endeavored to persuade  her to
return, she would not.  He averred that his  motive
for destroying the boys was the  fear of not being
able  to  maintain them;  whereas  he w7ould  have
spared the girl, not because he  loved  her more, but
because  she was better  able to maintain herself.
Having arrived at a turf-pit,  he first embraced his
children, and then pushed them all into  the water.
He stood by unmoved and saw them struggle  and
sink.   He then returned  quietly  to the town  and
told what he  had done.  He was  led back  to the
turf-pit, and beheld the dead  bodies of his children
without evincing  any emotion.  For  a moment he
wept, when he saw the bodies opened (for the pur-
pose  of  medico-legal proof of the  kind  of death),
but soon regained his tranquillity.   He affirmed that
he did not destroy his offspring  in order  to procure
happiness for them  in heaven, nor  from any  desire
to be put to death himself, as he wished to live.1
   § 155.  The case  of Henriette  Cornier,  which
occurred in Paris  a few years since,  in consequence
of the  imposing  weight  of medical opinions  that
were delivered on her trial,  and of the discussions to
which it gave rise in  the  various shapes of reports,
newspaper criticisms, and elaborate treatises from
some  of the  most distinguished physicians of  that
capital, has contributed, more than any other single
event, to advance  our  knowledge  of homicidal in-
1 Edinburgh Phrenological Journal, vol. 5, p. 87. 
SEC. II.]        PARTIAL MORAL  MANIA.          219

sanity.  A case so celebrated deserves  a  particular
notice here.  The facts as they will now be related
are contained in the indictment (acte aVaccusation),
which is given at  length by George t  in  his  account
of the trial.1
  Henriette Cornier, a female servant aged twenty-
seven years,  was  of a mild and  lively disposition,
full of gaiety, and remarkably fond of children.   In
the month of June, 1825,  a singular  change was
observed in her character ; she became silent, melan-
choly, absorbed in reverie, and finally sank into a kind
of stupor. She was dismissed from her place, but her
friends  could obtain  from  her no  account  of the
causes of her mental  dejection.  In the month  of
September she made an attempt to  commit suicide,
but was prevented.  In  the following  October  she
entered into the service of dame Fournier, but there
she still  presented the melancholic and desponding
disposition.  Dame Fournier observed  her  peculiar
dejection  and endeavored  in  vain to  ascertain  its
cause; the girl would  talk  only of her misfortunes
in losing her parents at an early age, and of the bad
treatment she received from her guardian.   On the
4th of November, her  conduct not having been pre-
viously different  from  what  it usually was,  she sud-
denly conceived  and  immediately executed the act
for which she was committed.
  About noon her mistress went out to  walk,  having
told Cornier to prepare dinner at the usual hour,
and to go to a neighboring shop kept by dame  Belon,
1 Discussion medico-legale, p. 70. 
220  MEDICAL  JURISPRUDENCE OF INSANITY. [CH. VII.

to buy some cheese.  She  had frequently gone to
this shop and had always  manifested  great fondness
for Belon's little girl,  a beautiful  child nineteen
months old.  On this  day she displayed her usual
fondness for it,  and persuaded its mother, who at first
was rather unwilling, to let her take' it out for a walk.
Cornier then hastened  back to her  mistress's  house
with  the  child, and laying it across her own bed,
severed its head from its body with a large kitchen
knife.  She subsequently declared that while execut-
ing this horrid deed, she felt no particular emotion—
neither of pleasure,  nor of pain.   Shortly  after, she
said, the sight of the horrible  spectacle before her
eyes brought her to herself, and  she  experienced
some emotions  of fear,  but they were of short dura-
tion.   At the end of two hours, during which time,
she had remained chiefly in  her own chamber, dame
Belon  came and inquired for her child,  from  the
bottom of the  staircase.   " Your  child is dead,"
said Henriette.   The mother, who at first thought
she was only  in jest,  soon became  alarmed, and
pushed forward into the  chamber, where she wit-
nessed the bloody sight of the mutilated fragments
of her child.  At that moment, Cornier snatched up
the head of  the murdered  child,  and threw it into
the street,  from  the open window.  The mother
rushed out of the house,  struck  with horror.  An
alarm was  raised;  the  father of the child and the
officers of justice with  a crowd of persons entered
the room.  Henriette was found  sitting on a chair
near the body  of the child, gazing at  it,  with the
bloody knife by her,  her hands and clothes covered
with blood.  She made no attempt  to escape, nor to 
SEC. II.]         PARTIAL MORAL MANIA.         221

deny the crime ; she confessed all the  circumstan-
ces, even her premeditated design and the perfidy of
her caresses,  which  had  persuaded the  unhappy
mother to entrust her with the child.  It was found
impossible to excite in her the slightest emotion of
remorse or grief; to all that  was  said, she replied,
with  indifference, " I intended  to  kill the child."
When closely  and earnestly interrogated,  as to her
motives for committing this dreadful act, she replied
that she had no particular reason  for  it; that the
idea had taken possession of her mind,  and that she
was destined to do it.  When asked why she threw
the head into the street, she answered that it was for
the purpose of attracting public attention, so that
people might come up to her chamber and see that
she alone was  guilty.  The nature  of her extraor-
dinary  replies, the  want of  motives  for such  an
atrocious deed, the absence of every kind of emotion,
and the state of stupor in which she remained,  fixed
the attention of the  medical men who were called
in, and impressed them with the belief that she was
mad.   On the examination before the magistrate she
confirmed the above statements respecting her  men-
tal condition,  adding, among  other  things, that she
had been unhappily married seven years before; that
she attempted to  drown  herself "because she was
ennuied at changing her place of service so often; "
that she knew  her  crime deserved  death and she
desired it.
   She was  tried for the first time, on the 27th of
February, 1826.  She then appeared to be in a state
of great nervous irritation ; her  limbs trembled ;
her eyes were fixed ; and  her understanding was 
222   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

dull and stupid.   A few days previously, the court,
at the request of her counsel,  appointed a  medical
commission consisting of Adelon, Esquirol, and Le-
veille, to examine the accused and all the documents
of the case, and  report on her " actual moral state."
Accordingly they reported that they were unable to
detect  any sign  or proof of mental derangement;
but added that it is extremely difficult in some cases,
to establish the existence of insanity,  it requiring a
long intimacy with the individual and  numerous op-
portunities of watching him under every variety of
circumstance, none of which they had possessed in
this case.   In fine, they reported that  though they
could not adduce any positive proof of her  insanity,
yet they were equally unable to pronounce her sane.
   This  report  not being satisfactory,  the trial was
postponed  to another session, and the  prisoner was
sent to  the Salpetriere to be observed  by the above-
named physicians.   After recapitulating their obser-
vations  which were continued three  months, they
came  to  the following conclusions:  " first,  that
during the whole  time Cornier was  under examina-
tion, from the 25th of February to  the 3d of June,
they had observed in regard to her moral state great
mental  dejection, extreme dullness of mind, and pro-
found chagrin;  secondly,  that the  actual situation
of Cornier sufficiently explains her moral state, and
thus does  not  of itself indicate mental  alienation
either general or partial."   They also added that it
was due to the cause of justice and to th,eir owm con-
science, to declare that their judgment of her actual
moral  condition  could not be  considered final, if  it
were proved,  as stated in the  acte d' accusation, that 
SEC. II.]
PARTIAL MORAL MANIA.
223
long before the 4th of November, the character and
habits  had  changed;  that  she  had  become  sad,
gloomy,  silent and  restless;  for  then  that which
might be attributed  to her present situation,  could
be only the  continuation of a melancholic state that
had existed for a year.1
   Cornier was again brought to trial  on the 24th of
June,  and  the jury returned a  verdict  of guilty of
"committing  homicide voluntarily but not with pre-
meditation ; "2  and accordingly  she was sentenced
to hard  labor for life.
   § 156.  Sometimes, the individual confesses a mo-
tive for the homicidal act which is rational and well
founded, but altogether inadequate to lead to such an
action in a sound mind.   There are seldom wanting
other circumstances in the previous conduct, conver-
sation,  or bodily  health, to confirm and establish be-
yond a reasonable doubt the presence of insanity, the
suspicion of which  is thus excited.   All doubt of the
correctness of this conclusion is removed  in the first
  1 Georget justly observes that the meaning of the committee would
have been better expressed in the following language.  "The actual
moral state of Henriette Cornier is  doubtful.  It may be the result
either of a painful moral affection, or of melancholy ; which it really
is, the nature of the  prior circumstances must decide.  If, several
months before the 4th of November, her character had changed ; if
she  became sad and gloomy without cause; if she had a motiveless
propensity to suicide ; and finally, if the homicide she committed was
without cause, and under the circumstances related in the acte oVaccu-
sation, it is certain that she has been and still is laboring under a kind
of mental alienation."
  2 This verdict is very properly censured by Georget, who says, that
if the accused was mad she ought to  have been acquitted ; and that if
not mad she acted from premeditation, and should have suffered the
punishment of death. 
224   MEDICAL JURISPRUDENCE  OF INSANITY.  [CH. VII.

of the following cases, which is introduced to  illus-
trate  this form of the disorder, by the pathological
changes discovered after  death, and in the second by
the previous existence of insanity.
   § 157.  At Rouen,  in  1820,  a young man named
Trestel, seventeen or eighteen years old, whose family
was respectable and in easy circumstances, obtained
an almost complete meeting of its various members to
the number of thirteen,  and endeavored  to poison
them  all  by putting arsenic into the soup.    The
severe vomiting which  it produced,  however, was
the means of saving all their lives.   It appeared in
evidence, that Trestel was so  imbecile at fifteen  years
of age, that he was incapable of executing the slight-
est commissions ;  that he  had strange and incohe-
rent ideas ; that he  was sad,  taciturn and incapa-
ble of being instructed ;  that he was in the habit of
addressing letters to  an  imaginary female whom he
was in love with.   On the trial as  well  as on the
previous examination, Trestel alleged as his motive
for committing the crime, that his  father  had fre-
quently threatened to send  him to  sea.   Notwith-
standing these strong indications of mental deficiency
and alienation he was convicted and sentenced to be
executed, but on the day appointed for the execution
he  killed himself  by  taking  poison.    His  body was
examined by Dr. Vingtrinier, surgeon of the prisons,
in the presence of three other  medical  men, and
there was found inflammation of the arachnoid  mem-
brane of the brain, characterized by thickening, in-
duration and redness, and by its almost entire  adhe-
sion to the pia mater.  In short not one of the four
physicians had the least doubt of the existence of 
SEC. II.]       PARTIAL MORAL MANIA.           225

arachnoid inflammation of very long standing.  How-
ever uncertain other symptoms and tests of insanity
may be this  at  least  is sure; and we are left with
the comfortable reflection, that an unfortunate youth
paid the last penalty of the law for the consequences
of bodily disease.1
   § 158. "A Portuguese, by the name of Rabello,
was employed by a mechanic in  the western part of
Litchfield county, Connecticut,  to assist him as  a
shoemaker.   He had been in the  neighboring towns,
and  his conduct appeared singular, but usually inof-
fensive.  In the family of the mechanic he had ap-
peared pleasant, and grateful for  the kindness which
had  been extended to him.   One day a little son of
his new employer accidentally stepped upon his toes.
The lad was  twelve years  old only.   Rabello w7as
exceedingly  angry and in the moment of his rage
threatened the boy's life.   The next day he appeared
sullen, refused his food, and looked wild  and mali-
cious.   The following morning, he went to the barn-
yard with the boy, seized an axe,  and killed  him on
the spot, mangling him in  the most shocking manner.
He went deliberately away from the house, but was
soon overtaken  by those  in  pursuit.   He acknowl-
edged that he killed the boy, and  gave as a reason
that  he stepped on his toes.   It was found, from the
evidence produced at his trial, that this was an of-
fence considered most heinous and not to be forgiven.
Many instances were given in which the same acci-
dent had produced the same excitement of temper
1 Georg'jt, Discussion Medico-legale sur la Folie, 65, 165.
         P 
226   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

often  accompanied with threats.   One of the physi-
cians who visited him in jail, stepped, apparently by
accident,  upon  his  toes while  counting his pulse.
The pulse,  he  declared,  rose  immediately forty
strokes in a minute,  his countenance  flushed up, and
he appeared instantly in a rage." x   Insanity was
pleaded in defence on his trial, and  on  this ground
he was acquitted by the jury.   It appeared in evi-
dence that his life and conduct  had been marked by
much singularity during his residence in this coun-
try ; and  after the trial it was  ascertained from the
Portuguese consul at New  York that he had been
previously deranged.  He  had  been  employed as a
clerk in  a mercantile house  at Madeira, to which
place he  had  returned a "little deranged" after
having been to Brazil.   From  Madeira he went to
Philadelphia, where  he got employment as a clerk
in the house of  some merchants, natives of Madeira,
who knew he had been a little deranged, but sup-
posed he had recovered.  One day one of the house
came in and asked him if any  body had called, when
Rabello  told  him he would break  his head, if he
asked him any such  questions.
   § 159.  In the last  phasis  of the  murderous pro-
pensity that will be noticed, though it is not properly
homicidal  mania, there exists  some hallucination,
and  the  individual  acts from motives—absurd and
unfounded it is  true—but still,  motives  to him.  In
consequence of the universal prevalence,  in some
  1 Dr. Woodward's Reports and other documents relating to the State
Lunatic Hospital at Worcester, Mass. p. 177. 
SEC. II.]         PARTIAL MORAL MANIA.           227

shape or other of religious fanaticism, and of the ex-
citement of the religious sentiments thereby produ-
ced,  a perversion of these sentiments is one of the
most common exciting causes of the murderous pro-
pensity in this class of cases.   When thus excited its
fury  knows no  restraints,  and whole families are
slaughtered in a single paroxysm.   Pinel gives the
case of a vine-dresser, who thought himself commis-
sioned to  procure the  eternal salvation of his family
by killing  them,  or by the  baptism of blood, as he
called it;  and accordingly executed his commission
so far as  to kill two of his children, when he was ar-
rested and confined.   Fourteen years after,  when he
was  thought to be convalescent,  he conceived the
project of offering up an expiatory sacrifice, by kill-
ing all  who  might come within his  reach, and he
succeeded in wounding the  keeper and  cutting the
throats of two other lunatics before he was arrested.1
   § 160.  Sometimes  the individual, even  when  in
easy circumstances, imagines  that he is coming  to
want, and to avoid this calamity, he kills his family
and generally himself.  The following case presents an
illustration of this very common manifestation of men-
tal disorder.
  Captain James  Purington, of Augusta, Maine, a
rich, independent farmer, of steady, domestic habits,
dark  complexion, grave countenance, reserved  in
company, never looking in the face of persons he ad-
dressed,  obstinate  in  his opinions,  though he  fre-
quently changed  his   religious notions  voluntarily,
1 Alienation Mentale, § ISO. 
228    MEDICAL JURISPRUDENCE OF INSANITY. [CH. VII.

died a decided  believer in  universal salvation, often
expressed anticipation of the moment when his fam-
ily would be happy, and sometimes how happy he
should be if they should die  at once.  He was very
avaricious, and  elated  or  depressed,  as his  affairs
were prosperous  or  adverse.   In August, 1805, he
moved to a  new farm which he rapidly improved.
He seemed happy till within a few weeks of his death.
The uncommon drought  depressed  him greatly, lest
his family should  suffer  for want of bread, and his
cattle starve.  On Sunday,  the 6th of July 1806,
Mrs. Purington and  the eldest daughter being at
church, the second daughter saw her  father writing
a letter which he, perceiving that he had been over-
looked, attempted to hide.   She  asked him what he
had  been writing.   He  said  'nothing,' and asked
for his butcher-knife, saying  he wanted  to sharpen
it.   Having made it very sharp,  he stood before the
glass, and seemed preparing to cut his throat.  His
daughter, terrified,  cried  ' what are you doing 1'
He calmly said, ' nothing ;' and laid the knife away.
This was told to his wife ; she searched  for the let-
ter and found it.   [It was  addressed to  his brother,
and  stated that he was  about going a long journey,
and  directed him to take charge  of his children].
On the 7th of July, at dinner-time, he found his wife
sitting in the barn weeping ; she disclosed the cause  ;
he said he did not intend suicide ; but he had a pre-
sentiment his death was near.   Towards the close
of the following day, he ground  the axe ; when the
family went  to bed,  he was reading the bible ; it
was found open on  the  table  at Ezekiel, chap. ix.
On the 9th of July, at two o'clock in the morning, 
SEC. II.]        PARTIAL MORAL MANIA.           229

his eldest  son  alarmed  the  neighbors ; they found
capt. Purington  lying on his  face, his two sons aged
five and eight  in  bed, with  their throats cut ;  the
razor on the table by his side,  the axe near ;  in the
next room, Mrs. Purington aged forty-four, in bed,
her head almost severed from the body;  near her
on  the  floor, a daughter murdered, ten years old;
in the other room  in bed, a daughter aged nineteen,
most dreadfully butchered ;  the second, aged fifteen
most desperately  wounded,  reclining  her head on
the infant, eighteen  months old, whose throat was
cut.  The  eldest  son  was  wounded,  when capt.
Purington  attacked  and dreadfully  mangled  the
second, twelve years old, who attempted to escape ;
capt. Purington  did not speak a word." J
   § 161.  The  various  forms of  homicidal  insanity
have thus been  illustrated, by selecting a few cases
only, from a mass that would fill a considerable  vol-
ume.    Now, however  these cases may differ from
one another, whether the individual has succumbed
to the  propensity to kill, after a long  struggle with
his better nature, or has yielded to it at once and
instantaneously  ; whether harassed by previous dis-
ease of body or despondency of mind, or apparently
in sound  health and with a cheerful  disposition ;
whether his passions have been tamed by the disci-
pline of a good  education,  or allowed to seek their
gratification without restraint; they all possess one
feature in common, the  irresistible, motiveless impulse
to destroy life.   Before entering upon any discussion
1 Parkman : Illustrations of Insanity. 
 230   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

 relative to the nature  of these forms of insanity,  it
 may  be well to consider the following analysis  of
 their most important features.
   § 162. I. In nearly all, the criminal  act has been
 preceded,  either by  some well-marked disturbance
 of the health, originating in  the  head, digestive sys-
 tem,  or uterus, or by an irritable, gloomy, dejected
 or melancholic state, in short by many of the symp-
 toms of the incubation of mania.  The absence of
 particulars in some of  the cases we find  recorded,
 leaves us in doubt how general  this  change really
 is; but a careful examination would, no doubt, show,
 often, if not always  its existence where, apparently
 it has never taken place.
   II. The impulse to destroy  is powerfully excited
 by the sight  of murderous  weapons, by favorable
 opportunities of accomplishing the act, by contradic-
 tion,  disgust, or some  other  equally trivial and  even
 imaginary  circumstance.
   III. The victims  of  the  homicidal  monomaniac
 are mostly, either entirely unknown or indifferent to
 him,  or they are  among his  most  loved and cher-
 ished objects ; and it is remarkable how often  they
 are children, and especially  his own offspring.
   IV. While the greater number deplore the terri-
 ble propensity by which they are controlled and beg
 to be subjected to restraint, a few diligently conceal
 it, or if they avow it, declare their murderous designs,
 and  form  divers schemes for  putting  them  in ex-
 ecution, testifying no sentiment of remorse or grief.
   V.  The  most of them having gratified their  pro-
pensity to kill, voluntarily confess the act and quietly
give themselves up to the proper authorities; a  very 
SEC. II.]       PARTIAL MORAL MANIA.           231

few only—and these, to an intelligent observer, show
the strongest indications of insanity—fly, and persist
in denying the act.
   VI. While the criminal act itself is, in some in-
stances, the only indication of insanity, the individual
appearing rational, as far as can  be  learned, both
before and after  the act; in others, it is  followed or
preceded, or both, by strange behavior,  if not open
and decided insanity.
   VII.  Some plead  insanity in defence of  their
conduct, or an  entire ignorance of what they did ;
others deny that they labored under any such condi-
tion, and at most acknowledge only a  perturbation
of mind.
   § 163.  Apart from the obvious similarity of all
these cases to those where the murderous propensity
coexists with hallucinations, as in the  last two,  the
circumstances under which the homicidal act is per-
petrated furnish strong ground  for believing,  that
they depend  on  mental alienation in  some form or
other;  so different  are  these  circumstances from
those  which  attend  the  commission of crime.  In
homicidal insanity, murder is committed without any
motive whatever strictly deserving the name ;  or at
most,  with one totally inadequate to produce the act
in a sane mind.   On the contrary,  murder is never
criminally committed without some motive adequate
to the purpose in  the  mind  that is actuated by it,
and with an obvious reference to the ill-fated victim.
Thus, the motive may be theft, or the advancement
of any personal interest, in  which case  it  will be
found that the victim  had  or was supposed  to have
property, or was  an obstacle to the designs or  ex- 
232  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VII.

pectations of another.   Or it may  be  revenge,  and
then the injury real or  imaginary  will  be found to
have been received by the  murderer from the object
of his wrath.   In short, with the criminal, murder is
always a means for accomplishing some selfish object,
and is frequently accompanied by some other crime;
whereas, with the homicidal monomaniac, murder is
the only object in view, and is  never  accompanied
by any other improper act.
  § 164.  The homicidal monomaniac,  after  gratify-
ing his bloody desires, testifies neither  remorse, nor
repentance, nor  satisfaction,  and  if judicially con-
demned, perhaps acknowledges the  justice of the
sentence.  The criminal either denies or confesses
his guilt ; if the  latter,  he either  humbly sues for
mercy, or glories in his crimes, and leaves the world
cursing  his judges and with his last breath exclaim-
ing against the injustice of his fate.
  The  criminal  never  sheds  more blood  than is
necessary for the attainment of his object ; the homi-
cidal monomaniac often sacrifices all within his reach
to the cravings of his murderous propensity.
  The criminal lays  plans  for the  execution of his
designs  ; time, place, and weapons are all suited to
his purpose; and when successful, he either flies from
the scene of his enormities, or makes every effort to
avoid discovery.   The homicidal  monomaniac,  on
the contrary, for  the most part, consults none of the
usual conveniences of crime ;  he falls  upon  the ob-
ject of his fury, oftentimes without  the most proper
means for accomplishing his purpose ;  and perhaps
in the presence of a multitude, as if  expressly to
court observation ; and then voluntarily surrenders 
SEC. II.]        PARTIAL MORAL MANIA.            233

himself to the constituted authorities.   When, as is
sometimes the case, he does prepare the means, and
calmly  and  deliberately  executes  his  project,  his
subsequent conduct is still the same as in the former
instance.
   The criminal  often has accomplices,  and always
vicious  associates: the homicidal  monomaniac has
neither.
   The acts of homicidal  insanity are generally, per-
haps always, preceded by some striking peculiarities
in the conduct or character of the individual, strongly
contrasting  with his natural manifestations;  while
those of the criminal are in correspondence with the
tenor of his past history or character.
   In homicidal  insanity,  a man murders his wife,
children, or others to whom he is tenderly attached;
this the criminal never does,  unless to gratify some
evil  passion,  or gain some  other selfish end,  too
obvious to be overlooked  in  the  slightest  investiga-
tion.
   §  165.  A stronger contrast than  is  presented, in
every respect, between the homicidal act of the real
criminal and that of the monomaniac, can  hardly be
imagined ; and  yet we are  obliged  to  acknowledge
that men of  learning and intelligence have often re-
fused to acknowledge  it, though, undoubtedly,  the
number of such is fast  diminishing.   Much  of the
unwillingness manifested  by  juries to abide by the
result,  to which  the above distinctions would necessa-
rily  lead them, arises from those feelings of horror
and indignation excited by the perpetration of cold-
blooded murders,  which incapacitate them from  dis-
criminating with their usual  acuteness  between the 
234  MEDICAL JURISPRUDENCE OF INSANITY.   [CH. VII.

various causes and motives of human action. Besides,
notwithstanding the great  similarity, for the most
part,  between these  cases,  one  will  occasionally
occur, where, from  defect of information,  no little
knowledge of insanity and of human nature  is re-
quired to find one's way through the mists of doubt
and obscurity in which it is involved.  When, there-
fore, as in  the case of jurors generally,  the  mind is
not fitted by  any of this  preparation so necessary to
a successful investigation of difficult cases, it seizes
only on some of the most obvious  though perhaps
least important points which  they  present, and  of
course the  verdict will often be  deplorably at vari-
ance with the dictates of true science. 
CH. VIII.]   LEGAL CONSEQUENCES OF MANIA.       235
                CHAPTER VIII.

          LEGAL CONSEQUENCES OF MANIA.

  § 166.  Man, being destined for the social condi-
tion, has received from  the  author of his being the
faculties necessary  for discovering and understand-
ing his relations to  his fellow-men, and possesses the
liberty, to a certain extent, of regulating his con-
duct agreeably or directly opposed to their sugges-
tions.   For the manner in which this power is used
he is morally responsible,  the elements of responsi-
bility always being  the original capacity, the healthy
action, and the cultivation of the moral and intellect-
ual faculties,—the  measure of the  former being in
proportion to the degree in which the latter are pos-
sessed.    In  legal  responsibility,  the last  element
above mentioned is not admitted,  and the first to a
very limited extent only,  the second alone  being
absolutely essential.  The relation of original inca-
pacity to legal  responsibility has  already been dis-
cussed,  when treating of mental deficiency; that of
cerebral disease now comes up for consideration.
  § 167.  The influence of this condition on respon-
sibility will obviously be proportioned to its severity
and the extent of its action,  and though  we cannot
hope to become acquainted with all its grades,  there
is no reason why we may not be able to recognise and
identify some of the more common  and prominent. 
 236   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VI11.

 If men had agreed to receive some particular analy-
 sis and arrangement  of the affective  and intellectual
 faculties, and to assign to each a  particular portion
 of the brain as its material organ,  we  might  then
 discuss the question how far disease  of one cerebral
 organ affects the actions of the rest,  with the pros-
 pect of arriving at something like definite  results.
 But as no such unanimity exists,  we  can only con-
 sider the observations that have  been  made on the
 derangement of particular faculties,  and thus form
 our opinions relative  to their influence,  by the  gen-
 eral tenor of experience.  Analogy  would  lead us
 to expect that this inquiry would  result in establish-
 ing the principle ;  first,  that  each and every kind
 and degree of mania  does not  equally diminish legal
 responsibility ; and secondly, that the effect of mania
 in this respect must be estimated  not merely by the
 severity of its outward symptoms, but  also in refer-
 ence to the particular faculty affected.  If now, these
 results are confirmed by  the   evidence  of facts, we
 have only to keep them steadily in view, in order to
 avoid much of the  difficulty usually complained of,
 in arriving at satisfactory  conclusions on  this much
 vexed and agitated subject.


                   Section I.

     Legal Consequences of Intellectual  Mania.

   § 168.  The common law relating  to  insanity,  as
before intimated, is open to censure, not so much on
account of the manner in  which it  modifies the civil 
SEC. 1.]    LEGAL CONSEQUENCES OF MANIA.      237

and criminal responsibilities of the lunatic, as of the
looseness,  inconsistency, and  incorrectness of the
principles on which the fact  of the existence of the
disease is judicially established.   The  disabilities it
imposes on this unfortunate class of  our fellow-men
are founded  in  the  most  humane and  enlightened
views, and  have for their object the  promotion of
their highest welfare.  To incapacitate a person from
making contracts,  bequeathing property,  and  per-
forming other civil acts, who has  lost his natural
power of discerning  and judging, who mistakes one
thing for another, and misapprehends his relations to
those around  him,  is  the  greatest mercy  he could
receive, instead of being an  arbitrary restriction of
his rights.
   § 169. In opposition to  that principle of the com-
mon law, which makes  the  lunatic who commits a
trespass on the persons  or property of others, amen-
able in damages to be recovered  by  a civil action,1
Hoffbauer declares, that  if the patient  is  "so de-
ranged that he is no longer master of his actions, he
is under no responsibility,  nor  obliged to make repar-
ation for injuries."2  He gives  no  reason for this
opinion, and we are unable to see how it can be even
plausibly supported.   To the maniac, who, when
restored  to  his senses, discovers  that  during his
derangement he  has  committed an  injury to his
neighbor's property, indemnity  for which  will strip
him  of  his  own possessions  and reduce him  to
absolute beggary, his  recovery must  seem indeed
1 Weaver v. Ward, llohart's Reports, 134.
* Op. cit. § 131, p. 139. 
238   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

like  escaping from one  evil only  to  encounter a
greater.  Such a possible consequence of madness,
it is  certainly painful to think of;  but as the dam-
age is  produced and must  be borne by one  party
or the other, we cannot hesitate which it should
be ;  for  though it  may be  hard for a person thus
to suffer for  actions committed while  utterly un-
conscious of their  nature,  it would manifestly be
the height of injustice  to  make another suffer, who
was  equally  innocent  and  perhaps equally uncon-
scious  of the act.
   §  170. There is one operation of the common law,
however, which  is  justly  a cause of  complaint,
namely,  that  by which lunatics,  even when under
guardianship,  are  subject  to  be   imprisoned like
others, in  default of satisfying a civil execution ob-
tained against them ;x because, whether such im-
prisonment  be considered  as a penal  or a merely
coercive measure, it is altogether inapplicable to the
insane.  It  cannot  coerce  one  who has  no control
over his  own property, and whose mental condition
is  supposed to be such that he is  unable to see any
relation  between the  means  and the end; and  to
punish a person,  for what he himself had no agency
whatever in doing,  is a violation of the first princi-
ples of justice.  To incarcerate some madmen in a
common jail would, in all probability, aggravate their
disorder, and if the  confinement were protracted to
the extent which the law would allow,  render it ut-
terly incurable.
1 Shelford on Lunacy, 407 ; Ex parte Leighton, 14 Mass. Rep. 207. 
SEC. 1.]    LEGAL CONSEQUENCES OF MANIA.      239

  § 171.  The civil disabilities  above-mentioned are
not incurred by every one laboring under mental de-
rangement ; the  measure  of insanity necessary to
produce this effect, or in legal phrase, the fact of the
party's being compos, or non compos mentis, is a ques-
tion to be submitted to judicial investigation, the re-
sult of which will depend on the views of individuals
relative to the effect of insanity on the mental oper-
ations, and to the respect due to opinions and decis-
ions already promulgated.   General intellectual ma-
nia, as we have represented it,  should  be followed,
to the fullest  extent,  by the legal consequences of
insanity ; but partial  intellectual mania does not ne-
cessarily render a person non compos, or so  impaired
in mind as to be no longer  legally responsible for his
acts,  any more  than  every disease of the  lungs or
stomach prevents a patient from attending to his or-
dinary affairs,  and enjoying a certain  measure of
health.   The question when mania invalidates a per-
son's  civil acts  and annuls  criminal responsibility,
and when it does not affect his liability in these re-
spects, has occasioned considerable discussion, and is
certainly the most delicate and  important  that the
whole range of this subject embraces.   No general
principles concerning it are to  be found in the com-
mon law, and cases seem to have  been  decided with
but little reference to one  another, according to the
medical  or legal views which happened at  the time
to possess the minds of the court and jury.  As in-
sanity has  become better known,  decisions have
occasionally been  more  correct,  but as the preva-
lence of these improvements has not been universal,
this branch of jurisprudence has often  retrograded. 
240  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VI11.

and thus the mind of the inquirer is  confused by an
array of opinions diametrically opposed.   General
principles  on  this  subject,  therefore, are yet to be
established;  and  in furtherance of this object, we
shall endeavor to lay down  such legal consequences
of partial intellectual mania, as seem to be warranted
by  correct medical knowledge  of madness  and by
enlightened principles of justice.
   § 172.   We see  some  persons managing  their
affairs with their ordinary shrewdness  and discretion,
evincing no extraordinary  exaltation of feeling or
fancy, and  on  all but one or a few points, in  the per-
fect enjoyment of their reason.  It has been  else-
where remarked, that strange as it may appear, it is
no  less true,  that notwithstanding the  serious de-
rangement of  the reasoning power which a person
must have  experienced, who entertains the  strange
fancies that sometimes find their way  into the mind,
it may be exercised on all  other subjects, so far as
we can  see, with no diminution of its  natural sound-
ness.  To deprive such a one of the management of
his affairs, or  to  invalidate his  contracts, under the
show of affording him protection, would be to inflict
a certain and a serious injury for the purpose of pre-
venting  a much smaller one that might never occur.
The principle that we would inculcate is, that mo-
nomania invalidates a civil act  only  when such act
comes within the circle of the diseased operations of
the mind.   The celebrated  Pascal believed at times
that he  was sitting on the brink of a precipice  over
which he was  momentarily in danger  of falling, and
a German professor of law, mentioned by Hoffbauer,
thought the freemasons were leagued against  him, 
 SEC. 1.]   LEGAL CONSEQUENCES OF MANIA.       241

 while he discharged the duties of his chair with his
 usual ability, and  numberless are the instances of
 worthy people who have imagined their heads turned
 round, or their limbs made of butter or  glass,  but
 who nevertheless manage their  concerns with their
 ordinary shrewdness.   No one,  however, following
 the dictates of his  own judgment, would seriously
 propose to  invalidate such of these men's acts as
 manifestly have no reference to the crotchets  they
 have imbibed.
   § 173. It is not to be understood however that in
 every case of partial mania we  have only to ascer-
 tain the insane delusion and then decide whether or
 not the act in question  could  have come within the
 range of its influence.  In many  instances the delu-
 sion is frequently changing, in which case, it is not
 only difficult to determine how far it  may have been
 connected with any particular act,  but the mind, in
 respect  to  other  operations,  has lost its  original
 soundness, to such a degree that it cannot be trusted
 in the transaction  of important  affairs.   Still this is
 not a sufficient reason against applying the general
 principle, where it can  be done without fear  of  mis-
 take. In doubtful instances we must be governed by
 the circumstances  of the case, and this course, with
 all its objections, seems far more rational  than the
 practice of universal disqualification.
  §  174.  The validity of a marriage  contracted in a
 state of partial mania, is not  to  be determined ex-
 actly upon  the above principles.   Here it is not
sufficient  to  consider merely  the connexion of the
hallucination with  the  idea  of being married,  nor
should we form any conclusion in favor of the capa-
             Q 
242   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

city of the deranged party,  from the propriety with
which  he  conducts  himself during  the ceremony.
The mere joining of hands and uttering  the  usual
responses are things not worth considering; it  is  the
new relations which the married  state  creates,  the
new responsibilities which it imposes, that should fix
our attention, as  the only points in regard to which
the question  of capacity can  be  properly agitated.
In other contracts, all the conditions  and circum-
stances may  be  definite and  brought into view at
once, and the capacity  of the  mind to comprehend
them determined with  comparative facility.   In  the
contract of marriage,  on the contrary, there  is no-
thing definite or certain ; the obligations which it im-
poses do not  admit of being  measured and discussed;
they are of an abstract kind, and  constantly varying
with every new scene  and  condition of life.   With
these views w7e are obliged to dissent from the prin-
ciple, laid down by the  Supreme  Judicial Court of
Massachusetts, in a case of libel  for divorce for in-
sanity  of the wife at the time  of the marriage, that
" the fact of the party's being able to go through  the
marriage ceremony with propriety, was prima facie
evidence of sufficient understanding to make the con-
tract." J  If by making the  contract is meant merely
the giving  of consent  and the  execution of certain
forms, then  indeed  the  fact  of  the  party's  going
through the ceremony with  propriety may be some
evidence of sufficient understanding to make it;  but
if  the  expression includes  the  slightest  idea  of  the
1 4 Pickering's Reports, 32. 
SEC. I.]    LEGAL  CONSEQUENCES OF MANIA.      243

nature of the  relations and duties  that  follow,  or
even of the bonds  and settlements that  sometimes
accompany it, then  the  fact here  mentioned  is  no
evidence  at  all  of sufficient  capacity.   Sir John
Nicholl, looking at the subject in a  different  light,
has very  properly said,  that  " going through  the
ceremony was not sufficient to establish the capacity
of the party ;  and that foolish, crazy persons  might
be instructed to go through  the formality of the cere-
mony, though wholly incapable of understanding the
marriage contract." x  In  a  similar case, Lord Stow-
ell, then Sir William Scott,  had previously observed,
on the fact given in evidence, that the party  "had
manifested perfect propriety of behavior "  during the
ceremony, " that much stress was not to  be laid on
that circumstance;  as persons,  in  that  state, will
nevertheless often pursue a favorite  purpose, with
the composure and  regularity of apparently  sound
minds."2
   § 175.  The  principles that should regulate  the
legal relations of the partially insane are  few and
simple.  While they should be left  in possession of
every civil right that they are not clearly incapable of
exercising, they should be subjected to the perform-
ance of no duties involving  the  interests  or comfort
of individuals, which may be equally well discharged
by others.   In the former instance we continue the
enjoyment of a right  that has  never  been  abused;
in the latter, we refrain from  imposing duties  on
1 Browning v. Reade, 2 Phillimore's Eccl. Rep. *'•'.).
2 Turner v. Meyers, 1 Hagg. Con. Rep. 414. 
244  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

people who are not qualified to perform  them.  We
cannot therefore agree with Hoffbauer, that a mono-
maniac should be  allowed  to manage  the  affairs of
another,  or be appointed to  the office  of guardian,
however much we might be  inclined to  respect the
validity of his civil acts.   In some instances it is im-
possible to know or  to  conjecture, beforehand, how
the predominant idea in his mind may be affected by
his connexion  with persons  and things that have
hitherto been foreign to his thought;  while in others,
it is far within the range of probability that  the con-
sequences  will  be ruinous  to himself  and others.
Here  for example, is a man  who  has long  believed
that he has an eel in his stomach, but on no other
point  has he manifested the slightest mental impair-
ment.  If a monomaniac is ever  a  suitable person
to manage the affairs of another,  it  would seem, at
first thought, that this one  certainly  is;  yet  nothing
would be more injudicious  than to entrust him with
any such duty, for in all probability, though perfectly
upright in his dealings, he would  be   irresistibly im-
pelled to dissipate  the  property  of others,  as  he
always has his own  earnings, in constant journey-
ings from  one empiric  to  another,  in  purchasing
medicines, and consulting physicians, for  the purpose
of getting relieved from his fancied tormenter.  This
exclusion, as Chambeyron  the French  translator of
Hoffbauer, justly remarks, does the  monomaniac no
wrong, it  frees  him from  a great responsibility, it
prevents dangers, possible at  least, either to the
ward  or to him.
  § 176.  The above views, though not yet distinctly
received  in courts,  are  countenanced by many dis- 
SEC. I.]    LEGAL CONSEQUENCES OF  MANIA.      245

tinguished physicians  and jurists.   Hoffbauer sup-
ports them to the fullest extent,  Esquirol  sanctions
them, by interposing no word of disapprobation, and
Georget admits  them  in application to civil  cases.
Paris and Fonblanque  have  explicitly  recognised
their correctness in the following passage.   " When
a man suffers under a partial  derangement of intel-
lect, and on  one point  only,  it would be  unjust to
invalidate acts which wrere totally distinct from, and
uninfluenced by this so-limited insanity ;  but if the
act done bear a strict  and evident  reference  to the
existing mental  delusion, we cannot see why the law
should not also  interpose  a limited protection, and
still less why courts of equity, which in their ordi-
nary jurisdiction relieve against mistake, should deny
their aid in such cases." x
   § 177.  Mr.  Evans,   the  translator of  Pothier's
Treatise  on   Obligations,  expresses an  opinion on
this subject,  no  less positive and  precise.   " I can-
not but  think,"  he says, " that a  mental disorder
operating on partial subjects, should, with  regard to
those subjects, be  attended with the same effects as
a total deprivation of reason ; and that on the other
hand, such a  partial disorder operating only  upon
particular subjects,  should not  in  its legal effects,
have an influence more extensive than  the subjects
to which it applies ; and that every question should
be reduced to the point, whether the act  under con-
sideration proceeded from  a mind  fully capable, in
respect  of that  act, of exercising  free,  sound  and
1 Medical Jurisprudence, 302. 
246   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

discriminating judgment;  but in case the infirmity
is established to exist, the  tendency of it to direct or
fetter the operations of the mind should be in general
regarded as sufficient presumptive evidence, without
requiring a direct and  positive proof of its actual
operation." J
  § 178.  It  has been already  remarked  that  the
practice of the English courts  in regard  to partial
insanity has been regulated by no settled principles.
Of the truth of this remark we  have a striking illus-
tration in Greenwood's case, which has been so often
cited.  Mr. Greenwood was  bred  to the bar  and
acted as  chairman at  the  quarter  sessions, but be-
coming diseased, and receiving  in a fever a draught
from the hand of his brother,  the delirium, taking its
ground then, connected itself with that idea;  and
he considered his brother as having given  him a po-
tion, with a view to destroy him.   He recovered in
all  other respects,  but that morbid image  never
departed ;  and that  idea appeared  connected  with
the will by which he disinherited his brother. Never-
theless, it was considered so necessary to have some
precise rule, that, though  a  verdict  had  been  ob-
tained in  the  common pleas  against  the  will,  the
judge strongly advised the jury to find the other way,
and they did accordingly find  in favor  of the will.
  Farther proceedings  took  place afterwards  and
concluded in a compromise.2  No one would be hardy
enough to  affirm that Greenwood's mind  was per-
1 2 Pothier on Obligations, Appendix, 24.
2 Lord Eldon, in White v. Wilson, 13 Vesey's Reports, 88. 
SEC. I.]    LEGAL  CONSEQUENCES OF MANIA.      247

fectly rational and sound, and as his insanity dis-
played  itself on all  topics relating to his brother,
every act involving this brother's  interests, to go no
farther, ought consequently to have been invalidated.
A plainer case cannot well be imagined.
   § 179. More enlarged and correct views prevailed
in the able and elaborate  judgment delivered by Sir
John Nicholl, in the case of Dew v. Clark,1 where the
existence of partial  mania is recognised,  and  the
necessity of bearing in mind  the fact  of its partial
operation on the  understanding,  while  determining
its influence on  the  civil  acts  of the  individual, is
strongly  inculcated.    The point  at issue was  the
validity of the will of one Stott (who  left personal
property nearly amounting to £40,000), bequeathing
the complainant,  who  was his  daughter  and  only
child, a life-interest in a small portion  of his estate,
the most of which was devised to his nephews.  The
object of inquiry was whether the extraordinary con-
duct  and feelings  of the deceased towards his daugh-
ter had any real cause, or was solely the offspring of
delusion in  a disordered mind,  and to this end an
unparalleled mass of evidence  was offered by each
party.  It was proved by the nephews that the testator
had considerable practice as a surgeon and medical
electrician from 1785 to 1820,  and that at all times
down to the latter period when  he  had a paralytic
stroke,  he  managed the whole  of  his  pecuniary
and professional  affairs in a  rational  manner,  and
rationally conducted all manner of business.   They
1 3 Addams's Reports, 79. 
248  MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

admitted that he was a man of an irritable and vio-
lent temper; of great pride and conceit;  very pre-
cise in  all his domestic and  other  arrangements;
very  impatient of contradiction,  and  imbued with
high notions of parental authority.  They represented
him to have entertained rigid notions of the total and
absolute depravity of human nature and  of the ne-
cessity  of sensible  conversion,  and  contended that
all  the singularities of his conduct could be attributed
to his peculiar  disposition and belief, without resort-
ing to insanity  for an explanation.  By the daughter,
it was shown by a body of evidence that placed the
fact beyond the shadow of a  reasonable doubt, that
from an early  period of her life,  he manifested an
insane aversion towards her.  It appears that he was
in the habit of  describing her, even to persons with
whom he was not intimately  acquainted, as sullen,
perverse, obstinate, and given  to lying ;  as a fiend,
a monster,  a  very  devil, the  special  property  of
Satan; and charging her with vices, of which it was
impossible  that a girl of her  age  could be guilty.
The peculiar and unequalled depravity of his child,
her vices, obstinacy,  and  profligacy were topics on
which he was  constantly dwelling, and his general
deportment towards her  not only negatived all idea
of natural affection,  but  betrayed a  most fiend-like
temper.  His  manner towards  her  w7as  fiery and
terrific; the instant she appeared, his  eye  flashed
with rage and  scorn, and  he spurned her from him
as he would a reptile.  He compelled her to do the
most menial offices,  such  as  sweeping the  rooms,
scouring the grates, washing  the  linen  and  the
dishes ;  to  live in the kitchen and  be  sparingly fed. 
SEC. I.]     LEGAL CONSEQUENCES  OF MANIA.      249

He once stripped  her naked, when  ten or eleven
years old, tied her to a bed-post, and  after flogging
her severely with a large rod intertwisted with brass
wire, rubbed her back with brine.   Repeatedly, and
on the most trivial occasions, he struck her with his
clenched fists, cut her flesh  with  a horsewhip,  tore
out her hair, and once aimed at her a blow with some
weapon which made a dent in a mahogany table, and
which  must have  killed her, had she  not avoided it.
Now it was abundantly proved that there existed no
real  cause whatever for this strange antipathy, but
that  the daughter was of an amiable,  obliging, and
docile  disposition—that  she  had always shown a
great  filial  affection  for  her  father—that she  con-
ducted at home and abroad  with the utmost  pro-
priety  and  decorum—that she was  a  person of
strictly moral and religious habits, and was  so  con-
sidered and known to be  by  the  friends of the de-
ceased and others of high reputation  and character.
The court, in making up its decision,  declared that
the  question at issue was, " not  whether  the  de-
ceased's  insanity  in certain other particulars, as
proved by the  daughter,  should  have  the effect of
defeating  a will, generally, of  the deceased,  or even
this identical will—but whether  his  insanity, on the
subject of his daughter,  should have  the  effect of
defeating, not so much any will  (a will generally) of
the deceased, as this identical will."   Accordingly,
considering it proved that the will was the direct,
unqualified  offspring  of that  morbid delusion   con-
cerning the daughter, thus put into act and  energy,
it  was  pronounced to be null  and void in law.  In
this decision we  see the  prevalence of those  more 
 250   MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

 correct and profound views  ofinsanity,  which have
 resulted from the inquiries of the last few years.
   The same principle had been previously laid down
 in the following case which was  adjudicated in Ken-
 tucky, in  1822.  George Moore made his  will  in
 April  1822,  and shortly after died.  It was the valid-
 ity of  this will which was the point at issue.   About
 twenty-four years previous  to  his  death,  he had a
 dangerous fever, during which he imbibed a  strong
 antipathy towards his  brothers, imagining  that  they
 intended to destroy or injure him,  though they at-
 tended him throughout his  illness,  and never gave
 the slightest foundation for his belief.  This antipathy
 continued to the day of his death,  with a single ex-
 ception, when  he made  a will  in  their  favor, but
 afterwards cancelled it.   When asked by one of the
 witnesses w7hy  he disinherited  his  brothers,  he be-
 came violently excited, and  declared  that  they had
 endeavored to get his estate  before  his death.   The
 court,  in its  decision, observe, that, "he cannot be
 accounted a free agent in  making his will, so far as
 his relatives  are  concerned,  although free as to the
 rest of the world.   But however free  he may have
 been as to other objects,  the conclusion is irresisti-
 ble, that this peculiar defect of intellect did influence
 his acts in making his will, and for this cause it ought
 not to be sustained.  It is not only this groundless
 hatred or malice  to his brethren  that ought to affect
 his will, but  also his  fears  of them,  which  he ex-
 pressed during his last  illness, conceiving  that they
 were attempting  to  get away his estate  before his
death,  or that they were lying in wait to shoot him,
 while  on   other  subjects he 'spoke rationally; all 
SEC. I.]     LEGAL CONSEQUENCES OF MANIA.      251

which are strong evidences of a derangement in one
department of his  mind, unaccountable indeed, but
directly influencing and operating upon the act which
is  now claimed  as  the  final  disposition of the
estate." J
  Esquirol has related a case of a very similar kind,
where  a person conceived an  antipathy  against his
brothers, sisters,  and  other relatives, who,  he be-
lieved  were  seeking  to  destroy him.   Under the
influence of this delusion he made testamentary dis-
positions, and Esquirol being consulted respecting
their validity, gave it as his opinion that the testator
was laboring under insanity.2
  § 180.  In criminal as well  as civil  cases, it is im-
portant to consider the operation of the predominant
idea, and its influence on  the  act in  question. There
certainly is  no reason  why  a  person  should be held
responsible  for a  criminal  act  that springs  from a
delusion which would be sufficient  to  invalidate any
civil act to which it might give rise.  A monomaniac's
sense of the fitness of things is not different when  he
signs a ruinous contract,  from what  it  is when  he
commits a criminal deed;  and if the inability to dis-
cern the true relations of things is  the  ground on
which  the former is invalidated,  it ought  equally to
annul criminal responsibility ; unless it can be shown
that the abstract conceptions of the nature and con-
sequences of crime are never affected in insanity, or
are compatible with a  degree of mental  soundness
1 Johnson v. Moore's heirs, 1 Littel's Reports, 371.
2 Annales d'Hygiene Publique, vol. 3, p. 370. 
 252   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

 that wrould incapacitate a person from buying a house
 or selling a piece of land.   It is yet a disputed point
 however, whether partial mania should have the full
 legal effect of  insanity, in criminal cases.   By  Hoff-
 bauer,  Fodere and some other writers,  it is con-
 tended that the same principle which determines the
 effect of mania in civil,  should also determine its
 effect in criminal cases ; that is, that criminal respon-
 sibility should  be annulled only when  the  act comes
 within the range  of the  diseased  operations of the
 mind.   In favor of this view, it may be urged, that
 the  connexion of the morbid  delusion  with  the
 criminal act is  generally very direct, and  not easily
 mistaken.   A  remote and  circuitous association of
 the predominant idea w7ith the deed in question, pre-
 sents fair ground for suspicion,  because the farther
 the thoughts of the monomaniac wander from  the
 object  of his delusion,  the less  are  they affected by-
 its influence.   If a man who imagines his legs are
 made of glass,  should see another approaching him
 with a stick for the purpose of breaking them, he
 could not help  resisting even to  bloodshed,  in what
 would  be to him an act of self-defence, but it would
 require a very  peculiar concatenation of circumstan-
 ces to warrant  us in  considering a rape or theft as
 the offspring of this hallucination, because the  idea
 of these acts would carry  the  thoughts far beyond
 the reach of its influence.
   § 181. Against  these  views  it may be  objected,
 that it  is not always easy to trace the connexion be-
 tween  the  predominant  idea and the criminal act.
The links that  connect the thoughts  which rise in
succession in the sound mind defy all our penetration, 
SEC. 1.]   LEGAL CONSEQUENCES OF MANIA.      253

and the few laws we have established  are totally in-
applicable  to the associations of the  insane mind.
No one will be bold enough to affirm  that a certain
idea  cannot possibly  be connected with a certain
other idea  in  a  healthy state of the  mind, least of
all when it is disordered by disease,  so that the ex-
istence of partial  insanity once  established, it is for
no human  tribunal to arbitrarily circumscribe the
circle of its diseased operations.   We  must remem-
ber also that sometimes the predominant idea is fre-
quently changing, and at others, is obstinately con-
cealed by the patient,  and is not  ascertained till after
his restoration to  health.  The views here objected
to have also found a  strong  opponent in Georget
whose  practical  knowledge  of  the subject and ac-
knowledged acuteness in  observing the manners of
the insane, entitle his opinions  to  great considera-
tion, if not to entire belief.   The following observa-
tions  of his  should never be forgotten in forming
conclusions on this disputed point. "In conversing,"
says he, "with patients on  topics foreign to  their
morbid delusions, you will generally  find no  differ-
ence between  them  and other people.  They not
only deal in common-place notions, but are capable
 of appreciating new  facts  and  trains of reasoning.
Still  more, they retain their sense of good and evil,
right and  wrong, and of social usages,  to  such a
 degree, that  whenever they forget  their moral suf-
 ferings and  their delusions,  they conduct, in their
 meetings, as they  otherwise  would  have done, in-
 quiring with interest  for one another's health, and
 maintaining  the  ordinary observances of society.
 They have special reasons even for regarding them- 
254  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

selves writh a degree of complacency ;  for the most
part they believe that  they  are  victims of arbitrary
measures, fraudulent  contrivances,  and projects  of
vengeance or  cupidity,  and thus they sympathize
with one another in their common misfortunes.  Ac-
cordingly the inmates of lunatic asylums are rarely
known to commit those reprehensible acts which are
regarded as crimes when dictated  by sound  reason,
though the most of them  ejijoy considerable freedom.
They often talk very sensibly of their interests, and
some even manage their property perfectly well."
   " Those patients who  are insane on one point only
more or less limited,  may  have experienced  some
severe moral disorders which influence the conduct
and actions of the individual, without materially in-
juring his judgment.    Those  who  conduct them-
selves so well in the asylum, in the midst of stran-
gers with whom they have no relations, and  against
whom they have conceived no prejudice nor cause
of complaint, and in quiet submission  to the rule of
the house, are no sooner at  liberty, in the bosom of
their families, than their  conduct becomes insupport-
able ; they are irritated by the slightest contradiction,
abusing and threatening  those who  address to  them
the slightest observation, and working themselves up
to the most intolerable excesses.   And whether the
reprehensible acts they then commit are really foreign
to the predominant idea or not, ought we to  make a
being responsible for them whose moral nature is  so
deeply affected ? " x These facts, it cannot be denied,
1 Discussion medico-legale sur la Folie, pp. 10, 14. 
SEC. I.]   LEGAL CONSEQUENCES OF MANIA.        255

furnish  strong  ground  for  the  remark with  which
Georget closes his observations on this point, namely,
that if, in following the  rule  that  partial  mania ex-
cludes the idea of culpability,  " the moralist and the
criminal judge run the risk of committing injustice
by sparing a really guilty person, certainly, the op-
posite course  would  lead  them  into  still greater
errors."
  § 182.  Hoffbauer has not only  limited the  excul-
patory  effects  of partial mania to  the acts  which
clearly come within its influence, but has laid down
the principle that  in the criminal jurisprudence  of
this condition, the predominant  idea should be con-
sidered as true ;  that is, that  the acts of the patient
should be judged as if he  had really  been  in the
circumstances he imagined himself to be when they
were  committed.   It is based on  the  common, but
erroneous notion, that insane people always  reason
correctly from  wrong premises, and therefore  it is
inapplicable  to the numerous instances  where the
premises and inferences are all equally  wrong.  If a
person imagines he heard the voice of God command-
ing him to immolate  his only child  and he accord-
ingly  obeys, it  may be said indeed that he  is not
responsible for the bloody  deed,  because it  would
have  been perfectly proper, had he  really heard the
command; but  are we to  be  told,  that  if he had
killed his  neighbor for a  fancied petty  injury, he is
not to be absolved from  punishment,  because, the
act would have been highly criminal,  even though
he might have really received the injury ?  It must
not be overlooked that in cases like the  latter, the
insanity manifests itself, not  only  in  the  fancied in- 
 256  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

 jury, but in  the  disproportionate punishment which
 he inflicts upon the offender, and it is absurd to con-
 sider one manifestation as a delusion, and the other
 a  crime.
   § 183. In the  English  courts there has  been  a
 great diversity of practice on this subject, according
 as it has been  affected by the speculative  opinions
 of the judge, the eloquence of counsel,  the magni-
 tude  of  the criminal act,  and the  ignorance  or
 humanity of juries.   If we  carefully examine  the
 cases tried within the  last hundred  years,  as they
 are  brought together  in  the  various  treatises on
 lunacy and on criminal law, the  utmost respect for
 authority will  not prevent  us from observing  the
 want of  any  definite principle  as the ground of the
 difference of their results.   Amid the mass of theo-
 retical and discordant speculations on the  psycho-
 logical effects of insanity, and  of crude  and fanciful
 tests for  detecting its presence, which these trials
 have elicited, the student who  turns  to them for the
 purpose of informing his mind on  this branch of his
 profession, finds himself completely disheartened and
 bewildered.   Instead of inquiring into the effect pro-
 duced by the peculiar delusions of the accused on his
 ordinary conduct  and conversation, and especially of
 their connexion with the criminal act in question,
 the courts in these cases, have been contented with
 laying down metaphysical dogmas on  the  conscious-
ness of right and  wrong, of good  and evil,  and the
measure of understanding still  possessed  by  the ac-
cused.  Under the influence of the doctrines of lord
Hale, partial insanity has seldom been considered as
sufficient, per se,  to  annul  responsibility  for  crime. 
SEC. 1.]    LEGAL CONSEQUENCES OF  MANIA.       257

When received as an exculpatory plea, it has gener-
ally been in those  cases  where  the principal delu-
sions  were of  a religious nature,  though the reason
of this preference it might be difficult to assign.
   § 184. The practice of the American courts, judg-
ing from the few  cases that have come to our know-
ledge, has been  guided by more  liberal  doctrines.
In the trial of Lawrence, at Washington, in 1835, for
shooting at president Jackson, the jury were advised
by the court to regulate their  verdict by the princi-
ples laid down in the case of Hadfield, which  had
been  stated to  them by the  district-attorney.1   In
the case of Theodore Wilson, tried in  York county,
Maine, in  183S,  for the murder of his wife in a par-
oxysm of insanity, the court  charged  the  jury  that
if they were satisfied the prisoner was not of sound
memory and discretion at the time of committing the
act,  they were bound to return a verdict of acquittal.
This  is all  that  could be  wished;  and considering
that  two  highly  respectable  physicians  had given
their opinion in evidence that the prisoner had some
consciousness of right and  wrong, and  that   the
attorney-general, though he admitted  the existence
of insanity in some degree,  denied that  it was of
sufficient extent to  exempt him from punishment,
supporting his assertion on the authority of the lead-
ing English cases relating to  insanity,  this decision
  1 Giles's Register, vol. 48, p. 119. The principle adopted in Had-
field's case was, that a person is not responsible for whatever criminal
act is committed under the influence of delusion. 
258   MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

indicates an advance  in  the criminal jurisprudence
of insanity that does credit to the humanity and in-
telligence of that court.
                    Section  II.

        Legal Consequences of Moral  Mania.

   § 185. General moral mania furnishes good ground
 for  invalidating  civil  acts, for notwithstanding the
 apparent integrity of the intellectual powers, it is
 probable  that their operation  is  influenced  to a
 greater  or less  extent,  by a  derangement of the
 moral powers.  The mutual  independence  of these
 two portions of our spiritual  nature is not  absolute
 and unconditional, but is always liable to be affected
 by the operation  of the  organic  laws.   The animal
 economy is a whole ; no part of it can exist without
 the rest, nor be injured or abstracted without marring
 the energy or harmony of the whole system ; and
 though each part is so far independent of the others
 as to contribute its distinct share in the production
 of  the  general result, even  sometimes  when  sur-
 rounded by the ravages of disease,  yet  the  general
 law is, that disease in one  part modifies more or
 less the action of all the rest, and especially  of those
 connected with it by contiguity  or  by resemblance
 of function.  Nature has established a certain adap-
 tation of the moral and intellectual faculties to one
 another,  leading  to that harmony  of action which
puts them in proper relation to external  things, and 
SEC II.]    LEGAL CONSEQUENCES OF MANIA.     259

we can scarcely conceive of any disturbance of their
equilibrium,  that  will not more or less impair  the
general result.  Amid the chaos  of the sentiments
and passions produced by moral  mania, the power
of the intellect must  necessarily suffer, and instead
of accurately examining and  weighing  the  sugges-
tions  of the moral powers, it is influenced by motives
which may be  rational enough,  but which would
never have been adopted in a  perfectly healthy state.
It is  hard  to conceive,  indeed, that with an under-
standing technically sound, the relations of a person
should be viewed  in an  entirely different light,  the
circle of his  rights and duties broken  and distorted,
and  his conduct  turned  into  a  course altogether
foreign to  his ordinary  habits and pursuits.  Not-
withstanding the correctness of his conversation, and
his plausible reasons for  his singular conduct, a strict
scrutiny of his actions,  if not his  words, will con-
vince us that his notions of right and  wrong are  ob-
scured and perverted, and that  his  own social posi-
tion is viewed through a medium which  gives a false
coloring to its whole  aspect.   Now,  though such a
person may not be governed by any blind,  irresisti-
ble impulse, yet to judge his acts  by the standard of
sanity and  attribute to them  the same legal conse-
quences as to those of sane  men,  would be clearly
unjust, because their real tendency is not and cannot
be perceived by him.   Not that his abstract  notions
of the nature of crime are at all altered,  for they  are
not, but  the real character of  his acts  being miscon-
ceived, he does not associate  them  with their ordi-
nary  moral relations.  No fear of punishment  re-
strains him from committing criminal acts, for he is 
 260  MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

 totally unconscious of violating any penal laws, and
 therefore, the great end of punishment, the preven-
 tion of crime, is wholly lost  in his case.  If there
 wTere no other reason for withholding punishment in
 cases of moral mania, this alone would be sufficient,
 that the fear of it,  which with  others is a powerful
 preventive of crime, or at least is supposed to be, in
 the most popular theories of criminal law, does not
 and cannot  exert  its  restraining  influence on  the
 mind.   No  one would think  of  attributing  moral
 guilt to earl Ferrers for entertaining the  insane idea
 that his steward was  a villain  conspiring  with the
 earl's  relatives  against  his  comfort and  interests
 (§ 112); why then should it be charged to him as a
crime, that, amid the tumult of his passions disturb-
ing the  healthy exercise of  his understanding,  he
considered himself  as the proper avenger of his own
wrongs ?  Each delusion was alike the offspring of
the same derangement, and it is unjust and unphilo-
sophical to regard one with indifference as the hallu-
cination of a madman, and be moved with horror at
the other and visit it with the utmost  terrors  of the
law, as the act of a brutal murderer.
  § 186. Liberty of will and  of action is absolutely
essential to  criminal  responsibility, unless  the con-
straint upon  either is  the natural and  well-known
result of immoral or illegal  conduct.   Culpability
supposes not  only a clear perception of the  conse-
quences of criminal acts, but  the liberty,  unembar-
rassed by disease of the active powers which  nature
has given us, of pursuing that course which is the re-
sult of the free choice of the intellectual  faculties.
It is one of those wise provisions in the arrangement 
SEC. II.]    LEGAL CONSEQUENCES OF MANIA.      261

of things, that the power of perceiving the good and
the evil, is never unassociated with that of obtaining
the one  and  avoiding the other.  When, therefore,
disease has brought upon an individual the very op-
posite condition, enlightened jurisprudence will hold
out to him its protection,  instead of crushing him as
a  sacrifice to violated  justice.   That the subject of
homicidal insanity is not a free agent, in the proper
sense of the  term,  is a truth that must not be ob-
scured by theoretical notions of the nature of insan-
ity, nor  by apprehensions of injurious consequences
from its admission.  Amid the rapid and tumultuous
succession of feelings that rush into his mind, the re-
flective powers are paralyzed,  and his movements
are solely the  result  of a blind, automatic impulse
with which the reason has as little to do, as with the
movements of a new-born infant.   That the notions
of right and  wrong continue unimpaired under these
circumstances,  proves  only the partial  operation of
the disease;  but in the internal  struggle that takes
place between  the affective and intellectual powers,
the former have  the advantage of being  raised to
their  maximum of energy by the excitement of dis-
ease, which,  on the other hand,  rather  tends to di-
minish the activity of the latter.   We have seen that
generally after  the fatal act has been accomplished,
and the violence of the paroxysm subsided, the mo-
nomaniac has gone and delivered himself into the
hands of justice,  as if, overwhelmed with  horror at
the enormity of his action,  he either considered his
own life the  only compensation he  could offer in re-
turn ;  or, it may be, felt that, the presence  of his fel-
low men, though  it would seal  his own fate, would 
262  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

be a welcome relief from the crushing agony of his
own spirit.   It is not to be wondered at, however, if
occasionally, the  tide of feeling  takes a  different
course,  and the murderer is prompted to avoid what
he  cannot help thinking to  be the just consequence
of his act, by flying from the bloody  scene, and even
denying his agency in it altogether.   Considering the
diversity  of  habits,  sentiments and  education,  uni-
formity  in an unessential phenomenon like this is not
to be expected.   That flying from pursuit indicates
a consciousness of having committed a reprehensible
act, and also a fear of punishment, is not denied, but
it has never been contended that the opposite course
implies  the absence of all ideas of  this kind from  the
mind of the homicidal monomaniac.   The real  point
at issue is, whether  the fear of punishment or even
the consciousness of wrong  doing  destroys  the sup-
position of insanity, and  this is settled by the well-
known fact that the inmates of lunatic asylums, after
having committed some reprehensible acts, will  often
persist in denying  their agency in  them, in  order to
avoid the reprimand or punishment which they know
would  follow their  conviction.   If  insane  persons
have any rational  ideas at all, and it is not denied
that they have, it is not strange that  they sometimes
are conscious of the penal consequences of their acts
and use the intelligence of a brute in order to avoid
them.   Besides, in  moral  insanity  the intellectual
faculties are supposed not to be impaired, and when
the fury of the paroxysm which has borne him  on in
spite of every attempt at  resistance  has subsided,
the homicidal monomaniac  returns,  in some degree
at least, to his ordinary habit of thinking and feeling. 
SEC. II.]      LEGAL CONSEQUENCES OF MANIA.     263

He regrets the havoc he has made, foresees its  dis-
graceful  consequences  to  himself, shudders at the
sight, and flies, like the most hardened criminal, to
avoid them.
   § 187. In medical  science, it is dangerous to  rea-
son against  facts.   Now we have  an  immense  mass
of cases related  by men  of unquestionable compe-
tence and  veracity,  where  people  are  irresistibly
impelled  to the  commission of criminal  acts while
fully  conscious of  their nature and  consequences ;
and  the force  of these facts  must be overcome by
something more than angry declamation  against vis-
ionary theories and ill-judged  humanity7.   They are
not fictions  invented  by medical men (as was rather
broadly  charged  upon them in some of the late trials
in France), for the purpose of puzzling juries and
defeating the  ends  of justice,  but plain, unvarnished
facts  as  they occurred in nature ; and to set them
aside without a thorough  investigation, as unworthy
,of influencing our decisions, indicates any thing rather
than  that spirit  of sober and  indefatigable inquiry
which should characterize the science  of jurispru-
dence.   We need  have no fear that the truth on this
subject will not  finally prevail, but  the  interests of
humanity require that this event should  take place
speedily.
   § 188. The distinction between  crimes and the
effects of homicidal monomania is too well-founded
to be set aside by  mere declamation, or appeals to
popular prejudices,  as has been  repeatedly done in
courts of justice.   On the trial of Papavoine for the
murder  of  two young  children near Paris, in 1823,
 the advocate-general,  in reply to the counsel of the 
 264   MEDICAL  JURISPRUDENCE OF  INSANITY.  [CH. VIII.

 prisoner who had pleaded homicidal  insanity in his
 defence,  declared  that  Papavoine committed  the
 crime, in  order  " to gratify  an  inveterate hatred
 against his fellow-men,  transformed at first,  into a
 weariness of  his own life, and  subsequently into an
 instinct of ferocity and a thirst of blood.  Embittered
 by his unhappy condition,  excited by a sense of his
 sufferings  and misfortunes,  irritated by the happiness
 of others  which awakened in him only ideas of fury,
 and drove him  into  seclusion  which  increased  the
 perversity of his depraved propensities, he arrived at
 that pitch  of brutal depravity where destruction be-
 came  a necessity and the sight of blood a horrible
 delight.   His hateful affections, after being long re-
 strained,  finally burst forth and raised in his bosom
 a  necessity of killing, which, like a young tiger, he
 sought to  gratify." J  That beings in  human  shape
 have  lived who  delighted in  the shedding of blood,
 and found a pastime in beholding the dying agonies
 of their victims, is a melancholy fact too well estab-
 lished by  the  Neros  and  Caligulas of history.  For
 such we  have no disposition  to  urge the plea of in-
 sanity, for though we are willing to believe them to
 have  been  unhappily constituted,  we  have no evi-
dence  that they labored  under cerebral disease,  and
they  certainly  exhibited none  of its  phenomena.
Motives,  the very slightest  no doubt,  generally  ex-
isted  for even their most  horrid  atrocities, and even
when they were  entirely  wanting,  there wras  still a
conformity of their bloody deeds with the whole tenor
' Georget:  Examen des proces criminelles. 
SEC. II.]    LEGAL CONSEQUENCES OF MANIA.     265

of their natural character.  They followed the bent of
their dispositions as manifested from childhood, glory-
ing in their preeminent wickedness and rendered fa-
miliar by habit with crime ;  and though  conscience
might have slumbered, or opposed but a feeble resist-
ance to the force of their passions, yet it was not per-
verted by diseased action so as to be blind to the exist-
ence of moral distinctions.   In homicidal insanity, on
the contrary, every thing is different.  The criminal
act for which its subject is called to an account, is the
result of a strong and sudden impulse, opposed to his
natural habits and generally  preceded or followed by
some derangement of the healthy actions of the brain
or other organ.  The advocate-general himself re-
presented Papavoine,  " as having been noted for his
unsocial disposition, for  avoiding his fellow-laborers,
for walking in retired, solitary  places, appearing to
be much absorbed in  the  vapors of a black melan-
choly."  This is not a picture of those human fiends
to whom he would assimilate Papavoine, but it is a
faithful one of a mind over which the clouds of insan-
ity are beginning to gather.  Where is the similarity
between this man, who, with a  character for probity
and  in a fit of melancholy, is irresistibly hurried to
the commission of a horrible deed, and those wretches
who, hardened by a life of crime, commit their enor-
mities  with perfect deliberation  and consciousness of
their nature.
   § 189.  It has been also urged that the subjects of
homicidal  insanity are, no less  than criminals, inju-
rious to society, the safety of which implicitly requires
their extermination, upon the same principle that we
do not hesitate to destroy a dog that has been so un- 
266  MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

fortunate as to go mad.  Sane, or insane, criminal or
not, such monsters should be cut off from the face of
the earth, and it is a misplaced  humanity to reserve
them for a different fate.  Such  language might have
been expected from  people who are moved only by
the feelings, that are immediately raised by the sight
of appalling  crimes, but it is an humiliating truth
that the opinions of those who are in the habit of dis-
criminating between various shades of guilt  and of
canvassing motives,  are too  often but an echo to the
popular voice.  If the old custom of smothering under
a feather bed the  miserable victims of hydrophobia
be now considered as a specimen of  the most  revolt-
ing barbarity, we cannot see why the punishment of
insane offenders should  be  regarded under a more
favorable  aspect.   Society  has a right  to protect
itself against the aggressions of the  dangerously in-
sane, but unnecessary severity in its protective meas-
ures defeats  the very purpose in view,  and indica-
tes  a want of humanity and intellectual enlighten-
ment.  While  confinement in prisons  and mad-houses
furnishes all the restraint which  the necessity of their
case requires, it is idle to urge the infliction of death
as the only means by which  society can be effectually
shielded from a repetition of their terrible enormities.
  §  190. One of the  principal objects of punishments
should be to deter from the  commission of crime, by
impressing the mind  with ideas of physical and moral
suffering as its certain consequence ;  and whenever it
is found to produce  a very different  effect, it is the
part of enlightened legislation to devise some other
means of prevention.  Nothing  can  be  more  absurd
than to inflict the very punishment which the delusion 
SEC. II.]     LEGAL CONSEQUENCES OF MANIA.      267

of the monomaniac often impels him to seek,—to put
him to death who voluntarily surrenders himself and
imploringly beseeches it as the only object he had at
heart in perpetrating a horrid crime.  What is it but
converting a dreadful  punishment  into  the  dearest
boon that earth can offer ?  In religious monomania,
it is not uncommon for the patient to believe that the
joys of heaven  are in store for him, and, under the
excitement of this  insane idea, to  murder a fellow-
creature,  in order that he may the sooner enter on
their fruition.   To execute one of this class, is to per-
petuate an evil which  needs only a change of penal
consequences to be effectually remedied.  A kind of
delusion has sometimes prevailed in certain  parts of
Europe which persuades its unfortunate subjects that
eternal happiness can be gained by being executed
for the murder of some innocent person.  The idea
is that suicide being itself a sin will not be followed
by the happiness they seek, but that murder, though
a greater crime,  can be repented of before the time
of execution.   This delusion prevailed epidemically
in Denmark, during the middle of  the last  century,
and  to  avoid sending an  unprepared person out of
the world, the victim generally selected was  a child.
Death, of course, was no punishment in this case,
and  at  last, the  king  issued an ordinance directing
that the guilty should be branded on the  forehead
with a hot iron and whipped, and be imprisoned for
life with hard labor.  Every year, on the anniversary
of their crime,  they  were to be  whipped.1  Lord
London Quarterly Review, vol. 12, p. 21 
268  MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

Dover, in his Life of Frederic, relates that such was
the severity of discipline among the Prussian troops
at Potsdam, that many wished for death to finish their
intolerable sufferings, and murdered children, which
they had enticed within  their power, in order to ob-
tain from justice  the  stroke they dared  not  inflict
upon themselves.1   Abolish capital  punishment  in
such cases, and the delusion will disappear with it ;
continue it, and no one can tell when the  latter will
end.
   § 191.   Not only is  the  moral effect of punish-
ment totally lost when  inflicted on the subjects of
homicidal insanity, since it does not deter other mad-
men from committing similar acts, but by a curious law
of the morbid action, every publicity obtained for them
by the trial and execution of the actors, leads to  their
repetition to an almost incredible extent.   At a sit-
ting of the Royal Academy of Medicine  in Paris,
August 8th,  1826,  Esquirol stated  that  since the
trial of Henriette Cornier, which occurred not two
months before, he had become acquainted with six
instances of a parallel nature.  Among these was a
Protestant  minister who became  affected  with the
desire of destroying a favorite child.   He  struggled
against this  terrible  inclination for fifteen  days, but
was at last driven to the attempt on his child's life,
in which he fortunately failed.  Several other physi-
cians, on the same occasion, bore similar  testimony
relative to  the  effect of  that trial,  and  the newspa-
1 Vol. 1, p. 321. 
SEC. II.]     LEGAL CONSEQUENCES OF MANIA.      269

pers about that period teemed with cases of child-
murder which had originated in the same way.
  §  192.   It  should not be forgotten,  that well-
grounded  suspicion that  the homicidal act was the
result of physical disease, instead of moral depravity,
is so horrid as to excite, in whatever mind it arises,
feelings of distrust and jealousy towards the law and
its ministers, infinitely more  to be dreaded than the
occasional acquittal of a supposititious maniac. When,
on the  contrary,  the  distinction is carefully made
between the acts of a sound and those of an unsound
mind, and a decision  in doubtful cases is dispassion-
ately and  deliberately formed upon every species of
evidence  calculated  to throw light upon it, the mind
is  impressed with a  new sense of the wisdom  and
majesty of the laws and writh  a feeling of security
under their discriminating operation.   The numerous
trials for  witchcraft  in a former age, and the occa-
sional condemnation of a maniac in the present, have
done more to lessen men's respect for the laws, than
all its overruled decisions have to weaken their con-
fidence in its certainty.  Insanity is a disease, before
the prospect of which the stoutest heart may quail,
but how much  more appalling is it made by the re-
flection, that in some wild paroxysm it may be fol-
lowed  by  legal consequences, that will consign its
unhappy subjects to an ignominious death.   In cases
of simulated madness,  the  purposes of justice are
more fully answered by receiving  and examining all
the  evidence  and patiently  showing its value  and
bearings,  and thus laying open the imposition to the
conviction of all, than by repelling the plea with idle
declamation  on its  injurious tendency.  Not  only 
 270   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

 does the criminal obtain his deserts, by such a course,
 but  the most cunning device of his ingenuity is seen
 to be  baffled, and the plea that should ever  shield
 innocence from  destruction is ineffectually urged to
 protect the guilty.  Every murmur at the injustice
 of the sentence  is hushed, all scruples are removed
 and all fears are dissipated, that  a fellow-being has
 been sacrificed,  whose only crime wras the misfortune
 of laboring under  disease  of the brain.   Besides,
 what,  if amid the  obscurity  in which a  case may
 sometimes be involved, a guilty person do escape—
 though this event must be of very rare occurrence,—
 is it not a maxim in legal  practice that it is better
 for ten guilty persons to escape punishment than for
 one  innocent person to sutler ?  But  though he es-
 cape the sentence of the law, yet society is perfectly
 secure from the  effects of mistake, because the very
 plea by which he obtains his acquittal, consigns him
 to confinement and surveillance.
  §  193.  In those  cases where there are some but
 not perfectly satisfactory indications of insanity,  the
 trial or sentence should be postponed, in order that
 opportunity may be  afforded to  those who  are  pro-
 perly qualified, for observing the state of the prison-
 er's  mind.   Where  the moral powers have  become
 so deranged  as  to  lead to criminal acts,  without,
 however,  any perceptible  impairment of the  intel-
 lect, time only is necessary in the greater proportion
 of cases to furnish indubitable evidence of mental de-
 rangement.   And whatever may be the result, the
 ends of justice  are  not defeated by waitino- a few
months, while the scruples of the  over humane are
removed,  and the acquiescence of the  ministers of 
SEC. 11.]     LEGAL CONSEQUENCES OF MANIA.      271

the law in measures calculated to establish innocence
rather than  guilt,  gains for  them a  confidence and
respect that the conviction of guilt never can.  Many
instances  might be mentioned where  the  accused,
whose insanity was doubtful  on trial, has, during the
confinement subsequent to his acquittal on a criminal
prosecution, become most manifestly insane.   Had-
field, who was tried for shooting at  the king and ac-
quitted on the ground of insanity, though during the
trial he displayed  no indications of disordered mind,
spent  the remainder of his  life in Bedlam  hospital,
and  for thirty years  showed scarcely any signs of
mental alienation, except once, when  suddenly and
without any known cause, he became so furious that
they were obliged to  chain him in his cell.   This
paroxysm lasted but a short  time, when he recovered
his ordinary state  of health.
   § 194.  Another reason for delay is,  that insanity
is sometimes so completely  veiled from observation,
as never to be suspected even  by the most intimate
associates of the patient.  An instructive case is re-
lated by Georget,  in which  the existence of insanity,
though of several years duration, was not recognised
till after the death of the subject.   The circumstan-
ces were  briefly  these.   Bertet, a  revenue-officer,
exercised  the duties of his office for three  years, in
the  manufactory  of M.  M. Ador and  Bonnaire, at
Vaugirard,  where he was only noticed  for  his unac-
commodating  disposition, melancholic  temperament
and  fondness for seclusion.   One day while M. Ador
was conversing with some of the workmen,  he was
requested by Bertet to affix his signature  to certain
papers.   He proceeded to his room for this purpose, 
272   MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

and while in  the  act of writing,  was shot dead by
Bertet, who immediately afterwards blew out his own
brains.   Among his papers  were found several ad-
dressed to  the advocate-general,  bearing  the most
singular  titles, such as  my last  reflections, my  last
sighs,  in  which  he declared  that  he had been
poisoned several  years before,  and gave  a  minute
account of the numerous remedies he had ineffectu-
ally used, insisting at the same  time that  his head
was  not  turned,  that  he acted  deliberately, and
giving very coherent reasons  to  prove it.   He an-
nounced that four victims were  required, namely,
the  two  heads   of  the  establishment, a  woman
who was living in it, and his old housekeeper, and
that in case he should be  contented with one, he
would leave  to justice the  charge of obtaining the
others.   Some of these papers he finishes with say-
ing, " To day my pains are less acute,—I feel  better,
—my vengeance is  retarded,"  or " my  pains  are
renewed—with them my  thoughts  of vengeance."
Among other wild fancies, he made a description of
the funeral monument to be raised to one of his vic-
tims, which was to be a gibbet covered with  figures
of instruments of punishment.  He also  described
his  own funeral  procession.  He wished  the four
corners of the pall to be carried by the four persons
above-mentioned, in case he should  not have sacri-
ficed them ; that the advocate-general should follow
the cortege ;  and  that when it reached the cemetery,
the latter should prepare a large ditch in which they
should first cast him, Bertet, and  then  the  four pall-
bearers.   In  another paper, he said he  designed for
each of his victims two gilt  balls, as an emblem of 
SEC. II.]    LEGAL CONSEQUENCES OF MANIA.       273

their ambition and thirst of gold,  and some  pulver-
ized cantharides, as an image of the torments which
he suffered.   Bertet  had never  shown  any  signs of
mental alienation in his official letters  and reports.
He was sometimes abstracted and loved to be alone,
but his disposition, in this respect, hald been of long
standing and seemed to be  owing to  the state of his
health,  of which  he was  constantly complaining,
though judging from  his exterior he seemed  to be
well enough.  He had always discharged  the duties
of his office  satisfactorily, and, by his own  solicita-
tion, had just before obtained a more profitable place.
Had not  Bertet  recorded  his insane fancies, but,
failing in  his suicidal attempt, had  been brought to
trial for the murder of M. Ador, the plea of insanity
would have  fallen on the most incredulous ears, and
he would  have paid the last penalty of the law.   In
a state  of confinement and seclusion, however, no-
thing but  time would have  been necessary to reveal
the true nature of his case.
   § 195.  Homicidal  monomania presents  us with
one of those remarkable phenomena, the existence of
which men  are slow  to  believe,  long after the evi-
dence in its favor has accumulated to such an extent
as to  render incredulity any thing but a virtue.  The
facts themselves cannot be  denied,  and the various
methods of  explaining them  on the hypothesis of a
sound understanding, though every  phase of human
character and every spring of human action has been
resorted to  for the purpose,  are  little calculated to
diminish  the confidence of impartial  minds in the
correctness  of the above  views.  Strongly impressed
as we are with their  importance, we  may have de-
             s 
274   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. VIII.

voted more attention to the objections that have been
urged against them, than  they  really  deserve ; we
shall therefore say but little more on this part of the
subject.   Against Georget's  proposition  relative to
the homicide  committed by Henriette  Cornier,  that
" an act so atrocious, so contrary to human  nature,
committed without interest, without  passion, opposed
to the  natural character  of the individual,  is  evi-
dently an act of  madness" j1 it has been seriously
objected that though we may  be unable to  discover
motives, yet  this  is  not  a  positive  proof  that there
actually are  no  motives.   This  objection  depends
upon a  question of fact,  and  we  shall content our-
selves with  putting  it to  every criminal lawyer to
answer for himself, whether a criminal act,  committed
by a person  whose motives defy  all penetration or
rational suspicion while his mind  evinces no signs of
impairment,  is not one of the most uncommon occur-
rences in the world—so uncommon perhaps,  as to
have never fallen within their experience ?
   § 196. By those  w7ho delight  not in metaphysical
subtleties, a  more summary, if not  more philosophi-
cal, explanation of homicidal monomania has  been
furnished in  the idea that it is to be attributed to an
instinct of ferocity ; to unnatural  depravity  of char-
acter ;  to a radical  perversity.  That such  qualities
do exist as the too common result of a defective con-
stitution,  or  a vicious  education,  is proved by the
testimony of every  day's experience, even if we had
not the best  authority for  believing that  the heart
1 Discussion medico-legale sur la Folie, 126. 
SEC. 11.]    LEGAL CONSEQUENCES OF MANIA.       275

may  be  " desperately  wicked."   But  even where
they exist to the fullest  extent, the  actions to which
they prompt have always some  immediate motive,
slight as it may be, of  pleasure  sought,  or  pain
avoided;  or if they can claim no higher title  than
that of instinct, it is one of no sudden, transitory char-
acter, but a constant  and consistent  portion of the
constitution.   It is an anomalous  instinct that mani-
fests itself but once or twice  in a person's life ;  and
therefore, we  cannot, without indulging in  the  most
unwarrantable use of language,  apply  this term to
those uncontrollable, abnormal influences  that  lead
to acts of fury and destruction.   What  resemblance
can we detect  between the Domitians and Neros of
history,  and  the Papavoines and  Corniers, whose
terrible acts have been commemorated in the records
of criminal jurisprudence ?   In the  former,  this in-
stinct of ferocity appeared in  their earliest youth;
it imparted a zest to every amusement,  and  excited
ingenuity to contrive new means  for heightening the
agonies of the wretched victims of their displeasure.
In the latter,  the character was mild and peaceable,
and their days were  spent in the quiet and creditable
discharge of the duties belonging  to their station, till
a  cloud  of melancholy enveloped  their minds and
under its shadow they perpetrated a single deed, at
the very thought of which  they would have   pre-
viously  shuddered  with horror.   In short,  all our
knowledge of human nature, all our experience of
the past, forces us to the conclusion, that " the  pres-
ence of mental alienation should  be  admitted in him
who commits  a homicide without positive  interest,
without  criminal  motives, and without a reasonable
passion." 
276  MEDICAL JURISPRUDENCE OF INSANITY. [CH. VIII.

   § 197. After what has been said on the subject of
homicidal monomania, it  will be scarcely necessary
to enter into particulars relative to the legal  conse-
quences of the other forms  of partial moral  mania.
Completely annulling,  as we believe they do, all
moral responsibility for acts committed under their
influence, the law can rightfully inflict no punishment
on their unfortunate subjects, though it should adopt
every measure  of  precaution  that  the  interests  of
society  require.   To punish the thief and the incen-
diary for acts which are the  result of disease is not
only unjust, but  it serves to aggravate their disorder,
and to prepare them, when their term of punishment
has closed, for renewing their  depredations on soci-
ety with increased  perseverance.  The  only proper
course to pursue with  this  class of offenders when
brought into courts of justice,  is to place them, or
obtain a guaranty from  their friends that  they shall
be placed, where judicious  medical treatment will
be  used for  the purpose of restoring  their moral
powers  to a sounder condition, and  where they will
be secluded from society until this end shall  be ac-
complished.
  If the doctrines here laid down relative to moral
insanity and its  legal  consequences  are correct,  it
would seem to follow as a matter of course, that they
should  exert their   legitimate influence on judicial
decisions.  Nevertheless, it is contended—and that
too by some who do not question the truth of these
doctrines—that they ought not to have this practical
effect, for the reason that insanity would thereby be
made the ground of defence  in  criminal  actions, to
a most pernicious extent.   This objection, stated in 
SEC. II]    LEGAL CONSEQUENCES OF MANIA.       277

the plainest  and strongest terms  we presume  to
be this.    If these  doctrines  should be recognised
in our courts of justice, and  suffered to influence
their decisions, almost every criminal would resort to
a defence, the  tendency of which is invariably  to
puzzle  and  distract  the minds  of the jury, and to
produce  the acquittal of many  a wretch, who wrould
first hear the mention of his own derangement from
the  lips  of  ingenious  counsel.  Now,  even  if we
were disposed  to accord  to  this objection  all  the
weight that is claimed  for it,  it would not seem to
warrant the  inference that is drawn from it.  Are we
to take from the maniac the defence  which  the  law
of nature secures to  him,  because it  may be some-
times offered by those who use it as a means of de-
ception ?  Are the innocent to be made to suffer for
the devices of the guilty ?  To avoid this cruel in-
justice, therefore, without at the same time inflicting
a positive evil on society, we would deduce from this
objection  an inference  of a   totally  different kind.
It is, to let the  right of the  accused party  to make
his defence be  cumbered  with no restrictions,  ex-
 pressed or implied;  let the plea of  insanity, if he
 choose  to make it,  be attentively listened to, the
 facts urged in its support closely scrutinized, the ac-
 cused carefully and dispassionately examined,  and
 his character and history  investigated.  If this duty
 be performed as it should be, and  always  may be,
 the case will seldom happen, when the truth will not
 be established to  the satisfaction of every unpreju-
 diced mind. If the accused  be really  insane,  we
 have the satisfaction  of reflecting, that an enlightened
 investigation of his case has saved an innocent per- 
278   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. Vlll.

son from  an ignominious fate,  while on the other
hand, if he be simulating insanity, every doubt will
be dissipated as to  the justice of his sentence, and
the conviction will be  strengthened  in  the  popular
mind, that the law will prevail over every false pre-
tence,  and  expose  the guilty  even  in their  most
secret refuge. 
CH. IX.]
DEMENTIA.
279
                CHAPTER  IX.

                    DEMENTIA.

  ^ 198. This form of insanity  is attended with a
general enfeeblement of the moral and intellectual
faculties which were originally sound and well-de-
veloped, in consequence  of age  or disease,  and is
characterized  by forgetfulness of the  past, indiffer-
ence to the present and future, %nd a  certain child-
ishness of disposition.  The  apparent similarity of
this state to that of imbecility or  idiocy renders it
necessary  that  they should  be  accurately  distin-
guished ;  for  nothing  could be  more  improper  or
unjust, than to view them merely as different shades
of the  same mental condition.  Idiocy and the higher
degrees of imbecility are congenital or nearly so, and
consist in  a destitution of  powers that were never
possessed.  Little or nothing is remembered, because
little  or nothing has  left  any impression upon the
mind,  and  no  advance is made in knowledge, because
the faculties  necessary for  obtaining  it have never
existed.  The proprieties  and decencies of life are
unobserved, for the simple  reason that their moral
relations have never been discerned, and their indif-
ference to  the most pressing wants is to be attributed
to the absence of the most common instincts of our
nature.  The idiot is restless, uneasy, and inatten-
tive, because  the faculties  that  direct the attention, 
280    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IX.

and draw from its application  valuable  results, have
been utterly denied.   In idiocy and  imbecility the
manners and  conversation strongly resemble those
of childhood; in dementia they  never lose  the  im-
press  of  manhood however  disjointed and  absurd
they may be.   The  former appear at an early  age
of life ; the latter never takes  place till after the  age
of puberty,  and generally increases with time, from
the slightest possible  impairment of mental energy
to the most  complete  fatuity.   In dementia the past
is forgotten,  or but  indistinctly  and unconnectedly
brought up to the mind; the attention wanders from
one thing to another ; the affairs of the present pos-
sess no interest; and the moral and social affections
are inactive, because  the  faculties, in consequence
of  pathological changes in  the brain, have fallen
into a state  of inertia  that  prevents  their  ordinary
manifestations.   The  whole  condition betrays  the
existence, not of physical imperfection, but of physi-
cal weakness (many of the bodily functions also  fre-
quently being enfeebled), and  consequently it may
sometimes be cured, or temporarily relieved.  When
once firmly  seated, it  is not incompatible with length
of years; and after death, we may find, on examina-
tion, lesions of structure, or diminutions of size, which
are accidental, the result of diseased action, and  not
original malconformations.  The above comparison
of mental deficiency with dementia shows, that they
depend on two very different conditions of the brain,
and consequently must display very different moral
and intellectual manifestations ; from which we  are
warranted in inferring that in regard to their medico-
legal relations, they cannot properly  be placed on
the same ground. 
CH. IX.]
DEMENTIA.
281
  § 199. Dementia is distinguished from mania, the
only other affection with which it is liable to be con-
founded, by characters that will not mislead the least
practised observer. The latter arises from an  exalt-
ation of vital power, from a morbid excess of ac-
tivity, by which  the cerebral functions are  not only
changed from  their healthy condition, but  are per-
formed with unusual force and rapidity.  The maniac
is irrational  from an inability to discern the ordinary
characters and relations of things,  amid the mass of
ideas that crowd upon his mind in mingled confusion;
while in dementia, the  reasoning faculty is  impaired
by a loss of its original strength, whereby it not only
mistakes the nature  of things, but  is unable, from
want of power, to rise to the contemplation of gen-
eral truths.   The  reasoning of the maniac does not
so much fail in the force and logic  of its  arguments,
as in  the  incorrectness of its assumptions ; but in
dementia the attempt to reason is  prevented by the
paucity of ideas, and that feebleness  of the percep-
tive powers, in  consequence  of which they do not
faithfully represent the  impressions  received from
without.   In  mania, when  the  memory fails, it  is
because new ideas have crowded into the mind, and
are mingled up  and confounded with the  past; in
dementia the same effect is produced  by an oblitera-
tion of past  impressions as soon as they are  made,
from a w7ant of sufficient power to  retain them.  In
the former, the mental  operations  are characterized
by hurry and confusion ;  in  the  latter,  by  extreme
slowness and frequent  apparent suspension of the
thinking process.   In  the  former,  the  habits  and
affections undergo a great  change, the conduct be- 
282    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IX

coming strange and inconsistent from the beginning,
and the persons and  things  that once pleased and
interested, viewed with indifference or aversion.  In
the latter,  the moral habits  and natural feelings, so
far as they are manifested at  all, lose none of their
ordinary character.   The temper may be more irri-
table,  but the moral disposition  evinces none of that
perversity wrhich characterizes mania.
   § 200.  Dementia, it must be  recollected, is some-
thing  more than  that  mere  loss of mental  power
which  results from the natural decay of the faculties ;
it is attended with those pathological  changes also
which  are  essential  to  the  production of insanity.
The mind  is  not only  feeble,  but it  is deranged.
Were  it not so, every old man would  labor under a
certain degree  of dementia.  The first  symptom,
which  indicates the approach of this affection, is gen-
erally  an  impairment  of the  memory of recent oc-
currences.  The events of early life have lost none
of their distinctness, while  recent  impressions are
feebly made,  and in  a short time  mostly forgotten.
While the visits of his friends are  forgotten beyond
the day or the week they are made, the patient may
talk of their former  interviews, and relate the  most
trivial  details  concerning  them.  From  this weak-
ness of memory seems to  arise  oftentimes the first
appearance of mental alienation.  The patient for-
getting the intermediate ideas, the connexion be-
tween those he does remember, and that order and
filiation of them necessary to  sound reasoning are
destroyed ; and hence those gaps  in  his ideas and
 those  inconsistencies  of conduct which  convey the
 impression of mental derangement.   Coincident with 
CH. IX.]
DEMENTIA.
283
 this failure of the memory,  or very shortly  after-
 wards, there is a diminution of the ordinary ability
 of recognising external objects, which arises not so
 much from a weakness of the organs of sensation, as
 of the organs of perception within.   That is, the im-
 pressions of sound, light, touch, &c. are well enough
 received, but the qualities of form, size, weight, color,
 &c.  are  imperfectly discerned.   Objects  not very
 different  are mistaken  for one another,  from an ina-
 bility to perceive at first sight  the qualities that dis-
 tinguish them, though  the individual  may  recognise
 his mistake when it is pointed out to him.
    § 201.  Thus far there is nothing that can properly
 be called  mental derangement;  the  pathological
 changes in the brain have only occasioned  a diminu-
 tion  of the natural power and  activity of  the mind.
 The first symptom indicative  of derangement (and
 it is  the  next  which  is  observed),  is a degree of in-
 coherence  in the ideas, like that of sleep.   It  may
 not  appear for days or weeks  together, or only on
 certain  occasions; or  it may be constant  from the
 beginning and appear  on all occasions.   The above
 symptoms  increase in  intensity more  or less  rapidly
 till complete  dementia is produced,  when  all the
 moral and intellectual powers  are involved in this
 state of  decay and derangement.  The memory of
 recent impressions fades away as fast as they are
 formed, and the past is beheld with considerable in-
 distinctness and  confusion, though events and  ac-
. quaintances of early  life are not yet forgotten.   The
 patient is  often at a  loss to know where he is,  or
 thinks himself at home when in the house of another,
 and  wonders why he is not engaged in his usual oc- 
284    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IX

cupations.   Places, times and circumstances are for-
gotten, or incorrectly remembered.   His friends are
not easily distinguished ;  morning, noon, and even-
ing,  yesterday and to-morrow are being constantly
blended  together; and he will get up in the night,
mistake the light of candles for that of day,  and  per-
sist in calling it morning.   Objects the most dissimi-
lar are mistaken for one  another, and consequently
his notions are often the most grotesque and absurd.
The intellect gradually becomes incapable of discern-
ing the relations of cause and effect, and of compar-
ing ideas together ;  in short any thing  like an effort
of reflection is beyond its  powers.  The person is
unable to follow the conversation, unless it be of the
simplest ideas,  and particularly  addressed to  him.
His  thoughts, when left to follow their  own course,
succeed  one  another  without connexion;   his lan-
guage is equally  incoherent ; and  insulated words
and  phrases are repeated without any consciousness
of their meaning.   "It seems," says Esquirol,  "as
if they were listening  to imaginary tales which  they
repeat, in  obedience to an  involuntary or automatic
impulse  excited  by their old habits, or fortuitous as-
sociations with actual impressions." J  Their mind is
often  occupied by hallucinations which continue a
longer or a shorter time,  and then disappear to be
succeeded  by others.   The useful or ornamental arts
which they may have practised with skill and follow-
ed with ardor, and the various other employments of
life, seem to be utterly forgotten, as if they had never  .
1 Dictionary of Medical Sciences, Art. Demence. 
CH. IX.]
DEMENTIA.
285
been  thought of.   Their time  is spent  either in
moving about with restless activity, or passing days,
weeks, or months  in the same  spot, in utter vacuity
of thought or purpose ; in setting their watches, or
observing the changes of the wind;  in pouring forth
an incessant jargon of words at the top of their voice,
or  uttering  low,  muttering  sounds  consisting of
scarcely  articulated words and broken phrases ; in
singing, crying or  laughing.
   § 202.  Though often  irascible and  self-willed,
their anger is momentary, and thus they readily yield
to the direction of others.  The moral powers, in
fact,  seem to  be  possessed of too  little energy to
maintain resolution, or cherish the passions.  Their
feebleness of purpose and passive  obedience to the
will  of  others, strikingly contrast with  the perti-
nacity and savage fury often evinced by the maniac.
With the remembrance of their friends and of their
former employments, there also  disappears all trace
of the social  and domestic affections.   All interest in
the concerns of others is lost, and family, friends and
relations are viewed with the indifference of perfect
strangers, and nothing is able to awaken an emotion
of pleasure or pain.
   § 203. The derangement of the intellectual pow-
ers is generally indicated by remarkable changes of
the  countenance.   The  skin  is pale and dry and
wrinkled ; the eyes sunken, dull and moistened with
tears ;  the pupils  dilated ;  the  look  uncertain and
wandering ;  the cheeks hollow and emaciated ; and
the whole face destitute of expression and indicative
of decay.   The organic  functions suffer but little ;
the appetite for  food is so  great  that the  patient 
286   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IX.

seems to be constantly eating, and the quantity con-
sumed is enormous.   Affections of the nervous sys-
tem, however, particularly paralysis,  are not unfre-
quent complications of dementia.
  § 204. Dementia appears under two different de-
grees of severity wmich are designated as acute and
chronic.  The former is a sequel of temporary errors
of regimen, of fevers, hemorrhages, metastases, sup-
pression of customary evacuations, and the debilitat-
ing treatment of mania.  It differs from the latter in
being more rapid in its progress, and in its successive
stages not being  so w7ell  distinguished from one
another.  It  is readily cured by regimen, exercise,
bathing, tonics, anti-spasmodics,  or  simply by re-
moving  the exciting cause.   It sometimes terminates
in an explosion of acute mania, which then becomes
critical.
  §  205.  Chronic  dementia may succeed mania,
apoplexy, epilepsy, masturbation,  and drunkenness,
but is generally that decay and derangement of mind
which occurs in old age.  It must be borne in mind,
however,  that  decay is  not to be confounded with
derangement ;  if it  is,  then  almost  every old man
may be pronounced to be demented.   It  may  be
difficult oftentimes to satisfy ourselves whether or
not the  former  is accompanied by the latter, but for
any practical purposes it may be seldom necessary.
The same decay which the bodily powers exhibit, as
they proceed to their natural termination in death, is
always participated by the mental; but it sometimes
happens that the latter are irretrievably affected long
before the former  have  shown any symptoms of fal-
tering in their course.  The  causes of this inversion 
CH. IX.]
DEMENTIA.
287
of the natural order of decay, so far as they are ex-
ternal, are to be found  probably in the great irregu-
larity of exercise, both of kind and duration, to which
the brain  is subjected by the habits  and wrants of a
highly civilized condition, whereby its  healthy elas-
ticity and vigor are  so  impaired,  that it  needs only
the first touch of decay to lose for ever the nicely ad-
justed balance of its faculties.   The transition from
the greatest mental exertion to the  most tedious in-
activity, from the various phases of excitement to the
irksome sameness of ennui, from the stimulus afforded
by the performance of a thousand duties, and the glow
that is constantly kindled by the hopes of the future,
to the monotony1 too often occasioned by loss of busi-
ness, friends, and the cares of  long accustomed pur-
suits, is of such frequent occurrence, that every thing
like regular and proper exercise, which is as indispen-
sable to the health of the brain as it is to that of every
other organ, is rarely enjoyed  by men who are en-
gaged in the active business of life.
   § 206.  In the  later  periods of life—and particu-
larly if  the constitution is weakened  by sickness or
dissipation—any exertion of the mind far beyond its
power to sustain  is liable to be rapidly followed by
a state of dementia.  The same effect is produced
when after many years of unremitting attention to
certain  pursuits,  the  mind is  suddenly deprived of
the objects on which it rested, and thrown upon itself
to furnish the means of excitement in  the  declining
years of life, when novelty presents no allurements,
and the circle of earthly prospects is being constantly
narrowed.  Take  an individual from the stir  and
bustle of a city residence ;  from the  unceasing strife 
288    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. IX

of competition  in the pursuit of wealth or honor ;
throw down the goal on which for years his eye has
rested, though  ever receding from his grasp ; place
him in the  country, at a distance from familiar faces
and scenes;  and unless his mind be  informed with
various knowledge, or warmed by an interest  in the
moral concerns of his  fellow-men around him,  it will
sink into that state of inactivity so favorable for the
operation of the predisposing causes of this disease.
   § 207. It  must not be supposed that old  age is
subject to no other kind of insanity than that of De-
mentia, for mania, even of the most furious descrip-
tion,  is not uncommon  at this period, and the im-
portance of distinguishing between them,  in a legal
point of view, must be immediately obvious.  Not
only may  the  mind remain  competent  to the dis-
charge of some of the civil duties of life,  in mania,
but there is  always a prospect  of its restoration to
health.  The characteristic symptoms, as well as the
exciting causes that  we  have  described  above,  if
carefully observed, will generally prevent us from
committing the serious mistake of confounding them
together, as is too often done, with scarcely a thought
of the  impropriety of the practice. 
CH. X.]   LEGAL CONSEQUENCES  OF DEMENTIA.    289
                 CHAPTER  X.

        LEGAL CONSEQUENCES OF DEMENTIA.

  § 208. In its last stages, dementia does not differ
of course,  in respect  to its legal  relations,  from
general intellectual mania.   It is  only  while the
mind is in its transition-state, if we may use the ex-
pression, passing from its sound  and natural condi-
tion to the  enfeeblement and total  extinction of its
reflective powers—and the entire change may occupy
months and years in its  progress—that its legal in-
capacity is ever  called in question.  The successive
steps of this disorder are so imperceptible and often-
times affect the  powers  so unequally,  that it is not
strange that so  much diversity of opinion should
arise respecting  the capacity of the mind which is
the subject of it, or that groundless suspicions  of
improper influence should be so frequently excited.
It must be  considered too, as a circumstance  calcu-
lated to favor  this effect, that the judgment  is de-
barred from forming an  unbiassed decision by sug-
gestions of interest or jealousy, which lead it to see
lapses  of the  mind that would otherwise have ap-
peared to be nothing  more than  that natural  loss of
energy, suffered  by the mind as it  " draws near to
its eternal home."   Most people too  are so little
accustomed to observe and analyze the mental phe-
nomena, and so  little acquainted with the physiologi-
           T 
290    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. X.

cal laws that govern their manifestations, that cir-
cumstances are often adduced as indications of un-
equivocal  insanity,  which  only  evince  some normal
peculiarities of the senile understanding.  They  need
only to be put in the  proper bias,  to  confound the
natural decay of the mental faculties with that de-
rangement which depends exclusively on pathological
affections; so strongly do  they resemble each other
to the superficial  observer.   By  how  many would
Bichat's beautiful picture of the closing scenes of old
age be mistaken to represent the defaced and shat-
tered temple that has been prostrated  by the touch
of disease.  " Seated near the fire and concentrated
within himself,  a  stranger to  every thing  without
him, he passes his days there, deprived of desire,
of passion, and sensation;  speaking little, because
he is determined by nothing to break his silence, yet
happy in  feeling that  he  still  exists,  when  almost
every other sentiment is gone." 1   Far greater then
must  be  the necessity  of caution in distinguishing
between  such  degrees  of capacity as  exist  in the
early and those of the latter stages of dementia, and
where too the  causes of  error are  so  much more
numerous.  The deafness that generally accompa-
nies  the early  stages, disables the individual  from
participating in or  listening  to the conversation of
those around him,  and thus gives to his  countenance
an expression of dullness  and  stupidity that might
easily mislead one not particularly  acquainted  with
him, while in fact he needs only to  be  properly ad-
1 Life and Death, p. 1, c. x. 
 CH. X.]   LEGAL CONSEQUENCES OF DEMENTIA.    291

 dressed, to display a mind that has  not yet ceased to
 think with some degree of accuracy and vigor.  The
 latter fact, however, will  be known  only to his inti-
 mate friends, while the former is  conveyed to that
 mass of common observers who are always ready to
 decide  upon a person's  mental capacity,  from an
 occasional glimpse of his  manner, or a few remarks
 on the most ordinary  topics.
   § 209.  A  judge  is  seldom required to decide
 questions of more delicacy—questions that demand
 such nice and  cautious balancing of evidence, such
 penetration into motives and biasses, such a  profound
 knowledge of the mental  manifestations as affected
 by disease,—than those  of mental capacity in  old
 age, where  the mind is confessedly laboring under
 some kind or degree of impairment.  The  standard
 by which  witnesses' opinions  are  formed in such
 cases is so different, and  the  pertinacity with which
 each one clings to his own conclusions,—in propor-
 tion generally to  his ignorance of the subject—is so
 strong,  that nothing but a great display of the above-
 mentioned qualities will enable the  judge to perform
 his duty with  credit to himself, and satisfaction to
 others.   Unless  he  can  state the  grounds of  his
 opinions, they are no better  than surmises, and he
 fails of accomplishing  one of the most  desirable
 objects of the law—that of establishing and  confirm-
 ing the popular confidence in its ministers.   Difficult
 as this duty  is, it will be very  much  lightened by
attending  to some of  those points which can always
be ascertained, and which  have an important bearing
on the question at issue. 
292   MEDICAL JURISPRUDENCE OF INSANITY.   [CH  X.

  § 210.  Though some  of  the perceptive  powers
may preserve their wonted activity through the whole
of the disease ; yet it is  in  these  that  the disorder
is first manifested,  and that  long before the higher
powers  of the understanding have materially  suf-
fered.   The  memory of persons, things,  and dates,
and especially of recent impressions,  is exceedingly
treacherous:  and so striking  is this impairment  to
those unaccustomed  to look beneath the  surface  of
appearances, that when they find they are not recog-
nised though once well-enough known ;  that past
events and the  actors  engaged  in  them,  are either
forgotten or singularly entangled and confused ;  and
that a certain listlessness and absence of mind takes
the place of former animations  and  attentiveness ;
they summarily conclude that for all business purpo-
ses, the patient  is utterly  incapacitated.  The  im-
pressions produced by a single short  interview have
no chance of being corrected  by subsequent oppor-
tunities, or by more  philosophical observations, and
the final opinion is adopted  and authoritatively  pro-
pounded,  that the individual in question did not  pos-
sess legal capacity.  If he take  no part in the con-
versation, and appear scarcely to know  what is pass-
ing around  him, we are not to  draw unfavorable
conclusions relative to his mental condition, until we
ascertain,  if possible,  that there are no peculiar
reasons why he should remain silent  and alone, and
that he  is no longer capable of pursuing  a  train of
thought of some length and complexity.  If he have
forgotten the names  and  circumstances  of those once
familiar, but  whom he has not been in the  habit of
seeing recently, it does not follow  that he has  also 
CH. X.]   LEGAL CONSEQUENCES  OF DEMENTIA.    293

forgotten those whose  relations  to  him  have kept
them within the sphere  of his daily observation and
made them the objects of his thoughts.  An old
servant or tenant whose countenance  may not have
been seen for weeks,  or months, is  not to be com-
pared in this respect, with the  near relative who is
frequently in his company, and  always regarded with
feelings of interest and  affection.  However certain
it may be that he has lost all sense  of the ordinary
proprieties of life, it needs farther evidence  to prove
that the persons and interests,  which have  been al-
ways nearest to  his  heart  and  connected with the
great purposes of his life,  have  utterly faded from
his  mind.   The evidence  of those,  therefore,  who
are qualified both by their habits of intimacy  with the
person whose mental capacity is in question, and by
their intelligence and education, to appreciate the
changes his mind may have undergone, is far more to
be relied on than that of people of a different descrip-
tion, who  make up their opinion hastily from a few
casual and  perhaps trivial circumstances.  The great
point to be determined  is, not whether he was apt
to forget the names  of  people in whom he felt no
particular interest, nor the  dates  of  events  which
concerned  him little, but  whether  in  conversation
about his affairs, his friends and relatives, he evinced
sufficient knowledge of both,  to be able to dispose
of the former with a  sound and untrammeled judg-
ment.  It is a fact that  many of those  old men who
appear so stupid, and who astonish  the stranger by
the singularities of their conduct, need only to have
their attention fairly  fixed on  their property, their
business, or their family, to  understand  them per- 
294    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. X-

fectly well, and  to  display  their sagacity in the re-
marks they make.  In the case of Kindleside v. Har-
rison,1 which we shall briefly notice in illustration of
these remarks, the  reader  may obtain a better  idea
than can otherwise  be  conveyed, of the kind of evi-
dence generally produced in cases of senile demen-
tia,  and derive  instruction  and high  intellectual
gratification  from  the  clearness  and  ability with
which it  is sifted and stamped with its  proper value,
in the judgment of the court, Sir John Nicholl.
   §  211. The points contested in this case were four
codicils  to  the will  of an old gentleman, on the
ground that at the time of  making them, he was  in-
capable,  by  reason of mental  decay,  of understand-
ing their nature and effect.  It was testified by some
of the servants of his brother, who  lived  at a little
distance  from him,  and by those of the  lady with
whom he, the deceased, resided, that during the two
or three years within which the codicils were made,
he frequently did not know people with whom he had
previously been well acquainted, without being told
who they were ; that he would go about  the house
and garden  looking around,  and appearing  not  to
know what he was about.  On one occasion,  he not
only did  not recognise a certain  person,  but could
not be made to understand who he was,  and it was
testified  by a very  different kind of witness, that the
deceased asked  him how  old was witness's father
(though he  had been  dead sixteen  years  and had
been his  partner in business), and soon   after, he
1 2 Phillimore's Reports, 449. 
CH. X.]   LEGAL CONSEQUENCES  OF DEMENTIA.    295

inquired of the witness after  his health,  as  if he
were  addressing another  person.   Several other
similar  lapses of memory and  various  appearances
of childishness in his conduct, were also revealed by
the evidence, amply sufficient, no doubt,  to induce
superficial observers to believe that he was mentally
incapacitated  from  disposing  of  property.  It ap-
peared however that he wras  in the habit of giving,
in favor of his brother's  butler, drafts  accurately
signed and filled up ; that at christmas-time, he gave
the servants Christmas boxes and  the usual  amount
of money, and entered the sums in his account-book;
that he received a farmer's  bills for  corn  and  paid
them  with drafts on his banker which he wrote him-
self, going through the whole business correctly, and
that he docketed the bills  and receipts on the back
with the name of the person to whom paid,  and the
amount of the bill, making corresponding  entries
also in his  private account-book ;  that he signed
twenty drafts at least one  morning  for payment of
his brother's debts, without instruction or assistance,
subscribing his own name as executor of his brother;
that he would detect errors in the casting up of other
people's accounts;  that he discharged his physician's
bills correctly;  and in short  that he  managed his
affairs, and that prudently and  correctly, to the last.
It was also testified that it was his  practice to read
aloud to the family the  psalms  and lessons of the
day;  that he was fond of a little  fun and played  at
whist remarkably well.  That  a  person might have
done all this and yet been unsound in mind,  is  cer-
tainly  not impossible ; but  it  was  far beyond the
power of a mind so broken  up by old  age and the 
296     MEDICAL JURISPRUDENCE OF INSANITY.  [CH. X.

invasion  of disease as to be  incapable of altering
testamentary  dispositions previously  made.   This
consideration, and the fact that the circumstances of
the case furnished  abundant reasons  for the altera-
tion,  induced  the  court  to  decide in  favor  of the
capacity of the testator. 
CH. XL]          FEBRILE DELIRIUM.             297
                CHAPTER  XL

                FEBRILE DELIRIUM.

  ^ 212. Cerebral affection of some kind or other,
we have considered as essential  to  the  existence of
insanity—as constituting in fact  the  whole disease ;
but there is another form  of mental  derangement of
very  common  occurrence;  in  which the cerebral
affection  is only an  accidental symptom  of  acute
disease in the brain or some other organ.  The func-
tions of the brain  are disturbed in  each,  but  they
differ so widely in their causes, progress, and termi-
nation,  that  the  propriety of  distinguishing them
from  each  other for  medico-legal,  as well as the-
rapeutical purposes, is universally recognised.   Few
diseases  terminate in death  without presenting at
some period or other  of their  progress,  but more
particularly towards their close, more or less distur-
bance of the mental faculties;  organic diseases of the
brain, especially  acute inflammation of  its  mem-
branes and its periphery, are frequently accompanied
with delirium;  and it  is sometimes a symptom of
acute disease in other organs,  in consequence  of the
cerebral irritation  which they  sympathetically pro-
duce.  It is seldom entirely absent   in fevers of any
severity, and is  readily  determined  by inflammations
of the mucous and serous membranes,  particularly
of the alimentary canal. In inflammation of the lungs, 
298    MEDICAL JURISPRUDENCE OF INSANITY.   [CH. XI.

liver, spleen, and kidneys, it appears only towards
the last period of the disease when it is approaching
a  fatal termination.   Surgical  operations  too  that
prove fatal are ordinarily  attended at last  with de-
lirium.  In chronic diseases, such as cancer, dropsy,
consumption, the mind  is  seldom impaired,  except
occasionally  during the final  struggle, it  wanders
over the  mingled and  broken  images  of the past.
Delirium  is also produced by  intoxicating  agents,
when it simulates mania  more  perfectly than when
it arises from other causes; but this form of the affec-
tion will be discussed in a different place.
   § 213.  Delirium sometimes  occurs suddenly, but
generally  comes  on  gradually,  and is  preceded by
premonitory symptoms, such as pain or throbbing in
the head, heat  of the  scalp,  and flushing  of the
cheeks.   Its first appearance is  manifested by a  pro-
pensity of the  patient  to  talk  during  sleep, and a
momentary forgetfulness  of  his situation,   and of
things about him, on waking from it.   After being
fully aroused, however, and his senses collected, the
mind  is comparatively  clear and tranquil, till  the
next slumber,  when the  same  scene  is repeated.
Gradually, the mental disorder becomes  more in-
tense,  and  the  intervals  between  its   returns, of
shorter duration,  until they  are  scarcely, or  not at
all perceptible.    The patient lies  on  his  back, his
eyes, if open, presenting a dull and listless look, and
is  almost  constantly  talking  to himself in  a  low,
muttering  tone.  Regardless of persons or  things
around  him, and scarcely capable of  recognising
them when aroused by his  attendants, his mind re-
tires within  itself to dwell  upon the   scenes  and 
CH. XL]          FEBRILE DELIRIUM.            299

events of the past which pass  before  it in wild and
disorderly array,  while the tongue feebly records the
varying impressions, in the form of disjointed,  inco-
herent discourse, or of senseless rhapsody.  In the
delirium which occurs towards the end  of chronic
diseases, the discourse  is often more  coherent and
continuous,  though the mind is no less absorbed in
its  own  reveries.  As  the disorder  advances, the
voice becomes  more  indistinct, the fingers are con-
stantly  picking at  the bed-clothes,  the evacuations
are  passed  insensibly, and  the patient is incapable
of being aroused to any farther effort of attention.
In some cases, delirium  is  attended with a  greater
degree of nervous  and  vascular  excitement which
more or  less  modifies the above-mentioned symp-
toms.   The  eyes  are  open, dry, and  bloodshot,
intently gazing  into vacancy,  as if fixed on  some
object  which is  really  present to the mind of  the
patient;  the skin is hotter  and dryer ; and  he  is
 more  restless  and intractable.   He   talks  more
 loudly,  occasionally breaking out  into cries  and
 vociferations,  and  tosses  about  in bed, frequently
 endeavoring to get up, though without any particular
 object in view.
   § 214. While  delirium  thus shuts  out all ideas
 and images connected with the present, it sometimes
 revives the impressions of the past which  had seemed
 long before to have been consigned to utter oblivion,
 in a manner unknown in a state  of health.   A case
 once occurred in St. Thomas's hospital,  of a patient
 who, when he became convalescent after a consider-
 able injury of  the head,  spoke a  language  that
 nobody' could understand, but which was, at  last 
 300   MEDICAL JURISPRUDENCE OF INSANITY.   [CH. XL

 ascertained to be Welsh.   It  appeared  that  he was
 a Welshman, and had been from  his native country
 about thirty years,  during which period,  he had en-
 tirely forgotten his  native tongue,  and acquired the
 English language.  But when he recovered from the
 accident, he had forgotten the language he had been
 so long and recently  in  the habit of speaking, and
 acquired that which he  had originally  learned and
 lost.1  Dr.  Rush mentions,  among many other simi-
 lar instances, that  the old  Swedes  of Philadelphia,
 when on  their  death-beds, would  always  pray in
 their native tongue, though they had  not spoken it
 for fifty or sixty years, and  had  probably forgotten it
 before they  were sick.2
   §  215. When delirium, or  more  properly speak-
 ing,  the disease on  which it depends, proves fatal, it
 usually passes  into coma.   Occasionally,  however,
 it disappears, some  days  or  hours  before  death, and
 leaves the mind in  possession of its  natural  sound-
ness.  Though enfeebled by disease,  and therefore
incapable of much  exertion of his  faculties, the pa-
tient is rational and intelligent,  recognises perfectly
well his relations to others,  and  on familiar subjects,
can arrange his ideas without dictation or guidance.
  §  216. So closely does delirium resemble mania
to  the casual observer, and so  important is it that
they should be distinguished from each other, that it
may be well to indicate some of the most common
and prominent features of each.   In mania,  the pa-
1 Tupper's Inquiry into Gall's System.
2 On Diseases of the Miud, p. 282. 
CH. XL]           FEBRILE DELIRIUM.             301

tient recognises persons and things,  and is perfectly
conscious of and  remembers  what is  passing around
him.  In delirium,  he can seldom  distinguish one
person or thing from another, and, as if fully occupied
with the images that crowd upon his memory, gives
no attention to those that are presented  from with-
out.  In delirium, there is an entire abolition of the
reasoning power  ; there is no attempt  at reasoning
at all;  the ideas  are all  and equally insane ; no sin-
gle train of thought escapes the morbid influence,
nor  does a single  operation of the mind  reveal a
glimpse of its  natural  vigor  and  acuteness.   In
mania,  however false and absurd the ideas may be,
we are never  at a loss to discover patches of cohe-
rence,, and  some semblance  of logical sequence in
the  discourse.   The  patient still  reasons,  but  he
reasons incorrectly. In mania, the muscular power is
not perceptibly diminished, and the individual moves
about with his ordinary ability.   Delirium is invari-
ably attended with great muscular debility; the pa-
tient is confined  to his bed,  and  is  capable of only
a momentary effort of exertion.   In  mania, sensation
 is not  necessarily  impaired,  and in most instances,
 the maniac sees, hears,  and feels with all his natural
 acuteness.   In  delirium, sensation  is  greatly im-
 paired, and this  avenue to the  understanding seems
 to be entirely closed.   In mania, many of the bodily
 functions are  undisturbed, and the appearance of the
 patient might not,  at first sight, convey the impres-
 sion of disease.  In delirium, every function suffers,
 and the whole aspect of the patient is indicative of
 disease.  Mania  exists alone and independent of any
 other disorder, while delirium is only an unessential 
302    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XI.

symptom of some other disease.   Being a symptom
only, the latter maintains certain  relations  with the
disease  on  which it  depends ;  it is relieved when
that  is relieved,  and is  aggravated when  that in-
creases in severity.   Mania, though it undoubtedly
tends to shorten life,  is not immediately dangerous,
whereas  the  disease  on  which  delirium depends,
speedily terminates in death, or restoration to health.
Mania never occurs till after the age of puberty  ;
delirium attacks all periods alike, from early child-
hood to extreme old age. 
CH. XIL]  LEGAL CONSEQUENCES  OF DELIRIUM.   303
                CHAPTER XII.

        LEGAL  CONSEQUENCES OF^DELIRIUM.

  § 217. Testamentary  dispositions  made  during
the intervals of febrile delirium, are  often contested
on the ground of incapacity, especially where there
is  any suspicion,  real, or  pretended, of  improper
influence on the testator's  mind.   These cases are
sometimes very embarrassing, and it is impossible to
come to a conclusion upon  the  direct evidence re-
specting the state of mind ; nothing  more  can  be
attained than an approximation  to correctness, by a
careful investigation of the attending circumstances.
When the  delirium accompanies only the daily ex-
acerbations of the fever, and disappears  with them,
there can be no doubt of the mind's being in a suit-
able condition,  during the intervals, for devising
property, but  not for  transacting  other  business  of
importance. The  existence of delirium at any period
of a disease will be sufficient to throw suspicion  on
any contracts entered into during such disease ; and
unless it can be shewn that the delirium was but an
occasional  symptom  and  of short duration when it
occurred, and that the mind of  the patient at  other
times  was  perfectly  calm and rational,  their va-
lidity is liable to  be destroyed.  When these two
conditions  are reversed, that of delirium  being the
habitual, and the lucid intervals the  occasional  state, 
304   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XII.

the mind may have sufficient capacity to make a will,
but certainly, no other civil act which it might  per-
form ought to be held valid, for the same reason that
the acts of imbeciles are avoided.   Georget, how-
ever,  does not hesitate to express his belief,  that,
under these circumstances, the reason  is not so  re-
stored that the patient can be declared  capable even
of making a will, and we readily admit that it is often
questionable whether the mind is  sufficiently steady
and collected to  comprehend the  relations of pro-
perty, or appreciate  the claims of kindred and friends.
But we would not make the disqualification universal,
for cases not unfrequently happen in which, after days
of constant delirium, reason for a while resumes her
dominion and the patient  converses with his accus-
tomed fluency and  wisdom,  describing his feelings,
giving directions to his family, and  alluding to  the
past with  a  clearness and accuracy that leave no
doubt  on  the  minds of those around of his perfect
sanity.  A safer practice  probably would be,  to be
governed  in our decision of this point by the circum-
stances that  attend  the making of  the will, the  pre-
vious  intentions of the testator, and the nature of his
disease.1
   § 218.  The law requires that in this affection, as
in mania,  the  occurrence of lucid intervals  should be
proved beyond a reasonable  doubt, but  as delirium
is merely an  adventitious symptom, and not,  like
  1 It must be recollected that the question is, not whether the mind
possesses its ordinary soundness and vigor, for we know it is always
enfeebled, but whether it retains what may be called a testamentary
capacity. 
CH. XIL]  LEGAL CONSEQUENCES OF DELIRIUM.    305

mania, the  habitual  state of the  patient, it will be
satisfied  with much less proof in  the former than  in
the latter affection.  Sir John Nicholl has very .justly
observed, that" in cases of permanent, proper insan-
ity, the proof of a lucid interval is matter of extreme
difficulty, and for this among other reasons, namely;
that the patient so affected is not unfrequently ration-
al to all outward appearance, without any real  abate-
ment of  his malady :  so that in truth and substance,
he is  just  as  insane,  in  his apparently rational,  as
he is  in his visible  raving  fits.   But the  apparently
rational  intervals  of persons, merely delirious, for
the most part, are really such.  Delirium is a fluctuat-
ing state of mind, created by temporary excitement;
in  the  absence of which, to be  ascertained by the
appearance of the patient, the  patient  is, most com-
monly,  really sane.   Hence,  as  also indeed,  from
their greater presumed frequency in most instances
in cases  of delirium,  the probabilities, a priori,  in
favor of a lucid interval, are infinitely stronger in  a
case  of  delirium, than in  one of permanent  proper
insanity  ;  and the difficulty of proving a lucid inter-
val is less, in the same exact proportion, in the former,
than it is in the latter case, and  has always been so
held by  this court." 1
   § 219. In the case from which the above passage
is taken, the  testatrix, a widow  lady, died of some
  1 Judgment in Brogden v. Brown, 2 Addams's Rep. 441. If the
reader is desirous of extending his knowledge of this subject, he will
he well rewarded for a careful perusal of this and the following cases,
in which the luminous expositions of Sir J. Nicholl convey their usual
pleasure and conviction:  Evans v. Knight, 1 Addams,  22D;  Lemann
v. Bonsall, ibid.  383.
                      U 
306   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XII.

acute disease after an illness of about ten days, dur-
ing the two or three last of which she was more or
less delirious.  Her will was made on the evening of
the day preceding her  death, and its  validity  was
opposed  on the  ground, that  she did not possess a
testamentary capacity at the time of its  execution.
The evidence of the two consulting physicians who
visited her about four o'clock, which was but a few
hours prior to the execution of  the will,  was decid-
edly unfavorable to her  testamentary capacity.  One
considered it "doubtful whether she was capable of
making a will, or not ;  his opinion rather was, that
she was not." He saw her once  or twice afterwards,
when she  was  "quite  delirious and clearly inca-
pable."   The other physicians who saw  her at  four
o'clock, conceived her "quite incapable of any com-
plicated act; undoubtedly of any thing that required
fixed  attention, or any  exercise of mental faculty."
The  attending physician,  however,  attributed  the
delirium  to the paroxysms of severe pain suffered by
the deceased, it being scarcely perceptible  when
these were absent, and believed  that in  the intervals
she had perfect capacity.  It appeared  too  that the
will, which had been prepared from instructions just
before received from her, was read over to the de-
ceased, placed before her while she was sitting up in
bed, and subscribed by her in the usual form with a
dash  below.  The  validity  of the  will  was estab-
lished.
   § 220.  In another case, the testator who died on
Friday the 24th  of April, of an attack of pneumonia,
during the latter stages of which he had considerable
delirium, made his testamentary dispositions  on the 
CH XII.]   LEGAL CONSEQUENCES OF DELIRIUM.   307

21st.   One of the physicians deposed that when  he
saw the  deceased on  the  21st,  "he was not in a
state of sound mind, memory and understanding, or
capable of doing any  act requiring the exercise of
thought,  judgment and reflection."  Another, who
saw him  for the  first and only time  on the 23d,
thought it was extremely  " improbable  that the de-
ceased should  have been free from wandering  and
mental affection, on a day so shortly before he saw
him, as the 21st."  It appeared, on the other hand,
that he gave instructions for a will without  any sug-
gestions  whatever from  the solicitor  who reduced
them  to  writing,  and  that  after they were read to
him, he approved and  subscribed them.   It was also
deposed  by other  witnesses, that when  the solicitor
came and while giving him instructions, he appeared
rational  and conducted with propriety.   The court
pronounced in favor of the deceased's  testamentary
capacity.1
  § 221. In cases where the validity of testamentary
dispositions  is  impugned  on the  ground  of mental
incapacity produced by delirium, or indeed by any
other disorder, it is the practice of the English Eccle-
siastical courts, not to confine their attention  exclu-
sively to the evidence  directly relating to the mental
condition of the testator, but to consider all the cir-
cumstances connected with the  testamentary act; for
the object is not  so much to settle the question of
soundness or unsoundness in general, as it is in refer-
ence to that particular act.  The principle is—and
1 Evans v. Knight and Moore, 1 Addams, 229. 
308    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XII.

it is one that is well-grounded in the common expe-
rience of men—that a  person may be capable of
testamentary acts, while technically and really un-
sound,  and incapable of doing other acts  requiring
much reflection and  deliberation.   Accordingly, his
testamentary capacity is to be determined, in a great
measure,  by the  nature of the act itself.    If it be
agreeable to instructions  or  declarations previously
expressed, when unquestionably sound in mind ; if it
be consonant to the general  tenor  of his affections ;
if  it be consistent and coherent, one part with  ano-
ther ;  and if it have been obtained by the exercise of
no improper influence ;  it will be established,  even
though the medical evidence may throw strong doubts
on the capacity of the  testator.   On  the  contrary,
when these conditions are absent, or are replaced by
others of an opposite description,  it will  as generally
be annulled, however plain and positive may be the
evidence  in favor of  the testator's capacity.1
   §  222. In some  affections of the head, and they
may be primary  or sympathetic, the patient  lies in a
comatose state, from which he may be aroused, when
he will recognise persons and answer  questions cor-
rectly respecting his feelings, but  drop asleep again
as soon as they cease to excite him.  That the  mind
is much  embarrassed  certainly cannot  be  doubted,
and  it is well known that when the patient recovers,
  1 In illustration of these remarks the reader is referred to Cook v.
Goude and Bennet, 1 Haggard, 577; King and Thwaits v. Farley, ibid.
502; Waters v. Howlett, 3 Haggard, 790; P.iid v. Bird, 2 Haggard,
142; Martin v. Wotton, 1 Lee's Feci. Rep. 130 ; Bittleston by her guar-
dian v. Clark, 2 Lee, 229 ; Marsh v. Tyrrel, 2 Haggard's Eccl. Rep.,
84. 
CH. XIL]  LEGAL CONSEQUENCES OF DELIRIUM.     309

he has, ordinarily, very little idea of what passed at
those times ;  indeed, he is generally unconscious of
every thing he either said or did.  It would be a bold
assertion to say that the mind, under these circum-
stances,  is  legally capable of making  testamentary
dispositions, and they ought therefore to receive no
favor from  courts.1   In case  of injury  to the  head,
it is not uncommon for the  patient (after  rallying
from its immediate effects) to answer questions ration-
ally, to appear collected and  intelligent, in short  to
have fully recovered his senses, though he may sub-
sequently declare that  he  is  utterly unconscious of
what were his acts, thoughts or feelings at that time.
Few, even among medical  men, who observe a per-
son under such circumstances, would have any hesi-
tation in expressing  their belief in his  testamentary
capacity, though the event would show that they had
labored under a serious error.
1 Brydges v. King, 1 Haggard's Eccl. Rep. 256. 
310   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XIII.
                CHAPTER XIII.

      DURATION AND  CURABILITY OF MADNESS.

   § 223.  With the exception of those cases of fatu-
ity that occur at a period more or less  remote from
birth, mania is the only kind of insanity that admits
of a cure  ; and though  its duration is various, the
probability of this event is almost entirely destroyed
within a comparatively short space of time.   This is
abundantly evident from the statistics of  madness
that have  been  published from  time to time by the
heads  of  various lunatic establishments.   Esquirol
concludes, on data  furnished by the returns of the
principal  French and  English  hospitals,  that  the
absolute number  of recoveries from  madness is
about  one in three ; and also  that the number of
recoveries varies from one in four, to one in two or
two and a half of the whole number of persons  af-
fected.  Pritchard regards this computation of recov-
eries  as much below  what really takes  place under
favorable circumstances, and undoubtedly if the cases
that  occur in private practice were included,  the
proportion of cases would be much  greater, since
patients are  seldom  sent  to public establishments
until private means, which are oftentimes successful,
have been tried for a short time.  It would seem  in-
deed from some reports  that in recent cases medical
treatment is almost as successful, as in those of long 
CH. XIIL]  DURATION AND CURABILITY OF MADNESS.  311

standing it is unsuccessful.  Dr. Burrowes states the
proportion of recent  cases  cured under his care so
high as ninety-one in one hundred, and  in  the Con-
necticut  Retreat, according to  capt. Hall,1 no less
than twenty-one out of twenty-three recent  cases
recovered.
   ^ 224.  Next  to the proportion of recoveries that
take place in insanity, the most  important  question
in this  connexion is its  comparative curability at
different periods of the disease.  Pinel, in a memoir
presented to the Institute in 1800, was led to con-
clude from a selection of cases  expressly chosen for
this  purpose, that a greater  number of recoveries
takes place in the first month than in any succeeding
one, and  that the mean time of the duration  of the
disease when cured  is between five and six months.
Esquirol, however, gives a table of recoveries at the
Salpetriere  during ten  years, which  shows a little
longer term to insanity.  Out of two  thousand and
five patients, twelve  hundred and twenty-three were
cured, viz.,  six hundred and  four during  the first
year ;  four hundred  and ninety-seven in the second ;
eighty-six in the third ;  and forty-one in  the seven
succeeding  years ;  from   which  it  appears  that
eleven twelfths  of the number of cures  is  obtained
within the first  two  years ; that the mean duration
of cases cured is a little short of one year ;  and that
after  the  third  year,  the probability of a cure  is
scarcely more  than  one in thirty.  M. Desportes
states, from  observations made at the Bicetre and
1 Travels in North America, vol. 1, p. 316. 
312   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. X11I.

Salpetriere, that of the whole number of recoveries
in 1822, 1823, and 1824, seven hundred and forty-
six took place in the first year,  and one  hundred
and eighteen only from  the second  to the seventh
year.
   §  225.  Recovery  from  insanity generally takes
place gradually, though occasionally the disease may
suddenly  disappear on  the occurrence of certain
moral  or physical impressions.   Pinel  relates the
case of a literary gentleman, who, in a paroxysm of
suicidal mania resolved to go and jump into the river.
On arriving at the bridge, he was attacked by rob-
bers, against whom he defended himself vigorously,
beat them off, forgot the  purpose of his excursion,
and returned home cured.  Dr.  Rush relates that one
of his patients, for whom he had recommended gentle
exercise on horseback, wras suddenly cured  in con-
sequence of the fright experienced from her horse
running away in  one of her  excursions.   He  was
stopped by a gate, and  when  her attendants came
up they found her entirely restored to reason.  Sev-
eral other cases  of recovery are related, produced
by a similar cause.  Esquirol speaks of having cured
a girl  at once by the terror she experienced at the
sight of the  actual  cautery which he was  about to
apply.   He  also  mentions the case  of a girl  who
after being insane ten years,  suddenly ran to her
 mother's bed,  exclaiming, as she  embraced  her,
 " mother, mother, I am  well."  She had  become
 insane in consequence of a suppression of the menses,
 which at last made their appearance on  the evening
 preceding her  cure.  Pritchard states that several
 instances of sudden cure from  the same cause have 
CH. XIII.]  DURATION AND CURABILITY OF MADNESS. 313

occurred in some of the English hospitals.   Insanity
has been sometimes cured by an attack of fever.  A
number of maniacs were once cured, in the Pennsyl-
vania hospital, by a malignant fever which appeared
in that establishment.   Direct appeals to the reason-
ing power  have sometimes been followed  by  imme-
diate recovery.  Pinel relates the case of a watch-
maker who  became deranged, and believed that he
had  been guillotined,  and that, in consequence  of
the  mixing of the heads of other victims, his own
had  been replaced by another.  When the miracle
of St. Denis was mentioned,  who carried his head
under his arm and kissed it  as  he went, he con-
tended for  the possibility  of  the fact, by appealing
to his own case,  when one of his companions burst
into  a loud laugh, saying,  "What a fool you are ;
how  could  St. Denis  kiss  his own head ?  was it
with his heel ?"   The absurdity of the idea  struck
his  mind and he never after spoke of the misplace-
ment.  Dr. Cox speaks of a patient  who believed
that  he  was the Holy Ghost. Another asked him
 "Are there two  Holy  Ghosts ?  how can you  be
the  Holy Ghost and I be  so  too V   He appeared
surprised,   and after  pausing awhile said,   "But
are  you the  Holy Ghost ?"  and  when  the other
 replied  "Did  you  not know that  I  was?"  he an-
 swered, " I did not know it before ; then I  cannot
 be the Holy Ghost."   It is probable that in  nearly
 if not quite all these cases of sudden recovery,  by
 means of  mental  impressions, the  disease was  de-
 clining, and that  its  termination was hastened only
 by these impressions. 
314   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XIII.

   § 226. Partial intellectual  mania  is  said to be
cured  with much more difficulty than general mania,
and the latter  is more easily cured  when  the sequel
of some violent cause, than when  it  has come on
gradually from  some  steadily continued influence.
Among the circumstances favorable to  recovery may
be  mentioned  a constitution not  greatly  debilitated
by  excesses of any kind, good moral and intellectual
education, the absence of hereditary predisposition,
and an early medical treatment.
   227. The above facts and considerations will fur-
nish the data, on which the physician  is to form  an
opinion relative to the  duration and curability of any
given  case of  insanity.   While in  very many  cases
incurability is certain, and there can be no hesitation
in certifying the same,  there are none  in  regard to
which  we can predict a certain recovery. The utmost
we can say in the  most favorable cases is, that the
patient will probably recover, and the physician can-
not be too cautious how he commits his own reputa-
tion and the interests and happiness of others by the
expression of  hasty and positive opinions.1   Idiocy,
imbecility, and senile dementia admit neither of cure
nor  amelioration, and  when mania is  of  more than
two years standing, and especially if other  circum-
stances are  not favorable, it may be safely said there
is but little hope of cure, but never that the case  is
  1 If proof be required of the propriety of this warning, the reader
will find a memorable one, in VVraxall's (Posthumous Memoirs) lively
description of the contradictory statements and dogmatic assertions
into which the medical attendants of George III. were betrayed by
party zeal, and which resulted in the confusion and disgrace of some
respectable physicians. 
 CH. XHL] DURATION AND CURABILITY OF MADNESS.  315

 beyond all hope. When mania comes on in a violent,
 furious manner, it would be improper to procure the
 interdiction of the patient, until  medical treatment,
 seclusion, &c. have been tried for a few months, and
 proved unsuccessful.  Neither is this measure always
 justifiable when the disease is so slight as not  to pre-
 vent  him from going abroad and  mingling  in the
 affairs of the world.  If the  patient however is a
 merchant, for instance, and  continues to engage in
 the management of his business, immediate interdic-
 tion wTould  be required  perhaps,  to  save him  from
 the effects of ruinous contracts.
   § 228. An  important feature of  insanity  in  a
 medico-legal point of view, is its tendency to relapse
 during convalescence, and to recurrence after being
 perfectly cured.  The general rule is, that  a brain
 which has once been the seat of the maniacal action
 is far  more liable to  its recurrence, than one which
 has not.  Many recover the full strength and activity
 of their mental faculties, but  the majority, Pritchard
 thinks, are curable only to a certain extent.  " They
 remain," says Esquirol,  " in such a state of suscep-
 tibility that  the slightest  causes give rise to relapses,
 and they only preserve their sanity by continuing to
 live in a  house where no mental agitation or inquie-
 tude,  no unfortunate contingency is likely to fall to
 their lot, and throw them back to their former state.
 There are   other  individuals whose faculties have
 sustained such a shock, that they are never capable
of returning  to  the sphere which they had held in
society.  They are perfectly rational, but have  not
sufficient mental  capacity to  become again  military
officers,  to  conduct  commercial affairs,  or  to fulfil 
 316  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIII.

 the duties belonging  to their appointments."   The
 proportion of cases in which insanity is recurrent, is
 estimated by different writers at from one tenth  to
 one sixth.  In those cases where the mind on recov-
 ery regains  its usual  capability, this  disposition  to
 recurrence is by no means  so strong, as  when it is
 left in  a weak and irritable state, and it diminishes
 with the length of the interval since  the  recovery.
 This feature of insanity  should ever  be borne  in
 mind  by the  physician, when required  to give his
 opinion on the propriety of removing the interdiction
 of an  insane patient, who is apparently restored to
 health.   He should seriously consider  the  risk that
 he runs, by entering again on the busy scenes of life
 and enduring the anxiety and excitement  attendant
 on the management  of his affairs, of renewing that
 cerebral  irritation which  the quiet and  repose of
 seclusion has temporarily  subdued.    In criminal
 cases also, it should  lead to a thorough and candid
 investigation of the plea of insanity urged in defence
 of those who have previously suffered from it, and  it
 should be satisfactorily settled whether or not  the
 circumstances attending the criminal act were likely
 to reproduce that  pathological condition on which
 insanity depends.   If it should prove that they were
 of that  nature, and that  the individual had but re-
 cently recovered from an, attack of  insanity, then it
 would  indicate a confidence that springs from  some
 other source  than a just appreciation of the  phenom-
 enon of  insanity under consideration,  to presume,
nevertheless,  the continuance of  mental soundness
and consequently of moral responsibility. 
CH. XI1L]  DURATION AND CURABILITY OF MADNESS. 317

  § 229. It has been already remarked that in most
instances, recovery  takes place  gradually and is
completed only after a period,  more  or less  long,
of convalescence.   Nothing therefore  can  be more
chimerical  than the idea of fixing  on any precise
moment when  all  disease has departed and perfect
health is  established ; and  yet  this  is what wre are
called upon  to do  when  required to  determine, as
we  sometimes are in criminal  cases, at what time
the accused  began  to be responsible.   To contend
that a convalescent  maniac  may be irresponsible
one day and responsible the next, would be no  less
absurd than to say to one recovering from inflamma-
tion of the lungs, that, as he valued  his life, he must
not  leave  his room  to-day,  though to-morrow he
might safely expose himself to  the severest inclem-
ency of the weather ; and to believe that the former
possessed a sound mind, because  laboring under no
hallucination and attacked  by no fits of fury,  would
be as erroneous, as to consider  the respiratory func-
tions of the latter  sound and vigorous, because we
hear  no cough and see  no difficulty of breathing.
The  time  that has elapsed  since  the unequivocal
insanity  of the accused,  is therefore  an important
element  in the determination of his mental  sound-
ness.   Just as exposure  to  bad weather, a  week
after an attack of inflammation of lungs had  begun
to  subside, would  be more likely to  reproduce the
disease,  than  it w7ould a  month  afterwards,  so  the
longer the  time since an attack of insanity has been
apparently  cured,  the less likely is the cerebral irri-
tation to be renewed by  sudden  provocations or
other causes that  tend to produce it.  Ample  time 
318   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIII.

must  be allowed to cover  the period of convales-
cence, and  if it be  difficult to fix  upon  the  exact
duration of this state, so much greater the necessity
of caution  in  determining the responsibility of the
accused.  Here it is often a merit to doubt, and jus-
tice requires that the accused should have the benefit
of our doubts. 
CH. XIV.]          LUCID INTERVALS.             319
                CHAPTER  XIV.

                 LUCID INTERVALS.

   § 230.  It  is  well  known that many diseases—
especially  of the  class called nervous—observe a
law of periodicity which is not uncommon in the ac-
tions  of the  animal  economy.   One effect  of  this
curious law consists  in  an intermission of the out-
ward  manifestations  of the disease,  so complete as
to bear the appearance of  a perfect  cure, and this,
in the present state of our  knowledge, is all that we
can, with  certainty,  say of it.   As  to  the  change
that takes place in the organic condition  of the part
affected, during  the  intermission, we  can  at best
hazard nothing more  than  a rude conjecture.   We
have no warrant for believing  that the  pathological
affection itself entirely disappears w7ith the  symp-
toms  that  arise from it, and perhaps never  shall
have,  until we are able to explain  why, after such
disappearance, the tendency of the disease to return
at certain intervals  should  still remain ; or in other
words, wherein the final, perfect cure  differs from
the temporary intermission.  But in view  of  the
established fact  that organic disease  often exists
without producing its ordinary symptoms, or reveal-
ing itself  by any appreciable signs, it seems the
more  probable  supposition,  that the  pathological
condition of the affected organs does not disappear 
320   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIV.

entirely during the  intermission,  but continues with
perhaps a modified  intensity.
  § 231.  The slightest examination will convince
us, that in the most complete  intermission of any
disease, that affects the whole system  to some extent,
the patient is far from enjoying sound health, or free
from every indication of morbid  action.  A greater
contrast  in the matter  of health, can  scarcely be
presented in the same individual, than that between
the paroxysm  and the intermission  of a  quotidian
fever; yet none will say, after the former has passed
off and the patient  is  no  longer  shaking  with cold
nor parched with heat, but is able to  arise and give
some  attention to his duties,  that he is entirely well.
Better, no doubt, he is ;  but his  mind is  weak, his
stomach declines  its once favorite food, a little  exer-
tion  overcomes him,  a  certain  malaise not easily
described pervades  his  whole system,  and which,
though not excessively  painful,  is  something  very
different  from  the buoyant  sensation of health.   We
are therefore bound to believe, that the disease still
exists, though its external aspect has changed.   And
here it may be as well to remark, that we must not
be led by an abuse  of language,  to attribute that to
the disease—to the pathological condition—which
belongs only  to  one of its  symptoms.   When the
epileptic,  a few7 days after  one of his frightful  con-
vulsions,  appears  to have regained his customary
health, no intelligent  physician  imagines  that  the
proximate cause  of this disturbance has  vanished
with the fit, leaving the organ it affected as sound as
ever.   The fit  itself, which is  a mere  symptom, is
indeed of periodical occurrence, but the  pathological 
CH. XIV.]           LUCID INTERVALS.            321

condition on which it depends continues, slowly and
surely though imperceptibly, to undermine the pow-
ers of the  constitution.  The general expression of
all our knowledge on the subject  of the intermission
of diseases is, then,  that certain  pathological condi-
tions  give  rise, among  other phenomena, to some
that  disappear for a time only to recur after  an in-
terval of more or  less duration.
   § 232.  That insanity, or rather  mania, is one of
the diseases that are subject  to  this law  of periodi-
city,  in some respects,  is universally admitted ;  but
to what extent the law operates,  is a point on which
there is much diversity  of opinion.   There  are few
cases in which we may not observe  various periods
in their course, when the severity  of the symptoms
is greatly alleviated ; when calmness takes the place
of fury, and a quick and sober demeanor succeeds to
noisy and restless  agitation ; when reason, driven
from  her throne, seems to be retracing her steps and
struggling for her lost dominion.   In  all this, how-
ever, there is nothing different from  what occurs in
many, if not the  greater proportion of chronic dis-
eases.  That the  intermissions of mania  are ever so
complete,  that the  mind is  restored to  its original
integrity,  would  seem  scarcely  probable,  from the
fact,  that the very seat  of the pathological  changes
is the material organ on which the manifestations of
the mental phenomena depend.  For if the  mind be
rendered as sound as before the  attack,  it  necessa-
rily follows that the brain is  equally restored, since
in point of health they  stand to each other in the
relation of cause and effect.  But  as  there  is no
proof that such is the case, and  as the supposition  is
              v 
322   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XIV.

not supported by what we do know of pathological
actions, we have no right, at  present, to conclude
that the physical condition on which mania depends
is  entirely removed during the intermission.  We
are thus led to scrutinize a little more closely these
periodical restorations of the insane mind, or lucid
intervals as they are called, in  order to  ascertain if
possible,  what  is the actual state  of  the  mind  at
these times.  But before doing this,  it will be  proper
to show what is understood in law by lucid intervals,
as explained by eminent legal authorities.
   § 233.  D'Aguesseau, in his  pleading  in the case
of the Abbe  d'Orleans,  says,  "It must not be  a
superficial tranquillity, a shadow of repose,  but  on
the contrary a profound tranquillity, a real repose ;
it  must be, not  a  mere ray of reason,   which only
makes its absence more apparent when it is  gone—
not  a flash of lightning, which  pierces through the
darkness  only to render it more gloomy and dismal—
not  a glimmering, which joins the  night  to the day ;
but a perfect light, a lively and continued lustre, a full
and entire day interposed between the  two separate
nights, of the fury which precedes and follows it; and,
to use another image, it is not a deceitful and faith-
less stillness which follows or forebodes a storm, but
a  sure and  steadfast tranquillity for a  time,   a real
calm,  a  perfect serenity; in fine,  without  looking
for so  many metaphors to represent our idea,  it must
be not a mere diminution,  a remission of the com-
plaint, but a kind of temporary cure, an  intermission
so clearly marked, as in every  respect  to  resemble
 the restoration  of health." J
1 Pothier on Obligations, by Evans, Appendix, 579. 
CH. XIV.]           LUCID INTERVALS.            323

   § 234. Many years after, Lord  Thurlow,  in the
court of chancery, thus stated his  views of the con-
dition of mind necessary to constitute a  lucid inter-
val.   " By a perfect interval, I do not mean a cooler
moment, an abatement of pain or  violence,  or of a
higher state of torture—a mind relieved from exces-
sive pressure ;  but an interval in  which the mind,
having  thrown off the  disease,  had  recovered its
general habit."1
   § 235. Here then is the lucid  interval as clearly
and minutely  described, as  a profusion of words
and metaphors could do it,  and as such it was be-
lived by these  authorities, no doubt, to  have a real
existence.   In the early periods of the English law,
the doctrine of lucid  intervals was universally ad-
mitted, and they seem to have been considered not
a rare, but a  very common phenomenon of mental
derangement.   Indeed, judging from  the  frequent
mention made  of them in all discussions on the sub-
ject, and from  the fact that  idiocy and lunacy—which
latter was considered, as its name would lead us  to
 suspect, to be of an intermittent nature—constituted,
 for a long time, the only division of mental diseases,
 it will not perhaps  be too  strong  an expression to
 say, that they  were viewed as an essential feature of
 mania.  This, however, was in the infancy of medi-
 cal science, before the phenomena of mania—which,
 until recently, has always been less understood than
 other diseases—were thoroughly and  accurately ob-
 served,  and  the  men  whose  ideas  we have just
' Attorney General v. Parnther, 3 Brown's Ch. Cases, 
324   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XIV.

quoted had no  practical  acquaintance with the dis-
order whose  phases they so vividly described.  Be-
fore  adopting  their views,  then, it will  be proper
to inquire how far they are supported by the investi-
gations of modern medical science.
   § 236.  While  the  doctrine of lucid intervals, as
explained by the language  above-quoted,  is upheld
by scarcely  a single  eminent name  in  the medical
profession, we find that their  existence is either de-
nied altogether, or they are regarded as  being only
a remission, instead of an intermission of the disease;
an abatement of  the  severity  of the  symptoms, not
a temporary  cure.  Mr.  Haslam,  who is  no mean
authority on  any question connected with  insanity,
emphatically declares, that, "as a constant observer
of this disease for more than twenty-five  years, I
cannot affirm  that the lunatics,  with whom I have
had daily intercourse, have manifested alternations
of insanity and reason.  They may at intervals be-
come more  tranquil, and less disposed  to obtrude
their  distempered fancies into notice.  For  a time
their  minds may  be less active, and  the succession
of their  thoughts consequently  more  deliberate;
they may endeavor to effect some desirable purpose,
and  artfully  conceal their real  opinions,  but they
have  not abandoned, nor  renounced their distem-
pered notions.  It is as unnecessary to repeat that a
few coherent sentences do  not  constitute the sanity
of the intellect;  as that the sounding of one or two
notes of a keyed instrument could ascertain it to be
in tune." !
1 Medical Jurisprudence of Insanity, p. 224. 
CH. XIV.]
LUCID INTERVALS.
325
  § 237. Strong as  this testimony  is,  and true, no
doubt, as the result of an individual's experience, it
cannot be  denied that others, whose opportunities
have not  been  less than  Mr. Haslam's, have dis-
tinctly recognised  the existence of intervals,  when
the patient not only  becomes more tranquil  and re-
served, but is  conscious  of having been mad, and
perceives the  folly of the delusions that have  en-
grossed his  thoughts.   But  so far are they from
attributing to the mind, during their occurrence, that
degree of soundness  which is contended for in the
passages above quoted, that they have  taken  great
care to inculcate a very different doctrine.   "The
mania, says Fodere, " which is accompanied  by fury,
is very often periodical;  that  is, as if granting an
occasional  truce to the patient,  it appears only at
certain epochs, between which he enjoys all  his rea-
son,  and seems to conduct and judge in all respects
like other men,  if we except  in  regard to  certain
ideas, the thought of which may  at any time occa-
sion  a fresh paroxysm." J
  § 238.  Georget, while he speaks of lucid  inter-
vals  "as returns to reason,"  is careful to add, that,
" in  this state, patients frequently experience  some
degree of malaise, of some disturbance of their  ideas,
and  weakness  of  mind, which prevents  them from
fixing their attention, for  any length of time, on  a
particular subject; from engaging in reading, writing
or attending to their affairs." 2
1 De Medecine Legale, t. i., p. 205, § 140.
8 Des Maladies Mentales, p. 46. 
326   MEDICAL JURISPRUDENCE OF INSANITY. [CH XIV.

  § 239.  " There are few cases of mania or melan-
choly," says Dr. Reid, " where  the light of reason
does not now and then shine out between the clouds.
In fevers of the mind, as well as those of the body,
there occur frequent intermissions.  But  the  mere
interruption of a disorder is  not to be mistaken for
its cure,  or  its ultimate conclusion.  Little  stress
ought to be laid upon those occasional and uncertain
disentanglements of intellect, in  which the patient
is for a time only extricated from the labyrinth of his
morbid hallucinations. Madmen may show, at starts,
more sense than ordinary men." 1
  § 240.  Dr. Combe, in one of the most philosophi-
cal treatises on Insanity, which the  present century
has produced,  expresses  similar views in  the  most
explicit and forcible language.   " But however calm
and  rational the patient may appear to  be, during
the lucid intervals,  as they  are  called, and while
enjoying  the  quietude of domestic society, or  the
limited  range  of a  well-regulated  asylum, it  must
never be  supposed,  that he is in as perfect posses-
sion  of his senses, as if he had never been ill.  In
ordinary  circumstances  and  under  ordinary excite-
ment, his perceptions may be accurate, and his judg-
ment perfectly sound ;  but a degree of irritability of
brain remains behind,  which renders him  unable to
withstand  any unusual emotion, any sudden provo-
cation, or  any unexpected and pressing emergency.
Were not  this the case, it is manifest that he would
  1 Essays on Hypochondriacal and other Nervous Affections:  21st
Essay, 
CH. XIV.]          LUCID INTERVALS.            327

not be more liable to a fresh paroxysm, than if he
had never been attacked.  And the opposite is noto-
riously  the fact;  for  relapses  are always to be
dreaded, not  only after  a lucid interval, but even
after perfect recovery.  And it is but just as well as
proper to keep this in mind, as it has too often hap-
pened, that the lunatic has been visited  with  the
heaviest  responsibility,  for  acts  committed  during
such an interval,  which, previous to the first attack
of the disease,  he  would  have  shrunk from with
horror." *
   § 241. With the views of these distinguished ob-
servers before us, what are we to  think of the doc-
trine, that  in the lucid intervals the mind is restored
to its natural strength  and soundness ;  that it  is
capable  of as great  intellectual exertions,  and  of
holding as  tight a rein over the  passions ;  that it  is
as able to  resist  foreign  influence and to act on its
own determinations, with its ordinary  prudence and
forecast; that having thrown off the  disease, it has
recovered  its general habit," or  that  it has under-
gone  a  " temporary cure ? "   Sounder  pathology
was never  written, than  is contained  in the extract
from Dr. Combe,  and  no physician,  who  has been
much conversant with  the  insane, will be disposed
to question its  correctness.   Fodere  goes  a step
farther and hazards a  theory  which  is plausible  at
least, to explain the  pathological causes  that pro-
duce this alternation of paroxysms and lucid intervals.
The former state,  he  considers,  is  attended by an
i Observations on Mental Derangement, p. 241. 
328   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIV.

excessive plethora of the blood-vessels of the brain,
and the latter by a relaxed, atonic condition of these
vessels, which is an  effect  of their previous forcible
distention.   In this  condition they are liable to be
suddenly engorged by  exciting causes, such as in-
temperance in eating or drinking, anger, violent ex-
ercise, insolation, &c.; or in consequence of a cer-
tain  predisposition of  constitution.1   Indeed,  it is
well known,  that the  return of the paroxysms is
often  retarded by regulated diet, bleeding, quiet,
seclusion,  kind treatment, and  the  absence of the
above-named stimuli.  It is thus shown, conclusively,
that in every lucid interval, there remains some un-
soundness of the material organ of the mind, which
may be designated generally as a morbid irritability,
which, on  the application of the slightest exciting
cause,  may produce  an outbreak of mania in all its
original severity.
  § 242. The principle of law, which holds the civil
responsibilities of the insane  to be unimpaired during
the lucid interval, we are willing to admit, is general-
ly correct.   It should be the  duty of courts, however,
to view their acts done at such  times w7ith the  most
watchful jealousy, because their minds,  though left
free from  all  delusion, are  nevertheless  weak  and
irritable, and  they are easily induced by the arts of
unprincipled men to enter into transactions, the folly
of which would have been obvious enough to  them
before they began  to be insane.   It  is  proper too
that the proof of the lucid interval should come up
1 De Medecine Legale, t. i., p. 208, § 140. 
CH. XIV.]           LUCID INTERVALS.               329

to the requirements  of distinguished  legal authori-
ties—of those, to go no farther—to whom we  have
already referred.   D'Aguesseau, in  continuation  of
the remarks above quoted, declares, that, " as it is
impossible to  judge  in  a  moment  of the  quality of
an  interval,  it  is  requisite  that there  should  be a
sufficient length  of  time for giving a perfect assur-
rance of  the temporary re-establishment  of reason,
which it is  not possible to  define   in general,  and
which depends upon the different kinds of fury, but
it is certain there must be a  time and a  considerable
time."   Lord Thurlow also, on  the  same occasion,
which elicited his  views of the  nature  of the  lucid
interval,  says, that  "the evidence  in support of the
allegation of a lucid interval,  after derangement at
any period has been established, should be as strong
and demonstrative of such fact, as where the object
of the proof is to establish derangement.1  The evi-
  1 It appears from a note in 1 Beck's Med. Juris. 586, that Lord Eldon
dissented from this proposition and thus stated  his objections to it to
Lord Thurlow himself.  " I have seen you exercising the duties of
lord chancellor with  ample sufficiency of mind  and understanding,
and with the greatest ability.   Now if providence should afflict you
with a fever, which should have the effect of taking away that sanity
of mind for a considerable time (for it does  not signify whether it is
the disease insanity, or a fever that makes you insane), would any one
say, that it required sucli very strong evidence to show that your mind
was restored to the power of performing such an act as making a will—
an act, to the performance of which a person of ordinary intelligence
is competent ? "  We are not informed how this objection struck Lord
Thurlow, but we trust that no  reader of the present work will be at a
loss to perceive its weakness for a moment. It does signify every thing,
whether it is the disease insanity or a fever that makes one insane, for
the delirium of fever  is but a  casual symptom of that disease, and,
together with the pathological  condition that gave rise to it, is pre-
sumed to disappear with the main disorder on which it depends.  This 
330   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XIV.

dence in such a case,  applying  to stated  intervals,
ought to go to the state and habit of the person, and
not to the accidental interview of  any  individual, or
to the degree  of self-possession  in  any   particular
act."   We  shall presently see how  far the practice
of the courts  has  accorded with  these views.
   § 243.  In cases of wills, the English ecclesiastical
courts, in a commendable respect for the sacred char-
acter of  testamentary  acts, have assumed considera-
ble latitude, and,  no doubt,  very  properly,  in  their
construction of lucid intervals; but occasionally they
have gone farther than even  the truths of  pathology
will warrant.
   In Cartwright v. Cartwright,2 the deceased, a sin-
gle  woman, made her  will  on  the 14th of August,
1775, which will  was contested on the ground of the
insanity of the testator.   " It was proved in general,
says the court,  that her habit and  condition of body,
and her manner,  for several  months  before the date
is the ordinary course of nature. On the contrary, mental alienation
is the essential, the pathognomonic, and oftentimes, the only  clearly
discernible  symptom of mania, and its disappearance furnishes the
only  intimation  perhaps that we have, of the cure of this disease.
Thus, our means of deciding this point being so small, we are neces-
sarily led to require stronger evidence  of their certainty, than of the
restoration of the mind in fever, because the latter is confirmed by a
multitude of symptoms.  Recovery from an  attack of fever is a phe-
nomenon that any one can see, but not such is recovery from an at-
tack of mania ; because, though the insane delusions or conduct by
which it was manifested may disappear, it remains to be determined
in every case, whether they are not purposely concealed from observa-
tion, or proper opportunity has been offered  to  the  patient to bring
them forward.  Just as the existence of mania requires stronger proof
than that of the delirium of fever, so does recovery from  the former
require stronger proof than recovery from the latter.
  2 1 Phillimore's Reports, 90. 
CH. XIV.]          LUCID INTERVALS.            331

of the will, was that of a person afflicted with many
of the worst symptoms of that dreadful  disease, and
continued so  certainly after  making the  will."   It
appears from the evidence, that for some time pre-
vious to the date of the will,  she  was very importu-
nate for the use of pen, ink,  and paper, which how-
ever were withheld from her  by the direction of her
physician.  Dr.  Battie, who  was  eminent for  his
knowledge and treatment of  mental disorders.  Her
importunity continuing, he at  length consented, in
order to quiet and  pacify her, that she might have
them, observing that it did not signify w7hat she might
write, as she was not fit to make a proper use of
pen, ink, and paper.   These being carried  to her,
her  hands which had been constantly  tied were
loosed,  and she sat down to a bureau to write.  Her
attendants, who were watching her outside the door,
saw  her write on several  pieces of paper in succes-
sion, which she tore  up and threw into the grate,
walking up and down the room in a wild and furious
manner, and muttering to  herself.  After  one or
two hours spent in this manner, she finally succeeded
in writing a will that  suited her, though  it occupied
but a few lines.  Such are the facts  that have any
bearing on the point at issue. It was decided by the
court, Sir William WTynne,  that she had a lucid in-
terval, while making the will, the validity of which
was  consequently established.  The grounds of  this
decision were,  that the will made a natural and con-
sistent distribution  of  her property, and, in  short,
that it was "a rational act rationally done ; "  hence
it was to be inferred,  that her mind was  visited by a
lucid interval,  at  the  moment of making it.   For, 
332   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XIV.

says the court, " I think the strongest and best proof,
that can  arise as  to a lucid interval,  is  that which
arises  from the act  itself; that  I look  upon as the
thing to be first examined, and  if it  can  be proved
and established, that  it is a  rational  act rationally
done,  the whole case  is proved."  It  seems to  have
occurred to the court, that  some catenation must be
made out between such an act and a  lucid interval ;
and it being in evidence, that,  at  times, she would
converse rationally,  we have the following deduc-
tions therefrom.   " If she could converse rationally,
that is a  lucid interval;  and that she did so and had
lucid intervals, I  think is completely established."
The fact  is, that the court, throughout its whole judg-
ment,  confounded testamentary capacity with a  lucid
interval,  without once seeming  to be aware  that
though the will might be a rational act,  and  there-
fore perhaps valid,1 it by no means followed, that a
lucid interval had taken place.   What it considered
as such here scarcely amounted to the  kind of re-
  1 This is in accordance with the law as laid down by Swinburne.
" If a lunatic person, or one that is beside himself at sometimes but
not continually, make his testament, and it is not known whether the
same were made while he was of sound mind and memory or no, then,
in  case the testament be so conceived as thereby no  argument of
phrensy or folly can  be gathered, it is to be presumed that the same
was made during the time of his calm and clear intermissions, and so
the testament shall be adjudged good, yea although it cannot be proved
that the testator useth to have any clear and quiet intermissions at all,
yet nevertheless, I suppose that if the testament be wisely and orderly
framed, the same ought to be accepted for a lawful instrument." Part
ii. sec. 3. So on the other hand, he adds, " if there be in it a  mixture
of wisdom and folly, it is to be presumed that the same was made
during the testator's  phrensy, even if there be but  one word sounding
to folly." 
CH. XIV.           LUCID INTERVALS.             333

mission described by Mr. Haslam (§ 236), for not a
single fact appears in  the evidence, from which we
can infer any alteration whatever in the state of her
disease.   True, the court thought, that  her  reason
had  returned, because,  though  released  from the
confinement of a straight-waistcoat, and trusted with
a candle, she did no mischief and did not abuse her
liberty ; but such things would have little  weight
with  medical men, especially at the  present day.
Nothing indeed can be more chimerical, because so
utterly contradicted by all that we know of insanity,
than this idea of a lucid  interval of a  few minutes
duration suddenly interposed amid years of mania,
and as suddenly disappearing.1   The point particu-
larly insisted  upon by the judge  is, that she would
sometimes converse rationally, as indeed most insane
people do.   "If," he says,  " she had particular sub-
jects  or topics in her mind,  and at such times would
converse rationally  upon  them,  and  when  those
topics were out of her mind would fly  into outrages
of phrensy and extravagance, does that all show that
at the former time she was deprived  of rational ca-
pacity ? "   He  does not seem to be aware,  that
it would not be surprising if wills should sometimes
be found among the number.
   1 Its consequences seem to render  it as pernicious as it is absurd.
 In the trial of Hadfield for shooting at the king, Lord Kenyon, after
' admitting that he was insane both before and after the act, and that it
 was improbable he had recovered his senses in the interim, declared,
 that " were they to run into nicety, proof might  be demanded of his
 insanity, at the precise moment when the act was committed ! " as if
 such proof were not utterly beyond the reach of human means. 
 334  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XIV.

   § 244, We have no fault to find with the principle
 of law,  which makes these wills valid, but we would
 have the ground on which such validity is established,
 distinctly understood to be the  character of the act,
 not the condition of the  testator's mind ; and if, in
 the above case, the court had  been  contented with
 proving the will to be a rational  act and  thence in-
 ferring testamentary capacity, there would have been
 nothing to complain of.   It is important that on sub-
jects like medical jurisprudence,  language should be
 used with strict adherence to its original and proper
 signification ;  and therefore  when a lucid interval is
 defined by competent authority to be a "temporary
 cure " of the disease,  a recovery of the mind's gen-
 eral habit, the  occurrence of which must be  proved
 by the "state  and  habit," of the person,  observed
 during a sufficient length of time, we have to com-
plain, that the term is applied to a mere remission in
 the violence of the symptoms,  which lasts but a few
 minutes and is  proved by a single coherent act.
  §  245.  The  construction here put upon the lucid
interval, not only conflicts with the  opinions of the
eminent  authorities we have quoted, but  has  not
been countenanced by  subsequent decisions even in
the ecclesiastical  courts.  In a recent case, where
the testamentary acts of an insane person were pro-
pounded by the executors, who endeavored to prove
the occurrence of a lucid  interval  at the time of their
execution, the court, Sir  John Nicholl, decided that
the proof was not sufficient,  though  it was unques-
tionably stronger  than  in the case of Cartwright v.
Cartwright.   The surgeon of the testator  who saw
him once within the period,—a little more than ten 
CH. XIV.]          LUCID INTERVALS.            335

months—that included the two wills in question, and
commenced a  frequent  attendance  on him between
two and three months afterwards, deposed,  that on
none of these occasions did he exhibit any symptoms
of insanity, but " conducted himself,  and talked and
discoursed in a rational manner,  and was in the full
possession of his  mental faculties."   The  solicitor
who took the  instructions  for  the  last will, consid-
ered him  of sound mind, and  deposed  that neither
of the witnesses treated him as a person of deranged
intellect or of unsound mind.  In  the testamentary
dispositions themselves, there was  nothing  to nega-
tive the idea of the most perfect  soundness  of mind.
In view of the fact, however, that the  testator was
so deranged that he was attended  by a keeper from
a lunatic asylum,  till within a  few  months of the
date  of the first will, and frequently manifested ab-
 surd  delusions during the period including both wills,
 the above proof was not considered  as  sufficient for
 the purpose,  reasoning upon  the general principles
 of insanity.  " It is clear,"  said  the court, " that
 persons essentially insane may be calm, may do acts,
 hold conversations, and even pass  in general society
 as perfectly sane.   It often requires  close  examina-
 tion  by persons skilled  in  the disorder, to  discover
 and ascertain whether or not the  mental derange-
 ment is removed,  and the mind again become per-
 fectly sound.  When there is  calmness, when there
 is rationality on ordinary subjects, those who see the
 party usually conclude that his recovery is peffect.
 .....Where  there is not actual recovery, and a
 return to the management  of himself  and  his  con- 
336   MEDICAL JURISPRUDENCE OF INSANITY. [CH XIV.

cerns by the unfortunate individual,  the proof of a
lucid interval is extremely difficult."1
   §  246.  It  has been  admitted, that,  with certain
reservations, the civil responsibilities of the  insane
are unimpaired during the lucid interval, because the
mind is sufficiently restored to enable  the individual
to act with tolerable discretion in his civil relations.
In respect to crime, however,  the matter is alto-
gether different, for reasons that will not be without
their force, we trust, to those who have attentively
considered the preceding  remarks.   These reasons
are,  that the crimes which are alleged  to have been
committed in a lucid interval, are  generally the re-
sult  of the momentary  excitement produced by sud-
den  provocations ; that these  provocations  put  an
end  to the temporary  cure,  by immediately repro-
ducing that pathological condition of the brain called
irritation,  and  that  this  irritation  is  the essential
cause of mental  derangement,  which  absolves from
all the legal consequences of crime. The conclusion
is, therefore, that we ought  never perhaps  to con-
vict  for a crime committed during the lucid interval,
because there is every  probability,  that the individ-
ual was under the  influence  of that  cerebral irrita-
tion, which  makes  a man  insane.  The  difference
between a person in the lucid interval  and one who
has  never been insane, on  which  we particularly
  1 Groom and Thomas v. Thomas and Thomas, 2 Hagg. Eccl. Rep.
433: In Whiter. Driver, 1 Phillimore, 84, however, a lucid interval
was held to be established, on much less proof than was offered in the
above case, though far more certainly than was admitted in Cartwright
v. Cartwright. 
CH. XIV.]            LUCID INTERVALS.            337

insist,  is, that, while in the latter, provocations stimu-
late the passions to the highest degree of which they
are capable in a state  of health, though still more or
less under his control, they  produce in the former
a pathological change which deprives him of every
thing like moral liberty.  It is scarcely necessary to
do more than barely state  these views,  since  their
correctness seems to have  been  universally recog-
nised in practice, not a single case having occurred,
so far  as can be  ascertained, where a  person has
been convicted  of  crime  committed during a  lucid
interval.  Burdened as the criminal law is with false
principles on the  subject of insanity,  the time has
gone by when juries will  return a  verdict of guilty
against one  who is admitted  to  have  been  insane,
within a short period of time before the criminal act
with which he is charged.
w 
338    MEDICAL JURISPRUDENCE OF INSANITY. [CH. XV.
                CHAPTER  XV.

               SIMULATED  INSANITY.

  § 247. The supposed  insurmountable difficulty of
distinguishing between feigned and real insanity has
conduced, probably more than all other causes to-
gether, to bind  the legal profession to the most  rigid
construction and application of the common law rela-
tive  to  this disease, and is  always put forward in
objection to the more humane doctrines that have been
inculcated in the present work.  That such difficulty
has been experienced, and given rise to much per-
plexity and  mistake, cannot  be denied; but it is to
be considered,  whether it  has not  arisen, less from
the obscurity of the subject, than from the imperfect
means that have been  generally applied to its eluci-
dation.  The opinions of physicians, which are ordi-
narily taken in doubtful cases, have been  received
with a deference, that was warranted more by general
professional reputation, than by superior knowledge
of this particular disease.   The treatment of insanity
is now so much confined to the  heads of extensive
establishments  in which its  subjects  are  congregated,
that opportunities for studying it are comparatively
limited in ordinary practice,  so that  a physician may
be justly celebrated in the knowledge and treatment
of other diseases, and at  the same time be poorly
qualified to decide upon questions relative to insanity, 
 CH. XV.]         SIMULATED INSANITY.           339

 in which every effort is made to perplex and mystify
 his mind. This truth cannot be disguised, and though
 physicians are frequently reluctant to recognise what
 indeed cannot be very discreditable to themselves,
 and are disposed to  act on the  popular notion  that
 all medical subjects  are equally familiar to them, this
 is no reason why courts and juries should ever forget
 it.  Nothing indeed  requires a severer  exercise  of a
 physician's knowledge  and tact, than a case of simu-
 lated insanity, but the same might be said with quite
 as much  truth, of other diseases that men have been
 led to feign, but  which, nevertheless, are  every day
 investigated and understood.
    § 248. The workings  of an insane mind—such
 as attract the popular notice—are apparently so con-
 fused  and discordant, so wild and unnatural, as to
 have given rise to the notion as prevalent as it is
 unfounded, that insanity may be easily imitated.  The
 method that is in madness, the constant and consist-
 ent reference  to  the predominant  idea, which  the
 practised observer detects amid the greatest  irregu-
 larity of conduct and language, is one of those essen-
 tial features in  the disease, which is generally over-
 looked, or  at  least very unsuccessfully  imitated.
 Those who  have been  longest  acquainted  with  the
 manners of the insane, and whose practical acquaint-
 ance with the  disease furnishes the most satisfac-
 tory guaranty of the correctness of their opinions,
 assure us that insanity is not easily feigned, and con-
 sequently that  no attempt at  imposition  can long
 escape the efforts of one properly qualified to expose
 it.   Georget does not believe, "that a  person who
has  not  made the insane a subject  of study,  can 
340    MEDICAL JURISPRUDENCE OF INSANITY. [CH. XV.

simulate madness so as  to  deceive a physician well
acquainted with the disease." *  Mr. Haslam declares,
that,  " to  sustain the  character of a paroxysm of
active insanity, would require a continuity of exer-
tion  beyond the power of a  sane person."2   Dr.
Conolly affirms, " that he can hardly imagine a case
which would be proof against  an efficient system of
observation."3 Another writer, while admitting that
attempts to  deceive are sometimes  successful, on
account of the imperfect  knowledge of the operations
of the mind in health and disease possessed by med-
ical men  in  general, observes,  however, that  when
we consider the " very peculiar complex phenomena
which characterize  true  madness, and reflect on  the
general ignorance of those who attempt to imitate
them, we  have no  right to expect  such  a finished
picture as could impose  on  persons well acquainted
with the real disease."4  With such authority before
us, to urge as an objection against the free admission
of insanity  in excuse for crime,  the extreme difficulty
of detecting attempts to feign it, can no longer be any
thing  more than the plea of ignorance or indolence.
The  only effect such difficulty should have on  the
minds of those, who  are to form their opinions by the
evidence they hear,  should be to impress  them with
a  stronger sense of the necessity  of an  intimate,
practical acquaintance with  insanity on the part of
  1 Des Maladies Mentales, p. 60.
  2 Medical Jurisprudence of Insanity, p. 322.
  3 Inquiry concerning the indications of Insanity, 467.
  4 Cyclopaedia of Practical Medicine: Article, Feigned Diseases, p.
146.
                       \ 
 CH. XV.]         SIMULATED INSANITY.           341

 the medical witness, and convince them that without
 this qualification, the testimony of the physician is
 but little better than that of any one else.  We shall
 now notice  those features of insanity the  knowledge
 of which, either from their not being generally obvi-
 ous, or not easily simulated, will enable us to  distin-
 guish the reality from the imitation ;  and  as general
 mania is oftener chosen than the other form of mental
 derangement, for the purpose of deception, we shall
 begin with that.
   § 249.  The grand fault committed by impostors
 is, that in their anxiety to produce an imitation  that
 shall deceive, they overdo the character they assume,
 and present nothing  but a clumsy caricature.   The
 representations of mania put forth  in the works of
 novelists and poets, with a few such admirable excep-
 tions as the Lear and Hamlet of Shakspeare,  are, of
 all their attempts to copy nature, the least like their
 model.  If then men of education, who may have had
 some opportunities for  observing the disease, have
 after all so imperfect a picture of its phenomena in
 their mind, what success could be expected from the
 attempts of persons who, for the most part, assume
 their task upon the spur of the occasion  with little
 preparation, and who have derived all their ideas of
 madness from a casual visit to an insane hospital, or
 from observing the manoeuvres of some roving maniac?
 With such, insanity is but another name for wildness,
 fury,  and unlimited  irregularity, and consequently,
 under the thin disguise they assume, there can read-
 ily be detected a constant  effort  to  impress on the
beholder the conviction  they are  anxious  to produce
by the mere force of noise and disorder.   The  really 
342   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XV.

mad are, generally speaking, not readily recognised
as  such  by a stranger, and they retain so much of
the rational as to require an effort to detect  the im-
pairment of their faculties.   In feigned cases, all this
is very different;  the person  is determined that his
derangement shall not be  overlooked for want of
numerous and obvious manifestations of its existence.
Under this impression,  the impostor  is constantly
guilty of some word or act grossly inconsistent with
real insanity, and affording an  easy clew to the truth
of the case.
  § 250.  Generally speaking,  a  maniac has no diffi-
culty in remembering his friends and acquaintances,
the places  he  has been accustomed to  frequent,
names, dates, and events, and  the occurrences of
his  life.   The ordinary relations of things  are, with
some exceptions, as easily and clearly perceived as
ever, and his discrimination of characters seems to be
marked by his usual shrewdness.   His replies to
questions, though they may sometimes indicate delu-
sion or extravagant notions,  generally  have some
relation to  the subject, and show that it has occupied
his  attention.  Now, a person simulating mania will
frequently deny all knowledge of men or things, with
whom he has always been familiar, especially when-
ever he  imagines  that such ignorance, if believed,
may be considered as a proof of his innocence.  The
very names, dates and transactions, with which he
has been most  lately and intimately conversant, he
will, for the same reason, refuse  to remember, while
the real  madman will, seldom, if ever, forget them,
in whatever shapes they may appear to his mind, or
with whatever delusions they may be connected.  His 
CH. XV.]         SIMULATED  INSANITY.            433

distorted perceptions may transform his humble dwell-
ing into a princely castle, and  the people about him
into generals and courtiers ready to execute his slight-
est orders,  but he will never  deny that  he has an
abode, nor  forget the existence  or names  of  those
whose station  and duties he has so entirely mistaken.
Grant his premises, and  oftentimes nothing can be
urged against  the conclusions of  the  madman's rea-
soning; but in simulated madness, the common error
is to imagine that nothing must be remembered cor-
rectly, and that the more inconsistent and absurd the
discourse, the better is the attempt at deception sus-
tained.   In partial  mania, the subject of delusion,
thoug hit may frequently  change, completely  occu-
pies the mind for a longer  or shorter period, and the
patient's discourse will  always  have some kind of
relation to  it.   When this  form of the disease is
simulated, the hallucinations are  not only frequently
changing, but when questioned concerning them, the
person  is more likely than not to shape  his answer
without  any reference to  the  subject, and  embrace
the opportunity to introduce a  new insane idea.  In
simulated madness there is also a certain hesitation
and appearance of premeditation in the succession of
ideas, however incoherent,  very different  from the
abruptness  and rapidity, with which in real madness,
the train of thought is changed.   This,  of itself, is
sufficient,  in  the majority of cases,  to  reveal the
deception to  the practised observer of insanity. In
simulated  mania, the impostor,  when  requested to
repeat  his disordered ideas, will  generally do it cor-
rectly,  as if anxious that none of his ravings should
 escape attention, or be forgotten ; while the genuine 
 344   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XV.

 patient will  be apt to wander from the  track, or
 introduce ideas that had not presented themselves
 before.  The following case, which we find in cne of
 Georget's works, will furnish an appropriate illustra-
 tion of the foregoing remarks, and  give an insight
 into the devices  of imposture, to be obtained  only
 from examples.
   § 251.  "Jean-Pierre, aged forty-three years, for-
 merly  a notary,  was  brought before  the  court of
 assizes of Paris, on  the 21st February, 1824, accused
 of crimes and misconduct, in which cunning and bad
 faith had been prominently  conspicuous.    He  had
 already been condemned for forgery ; and was  now
 accused  of  forgery,  swindling,  and incendiarism.
 When  examined after  his arrest, he answered  with
 precision every question that was put to him.   But
 about  a  month after, he  would  no longer explain
 himself, talked incoherently,  and finally  gave way to
 acts of fury,  breaking  and  destroying  every thing
 that came in his way, and throwing the furniture out
 of the window.   At the suggestion of  the  medical
 men who were called to examine him, Jean-Pierre
 was sent to the Bicetre, to be more closely observed.
 There  he became acquainted  with another pretended
 lunatic, accused also  of forgery and swindling,  and
retained in that house for the same purpose—that of
being observed by the physicians.   One night a vio-
lent fire broke out at the Bicetre, in three different
places  at once, in one of the buildings occupied by
the insane, which circumstance  led to the suspicion
that the fire was the effect of malice.  The next  day
it was discovered that the two supposed madmen  had
disappeared.   Jean-Pierre hid himself in Paris  in a 
CE. XV.]        SIMULATED INSANITY.           345

house where  his wife was employed  and where  he
was again arrested.  Immediately on his escape from
the Bicetre, he wrote a very sensible letter to one of
his friends ; but scarcely had he been taken when he
again assumed  the  character of a  madman.   From
the indictment,  it appears that the person who ran
away at  the same time  with  Jean-Pierre, confessed
that  they had formed  the plan of escaping in  com-
pany, and that  they had  profited  by the occurrence
of the fire to put it into execution.  He also said that
Jean-Pierre had made him swear to reveal nothing  ;
and he seems to have told as a secret to one of  the
officers  of La Force, that the fire was  the work of
Jean-Pierre.
   All the witnesses, who had  had any  transactions
with or  known any thing of the accused before his
arrest, deposed that he  always seemed  to them ra-
tional enough, and even very intelligent in business.
One of  the prisoners in La Force,  who  occasionally
met  and talked with Jean-Pierre,  declared that his
conversation was often very  incoherent, and that in
some of the phases of the moon, his mind was much
excited.  But these  observations  were  made after
the arrest of the accused.  It  was his conduct at the
trial, however,  which,  more  than any thing else,
proved  that  the madness of Jean-Pierre was  only
assumed ; for there is perhaps not one of his answers
 that would have been given by a madman.  The fol-
lowing  are a few of them.
   Q. How old are  you ?—A.  Twenty-six years, (he
was forty-three).
   Q. Have you ever had any business  with Messrs.
 Pellene and Desgranges (two of his dupes) ?—A.  I
don't know them. 
 346    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XV.

    Q.  Do  you acknowledge  the  pretended notarial
 deed which you  gave  this witness ?—A.  I  do not
 understand this.
    Q.  You have acknowledged this deed before the
 commissary of police ?—A.  It is possible.
    Q.  Why, the day of your  arrest, did you tear up
 the bill for three  thousand  eight  hundred francs?—
 A. I don't recollect.
    Q.  You stated in your previous examinations, that
 it  was because the bill had been paid.—A. It is
 possible.
   To  many other of his own  depositions the accused
 answered,  in like manner, thai; he did  not  recollect
 any thing about them.
   Q. Do you  know this witness (the portress of the
 house  he lived in) ?—A. I don't know that  woman.
   Q. Can you point out any person  who  was con-
 fined in La Force with you and who can  give any
 account  of your  then  state  of mind ?—A. I don't
 understand this.
   Q.  You  made your escape  from the Bicetre ?—A.
 Was you there ?
   Q.  At what hour  did you  escape ?—A.  At mid-
 night—one o'clock—three o'clock.
   Q.  What road did you take?—A. That of Meaux
 en Brie.   (He took that of  Normandy).
   Q.  Can you tell us who set the Bicetre  on fire ?—
 A.  I do not know what you mean.
   Q. You wrote a letter to captain  Froyoff the day
after your escape from  the Bicetre ?—A.  I did not
write that letter.  (It was his own handwriting).
  When charged  with setting fire  to  the  Bicetre,
Jean-Pierre uttered  the  most horrid imprecations, 
CH XV.]         SIMULATED INSANITY.          347

and incessantly  interrupted  his  counsel and  the
advocate-general in their pleadings, with contradic-
tions, ridiculous remarks, and curses.
   § 252.  In commenting on  this case,  Georget ob-
serves, that "among those madmen who have not
entirely lost their senses, and Jean-Pierre is not one
of this  kind, probably  not one will be  found who
would mistake the persons with  whom  he has been
connected,—who would not understand  what a nota-
rial act is,—who would have forgotten his actions,—
who  would  not know  what was  meant when  a
memorable  event was  recalled  to  him, and who
would make such singular answers as those we have
quoted.   The latter appear  as  so  many contradic-
tions to those who are accustomed  to  observe  the
insane.  When  people have  completely  lost their
reason, they either do not reply to  questions at all,
or branch off to  subjects that have no relation  to the
questions  addressed to them.  I have seen  patients
whose understanding was reduced to a  few  isolated
sensations,  and  who recognised their  parents and
friends, and called them by name.   Some, it is true,
can recognise nobody, but they certainly  would not
have returned all the answers above-mentioned, and
their  mental disorder would  have  been  otherwise
characterized."1
   § 253.  The change that takes place  in the  moral
character of the insane, in their affections and desires,
furnishes an excellent test of the genuineness of any
particular case, inasmuch as  this fact hardly enters
1 D s Maladies Mentales, p. 61. 
348   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XV.

into the popular notions of this disease.   Perhaps no
character of mania, general or partial, is more com-
mon than that inversion of feeling, which is  mani-
fested  in reference to every person or thing, that
comes within the circle of the domestic and friendly
relations.  The  feelings  of the  parent,  child,  and
spouse,  seem to  be  completely  eradicated,  while
family loses  its  ties,  home its  endearments,  and
friends their kind and soothing influence.  Suspicion
takes the place of confiding trust ; jealousy, of love;
and fierce and hostile demeanor, of grace and suav-
ity of manner.  As the severity of the disease abates,
the current of the affections begins to resume its
ordinary direction, and no indication of improvement
is more to be relied on, than manifestations of regard
for those to whom they are bound by ties of intimacy
or relationship.   The  impostor  is  seldom aware of
these facts, and generally evinces no settled diminu-
tion of his attachment to his  family  or friends.  He
does not scruple  to show his ordinary fondness for
his children or parents, or if he  happen to be  aware
of the trait of insanity here described, and has sup-
pressed all such displays, the first menace of  injury
to these objects  of his regard, is  sufficient to  tear
away his disguise and disclose the rational and affec-
tionate man.   In the  conspiracies and hostile plans
that constantly perplex the madman's brain, his inti-
mate friends bear the most prominent part, while the
impostor always pitches upon those as the disturbers
of his peace,  with whom  he has had some previous
disagreement, or at least, no particular intimacy.
   § 254. In real mania  there  is generally more  or
less  insensibility to  the ordinary  proprieties and 
CH. XV.]         SIMULATED INSANITY.           349

decencies  of  life,  insomuch  that  those who were
formerly  noted for the  purity  of their  manners,
freely indulge in obscene  language  and filthy prac-
tices.  Indeed,  it seldom happens that in  general
mania the patient preserves the natural propriety of
his conversation and  manners,  and this  departure
from the ordinary character will go far  to distinguish
the real from the simulated disease.
   § 255.  If, as we have  endeavored to prove else-
where,  mania  arises  from  cerebral   disorder,  we
might  reasonably expect to  find  it giving  rise  to
physical disturbances of more  or less  moment, and
accordingly, in most cases, it actually  is manifested
by various pathological symptoms which no device of
imposture can ever imitate.  To say nothing of the
wildness of the eye,  and a certain strangeness of
expression, as  easily  recognised  when  once  im-
pressed on the  mind,  as  it is  difficult   to describe,
there is some  degree  of  febrile  action  which it re-
quires no  very labored examination to discover.  The
pulse will be found more frequent than in health, and
when this increased frequency is observed in doubtful
cases, it will furnish a strong collateral proof of the
genuineness of the mental disorder.  In the case of a
criminal  condemned to be executed who was sus-
pected of feigning madness, the  opinion of  the late
Dr. Rush  was requested,  and when  that critical  ob-
server of disease found the pulse twenty beats more
frequent than in the natural state, he decided, chiefly
on the strength of this fact,  that  the  prisoner was
really mad.1  Of course,  it is not to  be understood
1 Intrdductory Lectures, p. 369. 
 350    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XV.

 that  whenever the pulse remains at the natural stan-
 dard, the plea of madness is fictitious, nor vice versa;
 it is mentioned merely as a valuable means  in con-
 nexion with  others, of arriving at  correct  conclu-
 sions in doubtful cases.
   § 256.  Sleeplessness, which is so common in mania,
 is another of those symptoms, the presence of which
 would furnish conclusive proof of real  insanity, and
 though its absence would  hardly warrant  the  con-
 trary conclusion, it would  certainly produce  strong
 suspicions, and thus give additional  weight  to less
 prominent symptoms.  In  real  mania, the  patient
 will be days and even  weeks  without  sleep, while
 the simulator, if aware of this  feature of the disease,
 will be observed,  when faithfully  watched,  not  to
 protract his sleeplessness to any thing like the period
 which it commonly remains in  the real  disease.   In
 fact, in  spite of all  his  efforts, sound sleep will in-
 variably overtake him before the second or third day.
 Impostors almost always attempt to  imitate the noc-
 turnal restlessness and  disorder of maniacs, but the
 imitation is as different from the reality, as the occa-
 sional disturbance by sound  slumbers can make it,—
 a difference which it would require  but little watch-
 ing to establish.
  § 257.  Perhaps there is  nothing which  of itself
furnishes a better test in  doubtful  cases,  than the
manner of their invasion.  Well-marked, real  mania
almost never occurs suddenly, but  is preceded, as
has been elsewhere noticed, by a course of prelimi-
nary symptoms which  occupy  a  period of more or
less duration, and which, though they do not always
suggest to the beholder the suspicion  of derange- 
CH. XV.]          SIMULATED INSANITY.           351

ment, will, when the disease  has become indubita-
bly  established,  be recollected  as  having appeared
strange and unaccountable.  In  simulated  insanity,
on the contrary, the invasion is  as sudden as is most
frequently the occasion that leads to it.   The simu-
lator being unaware of the progressive nature of the
invasion, suddenly, in  the  midst of health,  startles
his  attendants by an outbreak  of the  most extrava-
gantly wild and furious conduct,  while the minutest
inquiries will fail to establish the previous existence
of any precursory symptoms. No instance of strange,
or eccentric conduct or language,  not the slightest
departure from the individual's  natural thoughts and
affections, or manner of manifesting them, nor  any
indication  of bodily derangement, will  have  been
observed  by those who  were  about his  person.
When, therefore,  the  disease  has come on in this
manner, it may be safely concluded, if there be any
other  the  least ground of suspicion,  that the  case
is one of simulation.
   § 258.  When other  tests fail, the habits and con-
stitutional  peculiarities of the individual  may some-
times furnish us with  valuable  information.  If, for
instance, the person have indulged in intemperate
drinking,   the  occurrence  of mental  derangement
would  be  no unnatural sequel to the sudden  absti-
nence  from  intoxicating drinks to which  prisoners
are generally  subjected.   If insanity  have been  a
disease of his family, more especially if it have been
manifested  in former periods of his life, when there
existed no motive for deception, there must be  addi-
tional evidence strong enough to counterbalance the
presumption drawn from this fact, to induce the be- 
352   MEDICAL JURISPRUDENCE OF INSANITY. [CII. XV.

lief that the case is one of simulation.  When too
the person  is  well  known  to possess an  irritable,
nervous temperament, inordinately excited  by moral
or  physical causes,  this fact will very  justly raise a
bias in his  favor, and  lead  us  to  require  so much
additional weight in  the proofs of deception, and its
force  will be strengthened by the consideration, that
the circumstances in  which  he  has been  recently
placed, are  of the very kind  most calculated to  pro-
duce the effect to which he is thus predisposed.
   § 259.  In real mania there is always an  extreme
irritability of temper which makes  the  person impa-
tient  of the least contradiction, and  is constantly
breaking out into furious gusts of passion, as sudden
as the  apparent causes are inadequate to account for
them.   This feature  of mania is not easily imitated,
and nothing  less than long personal observation  of
the insane,  joined with no inconsiderable powers  of
mimicry,  would enable the  simulator  to  arrive at
even an approximation to  the reality.   When there-
fore, the pretended  madman maintains his temper
under  various little  annoyances and contradictions,
or only displays a  clumsily-enacted  passion, it  may
be  pretty safely concluded that  he is  feigning the
disease.
   Persons feigning mania  lack the bold, unflinching
look of real maniacs ;  they never look the physician
steadily in the face,  nor allow him to fix their  eye,
and on being accused,  their  change of countenance
plainly betrays that they are  conscious of the nature
of the charge.   Dr.  Hennen<«peaks of an instance,
where a person feigning madness confessed  that he 
CH. XV.]         SIMULATED INSANITY.           353

could not support the inquiring  glance of the physi-
cian who examined him.1
   § 260. It is a well-known fact that in real mad-
ness, the system becomes singularly insensible to the
power of  certain medicines—particularly  emetics,
drastic purgatives, and opium.  -'A dose  of the last
article, which would not procure a moment's sleep to
a real maniac, would completely overpower the simu-
lator, and in doubtful cases the result  of this experi-
ment should be entitled to considerable weight.  The
same may also be said of experiments on the effect of
tartar emetic.
   § 261. Partial  insanity, in  consequence  of  the
superior difficulty of the attempt, is much less fre-
quently  simulated, and with a much smaller  degree
of success,  than  the  general form of the disease.
Those w7ho undertake  it " are deficient," says Has-
lam,  " in the presiding principle,  the ruling delu-
sion, the unfounded  aversions, and causeless attach-
ments which characterize insanity—they are unable
to mimic the  solemn  dignity of characteristic mad-
ness, nor recur to those associations which mark this
disorder  ; and they will want the peculiarity of look
which so strongly impresses an experienced  obser-
ver."2   The  mental  and  physical peculiarities of
partial mania are of a kind that do not  obtrude them-
selves on the observation, and instead  of loudly pro-
claiming the presence  of a crazed  condition  and soli-
citing the attention of the beholder, some investigation
is required before they are discovered.   All  this is
1 Principles of Military Surgery, p. 364.
3 Medical Jurisprudence of Insanity, p. 323.
           X 
354   MEDICAL  JURISPRUDENCE OF INSANITY.  [CH. XV.

contrary to the  purposes of the simulator, which
require that an immediate and powerful  impression
should be made on those in whose charge he is placed.
If however, in consequence of ignorance or presump-
tion, these difficulties are unknown or under-estimat-
ed, and  the  task of simulating partial  madness is
assumed, we have only to bear in mind  the charac-
teristic features of the affection, to detect the coun-
terfeit almost at  a glance.   In  real monomania the
patient never  troubles himself to make  the subject
of his delusion  square with other notions  with which
it has more or less relation, and the spectator wonders
that he can possibly help observing the inconsistency
of his ideas, and that when pointed out  to him, he
should seem to be  indifferent to or  unaware of this
fact.   In the simulator,  on the contrary, the expe-
rienced physician will detect an unceasing endeavor
to soften  down the palpable absurdity of his delu-
sions,  or  reconcile them with correct  and  rational
notions.   This too obvious  anxiety to produce an
impression,  strongly  contrasts with the reserve and
indifference of the  real disorder, and will, of itself,
furnish almost  conclusive proof of simulation.   "A
real monomaniac," says Marc,  "is strongly preju-
diced in favor of his opinions, the slightest contradic-
tion excites  his temper, while the simulator readily
overlooks this essential point in his part,  if the  con-
tradiction be  skilfully managed.   The  taciturnity
peculiar to the real subjects of monomania, frequently
leaves simulators at fault, since the complaints of the
latter when sure of being seen or heard, and their
repugnance at dwelling in solitude are not met with, 
CH. XV.]        SIMULATED  INSANITY.            355

or at least, not in the same degree, in  the others."'
In addition to these characteristics of this form  of
mental derangement, it may be remarked that many
of the peculiarities diagnostic of general mania, are
no less  so of partial mania, such as  sleeplessness,
insensibility to opium, and irritability of temper.
   § 262. Idiocy  and imbecility are sometimes simu-
lated,  and the imitation  would be  very likely to de-
ceive those not practically acquainted with these men-
tal affections ;  but the history of the individual and
his physical constitution furnish such conclusive proof
of the imposture, that the attempt is less successful
than  when  the other forms  of insanity are  selected
for simulation.   In genuine cases,  if the affection be
congenital, the history of the patient or form of the
head will establish this fact.  If it have occurred  at
an after period of life, the circumstances that have
occasioned it may be learned from the  acquaintances
of the patient.    If the  form of  the  head  present
nothing unnatural, it is to be supposed  that the men-
tal deficiency, if there  be any  in  reality, is of the
acquired kind, so that if the person pretends to have
been from birth in his present condition, this of itself
would be sufficient proof of imposition.  If however,
he is  capable  of referring his mental deficiency to
the influence of any particular  adventitious causes,
the practitioner  can determine for  himself,  in a cer-
tain measure, how far  these alleged   causes could
have  contributed to produce the condition  in ques-
tion.   If they appear  to be  plainly  and  palpably
1 Dictionnaire de Medicine: Article, Alienes. 
356   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XV.

inadequate, he has a right to conclude that the per-
son is  acting the part of an impostor.   It sometimes
happens that the simulator has  had frequent  oppor-
tunities  of  observing the manners of  an idiot or
imbecile, and possessing some  powrers  of mimicry,
is able to give a pretty faithful  copy of the example
he has studied.  But there is a  stupid vacant cast of
countenance in these affections,  which it is difficult,
if not  impossible to imitate well enough to deceive
one much conversant with this class of beings.  Full
as difficult  is it -to imitate  the unfixed, uncertain,
expressionless look, and the frequently and abruptly
fluctuating train of their ideas.  Zacchias offers as a
test of idiocy the pusillanimous  and submissive char-
acter of its subjects, but it is now well knowm that
most idiots are liable, on  provocation, to gusts of
furious, brutal passion, as transient as  they are sud-
den.   Imbecility presents such a diversity of mental
deficiency both in  kind  and degree, that the simula-
tion  of it  will baffle the scrutiny of  the  observer,
who is  not prepared for his task by a considerable
acquaintance with  the phenomena  of the  imbecile
mind.   In  the first degree of real imbecility there is
a singular  mixture of stupidity and shrewdness, in
the fraudulent  imitation  of  which, the vigilant  ob-
server  may discover  proofs  of simulation.   He will
find that on points directly involving the interest of
the simulator, he will display the full endowment of
the shrewdness compatible with  this condition, while
he reserves his stupidity for occasions where his own
interests are not particularly concerned.  In replying
to the questions put to him,  he will be careful, amid
all his  display of imbecility, to say nothing  likely to 
CH. XV.]         SIMULATED INSANITY.            357

favor  a belief of his  guilt in the matter which has
led him  to assume the part of an impostor.  What
he says is intended to leave an impression favorable
to his innocence, and this effect he will endeavor  to
produce  as far  as  he dares.   When  therefore, the
person  replies  to inquiries in such a manner  as  to
criminate himself, it may be pretty safely concluded
that the  imbecility  is genuine ; and though the con-
verse of this rule may not be  equally true, yet if the
whole tenor of his  replies has an exculpatory turn,
strong ground of suspicion at least is  afforded, that
all is not right.  Imbecility in the first  degree will
seldom be counterfeited  however, from  the  simple
fact, that the real affection seldom annuls the crim-
inal responsibilities of those  who are acknowledged
to be its subjects.
   § 263. Senile dementia may be simulated by aged
persons, but it  is so  imperfectly  known  as a distinct
form  of  insanity,  that  its peculiar features would
probably be  mingled with those  of general and par-
tial  mania, and thus lead to an easy detection.   If
the physician will  steadily bear  in  mind that senile
dementia is  essentially characterized by deficiency
of mental excitement, he will not be long in arriving
at the truth  in doubtful cases, for the simulator will
inevitably indulge  in  hallucinations, and  perform
physical  movements indicative  of excessive  mental
excitement.   The  principal  points that distinguish
this affection from mania may  be briefly recapitulated.
In senile dementia, the delusions are based on  some
previous event of life,  and though irrational, are not
always absurd.  The memory decays, first, relative
to recent events,  and  finally, to every thing  it had 
358   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XV.

previously stored up.   The senses lose their acute-
ness ;  the power of recognising persons, places and
things, fails at last, and has gone for ever ;  and one
looks in vain for the least exertion of thought.   The
whole conduct  and language are  indicative  of com-
plete childishness;  and in this second childhood, the
necessity of vigilance to prevent the miserable patient
from injuring himself or others, is no less imperative
than in the first.   In mania the delusions are gener-
ally absurd as well as irrational ;  the memory mani-
fests no decay, unless we except on subjects  that
relate  to  the predominant idea; the strength and
accuracy of the senses are unimpaired ; persons and
things are as readily recognised as ever ;  and  occa-
sionally the mind flashes forth with  more  than its
usual power and vividness.   At times the character
assumes its  natural  manliness and dignity, and the
individual conducts with a propriety and discretion
scarcely  to  be distinguished from those of perfect
soundness of mind.   Bearing in mind these  charac-
teristic differences which are  so little known to any
but medical  men, we  cannot be easily deceived by
the best managed  attempt at simulating  senile de-
mentia.
   § 264.  Homicidal insanity,  when  the  fact of its
existence  shall be generally recognised,  will un-
doubtedly, be  often falsely  pleaded in excuse  for
crime, and the task imposed on the physician in such
cases, will be  sometimes a  difficult and  a  delicate
one.  The characteristic and distinctive features of
this affection have been elsewhere  stated (§  162),
and it is to a knowledge of them w7e are to look for
the means of detecting its counterfeits ; and  though 
CH. XV.]         SIMULATED INSANITY.           359

our investigation may occasionally  result only  in
doubt and uncertainty, yet generally speaking, when
rightly conducted, it will lead us to the truth.
   § 265. Besides a  knowledge of the symptoms of
insanity, which will  enable  the  physician to detect
its simulation, his own ingenuity may often contrive
some plan for outwitting  the  pretender, and entrap-
ping him in his own toils.  To  perform the part of
an insane person, carrying through its numerous and
complicated phases, requires an endowment of the
imitative powers, seldom bestowed on any,  least of
all, on those who would have occasion to use  it for
such purposes, so that the measure  of ingenuity by
which it is maintained, is scarcely ever a match for
the devices which a shrewd and vigilant physican has
always at hand. In  the case  of a girl feigning mania,
Fodere informed the keeper in her presence, that if
 she were not better the  next day, he should apply a
 hot iron between her  shoulders.   This immediately
 produced a decided  amendment.  In the  Cyclopaedia
 of Practical Medicine, is related the case of a sailor,
 whose simulated madness was manifested by a vehe-
 ment desire to throw himself overboard, which, after
 being prevented for some time,  he was at last per-
 mitted to do ; immediately  on  reaching  the water,
 however, he swam  vigorously and called loudly for
 a boat.1  A device frequently resorted to, is to men-
 tion in the hearing  of the person some  symptom of
 madness which is easily imitated, as not being pres-
 ent ; at a  subsequent examination,  if the disease is
1 Article, Feigned Diseases. 
360    MEDICAL JURISPRUDENCE OF INSANITY. [CH. XV.

feigned, this symptom will certainly  be observed,
whether it is or is not a symptom  of  madness.  In
the English  naval  and military service, where the
medical officer is  often called on to deal with feigned
insanity, punishment is  much resorted to, on the
principle that if the affection be counterfeited, it will
be more efficacious than any thing  else in restoring
the impostor to his right mind ; and if real, it  will
do good by acting as a powerful  derivative.  If the
latter part of the alternative were true, nothing cer-
tainly could  be more proper than sound flagellation;
but if any thing,  more surely than another,  will push
a case of mental  derangement  beyond  the  reach of
curative  means,   it is  corporeal  punishment.   The
misery thus  produced is  poorly compensated by the
few cases of  imposture which  it may be the means
of detecting.  In  the following case,  however, where
this kind of  treatment  was used,  it  would  undoubt-
edly have been very proper had the disorder actually
existed ; and as it may serve as a guide to  the prac-
titioner in similar instances, a brief  notice  of it may
not be out of place in  this connexion.
   Jean Gerard,  a bold  villain, murdered a woman
at Lyons in 1829. Immediately after being arrested,
he ceased to  speak altogether, and  appeared to be
in a state of  fatuity.   He laid  nearly  motionless in
his bed, and  when food was brought, his attendants
raised him up and it was  given to him in that  posi-
tion.   His hearing also seemed to be affected.   The
physicians who were directed  to  examine him, con-
cluded that if this were actually what it appeared to
be, a paralysis of the nerves of the  tongue and ear,
the actual cautery applied to  the soles  of the feet, 
CH. XV.         SIMULATED  INSANITY.           361

would be a proper remedy.  It being used however,
for several days, without any success, it was agreed
to apply it to the neck.  For two days,  no effect was
produced, but on the third, while preparations were
making for its application, Gerard evinced some signs
of repugnance to it, and after some urging, he spoke,
declaring his innocence of the  crime of which he was
charged.  His simulation was  thus exposed.1
   § 266.  When required to examine and report upon
cases of suspected simulation, the medical man can-
not be too cautious in  arriving at  his final decision.
The judgment is not to be determined by any single
symptom however striking,  but every pathological
indication, every possible motive  to action, in short
the whole moral, intellectual and physical history of
the individual should be faithfully studied, before we
venture to make  up  our definite opinion.   Ample
time should be demanded for  this  purpose,  and un-
less it be granted, the  physician  would be  justined
in declining altogether the duty assigned him.  Oppor-
tunities must be provided of observing the simulator,
when, thinking  himself not watched,  he  throws off
the guise he has assumed (which he will do at such
times), and  returns  to his own  proper  character.
The physician should never forget, however, the ex-
treme perseverance and vigilance with which these
people manage their  impositions, and not be too
easily induced  to  regard them favorably in conse-
quence of the results which such  opportunities may
sometimes furnish. For they will often suppose they
1 Annales D'Hygiene Publique, vol. ii. p. 392. 
362    MEDICAL JURISPRUDENCE OF INSANITY.  [CH XV.

are watched at times when  they have  no means of
knowing whether they are so or not.  Fodere speaks
of a girl,  undoubtedly a simulator,  who committed
every kind of indecency in her cell; and another case
is related of some French prisoners of war, who car-
ried " their simulation to so exquisite a height, as to
eat their own excrement, even when shut up in their
cells,  suspecting that they might be overlooked." ]
In suspected cases, therefore, the persons should be
strictly, and as far as possible,  secretly  watched, in
order that in their moments of forgetfulness or sense
of security, they may be seen laying aside their false
colors, and suddenly assuming their natural manners.
That this will happen sooner or later in every case,
there cannot be a doubt, for  the mind  will instinct-
ively seek relief from the painful exertion and sense
of restraint, rendered necessary by  an elaborate at-
tempt  at deception, by  throwing off the disguise
that has been  adopted,  and again  returning  to its
natural condition.  Again we caution the practitioner
not to  be in haste to  form his  opinion,  but to wait
long and patiently, for  opportunities that may shed
new light on the difficulties before him.
1 Cyclopaedia of Practical Medicine; Article, Feigned Diseases. 
CH. XVI.]         CONCEALED INSANITY.          363
               CHAPTER  XVI.

              CONCEALED  INSANITY.

  § 267. It sometimes happens, that  when maniacs
have learned what notions  of theirs are accounted
insane by  others, and have  understanding  enough
left to appreciate  the consequences of their mental
condition,  they endeavor  to  conceal it,  for  the
purpose  of avoiding  the  effect of those measures
which the law prescribes.   If the address and inge-
nuity which they then manifest have occasionally
succeeded in baffling the scrutiny of the  most prac-
tised  experts, it is not strange that common observ-
ers should  have been frequently deceived, and that
some of the medical profession  even, with a know-
ledge of this fact before their eyes, should have been
outwitted by their manoeuvres.  When it is consid-
ered, that the insanity of many consists in a few in-
sane notions, which do  not to all  appearance affect
their  general conduct and conversation, the difficulty
of concealing it,  by  professing  to  have renounced
their  belief in these notions, is perhaps  not  greater
than that which attends the accomplishment of most
of their designs.   Their task  too  is  materially les-
sened, it is to be recollected,  by the prevalent error,
that madness is inseparable from boisterous behavior
and complete disorder of the  ideas.  At the com-
mencement of the French Revolution, when the mob 
364  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XVI.

broke into  the lunatic hospitals, for the purpose of
liberating  those  among  their  inmates whom they
supposed to be unjustly  confined,  many recounted
their wrongs so clearly and  connectedly,  that they
were deemed at once  to be  victims  of oppression,
and ordered to be released.  Their conduct, on being
set free, soon convinced these enlightened champions
of their race,  that those who had put  them  in con-
finement, had, what they themselves had  not, some
reason for their measures.  Lord Eldon once related
that after repeated conferences and much conversa-
tion with a lunatic,  he was persuaded of the sound-
ness of his understanding, and prevailed on Lord
Thurlow to supersede the commission.  The lunatic,
calling  immediately afterwards on  his counsel to
thank him for his exertions,  convinced him in, five
minutes, that the  worst thing he could have done for
his client, was to get rid of the  commission.1   In
another place  (§ 21), will be  found  a case  which
well illustrates the adroitness and perseverance, with
which  maniacs will  sometimes conceal their mental
derangement.
   § 268. In England and in this country, the choice
of the  means for establishing the existence of insan-
ity when concealed, is  left  to individual sagacity.
This, no doubt, is sufficient, where great  practical
acquaintance  with   insanity  readily   suggests  the
course  best adapted to each particular  case, but the
great majority of  medical men  will feel the need of
some system  or order of proceeding,  that will sim-
1 Ex parte Holyland, 11 Vesey's Reports, 11. 
CH. XVI.]         CONCEALED INSANITY.          365

plify their inquiries and render them more efficient.
The French arrange their means into three general
divisions or classes, which are made use of, each in
succession, when the  preceding class has failed of its
object.   They are  called the interrogatory, the con-
tinued observation,  and the inquest, and  as  no better
arrangement has ever been offered,  it  may be well
to describe it ;  and it may be added in passing, that
it would materially conduce to our success in inqui-
ries of this kind, if they were always pursued in the
course here indicated.
   § 269.  Interrogatory.—The  interrogatory  em-
braces only  those  means of information,  which are
applicable in a personal interview with the patient.
After learning generally his  moral  and intellectual
character, his  education  and habits of living, the
duration and nature of his mental delusion (if it can
be ascertained from his acquaintances), and the state
of his relations to others,  and after observing the
expression of his  countenance, his demeanor and
general  appearance,  we may proceed to  a direct
examination  of his case.   In the  first place,  it  is
necessary to lull his suspicions and  remove his dis-
trust, as far as possible, by a free and  courteous de-
portment,  and an air of kindness and  unaffected
interest  in his welfare.  He should  then be engaged
in conversation, which  should lead  him by easy and
imperceptible transitions to  the particular subject on
which his mind  is deranged ; and the manner in which
he treats it should be  carefully  observed, for  if he
is really insane on that point, he will probably avow
it;  while  if he is not so, he will  take the  opportu-
nity to declare  his disbelief in the  notions imputed 
366  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVI.

to him, and bring forward various considerations to
support the truth of his assertions.   He should be
led to speak of his relatives and friends, especially
if they have taken any part in provoking his inter-
diction, or  otherwise  interfered  in his affairs, and
here he will need all his self-control to restrain him-
self from the angry and revengeful feelings which he
entertains towards them.  When confined in hospi-
tals or other lunatic  establishments, we should not
fail to ask how they like their  situation, and  what
they think of their companions ; for Georget observes
that many even of those  the least deranged, are such
poor observers, or have so little penetration, that they
are ignorant of the nature of their abode, and the
character of those around them.  When the  mental
disorder is  that of imbecility or dementia, we  must
not confine our questions to the simple topics of their
present condition or feelings, for they may be able
to answer them clearly  and rationally,  when sub-
jects requiring a little  more reflection  or exertion of
memory, may  be  far  beyond their comprehension.
It not  unfrequently  happens  that  the  mental  defi-
ciency affects  the faculties of the  mind unequally,
degrading some to the scale  of idiocy  and  leaving
others in a  state of tolerable strength and develope-
ment.   When, therefore, the capacity  of the mind
is in question, whether for interdiction  or any other
purpose, we must  not fail to test  the soundness of
all the faculties, by inquiries relative to the  objects
with which they are respectively  concerned,  since,
if satisfied with a partial examination, we may grossly
deceive ourselves and  injure the interests of others.
True, this requires a knowledge of the mental  consti- 
CH. XVI.]         CONCEALED  INSANITY.          367

tution  not possessed  by every  one charged with
this  kind of investigation ; but the deficiency, com-
mon as it is, proves nothing against  the  importance
of this knowledge.
   §  270.  The importance of the above  suggestions
is  strikingly  shown  by  the  case  of a young  man,
B----, noticed  by  Dr. Abercrombie,1  and  Dr.
Combe,2 which occasioned much trouble and litiga-
tion to  the  parties  concerned.   This  person was
educated for the church, and had  made  such profi-
ciency in  the  study  of Latin and Greek, that,  for
several years, he acted as a tutor in these languages.
He also displayed great  keenness and adroitness in
driving a bargain.  When, however, his mind was
directed  to those studies and  topics, which require
the exercise of the higher powers of the  intellect, he
was found so deficient that  he utterly  failed in his
second examination before the  presbytery, in which
his reasoning powers were tasked,  though the first,
which was in the languages,  he passed  successfully
and  creditably.   It was found,  too,  that  he  was in-
capable of comprehending the  relations  of business,
or even performing the ordinary duties of life.   Ac-
cordingly, it appeared in the course of the law-pro-
ceedings,  that those  witnesses  who  knew him only
as a linguist or a purchaser, did not  hesitate to pro-
nounce him an able, clever  man; while those who
had  business transactions with him that  called his
reflective powers into action, had no doubt whatever
of his imbecility.
1 On the Intellectual Powers.
2 On Mental Derangement, p. 244. 
368  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVI.

   § 271.  The interrogatory is sometimes sufficient
of itself, to establish the existence  of madness ; but
it oftener  fails of accomplishing its purpose, and we
are obliged to resort to other means.  General moral
mania will inevitably elude its  scrutiny, this kind of
derangement being exclusively manifested in the con-
duct, for the folly and  extravagance  of which  clear
and plausible reasons are always at hand.   No  defi-
nite conclusion in favor of the mental soundness of
the individual in question,  can be  drawn from the
result of the interrogatory, unless confirmed by those
of  the  subsequent  measures.   The correctness  of
this rule  was strongly contended for, even in the
time  of D'Aguesseau,  who  declares that however
wise and rational under the interrogatory, yet if the
fact of insanity is proved by a multitude of particular
acts and the  general tenor of conduct, interdiction
must be pronounced.1
  § 272.  Continued observation.—A systematic course
of observations continued for some time, may estab-
lish the fact of insanity in doubtful cases,  after seve-
ral  personal interviews have completely failed.   Op-
portunities, therefore,  should be demanded for visit-
ing the patient freely and frequently  ;  for watching
him at times  when he supposes himself unobserved ;
and for  exercising  a general surveillance  over his
conduct and conversation.  Those about him should
be enjoined to watch his movements,  and  he should
often, but cautiously, be led to  speak of the motives
of those who are anxious  to  prove his insanity.  It
1 Oeuvres Completes, t. iii. p. 592. 
CH. XVI.]         CONCEALED INSANITY.          369

often happens too, that those who are most  success-
ful in concealing every indication of disordered mind,
in their conversation, will betray themselves the mo-
ment they commit  their  thoughts to paper.  They
should be induced, therefore, to write letters to their
friends describing their present situation, and to  pre-
pare statements of  their  wrongs and grievances, and
thus we may be readily  furnished  with  instances of
incoherence and  folly, which  the  patient had  self-
command enough to withhold, when put  on his guard
by questions which he knows well enough are de-
signed to entrap him.   " The rapid transitions and
odd unions  of discordant  subjects,  the  relations of
things which have not happened, and could not  have
happened, are in many cases very remarkable ; and
a forgetfulness of common modes of spelling,  or of
the arrangement of the letters of words well-known,
will be  evinced by maniacs  who have been  well
educated, and who would  commit  no such mistakes
but for their malady." *
   § 273. Inquest.—When the above means fail, our
 inquiries must take a wider  range and be directed
 to the previous history of the patient, as made known
 to us by the testimony of friends and relatives, and
 those who have been connected with him in business,
 or had any other good opportunity of becoming ac-
 quainted with his mental condition. " The Inquest,"
 says Georget, "consists  in  collecting information
 respecting the patient's condition  before  and  after
 the presumed disease, and the causes  suspected to
1 Conolly: Inquiry concerning the Indications of Insanity, p. 469.
            Y 
370   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVI.

have impaired his mind.   For this purpose, we con-
sult his writings, and recur to the testimony of those
who have been about him and conversed with him;
who have been able  to observe him closely  and to
witness his insane  actions  and irrational  discourse.
We should be particularly careful however to require
of witnesses, facts rather than opinions.1  We should
ascertain if madness  be  a disease  of the family ; if
he have already evinced a  degree  of singularity in
his moral and intellectual character, or exaltation of
any kind ; if he have been  exposed  to the influence
of powerful causes, such as chagrins, severe and re-
peated crosses, reverses of fortune, &,c. ; if, without
any real  motive, he has manifested any change of his
habits, tastes, or affections ;  in short, we should in-
quire into all those circumstances which so frequently
precede the developement." 2  We are to look into
his business transactions, his management of family
affairs, his conduct in the domestic and  social  rela-
tions, and the part he has taken in public scenes and
duties.    His letters  and  written  communications
should be closely scrutinized,  especially those that
have any reference to the state  of his health,  or to
the legal  measures that have been taken against him,
for here  we  may meet  with  incoherent  and foolish
ideas,  that we have found nowhere  else.   In short,
no source of information likely  to  enlighten us on
the subject of the patient's mental condition, should
be  suffered to go  unexplored.   If the means thus
1 See llathorn v. King, 8 Mass. Reports, 371.
 Des Maladies Mentales, p. 57. 
CH. XVI.]         CONCEALED INSANITY.          371

indicated are faithfully used—if the whole life of the
individual have passed in review before us, and after
all, we are unable to prove the patient's insanity be-
yond a doubt,  we are bound  to  conclude that his
mind is sound, or at least, that he is not a proper sub-
ject  of legal interference.   This conclusion will be
no less proper, even  though we still  entertain  some
doubt of his  mental soundness,  for if he have suffi-
cient self-control and  penetration to enable him to
conceal his mental impairments and  conduct himself
rationally, but little  harm will  probably arise from
leaving him at present to his own discretion. 
372  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVII,
                CHAPTER  XVII.

                     SUICIDE.

   § 274. At the present day the subject of suicide
 is deprived of much of the medico-legal importance
 which it once possessed.  Still,  however, as ques-
 tions occasionally come up in which dispositions of
 property are made  to depend on the judicial views
 which are formed respecting  its  relations to mental
 derangement, it is highly proper that mistakes should
 not be committed from a want of correct notions of
 its nature.   With all the light on the subject which
 the  researches of modern inquirers have elicited,
 many probably are yet unable to answer understand-
 ing^ the question  so often started, whether  suicide
 is always or  ever  the  result of insanity.  It  may
 be proper,  therefore, to lay  before the reader the
 present state of our knowledge on this  subject,  in
 order  that he may  have the materials  for forming
 correct and well-grounded opinions respecting it.
   §  275. To  the healthy and well-balanced mind,
 suicide appears so strange and unaccountable  a phe-
 nomenon, that many distinguished wrriters have in-
 considerately regarded it as in all  cases, the effect of
 mental derangement; while, by many others, it has,
 with still less reason, been viewed as always the act
 of a sound, rational mind.  Neither  of these views
can be supported by an impartial consideration of all 
CH. XVII.]
SUICIDE.
373
the facts, and the truth probably lies  between  the
two  extremes.   Suicides  may be  divided  into two
classes founded upon the different  causes or circum-
stances by which they are  actuated.  The first in-
cludes those who  have deliberately committed the
act from  the force of  moral motives alone ; the se-
cond, those who have been affected with some patho-
logical condition of the brain, excited or not by moral
motives.
   §  276. If it be considered that life is not the only
nor perhaps the best gift we have received  from the
author of our being, it ought  not to appear strange
that men should sometimes be willing to relinquish
it for the sake  of securing  a  good, or avoiding an
evil.  We know well enough that life  is not so dear
that it will not be readily sacrificed,  when all that
makes it worth retaining is taken away. The intrepid
Roman chose rather to fall on his own sword, than
survive the liberties  of his country or live an igno-
minious  life ; and reverses of fortune which hurl men
from the pinnacles of wealth or power, or the  cer-
tain prospect of infamy  and  the world's  scorn, are
no  very inadequate motives for  terminating  one's
existence.  In  these cases,  the person,  no  doubt,
may act from error of judgment,  and thus be guilty
 of foolish and stupid conduct, but  we have no right
 to confound such error with unsoundness of mind.
 Inasmuch  as the prospect  before him may be  such
 that it will appear to his mind more painful to live
 than to  die, it is not to be wondered at, if, for want
 of courage to bear up against the  ills that threaten
 to overwhelm him, and battle it to the last, he should
 prefer  the latter ;  for,  after all, the choice might 
374  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XV11.

indicate less folly than that which often characterizes
the conduct of men.  True, the motive  may seem
sometimes totally inadequate to lead to such a deter-
mination,  when in reality  it may  be the only and
sufficient  motive ;  and,  this,  probably,  must al-
ways continue to be  one of the mysterious  facts in
our constitution, that the termination of our exist-
ence, from which  we instinctively shrink with feel-
ings of horror, should so often be voluntarily hastened
from the most trivial and insignificant motives.  No
doubt the  mental  disturbance  is always  great, but
the same may be affirmed of all cases where crime
is committed under the excitement of strong passions,
and  therefore is in  itself no proof of insanity.  It
cannot be  denied, however,  that the cases are com-
paratively few in regard to which it would be safe to
affirm,  that the excitement of the organic action of
the brain and nervous system, which  accompanies this
perturbation of mind, had not transcended the limits
of health and passed into real pathological irritation.
Among these few we can have no hesitation in plac-
ing the case of the pair  of youths  noticed by Mrs.
Trollope, who, after dining sumptuously at a fashion-
able restaurant at  the expense of their entertainer,
went to their  lodgings,  and suffocated  themselves
together in the same bed ;! or that of suicidal clubs,
the members of which bind themselves to die by their
own hands within an appointed  time.   Men, who,
with cultivated intellects  and refined passions, enter-
tain only the meanest conceptions of the great moral
1 Paris and the Parisians. 
CH. XVII.]
SUICIDE.
375
purposes of life, are ready to terminate their exist-
ence the moment it ceases to impart its usual zest to
sensual gratification.  Here,  self-destruction is obvi-
ously,  not the effect of physical disease, but of moral
depravity.   But how are we to account for those in-
stances of juvenile suicide so  often recorded, where
the dreadful propensity is excited by the most trivial
causes ?  Burrows speaks of a girl, but  little over
ten years of age, who, on being  reproved for some
trifling indiscretion, cried and sobbed bitterly, went
up stairs and hung herself in a pair of cotton braces;
and of another, eleven years old, who  drowned her-
self for  fear  of a simple  correction.1  A French
journal has lately reported the case of  a boy twelve
years old, who hung himself by fastening  his  hand-
kerchief to a nail in the wall, and passing a  loop of
it around his neck, for no other  reason, than because
he had been shut up in his  room  and  allowed only
dry bread, as a punishment for breaking his father's
watch.  The  same journal gives another case of
suicide committed by a  boy eleven years old, for
being reproved by his father; and several more of a
similar description  are also recorded.2   In these
cases,  the moral causes  seem altogether inadequate
to excite the suicidal  propensity, without first pro-
ducing some serious physical disturbance, for here
are none of those motives for self-destruction which
have just beeen mentioned, as  influencing the adult
mind.
1 Commentaries on Insanity, p. 440.
2 Medico-Chirurgical Review, N. S. vol. xxvii. p. 212. 
376  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XVII.

   § 277.  That suicide is often committed under the
impulse of mental derangement, even when  mental
derangement would not otherwise have been suspect-
ed, is a doctrine that was long since taught by some
medical writers, and has been confirmed  beyond the
shadow of a doubt, by the  researches of recent in-
quirers.   The propensity to  suicide connected with
an obviously melancholic disposition,  is now univer-
sally recognised  as  a form  of  monomania,  for its
symptoms are plainly indicative of cerebral derange-
ment.  These patients labor under a constant melan-
choly, conjuring up  the darkest  prospects, and pre-
saging nothing but evil fortune.   They have been
guilty  of  some sin, real or  imaginary,  which  they
believe to be of the most heinous nature, and thence-
forth there is no more happiness  nor comfort  in the
world for them.   They imagine their  friends  are
constantly watching  their  movements and engaged
in machinations against them, or  silently neglecting
and despising them.   At one time, morose and  taci-
turn ; at another, uttering the most bitter complaints,
weeping  and traversing  the  room,  as if  in extreme
mental anguish.  If  their thoughts  take  a  religious
turn, they imagine they have committed  the unpar-
donable sin, that their prayers are rejected, that the
Saviour turns away his face  from their  sight, and that
the miseries of the damned are to be  their everlast-
ing portion.   This unquiet and melancholic mood
will occasionally give way to  short  periods of com-
parative cheerfulness, when  the clouds seem to be
breaking away, and the individual approximating to
his natural character.  Their nervous system is weak
and irritable,  the circulation is quickened, the diges- 
CH XVII.]
SUICIDE.
377
tion more or less impaired, the secretions, especially
the biliary, more or  less deficient, or  vitiated, and
the mind is incapable of continued exertion.   After
this state has continued for some time, the mental
derangement  becomes   more  prominent,  and  the
wretched victim begins to  see  visions  and hear
strange voices, and believes that  he has  communi-
cations from superior beings.   All this  time the idea
of self-destruction is frequently, if not constantly be-
fore  the mind, and unless  the patient  be  narrowly
watched,  he will finally succeed, after various at-
tempts, in accomplishing his purpose.
   § 278. The suicidal propensity here described is
universally attributed  to  pathological causes ;  but
there is, besides, a large class of  cases, in which no
insanity of mind or body has been observed or sus-
pected, though we  have good reason to believe its
existence.  That one  may be so harassed with the
ills of life, as to deem it best to rid  himself at once
of both, is not perhaps very strange ; but when  a
person apparently in good health, and  surrounded
with  every thing that  can make  life  dear to him,
deliberately destroys  himself  without any  visible
cause, no  balancing  of motives,  or  scrutiny of  pri-
vate circumstances, can satisfactorily explain it, and
we are obliged  to consider  it as a form  of partial
moral mania.  Within a few years past, the attention
of the medical  profession has been directed  to  this
subject, and their researches have abundantly estab-
lished the fact, that the efficient cause is some patho-
logical change, or physical peculiarity, not in every
case easily defined or understood, but  none the  less
certain on that account. 
 378*  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVII.

    § 279.  Sometimes  this  monomania  is  attended
 apparently by no physical or moral  disorder,  the
 individual being  driven  by mere  impulse to self-
 destruction,  without  being  able to assign any reason
 therefor, real  or imaginary.   He  feels that he is
 urged on by an  impulse  he can neither account for
 nor resist, deplores his sad condition, and beseeches
 his friends to protect him from  himself.   In another
 class of cases, some powerful physical or moral  im-
 pression only is needed, to call the  suicidal propen-
 sity into fatal activity.   The wonderful  effect  of
 mental influences on  diseases of the  bodily organs,
 is so common a fact, that  we have no rational ground
 for disbelieving a similar  kind of agency  in the pro-
 duction of this phenomenon.  Thedistinguished accou-
 cheur, who attended  the princess Charlotte  in her
 fatal confinement, observed a pair of pistols  in  the
 room to which he had retired for repose,—the sight
 of which was sufficient, to a mind harassed by long
 and anxious attendance, and  overwhelmed,  as  it
 were, by the responsibilities of his situation, to pro-
 voke  a desire1—which he may  never  have felt be-
 fore—to die  by his own  hands.  The  case  of Sir
 Samuel Romilly, who committed suicide immediately
 after  sustaining  a severe  domestic  bereavement,
 strongly shows how  far the propensity  to commit
 this act is  beyond the control of moral principle or
 christian virtue,  even when, as it  was  with him,
previously  contemplated  and  conditionally  deter-
mined  upon.
  § 280. Among  the  features  which  ally the pro-
pensity to suicide with ordinary  mania, is that of its
hereditary disposition.   Dr. Gall knew several fami- 
CH. XVIL]             SUICIDE.                 379

lies in which the suicidal propensity prevailed through
several generations.  Among the cases he mentions,
is the following very remarkable one.  " The  Sieur
Ganthier, the owner of various houses built without
the barriers of Paris,  to be  used  as entrepots  of
goods, left seven children and a fortune of about two
millions of francs  to be divided  among them.  All
remained at Paris or in  the neighborhood, and pre-
served their patrimony ;  some even  increased it by
commercial  speculations.  None of  them met  with
any real misfortunes, but all enjoyed good  health,  a
competency, and general esteem.  All however, were
possessed with a rage for suicide, and all seven suc-
cumbed to it within the space of thirty or forty years.
Some hanged, some drowned themselves, and others
blew out their brains.   One  of the  first two had in-
vited sixteen  persons  to dine with him one Sunday.
The company collected,  the  dinner was served, and
the guests were at  the  table.  The master of the
house was called, but did not answer,—he was found
hanging in the garret.   Scarcely an hour before, he
was quietly giving orders to  the servants,  and chat-
ting with his friends.  The last, the owner of a house
in the rue de Richelieu,  having raised his house two
stories, became frightened at the expense, imagined
himself  ruined, and was  anxious   to  kill himself.
Thrice they prevented him, but  soon after he was
found dead, shot  by a pistol.  The estate, after  all
the  debts were paid, amounted to three hundred
thousand francs, and  he  might have been forty-five
years old at the time of his death.
   "In the family of M.  N. * * *,  the great-grand- 
380  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVII.

father,  the  grandfather, and the father  committed
suicide." J
   § 281. Fabret,  whose researches  have  thrown
much light on this affection, believes  that it is  more
disposed to be hereditary  than any other kind  of
insanity. He saw a mother and her daughter attacked
with the suicidal melancholy, and the  grandmother
of the latter was at Charenton for  the  same cause.
An individual,  he says, committed suicide  in Paris ;
his brother who came to attend the funeral, cried out
on seeing the body—" What fatality ! My father and
uncle both  destroyed  themselves  ; my brother has
imitated their example ;  and twenty times during my
journey hither, I thought of throwing myself into the
Seine."2
   § 282. Gall  also  relates  the  case  of a dyer of a
very taciturn humor, who had five sons and a daugh-
ter.   The eldest son,  after  being  settled in a pros-
perous business with a  family around  him, succeeded,
after many attempts, in  killing  himself by jumping
from the third  story of his house.   The second son,
who was rather taciturn, had some domestic troubles,
lost part of his  fortune  at play, and strangled himself
at the age of thirty-five.  The  third threw himself
from the window into  his garden, but did not hurt
himself; he pretended he was  trying  to fly.  The
fourth tried one day  to fire a pistol down his  throat,
but was prevented.   The  fifth was of  a bilious,
melancholic temperament,  quiet, and devoted  to
business ; he and his sister  shew no signs of being
1 Functions of the brain, vol. iv. p. 213.
1 Sur la Hypochondria et Suicide. 
CH. XV1L]
SUICIDE.
381
affected with their brother's malady.  One of their
cousins committed suicide.1
  § 283.  Like other kinds of mental derangement,
the suicidal propensity undergoes occasional exacer-
bations, from the influence of the seasons, periodical
congestions, &c.  The patient, perhaps, may have
thrown off  some of  the gloom which overshadowed
his mind, resumed a portion of his ordinary  cheer-
fulness  and interest in his  affairs, courted the com-
pany of his friends, and thus excited strong expecta-
tions of a perfect cure, when suddenly his  malady
breaks  out afresh ; the  sentiments  are  again per-
verted, the judgment disturbed, his breast torn with
anguish and despair, and the utmost  watchfulness is
necessary to prevent him  from  accomplishing his
fatal designs.
   § 284. Another trait which the suicidal propensity
possesses  in  common with  some nervous diseases,
though not insanity, is its disposition to prevail epi-
demically,  as it were, in consequence of that  law of
 our constitution, not well understood, called  sympa-
 thy.  It  is a matter of common observation, that the
 occurrence of one case of suicide is followed,  oftener
 than not, by one or more in the same community.  In
 a sitting  of the Academy of Medicine at Paris a few
 years since,  it  was mentioned by M. Costel  that a
 soldier at the Hotel des Invalids having hanged him-
 self on a post, his example was followed  in  a short
 time, by twelve other invalids, and that by removing
 this fatal post, the suicidal epidemic  was arrested.
1 Op. cit. sup. vol. iv. p. 216. 
 382   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVII.

 It is related that  thirteen hundred people destroyed
 themselves in Versailles in 1793 ; and that in one
 year,  1506, sixty perished by  their own  hands in
 Rouen.1
   § 285. The analogies, thus presented between the
 suicidal propensity and insanity or other nervous dis-
 eases in its symptoms, are also strengthened by the
 pathological changes observed after  death.   In the
 larger proportion of instances where examination is
 made, the brain or abdominal viscera are found  to
 have suffered organic lesions, more or less extensive,
 which, when confined to the latter, have affected the
 mind by sympathetic irritation.   Even in those cases
 where the fatal act was preceded by no  indications
 of disease,  or  other symptoms  that excited suspi-
 cions that the  individual  wras tired of life, dissection
 has often revealed the most serious disease, which
 must  have existed for  some time previous to death.
 True, the most careful dissection will sometimes fail
 of revealing the slightest deviation from the healthy
 structure, and  it is not necessary to  the support  of
 the above views of the  nature of this affection, that
 it always should.  For here, as in mania, sometimes
 the pathological change may not  have  gone beyond
 its primary stage,  that  of simple  irritation, which  is
not appreciable to the senses, but the existence  of
which we are bound to believe on the strength of the
symptoms.
1 Burrows's Commentaries on Insanity, p. 438, 
CH. XVIIL]  LEGAL CONSEQUENCES OF SUICIDE.     383
               CHAPTER  XVIIL

         LEGAL CONSEQUENCES OF SUICIDE.

  § 286. By the  common law of England, afelo de
se forfeited all chattels, real or  personal, which he
had in his own right,  and  various other property,
and his will  became void as to personal property.1
Such  severity has  been generally avoided  by the
almost universal practice of coroners'  juries return-
ing an inquest of  insanity.   At  present,  the fact of
suicide has no other importance, than what it derives
from  its  connexion with  the mental  derangement,
which may  be supposed  to have  given rise to it.
Courts would very justly refuse to  consider  it as
sufficient proof of insanity,  in the absence  of other
proofs,  because  it might  have  been the act  of a
rational mind, and because too if it really did spring
from insanity, the delusion  might have  been so cir-
cumscribed, as not to have perverted  the judgment
in regard to testamentary dispositions and other civil
acts.   The  principle  adopted in the ecclesiastical
courts is, that  in cases of doubtful  sanity—among
which those of suicide must always be ranged—the
validity of the individual's testament  must be deter-
mined solely by  the  character of that  instrument
itself.  Here is an inherent difficulty, that courts will
1 Blackstone's Commentaries, vol. iv. p. 190. 
384  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XVIL

never be very anxious to encounter, and, that is,  to
determine  the exact connexion of suicide  with in-
sanity—supposing the latter to be admitted—in point
of time.   When  this act  is the only proof we have
of  mental  derangement,  we are  left without the
means of ascertaining when this condition began to
exist or to disappear, and consequently nothing can
be more difficult  than to decide within  what  time,
either  before or after the suicidal attempt, the indi-
vidual can be pronounced insane.  It not uncommonly
happens that a person  kills  himself, or  makes the
attempt, shortly after  making his  will,  when the
question requires a  judicial decision, whether or not
the insanity which led to the  fatal act,  existed at the
time of making the  will.   The  practice has  usually
been,  if there were  no  other evidence  of unsound
mind, either in his conduct or conversation, or in the
testamentary dispositions themselves, not to impeach
the testator's sanity. In Burrows v. Burrows, it was
held by Sir John Nicholl, that  where  there was no
evidence of insanity at  the time of giving instruc-
tions for a will, the  commission  of suicide  three days
afterwards, did not invalidate the  will, by raising an
inference  of previous derangement.1   Chief justice
Parker also held  that suicide, committed fifteen days
after the date  of the person's will, was  not sufficient,
in the absence of other evidence, to prove him insane
and thus invalidate the will, on  account of the diffi-
culty we have just mentioned.2
  1 Burrows v. Burrows, 1 Haggard's Eccl. Reports, 109.
  2 His language was, that, " even if the act itself [suicide], should be
considered as proof demonstrative that the  reasoning faculty was dis- 
CH. XVIIL]  LEGAL  CONSEQUENCES  OF SUICIDE.     385

   § 287. Where, however, the  unreasonableness of
the will  itself raises a suspicion of the testator's san-
ity, the act of suicide within a  short time will  al-
ways  be strongly  confirmatory of it, and, in connex-
ion with  attending  circumstances,  may,  in some
instances,  turn suspicion into conviction.  There will
be little  danger of going wrong   in any cases of this
kind, if  we are  willing to be governed in our decis-
ions by the principles of equity  and  common sense,
rather than by technical distinctions  and antiquated
maxims.  If the will be  a rational act rationally done,
a suicidal  act or attempt ought  not to invalidate it,
because the presumption is, either, that the will was
made before the mind became impaired, or that  the
derangement was of a kind that  did  not prevent the
judgment  from  using its ordinary discretion in the
final  disposition of property.  If, on the contrary, it
be an unreasonable act, and especially if  it  be  con-
trary to the previously  expressed intentions of the
testator, then the act of suicide will be in itself strong
proof, that the mind  was  impaired  at  the  time of
making  the will.
turbed at the time of its commission, the difficulty of ascertaining with
precision the very inception of derangement, weakens its force in rela-
tion to any antecedent act."  Brooks and others v. Barrett and others,
7 Pickering's Reports, 94.
Z 
386   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIX.
               CHAPTER  XIX.

                 SOMNAMBULISM.

  § 288. Whether this condition is really any thing
more than a cooperation of the voluntary muscles with
the thoughts which  occupy the mind during sleep, is
a point very far from being settled among physiolo-
gists.   While to some, the exercise  of the natural
faculties alone seems to be sufficient  to explain its
phenomena, others have deemed it necessary to sup-
pose,  that some new and  extraordinary powers  of
sensation are  concerned in its  production, though
unable to convey a  very clear  idea  of their nature
or mode of operation.  Without discussing this ques-
tion here, our purpose will be answered, by  inquiring
how far the natural  faculties are exercised during its
continuance, and thus  ascertaining, as  well as may
be,  in what respect  it differs from the sleeping and
the waking states.
  § 289. Not  only  is locomotion enjoyed,  as the
etymology of the  term signifies,  but  the voluntary
muscles are  capable of executing motions  of the
most  delicate  kind.  Thus the somnambulist will
walk securely on the edge of a  precipice, saddle his
horse and ride off at a  gallop,  walk on siilts over a
swollen torrent, practise  airs on  a  musical instru-
ment ; in short, he may read, write, run, leap, climb, 
CH. XIX ]
SOMNAMBULISM.
387
and swim, as  well  as, and sometimes,  even better
than when fully awake.
  § 290. The extent,  to which vision is exercised,
differs in different cases.   In  one  class of cases, it
is very certain that the somnambulist does  not use
his eyes in the various operations which he performs.
Negretti, an Italian servant, whose celebrated history
is related by two different  physicians, would rise in
his sleep, go into the dining-room, spread a table for
dinner, and  place himself behind a chair with a plate
in his hand, as if waiting on  his  master.  When in
a place with which he  was not  perfectly  acquainted,
he was embarrassed in his proceedings, and felt about
him with his hands ; and  sometimes he  struck him-
self against  the wall and was severely injured.   He
sometimes carried about with  him a candle as if to
give him light, but  when  it was taken  away and a
bottle put in its place,  he  failed to perceive the dif-
ference.1  Galen says of himself, that he once walked
about a whole night in his sleep, till  awakened by
stumbling against  a stone which  laid  in his  way.
Here, it  appears  that the long-continued  habit of
performing certain operations enabled the individual,
with the aid of feeling alone,  to  repeat them in his
sleep.
  At other times, objects are  clearly discerned, but
the  imagination  transforms  them  into  those  with
which the mind happens,  at  the  moment, to be en-
gaged.  Thus, a  somnambulist described by Hoff-
man,  who dreamed he  was about  going on a journey,
1 Muratori: della forza della Fantazia Umana. 
 388   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIX.

 strided across the sill of an  open  window, kicking
 with his  heels, and exerting his  voice,  as  if he sup-
 posed  himself riding on his horse.
   In other instances again, things are done, in which
 vision, or an analogous power, is unquestionably ex-
 ercised.   Castelli, whose case wdiich is  one of the
 most  remarkable, is  related  by Francesco Soave,1
 was, one night, found translating  Italian into French,
 and observed to look  for the w7ords  in a dictionary.
 His light having gone out, he found himself in the
 dark, groped about for a candle,  and  went into the
 kitchen to light it.  He  would also get up, and go
 into his master's shop, and weigh out medicines for
 supposed customers.   When  some one had altered
 the marks which he  had placed  in  a book he was
 reading,  he noticed the change  and was  puzzled,
 saying, " Bel piacere  di sempre  togliermi i segni."
 Another  somnambulist, a priest whose case was pub-
 lished in  the French Encyclopedic, would arise from
 his bed  and compose sermons,  reading over each
page when finished, and  erasing and correcting with
 the utmost accuracy.  On one  occasion,  after writing
 " ce divine enfant," he erased the w7ord " divine,"
 and wrote " adorable  " over  it.  Perceiving that  ce
 could not stand before the last word, he altered it  to
cet, by  inserting after  it a t.   He would also write
music with the greatest accuracy.
   It appears  that  the  eyes  of  somnambulists are
sometimes closed while walking about,  and perhaps
always so when they  first get up,  though  by one
1 Ririessioni sopra il Somnambolismo. 
CH. XIX.]
SOMNAMBULISM.
389
writer they are  described  as  being  sometimes half
open.  In some  of the  cases  which have been al-
luded to, the eyes  were observed to be  open and
staring.
   § 291.  The senses of hearing and  of taste pre-
sent as many different modifications as that of sight.
The sound  of persons' voices talking  loud in his
presence is  unperceived by the somnambulist, and
that of a trumpet is no better heard,  unless put close
to his ears.   At other times,  very faint sounds are
heard at  considerable distances.   Negretti did not
distinguish between strongly seasoned cabbage, and
some salad he had prepared.  He  drank water in-
stead of wine which he  had asked for, and snuffed
ground coffee instead of snuff.  By  other  somnam-
bulists, however, such deceptions have been instantly
detected.  All that can  be  offered, by way of expla-
nation of  these diversities in the power  of sensation
in the same individual, is, that those impressions onrv
are recognised, which have some reference to or bond
of association with the thoughts that  are  passing
through the mind,—a fact strictly analogous to what
sometimes occurs  in dreaming.  It is  well known
that a person, who will hear and reply to questions
addressed to him relative to the subject he is dream-
ing  about,  may  not  notice nor be aware  of loud
sounds made near him.  The difference in the senso-
rial powers of different somnambulists, probably in-
dicates merely a difference in the degree  to which
this peculiar condition  is carried.   Where it is but
little removed  from that  of ordinary dreaming, the
sense of feeling alone, in a limited measure, is added
to the locomotive power ; when still farther removed, 
 390   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIX.

 the  senses  of sight and hearing  come  into  play,
 though but partially exercised ; and when displayed
 to its utmost extent, they enjoy  a  range and nicety
 of perception, not  witnessed  in  the  ordinary state,
 and hardly explicable  in  the  present state of our
 knowledge.
   § 292.  There  is  another  form  of  this affection,
 called ecstasis or  cataleptic somnambulism, from its
 being conjoined  with a  kind  of catalepsy, in which
 the walking and  other active  employments  are re-
 placed by what appears to  be a deep quiet sleep, the
 patient conversing with fluency and spirit, and exer-
 cising the mental faculties  with activity and acute-
 ness.  Both in this and the former kind,  the person
 generally loses all recollection of whatever transpires
 during the paroxysms,  though it  may be  revived in
 a subsequent paroxysm.  In some cases  that  have
 been related, the  memory during the  paroxysms
 embraced only the thoughts and occurrences of those
 periods;  those of the lucid intervals being  as entirely
 forgotten, as those of the paroxysms were, after they
 had subsided.
  §  293. It now scarcely  admits  of a doubt,  that
 somnambulism results  from some morbid condition
in the system, involving,  primarily or secondarily,
 the cerebral organism.  We see that its lighter forms
 are but a slight  modification  of dreaming, which is
universally admitted to be very much  influenced by
 the state of the corporeal  functions,  and which, in
certain disorders, is produced in a very troublesome
degree.  The analogy  of  ecstasis  to hysteria and
epilepsy with which it is often conjoined, is too strong
to escape the most cursory observation, and  not 
CH. XIX.]          SOMNAMBULISM.               391

merely  in its phenomena, but in its curability by the
use of remedial means.  Indeed, these affections are
known to pass  into each other by frequent and rapid
transitions, and to possess a strong common relation
to insanity.  The attacks of cataleptic somnambulism
are  invariably  preceded by derangements  of the
general health—in females, of the uterine functions
especially, and their recurrence is  prevented by the
methods of treatment, which  are found most success-
ful in those affections with which it is pathologically
related.  The  more active  forms   of sleep-walking,
seldom, if ever, exist, except  in connexion with those
habits  or conditions,  that  deteriorate the  general
health.   Intemperate  drinking  is   said  to be among
the causes that produce it; and an observer of Ne-
gretti's case attributed the disorder  to his immoderate
fondness of wine.  A  plethoric  condition  of the ves-
sels of  the head is also a strong predisposing cause
of it;  and in proof of this, Muratori relates that he
w7as assured by a physician, that nothing  but having
his hair cut off once  in  a couple  of months, saved
him from being  a somnambulist.   Its  hereditary
character, which, like  the same  trait in insanity, we
may fairly conclude depends on morbid  conditions,
also indicates its physical origin ;   and  the same in-
ference may be drawn from the  influence  of age and
sex in  its production.  The cataleptic form  of the
disorder chiefly  appears  in  females before  the last
critical period  ; while the other is  as much confined
to males, in whom it  mostly appears in  childhood
and the early  periods  of manhood,—seldom in old
age. 
392   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XIX.

  § 294. In the somnambulist, either the perceptive
organs are  inordinately  excited, and thus he is led
to mistake inward for  outward sensations ;  or the
perceptions, if correct, are misapprehended by some
obliquity of the reflective powers ;  in some instances
probably, both these events take  place.  He talks,
moves, and acts,  unconscious of his real condition,
and of nearly all his external relations.  The ideal
images that are brought before the mind are mingled
up and confounded with the real  objects of sense,
and the conduct is regulated accordingly.  Psycholo-
gically considered, then, somnambulism appears to be
not very remote from mania, the difference consist-
ing in some circumstances connected with the causes
that give rise to the derangement  of the faculties.
In the latter, the pathological affection  of the brain
is continuous; in the former, it  appears only during
sleep, by  which  its effects are greatly modified.
When the maniac finds  himself restored to health,
he looks on the period of his  derangement as  on a
dream crowded with grotesque images, heterogeneous
associations, and ever-changing scenes.  So the som-
nambulist,  on awaking,  is  conscious  only of having
been  in a  dream, the events of which have left a
more  or less vivid impression on his  memory.
  § 295. Like the maniac, too, the  sleep-walker's
sentiments and propensities are often included in the
same  circle of morbid action, in which the operations
of the understanding are involved.   The case of a
Carthusian monk is related, who, while awake, was
remarkable for his simplicity,  candor, and probity ;
but unfortunately, almost every night,  walked in his
sleep, and  like the fabled  Penelope, undid all the 
CH. XIX.]           SOMNAMBULISM.              393

good actions for which  he was  celebrated by day.
On such occasions, he was a  thief, a  robber, and a
plunderer of the dead.  A case  of a  pious  clergy-
man is somewhere described, who in his fits of som-
nambulism  would steal and  secrete whatever he
could lay his hands upon,  and on  one  occasion, he
even plundered his own church.  In a case of som-
nambulism  which occurred  a few years  since  in
Maine, there was a strong disposition  to commit sui-
cide.  The paroxysms  appeared every night,  and
watchers were required, as if the somnambulist had
been laboring under an acute disease.   He  always
attempted to  escape from his keepers, and  having
succeeded one night, an outcry was heard from a
neighboring pasture, and  he was found suspended by
a rope from the  limb of a high tree.    Fortunately,
he had attached  the rope to his  feet instead of his
 neck,  and consequently was but little injured. 
394    MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XX.
                CHAPTER XX.

      LEGAL CONSEQUENCES OF SOMNAMBULISM.

  § 296. Somnambulism  may  sometimes incapaci-
tate  a person from the proper performance of the
duties  and engagements of his  situation, and  then
unquestionably it may impair the validity of contracts
and  other  civil acts  to which  he is  a party.   By
rendering him troublesome, mischievous, and even
dangerous, it  furnishes good ground for annulling
contracts of service, whether it existed previously and
was concealed, or had made its appearance at a later
date.   Whether it should  be considered a sufficient
defence of breach of promise of marriage, or a valid
reason for divorce when concealed from one of the
parties previous to the marriage, are questions which
do not  properly admit of  a general answer.  Since
its evils may be  in some,  of the lightest, in  others,
of the most serious description, each particular  case
ought, in justice,  to  be decided solely on  its  own
merits, reference  being had to  the amount of injury
as compared  with  the  magnitude of the obligation
sought to be avoided.  If  it be  studiously concealed
or denied, when its avowal would  undoubtedly pre-
vent the other party from  entering into  a contract,
the latter ought  to be enabled to set aside his own
obligations on the ground  of fraud. 
CH. XX.] LEGAL CONSEQUENCES OF SOMNAMBULISM.  395

   § 297. As the somnambulist  does not enjoy the
free and rational  exercise of his  understanding, and
is  unconscious of his outward  relations,  during the
paroxysms, none of his acts can rightfully be imputed
to him as crimes.  Hoffbauer places him on the same
footing with one who labors under erreur de sentiment,
or erroneous perceptions, a form of monomania, ex-
cept that the former is not fully excused, if, knowing
his infirmity, he has not taken every possible  means
to prevent injurious consequences  to others.  Both
law and equity too would undoubtedly hold him liable,
with the maniac, in an action  of trespass, for injury
committed  to the property of others, though as  to
what extent this power would  be exercised, we have
no means of forming an opinion.  Hoffbauer suggests
as a reason for not regarding the criminal actions of
the somnambulist with too much indulgence, that they
have probably originated, if not in premeditation, at
least in the deep and  deliberate attention which  the
mind has given to the subject when awake.  This  is,
no doubt, the case in many  instances,  and  if men
were to be punished for their meditations, the  sug-
gestion  would be not without its weight;  but as  such
is not the  law, it is not very obvious  how this fact
can affect the legal consequences of somnambulism.
Fodere too,  by  a somewhat  similar kind of logic,
comes to the conclusion  that  the acts of a somnam-
bulist, instead of resulting from mental delusion, are
more independent than any others,  because they are
the free and unconstrained expression of his waking
thoughts and designs, and therefore that they are not
altogether  excusable.   He  seems  to have forgotten
that by no human law are men responsible for  their 
396   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XX.

secret thoughts, but  only for their  words and acts.
To these only does it look, and if they are found  to
have  proceeded from  a mind not in the full possession
of  its powers,  they  must be  excused without the
slightest reference to the former.  And as it cannot
be  denied that  they  are sometimes excited  by un-
founded  delusions, that have no affinity with the na-
tural  character and purposes of the individual, every
sentiment of justice cries out against ever  regarding
them like criminal acts.  Georget  quotes from  an
anonymous work a curious instance of somnambulism
in a monk, which was related to the author  by the
prior  of the convent who witnessed it himself.   Late
one evening, this somnambulist entered  the room of
the prior, his eyes open but fixed, his features con-
tracted into  a frown, and with  a knife in  his hand.
He walked straight up to the bed, as if to ascertain
if the prior were there, and then gave  three stabs
which penetrated the bed-clothes and a mat  which
served the purpose of a mattress.  He then return-
ed, his features relaxed, and an air of satisfaction
on  his countenance.   The next day, the prior ask-
ed  him what he had  dreamed  about the preceding
night.  The  monk confessed that having  dreamed
that his  mother  had  been murdered by the  prior,
and that her spirit had  appeared to him and cried
for  vengeance,  he was  transported  with fury   at
the sight,  and  ran  directly to  stab  her  assassin.
Shortly after, he awoke covered with perspiration,
and rejoiced  to find that it was only a dream.1   A
1 Des Maladies Mentales, p. 127. 
CH. XX.] LEGAL CONSEQUENCES OF SOMNAMBULISM.  397

similar case is also  related of two  individuals, who,
finding themselves  out over  night  in a place infest-
ed with robbers, one  engaged  to  watch while the
other slept, but the former falling asleep and dream-
ing of being pursued shot  his friend through the
heart. 
398   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXI.
                CHAPTER  XXL

            SIMULATED SOMNAMBULISM.

   § 298.  This disorder may be  simulated, first, by
those who have, at other times,  really experienced
its attacks ; secondly, by those who have not at any
time.  The motive may be, either  to  do something
which the individual  would not  otherwise dare  to
attempt, or to avoid the punishment  of an action,
which is alleged to have been committed  in one of
its paroxysms.  The difference, however, in the  diffi-
culty of  proof, is not  so great, as at first  sight
might be apprehended;  for, since the mind  is gener-
ally unconscious of what passes during the paroxysm,
the somnambulist possesses but little advantage  over
others, from his experience, in feigning  this  affection.
He will  be no less at fault in respect to those little
traits, which mark the  difference between  the  real
and feigned attacks, as well  as the  more important
phenomena.  When, however, it is admitted  that
the person has been subject to its  attacks, this fact
certainly furnishes a  presumption  of its reality  in
doubtful cases, which diminishes  the strength of the
evidence which the alleged case requires.
   § 299. When the feigned  paroxysm  is witnessed
by others  who are capable  of describing  minutely
what  they saw, a comparison of his conversation and
acts with those observed in the real  paroxysms,  may 
CH. XXL]      SIMULATED  SOMNAMBULISM.        399

furnish us with  a clew to the real  nature of the act
imputed  to him ; for it  is scarcely possible that, if
feigning, he will not be caught tripping in some of
his manoeuvres. A curious case is quoted by Hoffbauer
from an old writer, where nothing was wanting but a
tolerable knowledge of the state of the mental facul-
ties in somnambulism, to  expose the deception.   An
old ropemaker frequently fell  into a profound  sleep
in the midst of his occupation, whether sitting, or
standing, or walking in  the  street, when he would
begin to repeat,  by means  of words and gestures,
every thing he had been doing during the day, from
his prayer in  the morning till the very moment of
his falling  asleep.   If taken while walking abroad,
he  would pursue his course  just as if he had been
awake,  avoiding  persons and  things  which  might
harm him.   The story was related as one of genuine
somnambulism, though there were two circumstances
in it sufficient to have exposed the deception.  In the
first place, to  repeat the transactions of the  day in
this  manner, is contrary  to what  we know of som-
nambulists, who do  only  what they have premedi-
tated, or what  has strongly engaged their attention.
Secondly, this  man  acted a  double  part,—those of
the  sleeping and of  the  waking  states,—without
making the proper  distinction.   He first repeated
what he had done during the day, and then went on
with what he was in the  act of doing when  the par-
oxysm took him.  The ruse was finally discovered.
The man professed  himself cured,  as soon as a phy-
sician charged with examining  his case proposed to
bandage his eyes, to see  if he would then be able to
perform  those  actions, which had excited so  much 
400   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXI.

surprise.  No doubt can remain of the genuineness
of the attack, if the person performs feats which he
would not dare to do  when  awake, unless—which
would hardly be possible—he has systematically con-
cealed his skill and abilities ; the  converse  of the
proposition, however, cannot be equally true.   It
will  also  be a strong confirmation  of the evidence
in favor of its reality, if the physical symptoms, we
have mentioned as sometimes attending the somnam-
bulic disposition (§  293),  are shown to  have been
present.  But it generally happens that the somnam-
bulist walks unwitnessed, and must rest the proof of
his mental condition on his  own testimony and the
circumstances of the case.   The full burden of proof
manifestly devolves  on him, and if he fail of estab-
lishing it satisfactorily, he must suffer  the  conse-
quence.  There can  be  no other rule, for once acquit
a criminal on the score of somnambulism, which is
imperfectly or at  best  but  plausibly proved, and it
will soon become a favorite excuse for crime, when-
ever the offender  possesses the requisite address for
maintaining the deception.  Among the proofs, how-
ever, necessary to establish this defence, a prominent
place should  be claimed for  those  drawm from  the
nature of the criminal  act  itself.  If this be mani-
festly contrary to the known  character  and dispo-
sition of the accused,  and especially if it can  be
 shown that he could have entertained no motive for
 injuring  the  other  party, but little else beyond a
 straight story and  an  air of sincerity ought to be
 required  to establish the truth of his own assertions. 
CH. XXII.]   EFFECT OF INSANITY ON EVIDENCE.     401
               CHAPTER  XXII.

         EFFECT OF INSANITY ON EVIDENCE.

  § 300. The insane are disqualified  by law * from
appearing as witnesses in courts of justice, their in-
competence being inferred from their mental unsound-
ness.   The fact of incompetence to testify, however,
is  not necessarily connected  with that  of insanity,
and  it would be far more correct  to consider the
former an  independent fact  to be established by a
distinct order of proofs.   The truth is, an analogy,
in a medico-legal sense, has been too hastily assumed,
between  the act of testifying,  and  that of performing
business-contracts, or other civil  acts, and in conse-
quence, has shared with  them in  the same sentence
of disqualification, without an attempt to ascertain
the kind and degree of intellectual power which they
respectively require.  The  practice of including them
in the same category, is  certainly  not favored by the
present state of our  knowledge of insanity, nor does
it  approve  itself to  the  common sense of mankind.
To see what foundation in nature this  rule  of law
really has, we shall  proceed  to inquire how far the
competency of a witness is actually impaired  by the
different forms of insanity.
  ' 3 Thomas's Coke's Littleton, 489; Livingston v. Kiersted, j
Johnson's Reports, 362.
               AA 
 402   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXII.

   § 301.  According to Hoffbauer, before a witness
 can be deemed competent, it is necessary that  his
 senses should be sufficiently sound to take cognizance
 of the facts to which he testifies ;  that their impres-
 sions should have been really what he believes they
 were ; that  his testimony should  coincide with  his
 belief; and  lastly, that he should be able to convey
 to others  his own ideas without fear of being misin-
 terpreted.   These conditions, it may be added, con-
 stitute the capacity of a witness, and wherever they
 are present, his evidence should be received without
 agitating  the question of his mental  unsoundness,
 which is not absolutely incompatible with their  exist-
 ence.1
   § 302.  The  higher degrees of imbecility must of
 course disqualify  a witness, but  its less  aggravated
 forms  may not, under  all circumstances, have this
 effect.  His senses may be acute enough to  see and
 to hear  what he deposes  to ; no  illusions  may ob-
 trude  and mingle with  their  impressions ;  and his
 memory  may be retentive enough, provided too long
 a space of time do not intervene between the occur-
 rence of the facts and his deposition concerning them,
 to bear them in mind till relieved by judicial investi-
gation.  The facts to which he testifies  must be  of
the simplest kind, requiring the smallest  perceptive
effort to seize and appreciate,  and  so intelligible  to
  1 The third condition above-mentioned, may not at first sight appear
to be connected with capacity; but if the reader will refer to the obser-
vations (§ 122) on a class of people, who, in consequence of some natu-
ral defect, or organic disease, are incapable of telling the truth, even
when most conducive to their own interests, he will be convinced of
the propriety of placing it in this connexion. 
CH. XXII.]   EFFECT OF INSANITY ON EVIDENCE.    403

the meanest understanding, that the memory  can
easily retain them.  If the details are too numerous
and complicated, and especially if they include words
or actions not familiar with or analogous  to  his own
ordinary experience, or if they happened at  too re-
mote a period, they become confused and entangled
in his mind, and many of them fade from it altogether,
while some important members of the series  may not
have been attended to at all.   Hence the evidence
of imbeciles may present many a contradiction  and
hiatus, of which they may be perfectly unconscious
themselves, and  which  it would  be wrong to attri-
bute to intentional omissions, or a wish to  deceive.
If we bear in mind too that these persons are easily
embarrassed, it might naturally be expected  that the
presence of spectators, the perplexing questions of
counsel, and the formalities of a trial, would so  dis-
order their ideas as to make their testimony appear,
to those unacquainted with their  mental deficiency,
like the most  impudent  trifling, or downright men-
dacity.   The  more, howTever, the  witness   is per-
mitted to tell  his story  in  his own  way, and finds
encouragement in the looks of those around him, the
less of this will be observed.  The class described in
§ 52, are competent  to testify in matters of a more
complicated kind, requiring a larger grasp  of the
reflective faculties to embrace, and more tenacity of
memory to retain them, but like the others, they are
very liable to  be disconcerted by the questions of
strangers, and in consequence, betrayed into numer-
ous contradictions of their  own  testimony.   Since
then the competency of these imbeciles is well estab-
lished, nothing can be clearer than  the propriety of 
404  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXII.

admitting their evidence, and leaving it for the jury
to decide upon its credibility.
   § 303. In partial intellectual  mania the capacity
of testifying  under certain  circumstances and  with
certain reservations, is still preserved, though  con-
siderable knowledge of the case and extreme caution
are requisite to measure the witness's credibility. In
regard  to the greater  proportion of cases, the  only
doubt  is respecting the second and  third  conditions
of capacity (^ 301), no question  being raised  as to
the  presence of the others ; that  is,  whether the
witness has really seen, heard, &c, what he believes
he  saw and heard, and whether his testimony coin-
cides with his belief.   That he may offer in evidence
the offspring of a disordered  imagination, sincerely
believing it to have come under the cognizance of his
own senses,  is  undoubtedly  true ;  but no  less so
how7ever, that he may testify solely to what has come
under  his own  observation.   Which of these events
does actually take place,  is a question  to be settled
by reference to the nature of the evidence and the
character of  the witness's insanity.   When the mat-
ter on which he testifies, is remote  from  the insane
delusion which he entertains,  and cannot  very obvi-
ously come within the  circle of its influence, it would
be  wrong to reject his  testimony  on the score of
incompetency.   When we  see these monomaniacs
rational  on  every topic  but that which  constitutes
their derangement, shrewd and  methodical in the
transaction of business, quick to perceive and  able
to profit  by whatever appears  conducive to their
interests, trusted and respected  by  their neigh-
bors, it seems  more  difficult to disprove than to 
 CH. XXII.]   EFFECT OF INSANITY ON EVIDENCE.     405

 prove their competency.   The  power  of remem-
 bering and telling correctly what they have seen or
 heard, requires  no more strength  or soundness of
 mind, than numberless  other duties that nobody
 doubts their  ability  to perform, and the burden of
 proving  their incompetency should rest on those who
 urge it.   Even on topics connected with their insane
 belief, their capacity is  not necessarily destroyed,
 and in doubtful cases it would seem better to receive
 their evidence, and leave it for the court or counsel
 to disprove its credibility.   While the predominant
 idea  is highly false and absurd, they may, and very
 often do reason  upon it with force and correctness,
 their deductions being  sound and  their reflections
 appropriate.  Indeed, this mixture  of the  rational
 and the irrational, this inability to discern  the rela-
 tions of  congruity  between  the true  and the false,
 constitutes one of the most characteristic features of
 madness. Hence, it would not be unnatural for them
 to see things  in some way connected  with the delu-
 sion, in  most of  their relations, in their  true  light,
 and of this fact  we should  certainly avail ourselves
 in deciding on the admission of their evidence. The
 man who believes that he is charged  by government
 with  the regulation of the weather, may,  notwith-
 standing, observe meteorological changes, and testify
 accurately concerning the state of the weather at a
 particular time, perhaps  no one more so;  and he
 who believes that he has made an immense fortune
by  a  commercial speculation, may talk sensibly on
mercantile interests,  and be  perfect master  of  the
price current, and  thus be competent to testify on
any matter connected  with  the same that has come 
406   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXII.

under his observation.   The credibility of such wit-
nesses, however, depends very much on the  import-
ance of the subject on which they testify, and on the
relations of their evidence to that of other witnesses.
When they corroborate  the statements of other wit-
nesses, they  may justly challenge  our belief,  while
we should very properly hesitate to decide upon any
great interests of person or property, solely upon the
ground of their testimony.
   § 304.  The reported cases, where the competence
of witnesses  is destroyed by reason of insanity,  are
too few, to render it very apparent how far  the fol-
lowing represents the ordinary practice of American
courts.  It strikingly illustrates the effect of a rigid
adherence to  the common-law maxim, that the insane
are incapable of testifying, and therefore, may be
properly introduced  in this  place.   Jacob Schwartz
was tried on  an indictment for assaulting, with intent
to kill, Jonathan  Jones, at a term of the Supreme
Court  for the county of Lincoln, in Maine, in May
1833.  Jones himself was the principal witness, and
he stated that he went into Schwartz's house, for  the
purpose of conversing on religious  subjects with  his
wife,  who was also  Jones's sister ; that Schwartz,
who had  often forbidden him  to do so, followed him
into the  house, drove him out,  seized his gun, and
threatened to shoot  him ;  that he  then  ran  several
rods,  occasionally looking back at Schwartz, who
stood  in his door-way presenting his gun,  as if in  the
act of firing ; that Schwartz  finally fired and hit him,
several' shot  lodging in  his  hat  and coat, and a few
penetrating  into  the skin of  his back,  from which
they were taken  out  by some persons in a house to 
CH. XXII.]   EFFECT OF INSANITY ON EVIDENCE.    407

which  he immediately  ran.   The transaction was
witnessed by no one, besides  Jones.  By other wit-
nesses it was testified, that Jones ran into the house
where they wTere, exclaiming that Schwartz had shot
him, and that they assisted in taking the shot out of
the skin.  Thus far his testimony was rational and
consistent, and his manner calm and composed.  On
being cross-examined by the defendant's counsel who
had some knowledge of his case, he testified,  that he
used to work on a piece of land which he owned, but
that feeling himself called to  exhort sinners to re-
pentance, he went  about, in imitation of Christ  and
the  apostles,  preaching  the  gospel  and exhorting
sinners to forsake their evil ways.  He declared him-
self to be  an apostle, and  inspired by the holy
ghost ; also, that he was one of the saints  who are
to judge the world, and that  he should  bear a part
in the judgment of the great  day.  On  this  subject
he dilated largely and incoherently, his countenance
being animated, and his language and manner ardent
and impassioned.   Other  witnesses having testified,
that in his domiciliary visits, he had sometimes repre-
sented himself to  be the Lord Jesus Christ, he was
examined on  this  point.   Here  he was not very
explicit, and did not seem disposed to  make a full
disclosure,  as, he said,  he  could not perceive its
connexion with the question  at issue.   He  did not
expressly deny, however, that he  so considered him-
self, but  seemed disposed to leave it  to be  inferred
from particular things  in which he resembled Jesus
Christ, as in  his poverty, in  his  going  about to do
good,  and  in the  persecution  he suffered.  The
jury, not thinking it safe  to convict the defendant on 
 408  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXII.

 Jones's  testimony,  acquitted  him, and  the  court
 signified its approval of the verdict.
   § 305. If the testimony of Jones had stood alone,
 unsupported by confirmatory circumstances, no fault
 could have been reasonably found with this verdict.
 It would have been sufficient for the jury, to know
 that he w7as laboring under extensive hallucinations,
 with  which  the alleged criminal act was not very
 remotely connected in his mind, to  be justified in
 shrinking from the responsibility of depriving another
 on his testimony, of his good name, and  subjecting
 him to legal punishment.   Of the two evils,  that of
 convicting on insufficient evidence, and that of suf-
 fering a guilty person to escape a few years' impris-
 onment,  they would not have been liable to blame,
 for choosing to incur  the risk of that which they
 considered  the  least.   The circumstances of this
 case,  however, being  very different from what is
 here supposed, might  we  not  have reasonably ex-
 pected a different verdict ?  That  Jones was assault-
 ed at, or very near  the  time alleged, could  not be
 doubted for a moment,  and his exclamation,  as he
 entered the house  with  the appearance  of sudden
 fright, that Schwartz had shot him, and  his coming
 in the direction  from Schwartz's  house,  strongly
 authenticated  his statement, that  the assault was
 committed by Schwartz,—so strongly indeed, that
 in the  absence of any conflicting evidence on the
 part of the defendant, it was entitled to implicit be-
 lief.  Such a scene might, no doubt, have  been got
 up by a sane person, for the  purpose of gratifying
some malignant feelings, but men,  affected with the
kind of insanity under which Jones  was laboring, 
CH. XXII.]   EFFECT OF INSANITY ON EVIDENCE.    409

rarely,  if ever, contrive such schemes.  It was  a
circumstance too,  which should have had its weight,
that in relating the facts of the assault, he was calm
and consistent, and that it was only when touching
on  the subject of his delusions, that  he was excited
and incoherent.  His  insanity was not of the kind
which would deprive him of the  second condition of
capacity to testify (§ 301), and it is  the third only,
in  regard to  which there  could have  existed  any
reasonable  doubts ;  and these  obviated more or
less satisfactorily, by  the above-mentioned  circum-
stances.1
   § 306. The  view here taken of the competence of
some monomaniacs, as witnesses, is not without some
support in the legal profession.   " Of an insane per-
son," says Mr. Evans,  " it might for defect of other
evidence, merit to be considered,  whether  in  civil
cases at least,  the testimony  of such  might not be
admissible, upon points where his understanding did
not appear  to  be subject to disturbance; it being
well known that  in  many  of these  melancholy in-
stances, especially when the result of some  violent
passion, the party affected is entirely cool, clear, and
collected in his ideas, and as free as other persons,
from  the delusions  of a perverted  imagination, in
every thing not connected with the cause  of his in-
sanity ;  with regard to persons who  have  only tem-
porary fits of madness (those usually termed lunacy),
and at other times are in all respects sound of reason,
  1 For the facts of the above case, the author is indebted to the kind-
ness of J. G. Reed, Esq. of Waldoborough, Me., who was the defend-
ant's counsel. 
 410  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXII.

 these are then  considered as capable of testimony
 as of any other legal act." J
   § 307. If the evidence  of the  monomaniacs  in
 question be rejected, it must be from a fear of decep-
 tion ;  and probably most  of  the distrust manifested
 towards such witnesses arises from  a lurking suspi-
 cion, that their mental impairment  is necessarily ac-
 companied  with impaired  veracity.   It  cannot be
 denied that there is some ground for  this suspicion,
 and though it should not  have  the  effect of totally
 invalidating their testimony, it is proper  to bear it
 in mind whenever their credibility is in question.  It
 is well  known how prone  the  inmates of lunatic asy-
 lums are to complain of the servants, the overseers,
 and one another,  and prefer against them special
 charges that are without any foundation  whatever ;
 whether from an involuntary propensity to lying and
 mischief,  or from  a morbidly  exalted  imagination
 which distorts and discolors its perceptions, it is not
 easy to decide.  Some, however,  will  relate very
 accurately what they see and hear,  and their state-
 ments are received with  implicit  credit.  On the
 whole,  we may  conclude  with Georget,  "that it is
 necessary to know the patient, the character of his
madness, his customary relations to surrounding ob-
jects, before we can know  what degree of confidence
 to place in his assertions."  It should not be forgot-
 ten also, that in  the greater  proportion  of cases of
 mental  derangement, there is  a weakness of memory
 that prevents it  from retaining impressions so long
1 2 Pothier on Obligations, Appendix, 259. 
CH. XXIL]   EFFECT OF INSANITY ON EVIDENCE.    411

and so faithfully, as when in its sound condition ; and
therefore, the facts to which a monomaniac testifies
should always be of recent occurrence, to render his
testimony at all credible.
   § 808.  In the subjects of general mania,  all com-
petence to testify is lost, except during what is called
the lucid interval, when they  may testify in regard
to transactions that occurred during a lucid interval,
or at  a time previous  to their illness.   Their evi-
dence should be implicitly received only when it re-
lates  to simple facts easily perceived, for  their intel-
lect may be hardly strong enough to bring  to  mind
and expose in order,  a  complicated mass of details.
   § 309.  In partial moral mania, there is nothing to
incapacitate one from testifying,  unless we except in
that kind  of it  where the individual labors  under an
uncontrollable propensity  for lying.   Of  all  the
forms of mania, this  really diminishes  competence
more than any other, but it will  be long, probably,
before it will be considered in  this light, in courts of
justice.
   § 310.  In general  moral  mania, as illustrated be-
fore (§§ 110, 112), it has been seen that the  intel-
lectual powers are not perceptibly impaired, and that
the patient loses none of his interest in what passes
around him, nor of his power to observe and remem-
ber them  with ordinary  distinctness.  Under such
circumstances, there  would be little  reason for re-
jecting his evidence on  the score  of incapacity. Con-
sidering,  however, the great derangement of the
affective powers under  which he  labors, and the  un-
founded  likes  and  dislikes which it  produces,  his
veracity may be justly  suspected,  and his evidence 
 412   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXII.

 should be  entitled to  little weight, except  when
 limited to facts in regard to  which it can be shown
 that his feelings are not  interested.
   ^ 311. The competence of old men in the  early
 stages of dementia  to testify, is a point frequently
 discussed in courts  of justice, and the  want  is  se-
 verely felt,  of some fixed principles that shall serve
 as a guide to correct  decisions.   In  every stage of
 this affection, the impairment of the memory is more
 perceptible in regard to  recent than  remote impres-
 sions,  and it often happens that a person may have a
 distinct recollection of things that occurred  in  his
 youth, while those  of a month's or a year's date, are
 but imperfectly remembered, if at all.   To test the
 strength of  his memory respecting certain things, it
 is only necessary to ascertain if he  remembers vari-
 ous  other  transactions of about the  same  date  in
 which  he  is  known to have been engaged.  If  he
 can do this, it is a strong presumption in favor of his
 competency ; if not, it is  incumbent on the  party
 offering his testimony to show why his memory should
 have been more faithful in the one case  than in the
 other.   This is rendered still more necessary by the
 fact, that the weakness of mind incident to this con-
 dition makes its subjects  more easily swayed by the
 suggestions of others, and leads them  to believe that
 they remember what they are told they ought to re-
 member, or  what they are assured they actually did
 remember till within a recent period.  The slightest
 examination  will show how  much dependence can
be placed  on their recollections of recent events. 
CH. XXIIL]          DRUNKENNESS.               413
               CHAPTER XXIIL

                  DRUNKENNESS.

  ^312. Before  we can properly  appreciate  the
legal consequences of drunkenness,  it is  necessary
to understand its  immediate and remote  effects on
the mind, and the organism  with  which  it is con-
nected.  Correct information of this kind will enable
us to avoid many of the  prevalent errors  that have
arisen from vague  and  imperfect  notions  respecting
the nature of drunkenness.   We shall first consider
the symptoms, or immediate effects, of free  indul-
gence in intoxicating drinks ; for the  following ac-
count of which we are chiefly indebted to  Hoffbauer
and Macnish.1
   § 313. The first effect of alcoholic liquors is to
exalt the general  sentiment of self-satisfaction, and
diffuse an unusual serenity over the  mind.  The in-
tellectual as well  as physical powers act with a little
increase of vigor and activity, the thoughts flow with
more  facility and  accuracy, and the  individual be-
comes perfectly well pleased with himself  and others.
 He feels an exhilaration of spirits, a sense of warmth
 and gayety, and his imagination is crowded with de-
 lightful  images.   The  sight  and hearing are  very
1 Anatomy of Drunkenness. 
 414  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIIL

 slightly affected ; a low, humming sound is heard in
 the pauses of the conversation, and objects are en-
 veloped in a slight mist  which prevents them from
 being seen distinctly.   Thus far there is no appear-
 ance of drunkenness.   Soon the torrent of his ideas
 becomes more rapid and violent, and he can scarcely
 repress them.  This is the moment of his happiest
 sallies, and he pours forth his  thoughts with a force
 of expression and a richness of conception unknown
 in his sober  hours, and now  he feels the  ecstatic
 pleasures of getting drunk.  As yet the brain is in
 tolerable order, but a great effort is necessary to re-
 late a story or transaction at all complicated  in its
 details, for the  thoughts  succeed one  another too
 rapidly, to allow  sufficient time  to  arrange  them in
 the order that the recital requires.  This is the first
 well-marked  symptom  of intoxication.   Now  his
 ideas succeed one another with constantly increasing
 force and rapidity ; his sensations lose their ordinary
 delicacy;  and his imagination  gains as  fast  as they
 lose.   His language is, in some respects, more ora-
 torical and poetical, though he now feels an irresisti-
 ble propensity to  talk  nonsense,  but is perfectly
 conscious, all the  while,  that  it is  nonsense.  His
 voice is louder, because he hears less acutely, and
judges of the hearing  of others  by  his own.  Now
 the organic  activity of the brain is  at  its  height.
 His imagination is filled by strange and queer images,
 and he is conscious, if so it may be called, of a sense
 of oppression and giddiness in  his  head.  His per-
 ceptions of colors, forms, distance,  and numbers be-
 come utterly confused ;  he confounds one person with
 another;  the candles burn all colors  in succession, 
CH XXIIL]          DRUNKENNESS.               415

and are  multiplied fourfold;  and in stretching forth
his glass to set it on the table, he  lets it go  before
reaching its edge.  He is apt to imagine, either that
he has offended some one, and shows a ludicrous anx-
iety to apologize, or that he  has been offended, and
fixes  upon some one as the object of his maledic-
tions, perhaps his blows.  Judging from his discourse,
his  ideas begin to want connexion, notwithstanding
their  vivacity,  but this vivacity and rapidity of his
ideas give to his  passions an insurmountable  power
against which reason has nothing to oppose, and un-
less some accident turn him from their object, he is
hurried  on wherever  they  impel  him.  Soon  his
tongue stammers  and his voice gets thick ; his legs
falter, he falls from his seat, and  is plunged  into  a
profound sleep,  in which the  manifestation  of his
physical and intellectual powers is  completely extin-
guished.  In  this  condition, he  is said  to be dead
drunk.  Such  is  the ordinary course  of a  fit  of
drunkenness,  but  it sometimes varies more or  less,
with  the temperament or habits of the individual, and
the attending circumstances.
   § 314. Such is the  immediate effect of drunken-
ness  on  the mind; we have now to show how the
long-continued use of alcoholic liquors affects  the
moral and  intellectual  powers.   Except  in some
happily-organized natures, the original delicacy and
acuteness of the  moral  perceptions  are invariably
blunted  ; the relations of neighbor, citizen,  father,
spouse,   have lost their  accustomed place  in his
thoughts; great moral interests no longer obtain  a
strong hold on his attention ; the voice of distress
is apt to fall on his ear like an unmeaning sound; and 
416 MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXIIL

the finer emotions of the soul, which will occasionally
be  felt by the least cultivated minds, have entirely
deserted  his  nature.  The injury sustained by the
intellect is more obvious, if not  more  deplorable.
The course of the ideas is sluggish, and they  want
their former force and brilliancy ;  the mind has lost
its  comprehensiveness of grasp,  and  experiences a
difficulty  in  seizing  the  relations of one idea to
another; it is incapable of the long-continued efforts
which were once easy, and of concentrating  the whole
force of its faculties on the subjects submitted  to its
examination.   The consequence  is, that  the brain
having been so much accustomed to  artificial stimu-
lus, according to a  well-known  law  of the animal
economy, becomes incapable of an effort without the
aid  of this  stimulus, which is  necessary to the per-
formance of even its  most  ordinary exercise. Drink-
ing  is thus  made an indispensable habit,  and by this
means,  the  tame,  cold,  and  lifeless being,   as  if
touched by a spark of Promethean fire, is converted
into the animated, sociable, and efficient man of his
better days.  Sheridan never spoke in the house of
commons without the inspiration  of half a pint of
brandy, and numberless are the heroes of the buskin
and the sock, who require  to be wound up, as it were,
to a certain pitch, by artificial stimulus, before they
venture to undertake the labors of the night.
  ^  315. This account of the pathological effects of
drunkenness  would  be incomplete,  without   some
mention  of that  curious  disease  to which it  often
leads,  called delirium  tremens,  or  mania apotu.  It
may be the immediate effect of an  excess, or series
of excesses, in those who  are not  habitually intern- 
CH. XXIIL]
DRUNKENNESS.
417
perate, as well as in those who are; but it most com-
monly occurs in habitual drinkers, after a few days of
total abstinence from  spirituous  liquors.   It is  also
very liable to occur in this latter class when laboring
under other diseases, or severe external injuries that
give rise to any degree of constitutional disturbance.
The approach of the disease is  generally indicated
by a slight  tremor and  faltering  of the  hands and
lower extremities,  a tremulousness of the voice, a
certain restlessness  and  sense of anxiety which the
patient knows  not  how  to describe or  account for,
disturbed sleep, and impaired appetite. These symp-
toms having continued two or three days, at the end
of which time they have obviously increased in sever-
ity,  the patient  ceases to sleep altogether, and  soon
becomes delirious.   At first, the delirium is not con-
stant, the mind wandering during the  night, but,
during the day when its  attention is  fixed, capable
of rational discourse.  It is  not  long, however, be-
fore  it  becomes constant, and constitutes  the  most
prominent  feature  of  the disease.   This  state of
watchfulness  and delirium continues three or four
days, when, if the patient  recover, it is succeeded by
sleep, which, at first, appears in uneasy and irregular
naps, and lastly in long, sound, and refreshing slum-
bers.  When sleep does  not  supervene about this
period, the disease is fatal; and whether subjected to
medical treatment, or left to itself, neither  its symp-
toms nor duration are materially  modified.
   § 316. The character of the delirium in this disease
is peculiar, bearing a stronger resemblance to dream-
ing,  than any  other  form of mental derangement.
It would seem as if the  dreams  which  disturb and
              BB 
418  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIIL

harass the mind during  the imperfect   sleep  that
precedes the  explosion of the  disease, continue  to
occupy it  when awake,  being then viewed as reali-
ties, instead of dreams.   The patient  imagines him-
self, for instance, to be in some particular situation,
or engaged in certain occupations, according to each
individual's habits and profession,  and his discourse
and  conduct will be conformed to this  delusion, with
this  striking peculiarity, however, that  he is thwarted
at every step, and is constantly meeting with obsta-
cles that defy his utmost efforts to remove.   Almost
invariably, the patient manifests, more or less, feel-
ings of suspicion and fear, laboring  under continual
apprehension  of being  made the victim  of sinister
designs and   practices.   He  imagines that  certain
people have  conspired  to rob or murder him, and
insists that he can hear them in an adjoining apart-
ment, arranging  their plans and preparing  to rush
into his  room;  or  that  he is in  a  strange place
where he is  forcibly detained and  prevented from
going to his own home.   One of the  most common
hallucinations, is,  to be  constantly  seeing devils,
snakes, vermin,  and all  manner of unclean things
around  him   and about  him,  and  peopling every
nook and  corner of his apartment with these loath-
some objects.  The extreme terror which  these delu-
sions often inspire, produces  in the countenance, an
unutterable expression of anguish, and,  in the hope
of escaping from his fancied tormentors, the wretched
patient endeavors to cut his throat, or  jump from the
window.  Under the influence of these  terrible ap-
prehensions,  he  sometimes murders his wife or at-
tendant, whom his disordered imagination identifies 
CH. XXIIL]
DRUNKENNESS
419
with his enemies,  though he  is generally tractable
and not  inclined to be  mischievous.   After perpe-
trating an act of this kind, he generally gives some
illusive reason for  his conduct,  rejoices in his suc-
cess, and expresses his regret  at not  having done it
before.   So complete and obvious is the mental de-
rangement in this disease, so entirely are the thoughts
and actions governed by the most unfounded and ab-
surd delusions, that if any form  of  insanity absolves
from criminal responsibility, this certainly must have
that effect.
   § 317. Before being able to decide the question
understandingly, of the relation of drunkenness to
moral agency, it is necessary  to proceed  one step
farther  in   this  investigation,  and  inquire into  the
pathological, or as  it is technically called, the proxi-
mate cause of drunkenness.  No impressions, whether
from  within or  without,  can  affect the mind,  but
through  the brain.   In drunkenness, therefore, it is
this organ which is  principally  affected, and that por-
tion of it more particularly which is connected with
the manifestation of the  moral  and intellectual pow-
ers.  The  vital  actions of which it  is  the seat, re-
ceive an increased  share of activity, so that every
process that goes on, is conducted with fresh energy
and speed.   Drunkenness, however,  depends  on
something  more than mere increase of cerebral ac-
tion, because it varies, in some degree, with the na-
ture of the  intoxicating agent,  but what this specific
action is exactly, it is impossible for us to know. As
the fit  proceeds, this  increase of action continues,
until it  arrives  at  such  a  pitch, that the organ is
unable to perform its functions  properly ; hence, the 
420  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIIL

disorder  and tumult  of mind that attends  the last
stages of the fit.   The torpor and  exhaustion  that
follow, are the  natural consequence  of the previous
excessive stimulation, and the one is  generally pro-
portioned to the other.  This increased action  that
takes place in  drunkenness,  degenerates, after  fre-
quent repetition, into a permanent state of irritation
which, at last, becomes real inflammation. The coats
of the vessels  are thickened and less  transparent
than usual, and in  some places,  they assume a vari-
cose appearance.   The cerebral texture is less deli-
cate and elastic, becoming either unnaturally hard,
or soft.  Slight effusions of water are not uncommon.
These appearances,  to a  more  or less  extent, are
found in the brains of nearly all confirmed drunkards,
and it may be now considered a well-established fact
that  the habitual drunkard has always more or  less
of cerebral disease.
   §  318. Obviously  as these pathological  changes
are the effect of a long-continued voluntary habit,
there is strong evidence  in  favor of the idea  that
they, in turn, become efficient causes, and act pow-
erfully in maintaining this habit, even in spite of the
resistance of  the will.  So deplorably common  has
drunkenness been in  this country, that there are few
who have not seen the melancholy spectacle of the
most powerful  motives, the  most solemn promises
and resolutions, a constant sense of shame and dan-
ger,  bodily pain and chastisements, the prayers  and
supplications  of friendship,  of as little  avail in re-
forming the drunkard, as  they would have in avert-
ing an attack of fever, or  consumption.  With a full
knowledge of the  dreadful consequences to fortune, 
CH XXIIL]          DRUNKENNESS.              421

character and family,  he  plunges on  in  his  mad
career, deploring, it may be, with unutterable agony
of spirit, the resistless impulse by which he is mas-
tered.   Macnish  relates the case of a young man of
fortune,  twenty-six years  old, which  presents an
impressive illustration of this truth.  "Every morning
before  breakfast,"  he  says,  " he drank a  bottle of
brandy;  another he consumed between breakfast and
dinner,  and  a third, shortly before going  to  bed.
Independently of this, he indulged in wine and what-
ever liquor came within his reach.  Even during the
hours usually appropriated to sleep, the same system
was  pursued—brandy being placed at the bed-side
for his use in the  night-time.   To  this destructive
vice  he had been addicted since his sixteenth year;
and  it had gone on increasing from day to day till it
had  acquired its then alarming  and incredible mag-
nitude.   In vain did he try to resist the  insidious
poison.   With the  perfect consciousness that he was
destroying himself, and with every desire to struggle
against the insatiable cravings of his diseased appe-
tite,  he found it  utterly  impossible  to  offer  the
slightest opposition to them."1 Another, whose case
he quotes, replied to the remonstrances of his friend
who painted  the distresses of his  family, the  loss of
his business and character, and the ruin of his health,
"my good friend,  your remarks are just;  they are
indeed too true; but I can no longer resist temptation.
If a  bottle of brandy stood  at one hand, and the pit
of hell yawned at the other, and I  were convinced
1 Anatomy of Drunkenness, 163. 
422  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXIIL

that I would be pushed in as sure as I took one glass,
I could not refrain.   You are very kind, I ought to
be grateful for so many  kind, good friends, but  you
may spare yourselves the trouble of trying to reform
me; the thing is out of the question." J
  § 319.  These phenomena strongly remind us of
some of  the manifestations of moral mania,  and  if
farther evidence is necessary to convince us that they
are both connected with  similar  pathological condi-
tions,  it  is  abundantly  furnished  in  some  other
phenomena of drunkenness.  It  is now  well under-
stood that this vice sometimes assumes a periodical
character, persons indulging in the greatest excesses
periodically,  who  are  perfectly sober during  the
intervals,  which may be  from the space of a month to
that of a year.   From a state of complete sobriety,
they suddenly lapse into the most unbounded indulg-
ence in stimulating  drinks, and nothing but absolute
confinement can restrain them.  Macnish, who saw
several cases, says that they "seemed to be quite
aware of the uncontrollable nature of their  passion,
and proceeded systematically, confining themselves
to  their  room,  and  procuring a  large quantity of
ardent spirits.  As soon as this was done,  they com-
menced and drank to excess till vomiting ensued, and
the stomach absolutely  refused  to receive another
drop of liquor.   This state may  last a few days or  a
few weeks, according to constitutional strength, or
the rapidity  with which the libations are poured
down. So soon as the stomach rejects every thing
Idem, 162. 
CH. XXIIL]          DRUNKENNESS.              423

that  is  swallowed, and  severe sickness comes on,
the fit ceases.   From that moment recovery takes
place, and his former fondness for liquor is succeeded
by aversion  or disgust.   This gains such an ascend-
ency over him, that he abstains religiously from it for
weeks,  or months, or  even for a  year, as the case
may be.  During  this interval he leads a life of the
most  exemplary temperance, drinking nothing but
cold  water  and probably shunning every  society
where he is likely to be exposed to indulgence." :
   § 320. Esquirol has distinctly recognised this dis-
order,2 and attributing it to  the  influence of patho-
logical  changes, considers its unhappy victims as not
morally responsible.   This distinguished observer of
mental affections affirms, that " sometimes the abuse
of intoxicating drinks and drunkenness  are the first
symptoms,  or rather the most prominent symptoms,
of the first  stage of  madness ;" that "the stomach
being in that  peculiar condition  which  produces an
extremely painful, moral, and physical depression,
craves  strong drink ;" that  " this craving is imperi-
ous and irresistible ; " that " it  continues  as long as
the paroxysm, after which the patient becomes sober
 and assumes all the habits of a temperate life."  He
 also says, that these people  "obeyan impulse which
 they have not the power of resisting ; " that they are
 <' true  monomaniacs ; "  and that if carefully observed
 we shall find in them "  all the characteristic features
 of partial madness."  In illustration of his views he
 relates  the following case.  " M. N.,  a merchant,
1 Op. cit. 36.
2 Note in Hoffbauer, § 195. 
424   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XX11I.

aged about forty, of a robust  but  nervous constitu-
tion, became, six years before, towards the beginning
of autumn, gloomy and disquieted, in consequence,
apparently, of some reverses in his affairs.  After a
few weeks, he neglected his business, and became
irritable and ill-tempered  in his family.   His taste
and habits changed, he took to drinking, and seriously
endangered the safety of his fortune and  his family.
The prayers and tears of his wife  and  children,  the
authority  of  his father,  and  the  inroads  upon  his
property,  were equally unavailing in checking his
career.   Thus passed the  winter ;  at  the  approach
of spring, the craving for  drink ceased.   M. N. re-
sumed his regular and sober habits, and by his appli-
cation to business and increased  tenderness towards
his family, he endeavored to forget  the occurrences
of the past winter.  In the  following  autumn  there
appeared the same phenomenon, the same disorders,
and the same spontaneous cure in the spring.   It
was the same for the two following  years except that
the symptoms were so aggravated,  that his property
suffered severely, and his wife's  life was  sometimes
endangered.  At the end of his fourth paroxysm, in
1817, M. N.  came to  Paris  to  consult me and sub-
mit to my directions, conjuring me to deliver him
from a disease that rendered him the most miserable
of men."   Esquirol  subjected  him to a  course of
medical treatment, and in August sent  him off on a
journey into Italy.   That  year he  escaped, except
that in December  he  manifested a slight desire to
drink, but found himself able  to resist,  and never
afterwards had a return of his complaint.  He also
relates the case of a lady, who, after being melan- 
CH. XXIIL]
DRUNKENNESS.
425
cholic for six weeks, with weakness of the stomach
and  indisposition  to  take the  least exercise, was
suddenly seized with the strongest craving for spirit-
uous drinks, together with  sleeplessness, agitation,
disturbance of mind and perversion of the affections.
For six years, these symptoms  made their  appear-
ance annually,  and continued two months.
   § 321.  A case is related  in the  Journal des Pro-
gres,  fyc. vol.  xi., of a Parisian bookbinder,  sixty
years old,  who  for fifteen years was afflicted  with
periodical  drunkenness, having  previously  been a
model of sobriety  and virtue.  The paroxysm lasted
two or  three months with an interval of equal dura-
tion.  M. Pierquin, the narrator of the case, observed
him closely for the space of two  years, and found
that his daily habit was, to rise  at five or six o'clock
in the morning, take some money out of the till, and
hasten to the nearest cabaret, where he wrould  drink
incessantly, until ten or eleven  o'clock.  He would
then stagger home, go down into his cellar, bring up
some large bottles of wine, and  drink night and day,
seldom sleeping and very rarely eating.   During  the
early period of the attack, he would go to the  caba-
ret,  forenoon and afternoon ;  but  during  the last
eighteen or twenty days, he never  went from home.
Then he became  reserved,  passionate,  avoiding  the
light, and seeking the darkest corner of the kitchen.
He was never observed to be delirious,  nor deranged
in mind, but would answer  questions correctly, and
follow  the train  of  conversation.  The paroxysm
ended  in  a  profound  sleep from  which he would
awake  in his sober senses, and resume his avocations
as if he had just quitted them  the preceding  even- 
426   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXIIL

ing,  being unconscious, or pretending to be so,  of any
thing that had occurred.
   §  322.  It can scarcely be doubted that the above
cases originated in pathological  changes ; and there
is  also another class of cases which strongly point to
the same origin, and present a close affinity, both in
this respect, and in that of their symptoms.   In the
cases referred to, the persons  who are habitually
sober, are  irresistibly  impelled to indulge in the
reckless, unlimited use of intoxicating drinks, when-
ever agitated by strong moral  emotions.  The author
was  once acquainted with a very amiable, intelligent,
and virtuous young seaman, who, by means of strict
attention to  his duties, his staid deportment, and his
knowledge of  navigation,  rose to the command of a
ship, at a very early age.  During  his second voyage
as captain, while in a foreign port,  in a hot climate,
some circumstances occurred, which subjected him to
considerable fatigue and exposure  and  great anxiety
of mind, and seriously affected his health.  By this
and some other things which took  place  on the pas-
sage  home,  his mind was so disturbed,  that this
young man, who  hardly  knew  the taste of ardent
spirits, suddenly abandoned himself to  the wildest
excesses.  The fit continued  till within a few days
of their arrival in port, during  which  time he was
totally unconscious of what  was going  on,  and the
first  officer took  charge of the  vessel.  The  same
scenes again occurred the  next voyage, and he lost
his employment; but with these two exceptions, no
man  living  practised  more  rigid  abstinence  from
every  kind  of intoxicating drink.   Nothing   could
tempt him to the slightest indulgence, and he evinced 
CH. XXIIL]         DRUNKENNESS.                427

the strongest repugnance to all spirituous liquors of
whatever kind.  The author also knew another young
man of similar character, who rose in a similar man-
ner to the  command  of a  ship ;  but  no sooner did
he reach this reward of his merits, than he began to
drink with all the recklessness of an old toper.   As
soon as he was  degraded  to  an  inferior station, no
man could be more temperate, and this appearance
of reform  each  time encouraging his friends  with
the hope, that he had abandoned his bad habits alto-
gether, they would restore him to the  station he had
lost, to be again and again forfeited  by his mad pro-
pensity.  In these cases, it seems as  if the  anxiety
arising from a sense of heavy responsibility, and from
adverse circumstances,  produced an irritation,  if not
inflammation of some portion  of the  brain—of that
which, if phrenology be true,  is  connected with the
appetite of hunger and thirst.
   § 323. Esquirol mentions  the  case of a servant-
girl in the Salpetriere,  who,  upon the slightest cross
or contradiction, began and continued to drink until
prevented by strict seclusion.   If not prevented in
time, she got drunk,  became  furious,  and attempted
suicide. 
428  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXIV.
               CHAPTER  XXIV.

      LEGAL CONSEQUENCES  OF DRUNKENNESS.

   § 324.  Before we undertake to estimate the legal
responsibilities of drunkards, it will be necessary to
retrace our steps  for a  moment, in order to ascertain
what is the exact state of the mind, while under the
immediate influence of intoxicating drinks, and for
this purpose we  shall distinguish, with Hoffbauer,
three  degrees, or periods of drunkenness.  In the
first degree, to use  in some measure the language
of this writer, the ideas  are  only uncommonly viva-
cious ; consequently the empire of the understand-
ing over  the actions is so little weakened, that the
individual perfectly retains the consciousness of his
external  condition,  and in fact may be said to be in
complete  possession of his senses.   Still, this rapid
flow  of ideas is unfavorable to  reflection, and there
also accompanies it great irritability and activity of
the moral emotions.  It must be remembered  how-
ever, that anger is more rare  in this degree of drunk-
enness, in consequence of the self-satisfaction  which
the person  enjoys,  and  which renders  him  more
patient ;   but, on the other hand,  some previous
circumstances  that may have  increased his suscepti-
bility, even the sallies of a wild gayety, or a simple
dispute  of words, though conducted  with  courtesy, 
CH.XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS.  429

strongly dispose him to transports of passion.  Still,
as long  as  drunkenness  does not exceed  the  first
degree, the passions can be repressed.  In the second
degree of drunkenness a man has  still the use of his
senses, though they are remarkably enfeebled ; but
he is entirely beside himself; memory and judgment
have abandoned  him.   He acts as if he lived only
for the present, with no idea of the consequences  of
his actions, nor their relations to one another.   The
past has gone from his mind, and he cannot  be influ-
enced by considerations which he  no longer  remem-
bers.   He conducts himself as if no control over his
actions were necessary.  The slightest  provocation
is sufficient  to awaken the most unbounded rage.
He is  therefore  not unlike the maniac,  and can be
responsible for his actions, only so far as he is for
his  drunkenness.   In  the last  degree, he not only
loses  the possession of his  reason,  but his  senses
are so enfeebled, that  he is  no longer conscious  of
his external relations.   In this condition he is more
dangerous to himself than to others.
  § 325.  In  the  first  stage  of drunkenness, it  is
obvious that  the legal relations  of  the individual
cannot be affected, inasmuch as he has lost  none of
the ordinary  soundness  of  his judgment.   In the
second and third  stages, so much is the soundness of
his  understanding  and clearness  of his  perceptions
impaired, and his passions excited, that he acts more
or less unconsciously and without  deliberation.  But
since drunkenness is itself a sin, it becomes  a ques-
tion how far a person's liability  for the consequences
of his acts in that state can  be affected, by a condi-
tion which is itself utterly inexcusable.  A  remark- 
430  MEDICAL JURISPRUDENCE OF INSANITY. [CH.XXIV.

able diversity of views has prevailed on this  point at
different times and among different nations, and it
would certainly be a curious,  if not useful  inquiry,
to  investigate the  peculiar circumstances that have
given rise to  it.   In ancient Greece, he who com-
mitted a crime when drunk, received a double pun-
ishment ; one for  the crime itself;  another for  the
drunkenness that  prompted him  to commit  it ; and
in a magistrate it was made a capital offence.   The
Romans, on  the contrary, admitted drunkenness as
a plea in defence of any misdeeds committed under
its  influence, except when it occurred in a woman  ;
then it was punished  with death.   In  the Austrian
law under Joseph II. drunkenness  is made a sufficient
excuse for crime,  whenever it is not  accompanied
with an intention relative to the criminal act.   In the
French penal code, no mention is made  of drunk-
enness, either as a  ground of defence for  crimes and
offences,  or as impairing  the  validity of civil acts.
  In  1807,  the  court  of  cassation2  decided  that
drunkenness, being a voluntary  and reprehensible
state, could never constitute a legal or moral  excuse,
and the practice in  France has subsequently been in
accordance with this decision.  Georget, however,
has quoted a  case,2 where this principle seems to
have been avoided  by the jury by means  of a tech-
nicality in their verdict.   J. M. Erion was tried on
a charge of assault and battery upon his mother, and
it appeared on the trial that at  the moment of com-
  1 This is the highest court in the kingdom, and receives appeals
from all the other courts.
  2 Discussion medico-legale, p. 23. 
CH. XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS. 431

mitting  the assault,  he was in a fit of intoxication.
The verdict of the jury was, that he was guilty, but
acted  involuntarily;  and consequently, he was dis-
charged  in virtue  of the  364t.h art. of the code of
criminalinstruction,  viz.: "The court  will acquit the
accused if the act for which he is indicted is not pro-
hibited by  any penal law."1
   § 326. The common law of England has  shown
but little disposition  to afford relief from  any of the
immediate consequences of drunkenness,  either in
civil  or  criminal  cases.    It  has  never considered
mere  drunkenness alone,  a sufficient reason for  in-
validating  a deed or agreement, except when carried
to that excessive degree which deprives the party of
all consciousness of what  he  is doing.2   Courts of
equity  also  have  strenuously  refused their  relief,
unless the drunkenness were  procured by the fraud
or imposition of the other  party, for  the purpose of
obtaining some unfair advantage.3  Writers on natu-
ral and  public law,  however,  have regarded  drunk-
enness  under any circumstances, as a sufficient cause
  1 The apparent want of connexion  between the discharge of the
accused and the provisions of this article, is to be explained by the
difference of procedure in French and English courts.  The former,
unlike the  latter, permit the jury, in criminal casts, as well as civil, to
render a special verdict, and accordingly they found Erion guilty of the
assault, but that having "acted involuntarily," he was  guilty  of no
crime, and was entitled to a discharge from the court, as much as if he
had been found by the same verdict, guilty of the assault, but deranged,
and not acting voluntarily.  The law makes  no man responsible  for an
involuntary act, and drunkenness is not recognised as a circumstance
that deprives acts of this quality which are committed under  its influ-
ence.
  2 Cole v. Robbins, Buller's Nisi Prius.
  3 Cooke v. Clayworth, 18 Vesey's Rep. 12. 
432  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXIV.

for  avoiding any acts that may have been  executed
under its influence, upon the principle, that the free
and deliberate consent of the understanding is essen-
tial to the validity of such acts.1
  § 327. The  general doctrine  to  be derived from
the above principles, is, first, that  moderate drunk-
enness does  not  deprive  the  understanding of the
power of rational consent, is  not very apparent to
others, and  therefore ought not to be  allowed to
avoid any deed or contract; secondly, that, inasmuch
as  excessive drunkenness deprives a person  of all
consciousness of  what he is doing, and is  perfectly
obvious to every one, all acts executed while in that
condition are strongly exposed  to  the suspicion of
fraud, and may be avoided on that ground.  Nothing,
certainly, can be  fairer  than this,   since it equally
guards the  interests of the drunken party, and of
those who deal with him.
  § 328. In  regard  to the effect of drunkenness in
criminal  cases, it has been declared by a learned
expounder of the common law, that, " a drunkard,
who is voluntarius demon, hath  no privilege thereby ;
whatever ill or hurt  he doeth,  his drunkenness doth
aggravate it." 2   Drunkenness itself has never been
regarded as a crime,  and, in the practice of the pres-
ent time at least, it is not literally true,  that it is an
aggravating circumstance  when  attending  the com-
mission of real offences.    It may be said more cor-
rectly, that it has no  legal  effect whatever, on any
  1 Puffendorf's Law of Nature and Nations, B. 1, ch. 4, § 8; Pothier,
Traite des Obligations, n. 49.
  * Thomas's Coke's Littleton, 46. 
CH. XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS.  433

offence which it accompanies ; it neither modifies its
nature,  nor  increases,  nor mitigates  its penalties.
Drunkenness gives rise, however, directly or indi-
rectly, to various pathological  conditions affecting
the operations of the mind,  and  it  has become a
question of  considerable delicacy  in some cases, to
decide how  far legal  responsibility is diminished by
their presence.  Different  cases have been decided
on different grounds, and  to  make any remarks on
the subject perfectly intelligible, it will be necessary
to select a few  in  which the circumstances  and
grounds of decision are fully reported.   In the three
following, the condition, under the influence of which
the crime was committed, was Delirium  tremens, or
Mania a potu.
   § 329.  I. At the May term, in 1828, of the circuit
court of the United  States, Alexander  Drew, com-
mander of the whaling ship John  Jay, was tried for
the murder of his second mate,  Charles F.  Clark.
It appeared in evidence, that previously to the voyage
during which this  fatal  act occurred, Drew had  sus-
tained a fair character, and was  a  man of humane
and  benevolent disposition, though  addicted  to  the
excessive use  of  ardent spirits.  After recovering
from a drunken debauch, in the latter part of August,
1827, he resolved to drink no more, and all the liquor
on board the ship was thrown overboard.  In two or
three days  after,  he  lost  his appetite, was  unable
to sleep, and manifested various hallucinations.   He
thought the crew  had conspired to kill him,  and ex-
pressed great fear of an Indian belonging to the ship,
calling  him  by name when not present, and promising
that he would drink no more rum, if he would not
              cc 
434  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXIV.

kill him.  Sometimes he would sing obscene songs,
and sometimes,  hymns, and would pray and swear
alternately.   In  the night of the 31st of August, he
went on deck, and attempted to throw himself over-
board, but was restrained by the witness.  At seven
o'clock in the forenoon, September 1st,  while the
witness, Drew,  and  Clark  were at breakfast, Drew
suddenly  left  the table, and appeared to  conceal
something under his jacket which was on the transom
in another part of the cabin. He immediately turned
round  to Clark and  requested him to go upon deck.
The latter replied  that  he  would when he  should
have finished  his breakfast.   Drew then exclaimed,
"Go  upon deck, or I will help you,"  and immedi-
ately  took a knife that had been covered over by his
jacket,  and before  another  word  was spoken  by
either, he plunged  it into the right side of Clark's
breast.   Clark fell  instantly,  but soon afterwards,
rose and went upon deck.   As the witness  left the
cabin, Drew cocked his pistol, pointed it at him and
snapped it, but it missed fire.   Drew followed them
upon  deck, and addressing  the  chief mate, said,
" Mr.  Coffin,  in  twenty-four hours, the ship shall go
ashore."  He was then seized  and confined.  His
whole demeanor, for some weeks after, was  that of
an insane person.  When he first appeared  to be in
his right mind, he was informed of Clark's  death and
its cause, he replied that he knew nothing about  it,
that when he awoke,  he found  himself handcuffed,
and that it appeared to him like a dream.   It also
appeared that there had not been for months any
quarrel between Clark or Drew.
   § 330. After  hearing the witness who testified the 
CH. XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS. 435

above facts, the court  interposed,  and through Mr.
Justice  Story,  delivered its opinion, that  on these
admitted facts, the indictment could not be  main-
tained,  because  the  prisoner  was  unquestionably
insane at the time of committing the offence.   "The
question made at the bar," continued the court, "is
whether insanity, whose remote  cause  is habitual
drunkenness, is or is not an excuse in a court of law
for a homicide committed by the party while so  insane,
but not  at the time intoxicated or under the influence
of liquor.  We are clearly of opinion that insanity is a
competent excuse in such a case.  In general, insan-
ity is an excuse  for the commission of any  crime,
because the party has not the  possession of his rea-
son, wdiich includes responsibility.   An exception is
wdien the crime is committed while the party is in a
fit of intoxication, and while it  lasts, and not as in
this case a remote consequence, superinduced by the
antecedent exhaustion of the party, arising from gross
and habitual drunkenness.  However criminal, in a
moral point of view, such an indulgence is, and how-
ever justly a party may  be responsible for his acts
arising from it to Almighty God, human tribunals are
generally restricted from punishing them, since they
are not the acts of a reasonable  being.   Had the
crime been committed while Drew was in a fit of  in-
toxication,  he  would have been liable to be convicted
of murder.  As  he was not  then intoxicated,  but
merely  insane  from an abstinence from liquor,  he
cannot be  pronounced guilty  of  the offence.  The
law looks to the  immediate and not to the  remote
cause, to the actual state of the party and not to the
cause which remotely produced it.  Many species of 
436  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIV.

insanity arise remotely from what, in a moral point
of view, is a criminal neglect or fault of the party, as
from religious melancholy, undue exposure, extrava-
gant  pride, ambition,  &c, yet  such  insanity  has
always been deemed a sufficient excuse for any crime
done  under its  influence."  The jury returned a
verdict of not guilty.1
   § 331. II. At a term of the supreme court in York
county,  Me.,  April, 1836,  Theodore Wilson  was
tried for the murder of his  wife  in  June, 1835,  at
Kittery.   It appeared in evidence,  that for several
years, Wilson had  been addicted  to  intemperate
drinking; that on the Saturday previous  to the mur-
der, he brought some rum from  Portsmouth, N.  H.,
and that on the next day he had drunk it all.  It  did
not appear that he drank any  more  after  this,  and
circumstances render it  probable that  he did  not.
There was nothing strange or unusual in his conduct
till Wednesday  morning, when he arose  early and
went to the house of a neighbor to get some  barley
and procure a person to sow it for him.  He returned
home about six o'clock, and then complained of being
sick.  His wife assisted him  to undress, and he  laid
down, saying that  he was dying.   In the  meantime
he  complained that  his  wife would do nothing  for
him;  that she had often set  traps for him, and once
put fire and wood into the oven to burn him up.   He
ate some porridge  only for his  breakfast,  was con-
stantly talking, and among other things, spoke of his
having been fishing  when he  was four years  old.
' 3 American Jurist, 7—9; 5 Mason's Reports, 28. 
CH. XXIV] LEGAL CONSEQUENCES OF DRUNKENNESS. 437

While the family were at dinner, he arose from bed
and  walked  about  in great agitation,  striking  the
walls with his fists, and beating in the door with  the
tongs.  As  he became more furious, a woman who
resided with him at this time, left the house, he  and
his wife then being the only persons in  it.  A short
time  after, he was  seen  coming  out of  the  house
stark naked,  and in this condition he walked rapidly
down the road, throwing up his arms, and making a
wild, howling noise, and finally laid down by a fence.
It appeared that after he left the house,  his wife went
to one of the neighbors to ask his aid in getting her
husband back, but this person declining to interfere,
she went alone.  As she approached him still lying
by the fence, she asked him why he was lying there
and making such a noise.  He immediately sprung
up,  put his  hands upon  her  shoulders,  threw her
down, and beat out her brains with a stone.   He
 then left the body, and on reaching a house near by,
broke in the windows with his fists, and also  struck
 at the doors and side  of the house, to  seal it, as he
 said,  with  his  wife's blood.   Here he  proclaimed
 that  he had  killed his wife and meant  to kill two
 more; he was then arrested.  To those who watched
 with him during the night, he declared he was not
 sorry for what he had done, but  was glad of it,  and
 intended to  have  done it  before.   He continued
 furious, talking wildly  and  incoherently,  making
 unnatural noises,  sleeping  none,  and  apparently
 anxious to kill himself, till the next Saturday morn-
 ing,  when  he became,  and  remained  rational.   It
 further appeared, that in 1830, he went on a fishing
 voyage, and that being deprived of spirits,  he be- 
438  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIV.

came deranged three days after sailing, and had to
be confined.   He then began  to tear his clothes, and
try to tear the clothes of others.   He complained of
being sick, said he should die, and  requested the
captain to tell his  sons to take care of their mother.
He was afterwards set ashore, and did not go on the
voyage.
   His counsel set  up the plea of insanity in his de-
fence, and the court, in  charging the jury, observed
that it was not material  for them to determine  what
species of  insanity  it was under  which  the prisoner
had  been  suffering,  if satisfied  with the  fact of its
existence.  He was acquitted.1
   §  332.  III. John Birdsell was tried in 1829 by the
supreme  court of Ohio,  on   an  indictment  for the
murder of his wife, on Thursday, 5th  of March,
1829. It appeared in evidence, that for several years
the  prisoner  had  indulged  in  fits of intoxication,
which, in the latter part  of the time,  had been fol-
lowed by  delirium  tremens,  which generally lasted
for  several  days,  and went   off spontaneously.  In
these paroxysms,  he  had the  physical  and moral
symptoms that usually  characterize  the  disease.
Among many hallucinations under which he labored,
the prevailing one was, that his wife was in a com-
bination with three of his neighbors,  one of whom
was  his son by a former wife,  and that they had  con-
spired to take his  life.    He imagined  that his  wife
had a criminal intimacy with these persons, and  even
  1 For the facts in this case, the author acknowledges his obligations
to Nathan Dane Appleton, Esq., one of the defendant's counsel. 
\
CH. XXIV ] LEGAL CONSEQUENCES OF DRUNKENNESS.  439

threatened to kill her if she did not desist.   On the
Sunday before the murder,  he drank freely and  was
intoxicated, in which condition, he was quiet, dull,
and disposed to lie in bed.  Monday,  Tuesday,  and
Wednesday, presented nothing special. On Wednes-
day evening he complained to a neighbor, of feeling
unwell, and asked his son's  assistance in the perform-
ance of some necessary manual labor  for his family.
He seemed to the witness  to  be rational.   Dunns:
the night, he slept none, and  complained  of cramp
in the stomach. The next morning, his family thought
him crazy, but were not  alarmed,  as  they were ac-
customed to such attacks.  In the course of the day,
he took an axe and walked rapidly to the house of a
neighbor whom he desired  to go home with him, say-
ing that they wanted to kill him; and about the same
time he told  another  of  the supposed conspirators,
that he had overheard his wife and  him, that morn-
ing, whispering about taking his  (the  witness's) life.
He spent the day at home in the midst of his family,
apparently in agitation and  terror, but said he would
not hurt any one and did not  wish to be hurt.  He
also placed  a scythe  with  the  axe under the bed,
where the  latter was often  kept.   He manifested
jealousy of his wife, and told her to  act better,  for
she had already  caused the death of thirty thousand
men.   He fancied that the  persons of whom he was
jealous, were in  the loft manufacturing ropes to hang
him, and going up,  returned, saying that he had cut
the ropes in pieces and brought down  the fragments
in his hands, though he had nothing in them.  In the
course of the afternoon,  he fastened both the doors
of his house.  At the usual time, the wife went out 
440   MEDICAL JURISPRUDENCE OF INSANITY. [CH.XXIV

to milk, and he barred the door  after her.   On her
return, he fastened  it again.   She was seated near
the fire, and he was walking the room.   At length,
he took the axe from  under  the bed, and  gave the
fatal blow, following it  up with two others  on the
face.   His oldest daughter caught the axe which he
yielded up, and then he seized the scythe, with which
he  attempted to strike her.   She defended  herself
with a chair, till the smaller children having opened
the door, she escaped.  He took the youngest child
in his arms, and sat down by the window. The child
exclaimed, " mamma bleeds ! " which, he said, made
him feel badly.  When his neighbors arrived  imme-
diately afterwards, he gave himself up, acknowledged
what he had done, said he knew he should be hanged
for it, but that he ought to have done it nine months
sooner ; that if he had to do it again,  he would strike
two blows where he only struck  one.  It was testi-
fied that he talked so  rationally, that  many  of the
witnesses could not believe him deranged ; that he
evinced no dread of punishment for  his  crime, but
was  still in great apprehension from  the  persons,
who, he had believed, intended to kill him ; and that
he was glad he had  defeated their calculations.   On
his way to jail, he talked rationally and  composedly
about his affairs, and various other subjects, but fre-
quently asked the guard if they did not hear sweet
sounds of different kinds, and on being answered in
the negative, insisted that he  could not be mistaken.
After  his committal,  he became  rational and ex-
pressed his regret, at what he had done.
   § 333. The point submitted to the jury  for their
determination, was, whether the prisoner was capa- 
CH.XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS.  441

ble of  discriminating  between  right  and  wrong.
They concluded that he was, and returned a verdict
of guilty.   In consequence of a petition from  quite
a number of persons who had no doubts of Birdsell's
insanity, the punishment was commuted by the gov-
ernor, to  that of  imprisonment.   Previous to  the
commutation, he again  became  insane, and continued
so permanently.1
   § 334.  The essential features of the  above cases
being alike in every thing relative to their pathologi-
cal nature, we are left without any satisfactory reason
to account for the issue of the  last.  It is  probable
that the court adhered  to  the antiquated maxims of
the common law on the subject of  insanity, and that
the jury were governed by the opinions of the court,
or  relied,  w7ith  that  confidence  which ignorance
usually inspires, on their  own  crude and erroneous
notions.  The verdict  of the jury in  Birdsell's case,
furnishes  another instance of the deplorable conse-
quences of obliging a body of men,  the most of whom
are utterly unacquainted with the phenomena of in-
sanity, to decide  the question  of its  existence  in a
given example, and  with it the fate of an unfortunate
fellow-being, for weal  or for woe, here and hereafter.
They concluded that the accused was capable of dis-
tinguishing right from wrong, probably, because others
who knew as little  of  insanity  as  themselves testi-
fied, that immediately  after committing the murder,
  1 This case was reported, and the medico-legal questions growing
out of it were discussed at considerable length, by Dr. Drake, in the
Western Journal of the Medical and Physical Sciences, vol. iii.  Ex-
tracts from his papers may be found in  the American Jurist, vol. iii.
p. 10—16. 
442  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIV.

" he talked so rationally that they could not believe
him deranged," and on  such  a conclusion  they
founded their  fatal verdict.  Of course, it would  have
been too violent a contradiction in  terms, to  have
denied the existence of any insanity at all in a disease
whose very name is  delirium, but it  appeared that
the prisoner was not  altogether bereft of his senses,
not quite reduced to the condition  of a  brute or an
idiot.   Now without  resting  upon the  general fact
that the mind is always and  unequivocally deranged
in delirium tremens, there is proof enough that vari-
ous hallucinations took possession of Birdsell's mind
and prompted him to  the bloody  deed  for which he
was condemned—that he was under the  influence  of
manifest, unequivocal, strong  delusion,  that  test of
insanity, which, when present, never deceives.  If
any one, on being made acquainted with  the particu-
lars of Birdsell's case, can  pronounce  it not to be
insanity, he must have derived his notions of this
disease from some other  source than  the wards  of
the hospital and asylum.
  § 335. In the first  two cases, the directions of the
court  to the jury  were, substantially, that if  they
were   satisfied  the  accused  was insane  when he
committed  the criminal  act,  they were  not  to go
back and inquire into the causes of the insanity,  but,
on  this fact being  established  in their  minds, the
prisoner  was  entitled  to an  acquittal.   In  the  first
case, the court examined  the question, whether the
legal  consequences of insanity  are  affected by the
character of the cause which produces  it, and  so
clear  and satisfactory is  its opinion, that  any thing
further on  this point  is rendered  unnecessary here. 
CH. XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS.  443

In Birdsell's case,  there  was presented a new fea-
ture of no little interest to the medico-legal student,
which, though it was suffered to have no influence on
the verdict, might,  if the  court had chosen to urge
its opinion respecting it upon the jury, have prevent-
ed an acquittal, even if they had satisfied  themselves
beyond  a doubt, that  the party was incapable  of
distinguishing between right and wrong.  In replying
to the  arguments  of counsel for  a new trial,  the
court observed in  the course of its  remarks, " that
they were not called upon to give an opinion whether
Mania  a potu  would, under  any circumstances,  be
an excuse for  the  commission of a crime, but  they
felt  no unwillingness to express their opinion, that if
the  insanity were  the offspring of intemperance and
the  prisoner knew that intoxication would produce it,
he could not plead  it  as an  apology."   Birdsell, it
has been seen, had experienced  several fits of deli-
rium tremens following his drunken debauches, pre-
 vious to that  in which  he destroyed his wife,  and
consequently knew that  intoxication would  be likely
to produce  insanity.   How far this fact changes the
attitude of the case, is a point which deserves a care-
 ful examination,  before being  allowed to have a bear-
 ing on  judicial decisions.  If the party had known,
 that in his previous  attacks of delirium tremens, he
 had attempted the life of his wife,  then  indeed, this
 opinion would not have been without some founda-
 tion, for in  that case, perhaps, he  might have been
 justly held responsible for whatever criminal acts he
 committed while in a state of insanity, just so far  as
 he  was responsible for the intoxication that produced
 it.  All that Birdsell knew on this  subject, however, 
444  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIV.

was,  that indulgence in drinking,  having frequently
occasioned delirium tremens, would be liable to pro-
duce a renewal of its attacks.  As to what acts he
might commit while under their influence, he knew
absolutely nothing.   It is not very clear how delirium
tremens can  have a different effect on legal respon-
sibility, from that which would follow any other form
of mental derangement resulting from habits of intem-
perance.   If Birdsell's habits had led to attacks of
common   mania instead  of  delirium  tremens, his
guilt, in a moral point of view, would certainly have
been  no  less;  nor, on the  hypothesis of the  court
that insanity is no  apology for crime, if the party
knew  that intoxication would produce it, would his
legal  responsibility have been diminished.  It does
not appear  however, that,  in ordinary cases where
insanity is pleaded  in excuse for crime, the  question
is ever raised whether the insanity be a consequence
of intemperate  drinking, and, in the event of its be-
ing so, whether the party knew that such  a  result
might be expected.   It is not easy to resist the im-
pression,  that the opinion of the court,  against the
exculpatory effects of Birdsell's insanity, was deter-
mined, in some measure, by the reprehensible char-
acter  of its cause.  If his insanity had been produced
by  mingling  in  scenes of religious  excitement,  by
indulging  in  schemes of commercial speculation, or
a more criminal species  of  gambling,  would the
court  have said it furnished no apology for crime,
because he had suffered  previous  attacks in conse-
quence of exposure  to the action  of these  same
causes 1   Probably not; and yet if guilt is made to
consist in  disregarding the lessons  of  experience 
CH. XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS.  445

relative  to the manner in which the  insanity is pro-
duced, then the nature of its exciting causes is clearly
an  immaterial circumstance.  In short the opinion of
the court of Ohio conflicts with the principles  laid
down by Mr. Justice Story  (§ 330), and if the latter
be  admitted, as they must be, undoubtedly, by every
one, so far  as  they relate to the causes of insanity,
the former is untenable for  a moment, and  therefore
it is scarcely necessary to pursue this train of reflec-
tions any farther.
  § 336. In persons who have recovered from attacks
of disease or injury of the head, drunkenness some-
times produces a temporary madness which continues
only during the drunken fit, and leaves the mind in
the possession of its  habitual  sanity.   Is insanity a
valid excuse for criminal acts committed while under
the influence  of this  condition,  and while  liquor is
exerting  its immediate effects  upon   the brain  ?
"There are  many men,  soldiers,  who have been
severely wounded,  in  the head  especially, who well
know that excess makes them mad ; but if such per-
sons wilfully  deprive  themselves of reason,  they
ought not to be excused one crime by the voluntary
perpetration of another." J  In  the opinion of  Mr.
Justice Story above quoted,  it is also said, that insan-
ity  is not a competent  excuse for crime, if it be com-
mitted " while the  party  is in a fit of intoxication
and while it lasts,"  and the following case furnishes
an  instance of the practical application of this prin-
ciple.
1 Paris and Fonblanque: Medical Jurisprudence, vol. iii. 
 446  MEDICAL JURISPRUDENCE OF INSANITY.  [CH.XXIV.

   § 337. IV. William McDonough was tried and con-
 victed,  on an indictment for the  murder  of his wife,
 before  the  supreme  court  of Massachusetts  in No-
 vember, 1817.   It appeared in evidence, that many
 years previous, the defendant had received a severe
 injury of the head, in consequence of which he had
 suffered occasional paroxysms of insanity, though the
 general habit of his  mind was sound and clear.  It
 appeared that they were often produced by intoxica-
 tion, and there was some evidence to prove that they
 sometimes occurred unconnected  with  any apparent
 exciting cause.   In one of these  fits of insanity in-
 duced by drinking, and while actually under the influ-
 ence  of  liquor, he murdered his  wife.   The  court,
 in its charge to  the  jury, observed, that,  " if they
 believed the prisoner  was in a fit of lunacy when he
 committed the act, he should  be acquitted ; but if
 they believed he was  of sound mind, or, if his reason
 were  impaired, that  it was  caused by  intoxication
 only,  the fact being proved, and  no palliating cir-
 cumstances existing he must be convicted."1   If, in
 using this language, the court  had in view any cir-
 cumstance that might be deemed  to be of a palliating
 character, it is not easy to see what it was, unless it
 were  the pathological condition  resulting from the
 injury of the  head which rendered him peculiarly
susceptible  to the effects of ardent spirits.   If the
court  actually did consider this a  palliating circum-
 stance, it is to be  regretted that its language was not
more explicit on this point. It is very probable, that,
1 Trial of William McDonough for the murder of his wife, p. 65. 
CH. XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS.  447

in this  case also,  the jury were considerably influ-
enced by  the character  of  the exciting cause  of
McDonough's insanity.   If it had been testified that
instead of  getting  drunk, he was in the habit of at-
tending religious meetings where warm and pungent
appeals were addressed to his  feelings ;  that  the
excitement thus  produced, occasionally degenerated
into a fit of madness, in one of which he killed his
wife, the  jury  would  have acquitted  him  without
leaving their seats.  Yet the essential  condition of
guilt would  have been the same as in the case that
actually happened.  "The voluntary use of a stim-
ulus,"  as  it is  expressed by Dr. Beck, "which  he
was well aware would disorder his mind, fully placed
him  under the purview of  the law."1  It is not a
satisfactory reply to this objection, that in  the one
case, the exciting  cause  is, in  itself, of a commend-
able character, while in the other, it is in the highest
degree, sinful and  pernicious.  Drunkenness  in itself,
is not by law, a crime; and, though  the moral sense of
the community at the present day condemns even the
moderate  use of intoxicating drinks, it must be recol-
lected  that  twenty  years ago, and especially in the
class to which  McDonough belonged, such  use was
generally  considered not only harmless but absolutely
necessary  to the bodily  health.  Had he not labored
under  this peculiar  irritability  of the brain,  it is not
supposed  that the  bloody act would have been com-
  1 Medical Jurisprudence, 627.  In a subsequent edition of his work,
however, the Doctor observes, that, in using the language above-quoted,
he has "probably expressed himself too strongly," and seems inclined
to retract his approval of the verdict of the jury. 
448  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIV.

mitted or even thought of, so that  McDonough was
virtually convicted for the consequences of a bodily
infirmity.
   § 338.  V. The following case related by Georget
presents us with another striking illustration of men-
tal disorder  excited by the use of spirituous liquors.
Vatelot, a gendarme, while passing the Place  Louis
Quinze, suddenly struck the  sieur Chardon with his
sabre.   The latter turned  round, and seeing a stran-
ger brandishing a  sabre over his head, asked if he
knew him and what  he  meant.    "I know you,"
replied  Vatelot,  "you are my enemy,  and I will
give it to you."  At the same  moment he aimed at
him another blow,  and after pursuing him  a  while
with his drawn  sword, left him.  He soon met  the
sieur Bellon whom he struck on the head, and aimed
two blows at the  sieur Avenel  who accompanied
Bellon.   The sieur Beaupied who ran to their assist-
ance, and another person who never injured him, he
also threatened; and finally, observing a young lady
standing at  her door, he  struck her  over the head
with his sabre, and then fled.  On trial  before  the
court of assizes at  Paris, he denied  the facts, and
admitted that he had  been drinking, but was not
drunk.   He was convicted of homicide  committed
voluntarily,  but without  premeditation,  and con-
demned to hard labor for life.1
  § 339. The homicidal acts of Vatelot obviously have
all the  characteristics,  that distinguish those com-
mitted by furious maniacs.   " He attacked indiscrimi-
1 Discussion Medico-Legale, p. 159. 
CH. XXIV.] LEGAL CONSEQUENCES CF DRUNKENNESS. 449

nately all  whom  he met,"  said the  court,  " and
made four  successive attempts  at homicide without
being moved by any of the passions characteristic of
crime, but, in consequence of a fatal  frenzy  which
impelled him  to the shedding of blood whenever  an
opportunity offered."  One of the elements of guilt
in McDonough's case is wanting in  this, for it does
not appear that strong drink had ever  produced a fit
of insanity before, and thus it could not be urged that
Vatelot sinned against the  light of his own expe-
rience.   If he had  not drank  enough to intoxicate
him under  ordinary circumstances, he had done no-
thing which the law or public opinion recognised to
be wrong,  and there was not a shadow of justice in
rejecting his plea of insanity. Even if he had, are we
to make no distinction, as Georget  forcibly inquires,
between a drunken person who commits a crime from
motives  of interest,  such as theft,  or to gratify a
criminal passion existing before the intoxication, and
one who, like Vatelot, becomes a murderer without
interest, without motive,  without any rational cause
for his conduct ?
   § 340.  The following passage from a recent writer
on criminal law, indicates,  it is to be hoped, the
dawn of more correct and humane sentiments on this
point of medical  jurisprudence.  "If,  either the in-
sanity has  supervened from drinking," says Mr. Ali-
son,  " without the  panel's having been aware that
such an indulgence in his case leads to such a conse-
quence ; or if it  has arisen from the combination of
drinking with  a  half crazy or  infirm  state of mind,
or a previous wound or illness which rendered spirits
fatal to his intellect, to a degree unusual  in other
               DD 
450 MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXIV.

men, or  which could not have been  anticipated, it
seems inhuman to visit him with the extreme punish-
ment which was suitable in  the other case.   In such
a case, the proper course is to convict ; but in con-
sideration of the degree of  infirmity proved, recom-
mend to the royal mercy." *
   § 341. In the  present state of public opinion, it
would be difficult, perhaps,  to convince a jury that
the wretched victims of periodical drunkenness, or
of that other form  of the disorder which we have
illustrated (§ 329), ought not to be held responsible
for their criminal acts.  It would be objected proba-
bly, that these conditions are the  result of habitual
indulgence, and that at the  utmost, the only differ-
ence between these and other drunkards is, that they
are impelled  to  the gratification of their  insatiable
cravings by different degrees of violence—a circum-
stance which it would be mischievous to recognise in
estimating the degree of criminal responsibility. The
truth would  be  overlooked or disputed,  that this
irresistible propensity to excessive drinking is mani-
fested as often,  if not oftener, in temperate men, as
in habitual drunkards, and that it is  either a  symp-
tom of the first stage of madness,  or of a temporary
impairment of the mind produced  by  some distur-
bance of the cerebral circulation.  The drunkenness
being thus an accidental, involuntary, consequence of
a maniacal state of  the  mind,  it  cannot impart the
character of criminality to  any action  to which it
may give rise. If the merchant or servant-girl whose
1 Principles of the Criminal Law of Scotland, 654. 
CH.XXIV.] LEGAL CONSEQUENCES OF DRUNKENNESS. 451

cases we have  quoted from Esquirol (§§ 320, 323),
had committed  murder in one of their paroxysms, we
should, no  doubt, have had  the testimony of that
distinguished physician,  as he has already recorded
it in his writings,  that they  were " true monoma-
niacs," "not morally responsible."  The other cases
we have related, though differing a little from these,
in some of their accidental symptoms, evidently pro-
ceeded from the  same pathological causes, and if
moral responsibility  ceases in the former,  it must
equally cease i  n the latter. 
452    MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.
               CHAPTER  XXV.

                  INTERDICTION.

  § 342. With respect to the  kind and degree of
mental impairment that warrants interdiction, there
prevails the utmost  diversity of opinion, and  such
must continue to be  the case, till sounder views are
entertained of the true purposes of this  measure.
The radical fault  of speculations on  this subject is,
that the attention has been directed to general  rules
and abstract distinctions, rather  than to  a  thorough
and discriminating examination of the particular cir-
cumstances of each individual case.   In  the follow-
ing paragraphs will be found abundant  illustrations
of the truth of this remark.
   343. Imbeciles in the first  degree  cannot be justly
deprived of the management of their property,  on
the ground of mental deficiency  alone.   If they have
shown no  disposition to  squander  their money on
trifles, nor  suffered  their  affairs to  be grossly neg-
lected, there  can  be no  reasonable pretence  for
taking it  altogether  from  their  control  and enjoy-
ment.  Neither should we be too rigid in  our  scru-
tiny of these cases.   If a whole  life of extravagance,
or hazardous speculation, is  not enough to produce
the interdiction of a sound  person,  why  should an
occasional act of either in  one of feeble intellect,
provoke that measure ?   Of course  there  can  be no 
CH. XXV.]          INTERDICTION.               453

question of its propriety when it is perfectly obvious
that he is dissipating his fortune, to the great detriment
of himself and of those who are dependent on him.
   ^ 344.  Much discussion and tedious litigation have
arisen from  the difficulty  of determining  the exact
measure of intellectual capacity requisite  to the un-
disturbed enjoyment of civil rights  and privileges,
chiefly  in consequence of losing  sight of the real
object before us, and pursuing a shadow of our own
creating.  It is a question  of capacity in  reference
to certain ends and duties, and  we are not called on
to go beyond the consideration  of these,  in our en-
deavors to settle this question.  The speculative opin-
ions of the imbecile person, the little peculiarities of
his conduct, his style  of living  and talking,  and his
general deportment in  society, are points that re-
quire but little attention in  this inquiry.   Our busi-
ness  is with the  manner in  which he  has  conducted
his affairs, and from this chiefly, we are to draw our
 inferences respecting  his probable future conduct and
 capacity. And here  we are not bound to institute a
 rigid  comparison between  his  habits and those of
 people enjoying ordinary  soundness and vigor of in-
 tellect.  We are not  warranted in stripping him of
 all his possessions and leaving  him at  the mercy of
 others, the moment we can  fix  upon a single instance
 in the course of his life, where he has neglected to
 profit by a happy turn of fortune, or has rewarded a
 service,  or bestowed his bounties, in  a  manner  alto-
 gether opposed to   our  ideas of forethought  and
 economy.  Has the individual  indulged in repeated
 acts of extravagance, or  of profitless expenditure ?
 Has he engaged in the execution of visionary projects 
454   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXV.

with reckless  indifference as to the  extent of his
means and appliances ? Has he squandered his money
on favorites, or become an instrument in the hands
of designing and profligate associates for advancing
their own selfish projects  ?   These  are among the
most prominent questions  that require a satisfactory
answer,  and if they are kept steadily before us, there
will be little fear of  losing ourselves in the maze of
perplexities which the judicial investigation  of cases
of imbecility frequently creates.
   § 345. These views,  it will  be  seen, afford  no
countenance to the usual  practice of canvassing the
whole history of the imbecile person, arraying act
against act, and speech against speech, and  drawing
from each an inference for or against his capacity of
managing his own affairs in  his  own way.    Few of
those whose interests become involved  in protracted
litigation, are so destitute of intellect as never to
conduct like persons of well-developed minds under
similar circumstances.   They  may write   sensible
letters, make shrewd bargains, and converse  on ordi-
nary topics without betraying any mental deficiency,
while yielding implicitly to the  will of others, and
committing acts of folly that can arise  from  nothing
short of  unequivocal imbecility.   The popular error
that imbecility is only an inferior endowment  of mind
considered in regard to its  absolute quantity, has led
people to forget that in  this  condition, the  mental
faculties  may be very unequally  defective; and,
therefore, that very different conclusions would be
formed respecting an individual's capacity, according
as the attention is exclusively directed  to the mani-
festation  of this  or that  faculty.  Many also, w7ho, 
CH. XXV.]           INTERDICTION.              455

while surrounded by their usual circle of associations,
manage their slender means with  the  utmost pru-
dence and economy, would prove themselves  totally
inadequate to the management of a  large property,
and be easily led, by the influence of new associates
and  the  excitement  of new desires, into habits of
extravagance and dissipation.
   § 346.  The little success that has  attended every
attempt to fix upon certain  criteria as  tests of that
degree of imbecility which is  incompatible with the
management of property, and to run the line between
this mental condition and that  of  legal capacity, is
another circumstance in favor of the  course here in-
dicated.   "In order to arrive at the true meaning of
' imbecility of mind,' "  says Sir John Nicholl, " we
may  resort  to what the law describes as perfect
capacity,  which is most correctly found  in the form
of pleadings used in the ecclesiastical courts,  in the
averment in support of a will, that the  testator was
of ' sound mind, memory, and understanding—talked
and discoursed rationally and sensibly,  and was fully
capable of any rational act requiring thought,  judg-
ment, and reflection.' Here is the  legal standard." J
It may be doubted  if this definition can  ever be of
much practical service,  for  no  definition can be  so
which embraces either  more or less than is strictly
warranted by the exact nature of  the thing defined.
Many an imbecile who  could not  be safely trusted
with  the control of property for a single week, may
nevertheless " talk and discourse rationally and sen-
1 Ingram v. Wyatt, 1 Haggard's Eccl. Reports, 401. 
 456   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

 sibly," so  long  as the conversation is confined to
 simple subjects that have  long been familiar  to the
 mind ; and many  a  man  of legal capacity may  be
 found, of whom  it cannot be said  that he is "fully
 capable of any rational act" whatever,  "requiring
 thought■, judgment and reflection."   The  very point
 to be decided is, whether the person in question, who
 talks and discourses so rationally and sensibly, and
 does  so many  rational  acts, is or is not capable of
 managing  his affairs ; and however much we may
 scrutinize the character  of his intellect, the only just
 and accurate test of such capacity is  the manner  in
 which he has already managed his affairs.  The tests
 of legal capacity so much sought after in imbecility,
 cannot  be obtained, from  the nature of things, be-
 cause the general strength of mind is but an uncer-
 tain index of its ability when exercised on  particular
 subjects.   The ministers of the law therefore should
 be extremely cautious how they are moved by theo-
 retical  considerations,  instead  of  particular  facts
 bearing on the point at issue, in examining requests
 for interdiction on the ground of imbecility.
  § 347.  General  intellectual  and  general  moral
 mania  are always a sufficient cause of interdiction;
 for the reflective faculties are too much deranged  in
 those  disorders to discern the relations of  property,
 or to provide the necessary arrangements for preserv-
 ing  and improving it.  The only question is, how
 soon after  the  manifestation of the  disease, are we
 warranted in taking this measure.  Since its publicity
 serves  to  expose the patient and his family to the
popular and not unfounded prejudice against insanity,
and since mania, when early attended to, is cured, 
CH. XXV.]           INTERDICTION.               457

in the larger proportion of cases, within the first or
second year, this step should be delayed, unless extra-
ordinary reasons  require  immediate action,  till the
effect of judicious treatment has been observed.  The
restraint and seclusion which curative measures neces-
sarily require, prevent the patient from engaging  in
business, and indeed place him in the same condition
as would sickness of any other kind.  No harm is
done by a little  delay,  but the practice of taking
property from its lawful possessors to place it in the
control of others, who may have no other object than
that of enriching  themselves by their  trust, the first
moment the presence of  madness  is satisfactorily
established, must  lead to positive and considerable
evils.   So  jealous is the French law of this hasty
interference, that it permits nothing less than habitual
insanity to procure interdiction.]
   § 348. In partial  mania, Hoffbauer2  thinks  we
should be governed by the nature of the predominant
idea, not considering it a sufficient ground of inter-
diction, unless connected with the subject of property,
in a manner likely to lead to its wasteful and improvi-
dent management.   Such too was the opinion of Dr.
Rush,3  and  a  late writer4  has contended against
the  opposite practice  with signal ability and skill.
"Mental derangement, to be a sufficient reason for
interdiction," says a French jurist,5  "should have
reference  to the ordinary affairs of civil life,  and  to
> Code civil, Art. 489.                    s Op. cit. § 110.
5 Lecture on Medical Jurisprudence, Philadelphia, 1811.
* Conolly's Indications of Insanity.
5 Toullier, le Droit civil Francais, &c, 1811. 
458    MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

the government  of the  person and  property of the
individual; a man who is merely visionary, or enter-
tains  speculative  notions  that are  palpably false,
should not be interdicted,  if he manage  his affairs
well enough in  other respects." J   Georget,  how-
ever,  thinks that monomaniacs are not to be trusted,
and that we can never be sure that the predominant
idea may not, by means  of some mental associations,
lead to the dissipation  of their  fortunes.  Accord-
ingly,  he is dissatisfied with the  decision  of the
tribunal of La Seine, who rejected a petition  for the
interdiction  of M. Selves, a  celebrated  advocate,
although admitted to  be a  "meddler in his  family,
litigious  in society, impertinent towards  the  magis-
trates, vainly profuse in his expenditures, and  subject
to some illusions." 2   This distrust of the insane of
whatever description,  is  nowhere more strongly im-
plied  than in the habitual  practice of Great  Britain
at the  present day.  One finds it difficult  to  believe
on what slight grounds, interdiction is there every
day procured,—a measure, that  with the ostensible
purpose  of  protecting the interests  of  the  insane
party,  is too often, in reality, designed to promote
the selfish views of relatives and  friends.  A  kind
and degree of mental  impairment  that  has never
obscured the patient's  knowledge of his relative  situ-
ation, never  altered his disposition to be kind and
useful  to those   around him,  never  weakened his
enjoyment of social pleasures, and never affected
1 Toullier, le Droit civil Francais, &c. 1811.
2 Des Maladies Mentales, p. 108. 
CH. XXV.J
INTERDICTION.
459
his capacity to  manage  his concerns with his  usual
prudence,  has  been repeatedly deemed a sufficient
reason for depriving him of the use and enjoyment of
his own property, and subjecting him to all the disa-
bilities the law  can impose.  Dr. Conolly speaks of a
gentleman on whose account his family applied for a
commission of lunacy, because he had  become pos-
sessed with the idea, that the queen of England was
in love with him. Yet this person conducted himself
very well in most of the offices of life, and  on one
occasion after this application was made, while dining
with a  party of friends in  company with the lord
chancellor,  he  contributed  so  remarkably  to  the
enjoyment of the day by his polite, agreeable and
amusing manner, that this functionary could not help
expressing to him how much he had been gratified
by his introduction to  him, and  how utterly absurd
it now appeared to  him, to have ever given credit to
the story of his delusion.  This  was  enough to pro-
duce its avowal from the patient, and  the issuing of
the commission from  the  lord chancellor.  The
sequel furnished a striking comment on  the injustice
of this act;  for the insane gentleman gave so  much
assistance  to those entrusted with the management
of his affairs, that he was the means  of their getting
over difficulties  which,  without his aid, would have
been  insurmountable ; and in the end,  he was actu-
ally, if not formally, constituted  the steward  of his
own estate.  It is well  known that a monomaniac in
England, who fancied himself duke  of Hexham and
was accordingly interdicted, became  the agent of his
own committee  for the management of his own estate,
and did the  duties of the  office, for a time at  least,
not incorrectly. 
460   MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXV.

  § 349. The case of Mr.  Edward Davies, which
engrossed the attention of the English  public, a few
years since, being, says Dr. Gooch, "by far the most
important lunatic cause which  has been tried in our
time," furnishes  a striking illustration of the manner
in which these things are managed in England.  Mr.
Edward Davies  was born of  humble  parents, and
though  particularly  shy and  reserved  among  his
school-fellows, he was  generally  considered  sharp
and intelligent.    On leaving school,  he commenced
the business of a tea-dealer  in London, and by inde-
fatigable industry and cautious management, rapidly
became rich. It  appears that his health, at best, was
delicate, and that he suffered  much  from  dyspepsia
and  nervous excitement.  He was fond of reading
medical books;   and, like most persons who indulge
in such a taste, was fanciful about his complaints and
subject to  false  alarms.  The defects of his early
education,  he endeavored  to remedy, by reading
what he took to  be the best  authors, and  was often
guilty of making a ridiculous display of his acquire-
ments, by making long  quotations which he would
spout with a  theatrical air.  He was of a remarkably
timid and yielding disposition, to such a  degree  as
to be completely subjected  to the  authority of his
mother.  Though he was twenty-seven  years  of age,
and  managing an extensive and lucrative business,
she would not allow him to carry any money in his
pocket, nor  to spend the most  trifling sum without
her permission.   He  dared  not  go to  the play, nor
leave the house  for a few  hours, without asking her
leave.  She was particularly  at great  pains to pre-
vent his meeting young  women, lest, in the  event of 
CH. XXV.]          INTERDICTION.              461

his marriage, she might be displaced from the control
of his conduct, and the command of his purse; and
she took various opportunities of inducing him to give
considerable sums of money to different branches of
her  family.  At  the age  of twenty-seven, he grew
restive under the  maternal restraints, and made many
attempts to emancipate himself.  He offered to leave
the shop to his mother and take his  own property
away; or to give her seven thousand pounds, on her
consenting to leave the concern; but she was  not to
be got rid  of at that price.   The  incessant state of
contention at last seriously impaired his health  and
his mental tranquillity, and on the first of July, 1829,
he applied to Mr. Lawrence, the surgeon.  He  told
this gentleman a long story about his health and his
tea-trade;  and  at  another  interview,  he  recited
poetry and expressed a strong  antipathy  to his
mother and several relations.  Mr. Lawrence con-
 sidered him of unsound mind, but thought that if he
 could be reconciled  to his mother and  family, the
 disease would be at an end—that his antipathy to his
 mother was his chief delusion.
   § 350.  About this time, he applied to Dr. Latham,
 claiming his protection.   His discourse was wild and
 rambling, and his manner strange and  excited.   He
 told the doctor  in a  sort of whisper, that he had a
 tale to relate of the greatest horror,  and then flung
 himself away and stalked into the middle of the room.
 He  appeared very apprehensive lest  he might be
 overheard, and begged that he might lock the doors
 and close the windows.   He spoke of his wealth and
 his  trade, and  quoted  poetry largely,  using great
 gesticulation and throwing his arms about.  Several 
 462  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

 times he asked if he looked insane, and on leaving
 the house, he said; "If you  fail  (in his promise to
 call on him) dread the vengeance of a madman; for
 I carry a loaded pistol."  Dr. Latham  thought him
 insane, though not prepared to recommend that he
 should be shut up as an acknowledged lunatic.
   Shortly after this, he left his own  house and went
 to spend the night at  Furnival  Inn, on  the third of
 August.  About one o'clock in the night, he rang  the
 bell, and told the waiter that  there  were thieves in
 the  house; that he heard them  snapping off pistols,
 and striking a light.  On being remonstrated with by
 the  waiter, on the impropriety of his ringing the bell,
 and thus disturbing the lodgers,  he said he was sorry
 for it,  went upon his knees, and humbly begged his
 pardon.
   § 351. It must be borne in mind,  that on the same
 days on  which  Dr.  Latham,  Mr.  Lawrence, and
 others, saw him in his most explosive  state, his friends
 who had known him long, passed  hours with him;
 and  though he  was ill  and terrified,  he appeared  to
 them quite himself, and as equal as ever he had been
 to give directions about  his shop affairs.
  Indeed, the very persons who were  trying to confine
 him  as unfit to take care of his business, were them-
 selves consulting him about the management of that
 business.
   ^  352. Mr. Davies was shortly after this removed
 to a private mad-house,  where  he remained till the
 end of December, when he was liberated by the ver-
dict  of the jury.   Here his agitation subsided, his
incoherence diminished almost to nothing; and the
only  remaining grounds for  believing him a lunatic, 
CH. XXV.]           INTERDICTION.              463

were his antipathy to his mother, and certain  sus-
picions that were considered to be delirious.  Never-
theless, a commission of lunacy was granted by the
lord chancellor,  which finally resulted in restoring
him to liberty, and the management  of his property.
The evidence of  the physicians, who were sent ex-
pressly for the purpose of examining Mr. Davies,  at
various interviews, and who pronounced him to be
mad, is worthy of a little notice, inasmuch,  as  they
present the grounds on which, in the year 1829, the
most eminent physicians for  diseases of the mind
shut up patients  in mad-houses, among the English.
   § 353. Sir George Tuthill testified, that  he was
of unsound  mind, at the period of  his last visit;
principally,  because he spoke indignantly  of the
manner in which he had been  treated by his  family.
His additional reasons for thinking  him insane, and
unable to manage his  affairs, were his learning  to
box, his purchasing a fowl for ten shillings,  and his
saying that he could weep over his little  rabbits,
which he had not seen for six weeks.
   Dr.  Algernon Frampton testified, that he could
 not consider him sane on the seventh of December,
 because he would not admit himself to have  been
 insane on the eighth of August.  He thought there
 was a delusion in his mind as to his mother's conduct,
 though he admitted there would be no delusion,  if  his
 mother  had interfered  as Davies described, and as
 other witnesses testified.  He thought that the pur-
 chase of  a certain estate  for  6000 guineas was  in
 itself an act of insanity, considering his circumstances,
 though he admitted that  he knew nothing of his cir- 
464  MEDICAL JURISPRUDENCE OF INSANITY.  [CH. XXV.

cumstances.  A man of business, he thought, ought
not  to lock up  so  much  of  his capital.  He never
inquired how Mr.  Davies  managed  his  business,
though he declared that he was incapable  of mana-
ging it.
   Mr. Haslam  testified,  that  he  w7as  induced  to
consider him insane, from his manner of complaining
of the dirty habits of the keepers of the establish-
ment where he was confined.   He said decidedly,
that as long as his morbid hostility remained  against
his mother,  it was not safe for him to go at  large.
   § 354. In opposition to this evidence—and it is
but a small portion  of what might be given—it may
be well  to exhibit a specimen or two of that given by
Mr.  Davies's  medical witnesses.  Dr.  Macmichael
who had been sent down by the  lord  chancellor  to
examine into the  state of his mind,  satisfactorily
showed  that Mr. Davies's peculiar notions and views,
which had  been considered  by many as delusions,
either did not exist at all, or proved  upon examina-
tion, to be  perfectly rational  and proper.  In attri-
buting his  prosperity to  the favor  of providence,
which had been mentioned as one of his delusions,
he said he did not mean immediate or special inter-
ference, but that general providence which regulates
human affairs.   His boast of having improved the
revenue by his biddings,  which had also been imputed
to him as a delusion, he  explained by  saying that
there was a certain  kind of tea that was now almost
given away;  that if he  bid higher than others, the
dutv would be increased,  and that  thus he  should
put money  into  the  pocket  of government.   He 
CH. XXV.]          INTERDICTION.              465

showed, that instead of sacrificing his  property  by
this course, he realized a large  sum of money in a
very short time.  Dr. Macmichael was not willing to
admit that his learning pugilism, or carrying pistols,
was  any evidence of unsoundness of mind, for  he
might have had good reason for doing both.
   §  355. Dr.  Mackinnon, who  was connected  by
marriage  with the family of Mr. .Davies,  and had
visited him several  times during  his confinement,
thought him,  from  the first  interview to  the last,
capable of  managing himself and his  affairs.  He
showed that many of his  peculiar  habits and man-
ners, which had given rise to the  idea  of insanity,
he had always  manifested when in good health. His
letters, which,  from being full of quotations and puns,
were thought to indicate disordered mind, he showed
were not different,  in that respect,  from  those  he
wrote long before insanity was imputed to him.  He
conversed with him freely on the affairs of his family,
and  his remarks upon his  mother's  interference were
rational, just, and free from excitement.  His inquiry
into the imputed delusions, ended in the  same re-
sult  as Dr. Macmichael's.  In particular, he did not
consider his hostility to  his  mother as a  delusion,
for,  from the son's account, there w7as  good reason
for it.   On a variety of other  subjects,  his discourse
was calm and rational.
   § 356. It certainly would not  be strange,  if this
case should induce every one  to  adopt  the conclu-
sion of Dr. Gooch, that " it ought  to be made pun-
ishable, by heavy fine and imprisonment, to deprive
a man of his  liberty for  any cause excepting mis-
chievousness to others and to himself, and the parties
               EE 
466   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

who commit such outrages ought to be prosecuted at
the public expense." 1
   § 357. This case is not calculated  to recommend
the opinion of those, who look on the slightest men-
tal aberration as a  sufficient  ground of interdiction.
The principle to be followed  here  is precisely that,
which we have indicated as  applicable to cases of
imbecility.  Instead of puzzling ourselves with vain
attempts to guage the depth and breadth of the abso-
lute capacity  of the  mind,  our duty  is  simply to
ascertain  if the individual has  been guilty  of any
instances of gross  improvidence, of expenditure  be-
yond  his means, or for  objects unsuited to his sta-
tion and pursuits.   If it be found that  he has, then
interdiction is implicitly required by a  regard to his
own and the  interests of those  who  are dependent
on him for support, or entertain rational expectations
of being benefited by his wealth.   If he has not,
it is not very clear how  his  property  can  be taken
from his control, without deeply  violating the first
 principles of civil  liberty.  If no one doubts that the
 mental  operations in  monomania may be  perfectly
 sound, except within a certain  very  narrow circle,
 why should it be a matter of surprise,  that ideas of
 property should sometimes  be  among those  which
 are unaffected by  the influence of the disorder ?  To
 deprive a person,  laboring under a partial mania that
 does not involve his  notions of property, of the na-
 tural right of controlling and  disposing of his own for-
  1 The facts of the above case are taken from an article written, it
is said, by the late Dr. Gooch, in the London Quarterly Review,
vol. xlii. 
CH. XXV.]           INTERDICTION.              467

tune, is as unjust  and irrational, as it  would be to
inflict upon a felon convicted of theft,  the penalties
attached to the violation of every article in the crim-
inal code.  If,  too, we  interdict one monomaniac,
whose derangement is limited  to  a  single subject,
we  are  bound  in consistency to proceed  till  we
have included all, from him who believes  he has lost
his  rational  soul, to  the poor hypochondriac  who
imagines his  legs  are  made of glass, or that a fish
has taken up its abode in his stomach.  The mischief
that would arise from such  a course  of disqualifica-
tion, may be  easily enough conceived, without the
aid of any more particular description.   Even when
the hallucination  has  reference  to property, as the
idea for instance,  that  the  individual possesses im-
mense wealth, or  that every ship which  enters  the
harbor is his  and freighted with his goods, we are
not too hastily to  strip him  of what is really his own,
for he might, nevertheless,  in the management of it,
evince the most commendable  prudence  and econ-
omy.  It is a remarkable, but not an uncommon fact,
that monomaniacs often make  no  practical applica-
tion of their insane notions to their own  conduct or
concerns, but continue to manage both, as if no such
delusion existed.
    § 358. In the progress of  dementia, there always
comes a period sooner or later, when interdiction is
required, wherever the patient has much property,
 or conflicting interests are involved in its disposition.
 To decide when this period has actually  arrived, is
 generally a difficult and responsible duty.  To avoid
 the disagreeable alternative of favoring the designs
of selfish relatives, which would be promoted by the 
468   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

interdiction and seclusion of the old man,  by prema-
ture interference, or  of delaying proper  measures,
for  fear  of being thought  accessory  to schemes of
fraud and  oppression, until  too late  to  be  of any
service, is to gain the happy medium which all should
seek, but which few perhaps  are successful enough
to obtain.  The difficulties which medical  men  have
to encounter, who are consulted in such  cases, are
graphically described by  Dr.  Conolly.   "An old
gentleman,"  he says, " whose intellects are so im-
paired that he does not know whether he has received
his rents or not, or who is unable to arrange his own
dress decently, and requires,  when up stairs,  all the
attention of a child, is seen by the medical  practi-
tioner, for  the purpose of  its  being ascertained how
far interference with his property is justifiable.  The
very servant who is hourly robbing him, takes care
to send  him down very carefully drest.  The mere
effect of habit is  to cause  the patient himself to be
more guarded and exact in his manner and words in
the  presence  of a stranger; he feels under a tempo-
rary and a wholesome restraint ; asks and answers
common questions as well as most other  old men,
and  is perfectly  correct in his deportment.   Two
very serious evils may ensue.   If the  practitioner is
unacquainted with the varieties of the  mind and their
tendencies ;  and  imagines that insanity and sanity
cannot  be mixed up  together in the mind as they
are in the  body ; he feels  a degree of conscientious
horror concerning any interference with an old gen-
tleman  who  may be  a little  weak, but wdio,  he is
quite convinced,  is  no more mad than any of those
about him.   He turns his thoughts to the probable 
CH. XXV.]
INTERDICTION.
469
motives of interest, in the children or the friends,
and, determining not  to  warrant any  kind of re-
straint, inwardly applauds his own sagacity and incor-
ruptibility. The friends, now more afraid to interfere
than before, allow the old  man  to do  as  he likes,
and  he sets off, and gets married to a worthless and
designing woman, or he  alters his will in favor of
some unprincipled person, or  finds his way to some
neighboring town, where  he becomes a disgraceful
spectacle,  and gets  robbed of his money  and ill-
treated ;  or perhaps he falls  into the pond, and is
drowned ; all the world then exclaiming against the
heartlessness and inattention of those about him, and
the  unaccountable  supineness of those who were
consulted about the case.   Thus, the view of a very
plain and easy duty is, not unfrequently, obscured by
prevalent opinions respecting the nature of insanity,
and  respecting the measures which insanity is sup-
posed to render indispensable.  If the patient whom
I have described, as conducting  himself so satisfac-
torily in  a short and common conversation, is left to
his own thought for a little time,  and his attention is
not excited by those about him, his state will become
evident enough.   He will be seen to be wandering,
and  lost in his reflections, and will perhaps rise up,
and  endeavor  to  make his way out of the room, but
without  seeming to  remember the situation of the
door.  Or he  will declare his  intention  to set off on
a long journey,  or by many slight indications  show
that his mind  is reduced to imbecility.  In some, the
effects of the  recent  restraint of a stranger's pres-
ence may be  more permanent than in others ; but
half an hour or a few hours at the utmost, will suffice 
470   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

to show the state of the case.   The decision  is im-
portant, and due time must be allowed for it.  If one
visit is  not sufficient, the visit should be repeated,
until  the  practitioner can  give  a clear and decided
opinion.
   " But now comes the other danger.  A sanguine
practitioner sees the undoubted signs of folly and
weakness in  the old man, and  forgetting that they
are as much the effects of age as are the unsteadiness
of his limbs, and the dullness  of his hearing, pro-
nounces  the  patient to be mad ; and to gratify per-
sons of no feeling or compunction, consigns the poor
patient  to strange hands, and causes him to  spend
the little  remnant of his days  away from his own
house, and unseen by any of those whom  his former
care perhaps preserved, and whom his wealth will
enrich." J
   § 359.  The principles we have indicated, as proper
to guide us in  deciding  questions  of interdiction in
the various forms of imbecility and mania, are  not to
be so implicitly relied on here, because the unfitness
of the patient to manage his own concerns is often
proved,  not so much by specific  acts of extravagance
or folly, as by his subjection to the will of those who
are deliberately and cautiously preying upon his sub-
stance.   We may also  bear in  mind, that although
we take from him  the control of his  property, even
while his faculties are sound enough to  make him
capable of performing  the duty  himself, yet we are
only  prematurely  taking a  measure which  a  few
weeks or months  will  generally render  absolutely
necessary.
1 Indications of Insanity, 440. 
CH. XXV.]          INTERDICTION.               471

  § 360. It is to be regretted that in cases of insan-
ity, where the mental disorder does not seem sufficient
to warrant so extreme a measure as complete inter-
diction, while it occasions reasonable  doubts of the
ability to manage property with ordinary  prudence,
our laws have established no  inferior grades of re-
straint.  The civil code of France ordains that " in
rejecting a demand for interdiction, the court may
nevertheless, if circumstances  require it,  debar the
defendant from appearing in suits,  making contracts,
borrowing, receiving payment for debts or giving  a
discharge, alienating or pledging his property, with-
out the aid of a council which  shall be appointed in
the same judgment." *  It would be well, if something
of this kind always found a place  in the legal regu-
lations of  the insane.
   § 361. Restraint is  a  measure entirely distinct
from that of interdiction, and neither should be con-
sidered, as they sometimes are, necessarily dependent
on the other.  On no point in  the whole range of the
subject under consideration, is it more necessary that
we entertain clear and definite notions,  than on  that
of the restraint of the  insane, because,  while often
essential to  the restoration or  comfort of the patient,
 and  to the safety  of the community, it is, at the
 same time,  liable  to  the most  serious and shame-
ful abuses.  In  this country, it  is true,  the public
 attention has scarcely been  attracted to this subject,
 but either human nature is very different here from
 what it is in  other countries, or  we shall, at some
1 Code Civil, Art., 499. 
 472   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

 time or other, have to deplore the abuses which they
 are now anxiously seeking to remedy, unless, admon-
 ished by the  lesson there set  before us, we prevent
 them altogether  by suitable and seasonable legisla-
 tion.
   § 362. In confining  the insane,  we have in view
 one  or  more  of the following objects;  first,  their
 own  restoration  to health ;  secondly,  their comfort
 and  w7ell-being  merely, with  little expectation of
 their cure ; thirdly, the security of society.  When
 the restoration of the  patient is  the  object  sought
 for, as it always  is or should be, in  recent cases, no
 unnecessary restrictions should be imposed on  this
 measure.   The  simple fact of the  recency  of the
 case  should be  sufficient,  when properly attested,
 to warrant his seclusion,  if it  be deemed necessary
 to his cure.   It  is in  that  large class of patients,
 whose  disorder  is of  too  long standing  to admit
 of any rational expectations of cure,  that restraint is
 most  in  danger  of being abused.  Among the rea-
 sons  generally offered  for  taking this  measure, we
 hear,  perhaps,  that  the patient is  destroying the
 peace of his  family by constant  ill-temper,  or  by
 overbearing or furious  deportment, or that he  can-
 not receive in his own house the attentions which his
 situation requires.  The idea of depriving a person
 of his liberty, merely because certain other persons
 w7ho would be benefited by such a step, say that he
 is mad, is of so monstrous a  nature,  that one  finds
 it difficult to believe that it  has ever been actually
carried into practice.   Perhaps,  in  this  country, it
never has;  if so, however,  it  is not because it has
been prevented by the salutary restraints of the  law, 
CH. XXV.]           INTERDICTION.              473

which, in many states, at least, is utterly silent re-
specting it.  It may not have entered into the minds
of grasping and ill-natured  relatives,  that removal
and confinement present a readier means of obtain-
ing the control of property on which their affections
are placed,  than the slow  and uncertain  effects of
disease or old age ; but it would be unwise to act as
if this state of innocence were to continue always.
In Great Britain, where the confinement of the insane
has been the subject of much parliamentary inquiry,
and various acts and amendments to acts have  been
passed, for the purpose of preventing the abuses that
from time to time  have been brought  to light, this
measure has in consequence become so  hedged round
with  checks  and precautions, that it would  seem
difficult, if not impossible, that it should become a
means of injustice and cruelty.   How  far the object
proposed has  been obtained, may be sufficiently un-
derstood from the testimony of one whose ample ex-
perience rendered him well qualified to give it.  " It
is a miserable  thing to come away from  a  lunatic
house,  as I have many times done, with a conviction
that there  were individuals in it, whose  liberation
and a  proper superintendence would turn wretched-
ness into comfort, without  endangering the interests
of any human being ;  persons unfit, perhaps, to re-
turn to their  families,  or  even  to see them  every
day;  but yet alive  to  warm  affections,  never  more
to be indulged ; longing, as parents long, to see the
faces of their  children; but, in  consequence  of an
infirmity of temper, doubtless of a morbid kind, and
requiring superintendence, subjected to live  and die
in a place which  was  to them a prison,  without a 
474  MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

friend with  whom  they could unreservedly  con-
verse." *
   § 363.  It would be out of place here to detail the
provisions of such a legislative act, as  would place
the  restraint of the insane  as  far as  possible  be-
yond the reach of abuse, but its general features may
be stated  in a few words.   The right of keeping the
insane in  confinement should be obtained  by  license
from the government, which should impose such con-
ditions as  will best promote their welfare.  It should
appoint a  board  of commissioners, two or more of
whom should be medical  men of some practical
knowledge of insanity,  whose duty it  should be to
visit, from time to time,  houses  licensed for  the re-
ception of the insane, examine their accommodations,
the moral  and medical  treatment  made use  of, and
every other point in which the welfare of the inmates
is deeply concerned, and submit their report to some
branch of  the government.   They should have the
power of  discharging any  patient whom  they may
consider unjustly confined, or  capable of enjoying
himself more at his own home.  No patient  should
be  admitted without a  certificate of  two or more
physicians, one of whom should be an expert, coun-
tersigned  by the selectmen of the  town or mayor of
the city in which the patient  resides,  that the indi-
vidual is insane,  and is  unable  to receive at home
that care or attention which is necessary to his resto-
ration, or  to his temporary comfort and final welfare.
The superintendents of these houses should  be re-
1 Conolly: Indications of Insanity, 438. 
CH. XXV.]             INTERDICTION.               475
quired to keep a register, in which should be noted
the  names of the  patients, the date of  their admis-
sion, the character of their insanity, by whom their
certificates are signed, and such other particulars as
may be deemed necessary  by the commissioners.
   § 364.  The  third  object  above-mentioned,  as
sought  by  the  confinement  of the  insane,  is  the
security of society.   By the laws of Maine, any  two
justices of the peace are authorized to commit to the
house of correction any person  within their county,
who,  they are convinced, is  lunatic, and so furiously
mad,  as to render it dangerous to the  peace or the
safety of the good people, for him to  go  at large,
there to be detained till he or she shall be  restored
to his  or  her mind, or otherwise delivered  by due
course  of law.1   It may naturally excite some  sur-
prise that  so grave  a question, as  that of the per-
petual  imprisonment of a  person, should not  have
been  entrusted to  the decision of a  higher set  of
  1 The same was the law of Massachusetts, until quite recently ; but
by the laws now in force in that state, all lunatics, " so furiously mad
as to render it manifestly dangerous to the peace and safety of the com-
munity, that they should be at large," are, upon complaint made to the
Judges of Probate in the several counties, to be committed to the State
Lunatic Hospital at Worcester; and, "whenever request for that pur-
pose shall be made by the person  complained against," the Judge is
obliged to order a jury to be summoned, to try the question of insanity.
By a law passed April 13, 1836, two justices, one of the quorum, are
authorized to commit to the house of correction, any " idiot or lunatic
or insane" person,  "not being furiously mad;" and, at  this date,
March 20, 1838, a bill is pending before the Legislature, giving the
right of trial by jury, upon request of the person complained against, in
those cases also.  After the passing of this law, no person in Massa-
chusetts  can be confined by process of law, as an idiot, lunatic or in-
sane person, without the right of a trial by jury. 
476   MEDICAL JURISPRUDENCE OF INSANITY. [CH. XXV.

functionaries than a couple of justices of the peace.
When, in addition to this,  it  is  considered that no
plan.of inquiry is laid down for them to pursue, nor
a single hint to guide  them in their examination ;
that they are  left to summon  only what witnesses
they please, and with as  much or  as little publicity
as they please, we are forced to believe that it is not
in human nature,  that such  power should  escape
frequent  and flagrant abuses.1  Temporary confine-
ment is all that the immediate security of society re-
quires, and therefore the term  of imprisonment, for
which justices should  have the  power to commit,
should be limited to a few weeks  or  months.   If  it
be deemed necessary that  this  term  should be pro-
tracted, it should be only by order of the judge of
probate or one of the justices of the courts  of  law,
whose duty it should be to examine  the circumstan-
ces of the case, and if he decide in favor of farther
imprisonment for  another term which should be fixed
by law, to ascertain by proper inquiries from time to
time, whether any change in the mental condition of
the patient will warrant his release before  the end
of such term.
  1 It is stated in the first annual report of the Trustees of the State
Lunatic Hospital of Massachusetts, that under a similar provision of
law then in force in that state, an idiot had been committed who could
neither stand nor  walk, who was unable to extend the lower limbs
from the closest  possible contraction towards the body, and who had
but little muscular strength even in his arms.  Reports and other docu-
ments relative to the State Lunatic Hospital, p. 42. 
INDEX.
                [The Figures refer to the Sections.]

Amos, Mr., his definition of unsoundness of mind,     .    .       5
Adaptation of the moral and intellectual powers,  .    .    .     185
Alison, Mr., on the test of right and wrong in insanity, 19; on
    delusion, do. 20; on drunkenness as an excuse for crime, 340.
Arnold, case of,.........10
Arithmetical acquirements, not conclusive proof of legal capa-
    city,     ..........55,83

B----, case of,.........270
B., Abraham, case of,........115
Barclay, case of,.........73
Baxter, case of,.........     54
Beauquaire, his will established, *......84
Bellingham,  case of,........15
Ben Johnson, hallucination of,......99
Bertet, case of,.........194
Birdsell, case of,.........332
Brain, the seat of mania, 87;  small and diseased in idiocy, 35.
Brown, Rev. Simon, his delusion,.....105
Brown, Wm. case of,........139

 Cartwright v. Cartwright,  case of,.....243
 Castelli, case of,.........290
 Character, change of, essential symptom of  mania,    .    .      92
 Chitty, Mr., on right and wrong as a test of insanity, 19; views
      of moral insanity, 23.
 Classification of mental diseases,......34
 Code, French criminal, its law relative to insanity,     .    .      13
 Coke, lord, his classification  of the insane, 3; on the law of
      drunkenness,........328
 Combe, Dr., on change of character,  93 ; on lucid intervals, 240.
 Competency of a witness, conditions of,     ....     301
 Commission of lunacy, its proper duty,      ....       5
 Confinement of the insane, its objects,      ....     362
 ConoUy, Dr., on confinement of the insane, 358; on simulated
      insanity,  248 ;  on the writing of the insane, 272.
 Continued observation,........272
 Contracts, common law of, 7 ; how affected by partial mania,
      172; invalidated by somnambulism, 296.
  Cornier, case of,  .     .     .......29,155
  Cox, Dr., his description of moral mania,    ....    110
  Cretinism,..........     37
  Curability of madness at different periods,    .    .     .   .    224
  Cunning, active in  the insane, 21; in imbecility, 52.

  Davies, case of,.........349
  D'Aguesseau, on lucid intervals, 233; on the interrogatory, 271.
  Delirium, common in the last stages of disease, 212; its effect 
478
INDEX.
     on the memory, 214; how distinguished from mania, 216;
     its lucid intervals, 218.
 Delirium tremens, described, 315; cases of, 329, 331, 332.
 Deafness in old age,........208
 Decay of old age,.........205
 Delay in trying cases of insanity, enjoined,   ....     193
 Delusions, considered as a test of insanity, 22; their effect on
     the mental soundness, 181.
 Delepine, case of,........65—59
 Design, not a test of insanity,......21
 Destructiveness, first described by Pinel,     ....     134
 Dew v. Clarke, case of,.......178
 Drew, case of,.........329
 Drunkenness, fit of, described, 313; periodical, 319.

 Eccentricity, its relation to insanity,.....92
 Extacies,..........292
 Eldon, lord, his definition of unsound mind. 5; on the proof of
     a lucid interval, 241, note.
 Epilepsy, its tendency to degenerate into madness,     .    .     75
 Erion, case of,   .     .  ■.......430
 E. S., case of,.........77
 Esquirol on recurrence of madness, 228 ; on periodical drunk-
     enness, 320.
Erskine, his objection to a verdict, 5;  lays down delusion as
     a test  of insanity, 14.
Evans, on  the legal consequences of partial mania,     .     . 177,306
Experts, their duties defined,.....29, note.
Epidemic character of homicidal insanity, 191; of suicide, 284.

 Ferrers, earl, case of,........112,185
Ferocity, instinct of, not the cause of homicidal insanity,    .    196
Flight of homicidal monomoniacs,.....186
Fodere, his theory of lucid intervals, 241; on the legal conse-
     quences of somnambulism, 297.
Franck, case of,.........129
Frederick the  great, case of,.......118

Georget, his views of  lucid intervals, 238; on  simulated mad-
     ness, 248; remarks on  Jean-Pierre's case, 252;  on the      /
     inquest, 273; on  imbeciles,  52; on drunkenness, 338.
Gerard, case of,.........265
Gibbs, Sir  V., on the criminal law of insanity,   .     .     .10, 16
Greenwood, case of,........178

Hadfield, case of, noticed,.......14,193
 Hale, lord, distinction between total and partial insanity,    .      8
Hallucinations, explained,.......99
Hansterin, case of,........153
 H. P., case of,    .........117
Hardwicke, lord, his definition of unsoundness of mind,     .      5
Haslam, on lucid intervals, 236;  on simulated insanity, 248.
Head, very small or very large in idiocy, 35; injuries of, their
     effect on the mind,  222.
Homicidal monomania, analysis of its features, 162; contrasted
     with real crime, 164. 
INDEX.
479
Hume, on right and wrong as a test of insanity,   ...     19
Hoffbauer, description of imbecility, 44—47; of stupidity 48—
     50;  on moral insanity, 111.

I. K., case of,     .     .    .     .     .     .     .     .     .     114
Imprisonment of lunatics on civil execution,      .     .     .     170
Incoherence of ideas, not essential to insanity,     .     .     .     250
Incendiarism, morbid propensity to,     ...        52, 69, 129
Incubation of madness,.......94
Inquest,..........273
Interrogatory,.......•     •     268
Interdiction, not warranted merely by alienation of mind,     .     357
Irritation, initial stage of disease,.....88
Intermission of disease,.......231

 Jean-Pierre, case of,........251
 Jensen, case of,.........144
 Jones, case of,    .........304

 Kindleside v.  Harrison,.......210
 Kenyon, lord, his decision  in Hadfield's case,     .    .    .     243

 Lawrence, case of,........184
 Lecouffe, case of,.......; . .  "      ^
 Liberty of will and action, essential to criminal responsibility,    186
 Lying, propensity to,........122
 Lyndhurst, lord, his decision in Rex v. Orford,     ...     19

 Madhouses, how to be regulated,......
 Mania, definition of,.....•     •    •     100
 Mania, partial, considered as an excuse for  crime, 183; less
      easily feigned than general, 261; its effect on civil acts, 172.
 Mansfield, C. J., on the criminal law of insanity,  ...     16
 Marc, on simulation of partial mania,  .    .     •     •     .     261
 Marriage, validity of,  in imbeciles, 85; in maniacs, 174.
  Melancholia,........   ■     •     J02
  Memory, weakness of, an early symptom of dementia, .     .     200
  McDonough, case of,........  •     337
  Mind, a true philosophy of, essential to a knowledge of insanity,      5b
  Monomania,.........^02
  Moore, will  of,.........j™
  Mounin, case of,.........li6

  N—, Madame, case of,.......JJ6
  Negretti, case of, .    ■•.-,.,.....oon
  Nervous diseases more or less periodical,    .    .    •    •     <«"
  Nicholl, Sir  J., on the proof of insanity in case of civil acts,
      12;  decision in a case of marriage, 175; on lucid inter-
      vals, 218, 245 ; decision in a case of suicide, 286.

  Papavoine, case of,.....•.   •   . •
  Paris and Fonblanque, on legal consequences of partial mania,
      176; of drunkenness,   .......336
  Parker. C. J., decision in a case of suicide,   ....    28b
  Pascal,' his hallucination,.......100
  Periodicity of disease,........^u 
480                         INDEX.
Peyronnet, approves of Hale's doctrines on the criminal  law of
     insanity,.........11
Physical changes in mania, 96 ; in dementia, 203.
Pinel first described moral insanity,.....109
Plea of insanity should be carefully heard and investigated,   .    192
Portsmouth,  earl, case of,.......56
Prescott, case of,       ........70—72
Predominant idea to be considered......180,181
Prichard, definition of moral insanity, 109; cases of, 114—117.
Punishment, its object,.......190
Purington, case of,........160

Rabello, case of,.........158
Recovery from madness,.......224
Recurrence of madness,.......228
Reed, Dr. on lucid intervals,.......239
R. M., case of,    .     .     .......137
Religious fanaticism, a cause of morbid activity of the propen-
    sity to destroy,........159
Responsibility, its elements,......59, 166
Right and wrong, knowledge of, not a test of insanity,  .     .      18
Rush, Dr. on moral imbecility,  79 ; on the propensity to steal, 121.
Schmidt, case of,.........63, 64
Selves, case of,    .........
Sensations, illusive,.......104, 109
Sexual propensity, morbid activity of,   .    .    .     .    124—127
Sgambari, case of,........106
Shelford on suicide,.......13 note.
Simulation of insanity may be detected, 248; not easily practised, 249.
Society, security of, does not require the  death of homicidal
    monomaniacs,........1S9
Somnambulism, burden of proving it lies on the defendant,  .    297
Statutory provisions relative to insanity as an excuse for crime,     26
Story, J., his decision in a case of drunkenness,   .      .    .    330
Stowel, lord,  his decision in a case of marriage,   .      .    .    174
Suffrage exercised by idiots,.......57
Stupidity distinguished from imbecility,     .... 40—43
Suicide, from religious  monomania, 277; hereditary,  280;
    epidemic, 284;  not considered proof of insanity,  286;
    juvenile, 276.
Swinburne, on the law of insanity relative to wills,    .    .  12, 243

Testamentary capacity in imbecility, 84; how regarded by the
    ecclesiastical courts, 221.
Theft, common in imbecility, 52 ; irresistible propensity to, 121.
Thurlow, his  description of a lucid interval,  ....    234
Trespass, action of, lies against the insane,  ....    169
Trestel, case  of,.........157

Unsoundness of mind, discussed,......5

Vatelot, case  of,.........338

Wilson, case  of,.........184
Witnesses, medical,........27
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