[50:A]A broad distinction should be made between the immediate and remote effects of intoxication. A man is not held guiltless who perpetrates a crime during the state of intoxication. He voluntarily introduces into his system a stimulus which augments his ferocity, diminishes his moral affections, and overshadows his reason. But the usual effect of this stimulus is temporary, he awakes from his debauch rational, and commonly drags after him the heavy chain of reflection. It is however equally true that this single excess may be continued into permanent insanity: he may remain for many months in a state of mental derangment, and during the prevalence of his disorder may be compelled to forego all intoxicating beverage.—If such person after the elapse of several weeks from the commencement of his disorder, should, under its influence, commit a fatal outrage, no system of jurisprudence would connect the violence with the cause which originally produced the disease.
[50:A]A broad distinction should be made between the immediate and remote effects of intoxication. A man is not held guiltless who perpetrates a crime during the state of intoxication. He voluntarily introduces into his system a stimulus which augments his ferocity, diminishes his moral affections, and overshadows his reason. But the usual effect of this stimulus is temporary, he awakes from his debauch rational, and commonly drags after him the heavy chain of reflection. It is however equally true that this single excess may be continued into permanent insanity: he may remain for many months in a state of mental derangment, and during the prevalence of his disorder may be compelled to forego all intoxicating beverage.—If such person after the elapse of several weeks from the commencement of his disorder, should, under its influence, commit a fatal outrage, no system of jurisprudence would connect the violence with the cause which originally produced the disease.
Notwithstanding the medical evidence may be incapable, totidem verbis, to give a cleardefinition of madness, so as to be suited to the conception of all persons, and to comprehend the various shapes of this disease, on account of the various notions affixed by different persons to the abstract terms he may employ; yet it is always in his power to state such perversions of thought—such projects—and such conduct, contradistinguished from that which all men hold to be rational, as shall leave no doubt on the minds of those who are to appreciate his evidence, that insanity exists: and if the person be really insane, it must be from the ignorance or neglect of the medical practitioner, if he do not satisfactorily establish his derangement, provided his opportunities of visiting and conversing with the patient have been sufficient.
In those cases where insane persons have deliberately destroyed others there has been some existing and prominent delusion whichhas been fully believed to beTrueandGoodandRight, which has constituted the motive, and urged on the miserable victim of this delusion to the accomplishment of his purpose. Lord Erskine in the fewest words has most impressively comprehended this subject, “In cases of atrocity, the relation between the disease and the act should be apparent.” And again, “I think as a doctrine of law, the delusion and the act should be connected.” With the lunatic the object to be attained has seldom been adequate to the hazard of the enterprize, nor has the motive been proportionate to the violence committed: in the majority of instances some previous intimation of the intended attack has been communicated, if the object has been accessible; and the warning itself has usually borne the stamp of a deranged intellect. These distempered minds have never inflicted violence for private emolument, or personaladvancement, but have been persuaded, that they are selected from the mass of mankind to confer exemplary justice, and to ameliorate the condition of their species. The motive for the injury inflicted has generally been virtuous and honorable in the deluded imagination of the maniac. It is true that on most occasions there has been the utmost subtilty of contrivance and deliberate execution of the projected mischief, whether it has been directed against others, or exerted for their own destruction. The execution of the project so far from being unwise, has usually deceived and astonished the wisest; but the principle, the firm belief, the motive to action, has been the “stuff which dreams are made of.”
There is another form of this disorder under the influence of which some insane persons become highly dangerous; but whichhas not been hitherto sufficiently noticed, although it deserves the fullest consideration. As several instances of this state have fallen under my own observation I shall beg to relate two or three cases with as much brevity as may adequately suffice to convey the facts. It has been already remarked that some insane persons who have recovered the proper direction of their intellects have thoroughly remembered the particulars of their diseased state:—in the instances to be related they have retained no trace of their disorder, nor any of the circumstances which occurred during its continuance.
A very powerful man, above the ordinary stature, who in his youth had been subject to epileptic attacks, and frequently to intervals of sullen abstraction, which increased after the epileptic fits had subsided, became suddenly furious, and during the transportsof his disorder destroyed two children and a woman. For this act there appeared to be no motive. He was ordered to be confined, where he continued until his death. For many years during his seclusion I had constant opportunities of seeing and conversing with him. He was ordinarily in a very tranquil state, and did not discourse irrationally;—indeed there was no particular subject on which his mind appeared to be disarranged, nor were there any persons against whom he entertained an aversion. Much of his time was passed in reading, which he said afforded him great consolation. On many occasions I endeavoured to draw from him some account of the motives which induced him to destroy the persons above-mentioned; but he uniformly and steadily persisted that he had no recollection whatever of such occurrence. He said, he understood he had done something which was verywicked, and for which he was confined; and which he had no doubt was true, from the respectability of the persons who informed him of his crime; but he thanked God he had no more memory of what had passed than if it had been committed in his sleep.—During the years of his confinement he had many furious paroxysms, and in order to be fully satisfied of the truth of his asseverations as to his want of recollection during these attacks, he was once blooded at the commencement of the paroxysm, although with considerable difficulty, and on another occasion cupped when its violence was subsiding,—yet when he was restored to his ordinary state of tranquility he neither recollected the persons who were present nor the operations which had been performed.—Of the same class of mental affection was the case of a young lady, who became insane in consequence of having experienced some severedisappointments. She attempted to destroy herself in various ways, and was therefore obliged to be strictly restrained; but to others she manifested no evil intentions. When spoken to, she returned correct answers, although she never began a conversation. During the day she sat apparently sullen and abstracted, and seemed to take no notice of what was passing. After the elapse of three weeks, as she was sitting in her usual manner, she uttered a shriek, appeared for a few moments in a state of alarm and confusion, and suddenly recovered.—Of her repeated attempts at suicide she had not the slightest recollection.—When I visited her the following day she received me as a perfect stranger; and was not conscious she had ever seen me before; and during several subsequent interviews, in order to be certain of her recovery, I was persuaded she did not retain the slightest remembrance of any of the circumstancesof her malady. A third case of this nature lately occurred. A young man with hereditary predisposition to insanity, his mother and grandmother having been so disordered; in consequence of severe losses, was seized with a paroxysm of furious madness, which continued without abatement for four months. At the expiration of three months he had a considerable mortification on the lower part of the back, which required surgical attention during three weeks. When the sore was healed he was removed to another situation for the treatment of his insanity, where he perfectly recovered. After his complete restoration he neither recollected the asylum where he was first placed, the disease of his back, nor his removal to the situation where he ultimately regained his reason.
To the states of mind above described, the question of good and evil can in no wayapply; because these persons have wanted all recollection of their state, and of any act perpetrated; which implies that they were unconscious of any motive urging them to its commission; and which being unremembered, renders them incapable, as moral agents, of contemplating theRightorWrongof the act previous to its execution. It is likewise well known, that even ideots, who are ordinarily tranquil, and apparently harmless, will occasionally burst into paroxysms of fury, and deal indiscriminate destruction to those around them, frequently without the slightest cause, and certainly without pre-meditation:—and whose inferior scale of intellect does not enable them to give a reason for their actions. These states have been mentioned that they may be recognized by the medical practitioner, and become known to the advocate, in order that he may apply them to the existing law.
Finally, it is necessary to observe that insanity may be counterfeited by the criminal, in order to defeat the progress of justice;—and with this view, may attempt to impose on the medical practitioner. During the course of my experience I have witnessed only two attempts of such imposture, and in both instances the deception was so clumsily executed, that it required but little knowledge of the disorder to detect it. To sustain the character of a paroxysm of active insanity would require a continuity of exertion beyond the power of a sane person;—they do not keep up the deception when they suppose themselves alone and unwatched;—the assumed malady then disappears, and the imposture is re-commenced when they are in the society of others. They are likewise unable to prevent sleep. If they endeavour to imitate the passive form of this malady, which is an attempt of considerably greaterdifficulty, they are deficient in the presiding principles, the ruling delusion, the unfounded aversions, and causeless attachments which characterize insanity—they are unable to mimic the solemn dignity of systematic madness, nor recur to those associations which mark this disorder; and they will want the peculiarity of look, which so strongly impresses an experienced observer.
It now remains to treat of that morbid condition of intellect which requires the interposition of the law to protect the person and property of the party so affected.[61:A]Thegeneral reasoning which has been adopted concerning insanity, in criminal cases, will equally apply to the present subject; but there are some particular considerations deserving attention in this part of the enquiry. The members of the medical profession have long and anxiously endeavoured to frame a definition of insanity, which is an attempt in a few words to exhibit the essential character of this disorder; so that it may be recognized when it exists;—these efforts have been hitherto fruitless, nor is there any rational expectation that this desideratum will be speedily accomplished. The Lawyer has taken a different view of the subject: he has been little solicitous to become acquainted with the physiological distinctions of disorderedintellect, or the causes producing such state:—these he has confided to the medical evidence to explain. His enquiry has been directed to ascertain if such state of mind prevails, as actually disqualifies the particular person from conducting himself, or managing his affairs, and he expects from the medical evidence sufficient proofs of such incompetence. To this condition of intellect, when satisfactorily demonstrated, the law applies its remedy and protection. This incapacity of conducting himself, or of managing his affairs, arising from a morbid state of intellect;—whether it be from perversion of mind or imbecility, is in the estimation of the lawyer equivalent to a definition of insanity, and perhaps it is the best that can be furnished.
[61:A]It has been observed that the finding a commission is like signing the death-warrant of an individual: it certainly consigns his person and property to the management of others appointed by the chancellor. But it should be fully understood that this process is exclusively a process of law, and resorted to by the relations, or trustees for the insane person. The medical practitioner has no interest whatever in this legal instrument—on the contrary, he is generally a loser by the finding of the commission, which ordinarily implies (though improperly) a confirmed state of disease, rendering less necessary medical advice and attendance.
[61:A]It has been observed that the finding a commission is like signing the death-warrant of an individual: it certainly consigns his person and property to the management of others appointed by the chancellor. But it should be fully understood that this process is exclusively a process of law, and resorted to by the relations, or trustees for the insane person. The medical practitioner has no interest whatever in this legal instrument—on the contrary, he is generally a loser by the finding of the commission, which ordinarily implies (though improperly) a confirmed state of disease, rendering less necessary medical advice and attendance.
In many instances, the insanity of the person is so clear, so evident and demonstrable, that it is immediately acknowledged by thecommissioners and jury;—in such cases the medical practitioner has an easy duty to perform. There are however occasions where the state of the person’s mind involves considerable doubt, and creates much difficulty in determining: and in these equivocal and embarrassing circumstances, the skill and experience of the physician must furnish the documents and reasons for the decision of the jury. He is presumed, in consequence of his previous attendance on the patient, from the repeated conversations he has held with him, and from an attentive observation of his conduct, to be fully informed of the state of his mind: and as the commission is commonly granted by the medical affidavit of the party’s lunacy, it is a natural expectation that such medical evidence should be competent to prove to the extent he has deposed on oath. The gentlemen who compose the jury and whose province it is to determine on the lunacyof the party, may not be acquainted with the different species of insanity, nor possess any considerable knowledge of the physiology of the intellect; yet they are entitled, and fully able to exercise their judgment, their honest and plain sense, on those opinions and that conduct which characterize an insane mind, and which disqualify the person so affected from having the management of himself or of his affairs. It is the duty of the medical evidence to become acquainted with his prevailing opinions, and also with his propensity to act on them, to ascertain his capricious partialities and unfounded resentments:—and whether he meditates his own destruction, or seeks to take away the life of another. Either of these propensities originating purely from insanity, both for the safety of the patient and of the community claim the protection of the law. Although the commissioners and jury have a right to expect from the medicalevidence a full developement of the patient’s condition of intellect, yet it has not unfrequently occurred that even medical persons have so widely differed concerning the mental state of an individual, that one party has deposed to his sanity, and the other has testified to his madness; if therefore such contrariety of opinion should exist between those persons who are supposed most competent to detect insanity, it cannot diminish our confidence in the decision of an intelligent and impartial jury.
It may here be proper to notice that in the criminal court the testimony of others is sufficient to establish the insanity of the prisoner. Under a writ de Lunatico Inquirendo, superadded to the testimony of others, the person supposed to be insane, is usually produced before the commissioners and jury, and by them examined, in order to confirm or invalidate the evidence which has been adduced, and tosatisfy their minds that heisa lunatic at the time of their enquiry. Although there is much fairness and impartiality in the examination of the patient by the commissioners and jury to ascertain by actual enquiry that his state of mind tallies with the evidence deposed: yet it sometimes occurs, that the patient, fully aware of the proceedings, will by subtilty endeavour to defeat them. He will artfully conceal his real opinions and even affect to renounce such as have been deemed proofs of his insanity, and on many occasions he has been so skilfully tutored as to foil the united penetration of lawyer and physician. It is on such occasions that the sagacity and experience of the medical practitioner are demanded, and it will in some instances occupy a considerable time to institute such examination as shall suffice to unravel the real state of his opinions. It is nearly impossible to give any specific directions for conductingsuch examination as shall inevitably disclose the delusions existing in the mind of a crafty lunatic; but in my own opinion it is always to be accomplished, provided sufficient time be allowed, and the examiner be not interrupted. It is not to be effected by directly selecting the subjects of his delusion, for he will immediately perceive the drift of such enquiries, and endeavour to evade, or pretend to disown them:—the purpose is more effectually answered by leading him to the origin of his distemper and tracing down the consecutive series of his actions and association of ideas:—in going over the road where he has stumbled he will infallibly trip again. If in a case of actual insanity the medical practitioner, from inattentiveness, mistake, or want of experience should fail to expose the real condition of the patient’s intellect, and he should be found not lunatic, he would be set afloat, to pursue the dictates of his perilousvolition; he might uncontrolled dissipate his property, and reduce himself and family to beggary:—if his life were insured, if he subsisted on an annuity, or held a commission in the naval or military service he might wander and destroy himself, and thereby deprive his successors of their immediate support or expected benefit:—or he might commit some outrage for which he would be arraigned in a criminal court. The record of having been found not lunatic by a jury legally constituted to enquire into the state of his mind, would be the strongest bar to a plea of insanity in a criminal court, who after such proceedings would be little disposed to credit the theories of medical metaphysicians.
It is not necessary to enter on an investigation, or to enumerate all the particular states of mind which may be comprehended under the terms Insanity, Madness or Lunacy, but itis a subject of grave and important enquiry to ascertain what degree of mental derangement, or imbecility ought to disqualify an individual from being the master of his person and property. It has sometimes occurred that persons evidently under mental derangement have for months continued to transact their affairs with prudence, and have conducted themselves quietly in society. Notwithstanding the disordered state of their ideas, they have not obeyed the impulse, nor followed the direction of their insane opinions, and have forborn to act to their own detriment or to the annoyance of others. Several of such instances have fallen under my own observation: but the greater part have eventually destroyed themselves, or become so furious that seclusion was absolutely necessary. It is therefore impossible, under a state of existing insanity to predict the future conduct of an individual thus affected, or to becomeresponsible for the continuance of his harmless disposition.
In the discussion of this question it should be kept in view that the medical evidence is called upon to state, in the first place, that the person is of insane mind: and secondly, that in consequence of such state, he is incapable of conducting himself or of managing his affairs. If it be a matter of general and legitimate inference, that a person of insane mind is consequently unable to the management of himself and affairs; the proof of his insanity necessarily involves his incompetency: if it be supposed that, although of insane mind, a man may be capable of conducting himself and his affairs, it is then incumbent on the medical practitioner to shew from the nature and tendency of his particular insanity that he is unfit to be trusted with either. Such prediction must necessarily be the resultof copious experience, and formed in the way of a general conclusion, and it should be understood that this opinion of his incompetency regards his existing condition of mind at the time of the legal enquiry. Although a person might labour under a variety of mental infirmities, which by medical practitioners might be technically denominated false perception, delusion, hallucination, &c. still if these symptoms did not go to the extent of disqualifying him from conducting himself and managing his affairs, such symptoms in a legal point of view would, probably, not amount to insanity, nor justify the restraint of a commission of lunacy. It is true such symptoms seldom occur without producing the incompetency which the law regards as the warrant for its restraint, and fulfils the legal interpretation of insanity.
The employment of terms in an ambiguoussense has ever been the bane of philosophy, and the obstacle to its advancement. Without the meaning of important words be accurately defined, no general reasoning can be established. On some occasions the termUNSOUND MINDhas been introduced, and considerable emphasis has been laid on it by lawyers; as possessing an intrinsic meaning, and designating a peculiar state of morbid intellect, notprecisely similarto insanity, but of equivalent effect in depriving a person of the management of himself and affairs. It is of the utmost importance that the termunsound mindshould be fully and accurately considered. Had this term originated from medical persons, it is most probable they would, at least have endeavoured to explain it; but it is of higher descent, and adopted by those luminaries of the law to whom we look up with confidence and respect. The force and extent of the term unsound mindare described in the luminous judgment of the present Chancellor on a recent case. Of this learned exposition of the law, every medical practitioner should be informed, as it will serve to guide him, when he is called to give his deposition on the state of a patient’s intellect. In the judgment adverted to, his Lordship observes, “I have searched, and caused a most careful search to be made into all the records and procedures on lunacy which are extant. I believe, and I think I may venture to say, that originally commissions of this sort were of two kinds, a commission aiming at, and enquiring, whether the individual had been an ideot ex nativitate, or whether, on the other hand, he was a lunatic. The question whether he was a lunatic, being a question, admitting in the solution of it, of a decision that imputed to him at one time, an extremely sound mind, but at other times an occurrence ofinsanity, with reference to which, it was necessary to guard his person and his property by a commission issuing. It seems to have been a very long time before those who had the administration of justice in this department, thought themselves at liberty to issue a commission, when the person was represented as not being ideot ex nativitate, as not being lunatic, but as being ofunsound mind, importing by those words, the notion, that the party was insome such state, as was to be contradistinguished from idiotcy, and as he was to be contradistinguished from lunacy, and yetsuchas made him a proper object of a commissionin the natureof a commission to enquire of idiotcy, or a commission to enquire of lunacy. From the moment that that had been established, down to this moment, it appears to me however to have been at the same time established, that whatever maybe the degree of weakness or imbecility of the party—whatever may be the degree of incapacity of the party to manage his own affairs, if the finding of the jury is only, that he was of an extreme imbecility of mind, that he has an inability to manage his own affairs; if they will not proceed to infer from that, in their finding upon oath, that he is ofunsound mind, they have not established by the result of the enquiry, a case upon which the Chancellor can make a grant, constituting a committee either of the person or estate. All the cases decide that mere imbecility will not do; that an inability to manage a man’s affairs will not do, unless that inability and that incapacity to manage his affairs amount to evidence that he is of unsound mind; and he must be found to be so. Now there is a great difference between inability to manage a man’s affairs, and imbecility of mind takenas evidence of unsoundness of mind. The case of Charlton Palmer in which this was very much discussed, was the case of a man stricken in years, and whose mind, was the mind of a child, it wastherefore in that sense, imbecility and inability to manage his affairs whichconstitutedunsoundness of mind.” This is the law, the principle established for the regulation of medical opinion; and it will be immediately perceived, that the burthen of this ponderous machine, turns on the explanation which may be given to the term unsoundness of mind. As far as the term unsound is employed and understood by medical persons, it signifies a morbid condition of the human constitution, or a morbid state of some particular organ, and this state of unsoundness is inferred to exist from particular and well marked symptoms, which experience has detected to indicate, constitutional or local morbid affections. If this term betransferred to mind, it is equally incumbent on the person who employs it, to point out the particular symptoms or mental phenomena which characterize this unsoundness of the individual’s mind. It ought to be well considered that our knowledge of the intellectual faculties, and of their operations is very limited, and that the progress of the philosophy of mind, has borne no proportion to the rapid advances which have been made by Anatomy, Physiology and Pathology, in the structure, offices and morbid alterations of the body. All that we can know of the mind of an individual is from the communication of his ideas in terms or signs which are conventional between us, in order to be intelligible, or from his actions. Thus by discourse, which is imparted to the ear, or by intelligible characters presented to the eye, which convey his thoughts, and by his conduct, we are enabled to estimate the character of his mind. Thelawyer has been accustomed to receive mental phenomena as the only evidences of the state of an individual’s intellect: he would be dissatisfied, and in my own opinion, properly, with any bodily symptoms, such as peculiar conformation of the head, excessive determination of blood thereto, protrusion or glistening of the eye, increased pulsation of the Carotid arteries, &c.—these may be indications to medical persons in the treatment of insanity, but they do not constitute any direct evidences of mind. On the scale of intellectual capacity there is an extensive range, some are eminently gifted, and others so sparingly supplied that they are unfit for the common purposes of life, and require to be protected. These are Ideots ex Nativitate. If it be attempted to teach them, they are deficient of the capacity to acquire sufficient to manage the property they may be possessed of, or to conduct themselves. Is it here incumbent on themedical practitioner to state that this natural deficiency of intellect arises from unsoundness of mind, or that the unsoundness is the effect of such deficiency: in order that the individual may experience the wise, politic, and humane protection of the law?—It frequently occurs that those of extensive capacity and high attainments are by an apoplectic or paralytic attack suddenly deprived of their intellectual faculties, and reduced to the state of an ideot ex nativitate. Is it in this case necessary, for the legal protection of the party, to insist on the hypothesis of unsoundness? Is it insufficient to detail the miserable remnants of his former state, and exhibit to the jury the shocking spectacle? Must there be a compulsion to infer, that this abolition of the faculties amounts to evidence of the unsoundness of his mind? We are acquainted with the mind from the phœnomena it displays; but the cause of these phœnomena isto us inscrutable: by discourse and conduct we infer its soundness, by the same evidences its unsoundness must be detected. This appears however to militate against the dictum of law, which states, “Whatever may be the degree of weakness or imbecility of the party—whatever may be the degree of incapacity of the party to manage his own affairs, if the finding of the jury is only that he was of an extreme imbecility of mind, that he has an inability to manage his affairs: if they will not proceed to infer from that, in their finding upon oath, that he is ofunsound mind, they have not established, by the result of their enquiry, a case, upon which the Chancellor can make a grant constituting a committee either of the person or estate.” Is not this extreme imbecility of mind and inability to manage his affairs the only evidence of his unsoundness of mind? if not, what further isrequired? for it is not necessary, according to law, that he should be a lunatic. If these be insufficient to constitute him ofunsound mind, then the inference is clear and warranted, that he may be of extreme imbecility, and have an inability to manage his affairs, and, notwithstanding all this, may be ofsound mind: and ifunsoundness, besome such state, as may be contradistinguished from idiotcy and lunacy, then an ideot and a lunatic may be ofsound mind.
In the case referred to of Charlton Palmer, who was a man stricken in years, and “whose mind was the mind of a child, it wastherefore in that senseimbecility and inability to manage his affairs, whichconstitutedunsoundness of mind.” Here the imbecility and inability to manage,didconstitute the unsoundness: the wordstherefore, in that sense, evidently refer to his mind being “themind of a child,” which is perhaps a mode of expression more familiar than accurate; as no one could properly infer, that the mind of a child was necessarily unsound.
If the word unsoundness be particularly examined, and for that purpose we consult Dr. Johnson’s Dictionary, we shall find it employed in three different senses, but no one in which it implies any particular condition of mind:—the adjective unsound has a dozen different meanings, but none in the sense of vitiated intellect. From authority therefore we obtain no information. If we proceed to its derivation, we shall find that our Anglosaxon ancestors by the wordSUND(whence ourSOUND) meant precisely the LatinSANUS.UnsundAnglosaxon, or unsound English, would therefore be of equivalent meaning with the LatinINSANUS.
In those instances where the word unsound is used in our own profession, it designates something cognizable by the senses. An unsound tooth bears in its external character or internal feeling, sufficient evidence of its unsoundness. A fistulous sore may appear to be healed, but the skill of the surgeon can readily detect that it is unsound at the bottom: and both the dentist and the surgeon can give sufficient reasons, as the foundation of their opinion. Unsound doctrine, differs from that which is orthodox in certain particulars or essential points, which constitute its unsoundness.
Superadded to these, let the facts be examined as they are recorded in nature and experience. Of the human intellect there can only be three states: sound mind, insanity, and idiotcy. Of these states there may be different degrees. The mind of oneman may be relatively more sound than another; his attention may be more fixed and enduring—his memory more retentive; his judgment may be clearer, and possess superior vigour; and his imagination shall exhibit a brighter flame. Notwithstanding this exalted capacity, the individual who is removed many degrees lower on the scale, may possess sufficient soundness for the purposes of his nature:—he may be capable to conduct himself, and likewise to manage his affairs. Insanity, is another condition of the human mind, and of this state there are various forms and different degrees; and when a morbid state of intellect prevails, under which a man cannot conduct himself, which implies that he is not safe to be trusted with his own life, nor with the life of another—that in his motives to action he cannot discriminate between right and wrong, or withoutmotive is irresistibly impelled to act, and therefore becomes a being, not responsible for his conduct, and is incapable of managing his affairs—such state implies the necessity of being guarded by the instrument of the law: and this state of insanity, which includes all the various terms of madness, melancholy, lunacy, mental derangement, &c. necessarily evinces the unsoundness of the individual’s mind. Lastly, idiotcy, which, whether it be ex nativitate, or supervene at any period of life, implies a deficiency of intellectual capacity, to an extent which renders him incapable of the mental offices, which enable a man to conduct himself, and manage his affairs, and which of necessity infers the unsoundness of his mind, and the propriety of legal protection.
Those are the states of the human intellect which have a distinct and separate existence,and which are capable of being described from their manifestations; there can be no intermediate state, and certainly no abstract or independant unsoundness: which, when it is acknowledged, must, on the one hand, be derived from insanity, or from idiotcy on the other. But the law has established a different system, and it is observed that “It seems to have been a very long time before those who had the administration of justice in this department, thought themselves at liberty to issue a commission, when the person was represented as not being ideot ex nativitate, as not being lunatic, but as being of unsound mind, importing by those words, the notion, that the party was insome such state, as was to be contradistinguished from idiotcy; and as he was to be contradistinguished from lunacy, and yetsuchas made him a proper object of a commission,in the natureof a commission to enquire ofidiotcy, or a commission to enquire of lunacy.” Accepting this with great humility as the law, it is equally dutiful to endeavour to discover on what facts or experience it was established: and the only clue to this investigation is found in the words “in some such state,” as was neither idiotcy nor lunacy, but “such” as disqualified him from exercising the volition of an ordinary man, by an instrument “in the nature” of a commission applicable to ideot or lunatic.
If this undefined unsoundness of mind, can thus dispossess the individual of his liberty, and of the use of his property, under the issuing of a commission, it performs sufficient; but it may be respectfully enquired, what would be the general opinion, or that of the commissioners of the College of Physicians, if a medical practitioner were to give a certificate to confine a person in a madhouse, declaringhe was neither an ideot nor a lunatic, but of unsound mind?—And what attention would the judge and jury give to a physician in a criminal court who came to prove that a man who had committed murder was not responsible for the crime, because he was neither an ideot nor a lunatic, but of unsound mind; importing by these words that he was insome such stateas was to be contradistinguished from idiotcy, and as he was to be contradistinguished from lunacy? After having taken this view of the subject, which is the result of extensive experience in this department of the profession, and of diligent enquiry into the nature of the human mind; it appears to me, that the medical practitioner may safely and conscientiously infer unsoundness of mind, if such term be legally insisted on, whenever a morbid condition of intellect prevails, to an extent which deprives the mind of its natural and healthy offices, by producingan incapacity or inability in the individual to conduct himself and manage his affairs.
From the observations which have been detailed concerning unsoundness of mind there is, according to legal construction, an evident connection between unsoundness and imbecility. My object, however, is not the interpretation of law, but the exposition of nature and fact. It alone interests me to describe the phœnomena of mind—to compare the performance of its offices in a sound and morbid state—and to measure by the accredited standard of common sense and intelligible reasoning, the degree of imbecility, inability, or incapacity, which disqualifies an individual to conduct himself and manage his affairs.
The necessity of legal interference and protection in cases of insanity, having beensufficiently adverted to; it now remains to shew that a person from imbecility of mind may be equally incompetent to the management of himself and affairs. The mind may be weak from birth, or it may at any period of life become enfeebled by disease. Like the body it has its regular periods of growth and development, of maturity and declension: but they are not periodically connected. An unusual precocity of mental vigour has been occasionally remarked; and in advanced age the wisdom of the man frequently survives the infirmities of the body. Men are relatively competent, wise or foolish, learned or ignorant, compared with others. On the scale of intellectual being, we may place the philosopher at the summit, at the bottom the degraded ideot: and in the population of this world the intermediate range is adequately filled up. There are many considerations which demand attention on this importantsubject. To state that certain acquirements were to be attained as the proof of competency, would be an imperfect criterion. Much might be acquiredmemoriter, which the learner would not understand: a very feeble intellect, insufficient for the purposes of human affairs, might be trained to answer correctly a string of known questions, without being able to comprehend or adapt them to any useful purposes. It should likewise be considered that the different departments of employment require very different degrees of mental capacity. A person might be able to manage duly a small income, who would be inadequate to the distribution of a large revenue: a man might be competent to keep a shop, who would become overwhelmed and distracted in the learned professions: a country squire might gallop hospitably through life, without being able to discharge his duty as a magistrate. It is not the want ofacquirement that should disqualify an individual; many persons from distaste, indolence, from neglect of parents and guardians, remain lamentably ignorant in the current acceptation of the words—they are unable to write or read, they are unacquainted with the symbols which represent numbers: yet with these deficiencies they are enabled to conduct themselves in the world. Speech itself is not absolutely necessary; because a person born deaf, and consequently dumb, if he understood the signification of characters, called letters, and their composition, termed words: if he comprehended that such words were significant of such things, so that when the object was presented he could select the appropriate word, and alternately when he saw the word could point to the thing:—moreover, if he had learned to form these characters, he would possess a sufficient substitute for speech, and become capable of intelligiblecommunication—as a correspondent he would be on a level with him who enjoyed the utmost fluency of speech. So bountiful has the author of nature been in the construction of the human frame, that when one avenue to knowledge has been impervious, it has been transmitted through the medium of another; sufficiently to constitute the person an intelligent being and a moral agent. It is thecapacityof acquirement to which we are to direct our investigations. If a scale were constructed, and a certain degree fixed as the point of competency, the circumstance of his not having arrived at such point, ought not to disqualify the person. It ought to bedeterminedthat he is unable to acquire so much. It is true a man may be ignorant as far as certain acquirements, which we term learning, are concerned, and which form the basis of ordinary education; he may know nothing of what has passed in the world, which wedenominate the history of our species; but he may be an attentive observer of the objects in nature, and know fully the purposes to which they are applied. Such a man, although ignorant, does not want the capacity to acquire, and therefore ought not to be disqualified. It has occurred to me in many instances, to be consulted concerning persons whose minds have been naturally weak, or enfeebled by disease; and it always appeared that by patient enquiry, a satisfactory estimate of their capacity might be instituted. It would extend far beyond the limits of the present work to detail the whole of the circumstances connected with this subject; but it may be briefly stated that the person exercising his judgment ought particularly to ascertain the power of his attention; as his knowledge of objects, and his memory of them, will depend on the duration of his attention; and it will be indispensably necessary toinvestigate his comprehension of numbers, without which the nature of property cannot be understood. 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 management of property. If he could comprehend that twice two composed four, he could find no difficulty in understanding that twice, or twain ten, constituted twenty. Thisnumerationalso presumes he comprehended that so many taken from ten, or substracted which is the converse, would leave so many as the remainder—without such capacity, no man, in my own opinion, could understand the nature of property, which is represented by numbers of pounds, shillings, and pence. Indeed the capacity to acquire this knowledge seems to constitute the preeminence of man in the creation, as an intellectual being. The same imbecility ofmind is often produced in adults, and in those of advanced age, by paralytic or epileptic attacks, and from various affections of the brain, and requires the same accurate investigation, to determine on the competency of such persons, to be entrusted with the management of themselves and affairs.
From the foregoing remarks, it appears indispensably necessary that some criterion should be fixed as the test of sufficient capacity. In the case even of an ideot ex nativitate, it must be ascertained that he is really an ideot; and the same process of investigation, which enables us to determine this fact, will apply to the intermediate gradations of human capacity. All ideots are not of the same degree of intellectual depravity; some possess more memory than others, and display a talent for imitation;—they will whistle tunes correctly, and repeat passages from books,which they have been taught by ear; but they are incapable of comprehending what they repeat.
There is a degree of intellect, although mean, when compared with superior minds, which will enable a human being to take charge of himself, and transact his affairs; and there is also an inferior degree, which incapacitates him from the performance of those offices: and patient examinations at repeated interviews will enable the observer to ascertain his competency, and to afford a satisfactory evidence of the state of his mind: for the mind of every man may be gauged, both as to its acquirements and capacity. By imbecility, therefore, which may be either natural, or induced by a variety of causes, it will be seen, that I mean a state or degree of mental incapacity equivalent to ideotcy, a degree, which renders him incompetent to themanagement of himself and affairs:—and which degree, by observation and enquiry, may always be ascertained. This degree, satisfactorily measured, does, in my own opinion, amount to unsoundness of the individual’s mind: as it includes all the mental evidences which constitute unsoundness.
Connected with these subjects, there is a point of considerable importance, and of frequent occurrence, which yet remains to be examined, and with which the present essay will conclude: namely, the state of mind, under which, a person may legally dispose of his property by will. Medical practitioners are often called upon to attest the competence or incapacity of particular persons to the performance of this act, which requires a state of disposing mind. In many instances it is deferred to that extremity of bodily disease when recovery is hopeless. To urge itspropriety or necessity at an earlier period, often excites alarm or despondency, and such state of feeling, the medical attendant, in many disorders, is unwilling to excite. As a person of liberal education, and from the enquiries he has made during his attendance on the patient, he is justly presumed a proper judge of his competence to dispose. This instrument is termed a will, which does not simply imply an act of volition, but the volition of a sound or sane mind; because a lunatic, of all men, is most the creature of volition. The same conditions of intellect which have been heretofore enumerated, as exempting him from punishment, and disqualifying him from the management of his affairs, would, as far as a medical opinion may prevail, equally disable him from disposing of his property: such disposal involving the most important part of its management.
There is great, perhaps insuperable, difficulty in considering this subject in a general point of view. It is presumed, that no person, actually under a commission of lunacy, could legally dispose of his property by will, because such instrument confides the management of his affairs to others. But in the judgment before cited, and where the law is expounded by the highest and most competent authority, it appears, that the legal definition of a lunatic, implies a person interchangeably visited by insanity and reason. “The question whether he was a lunatic, being a question, admitting in the solution of it of a decision, that imputed to him at one time anextremely sound mind, but at other times an occurrence ofinsanity, with reference towhich, it was necessary to guard his person and his property by a commission issuing.”
In the insane mind, these parentheses of reason, have been technically denominated a lucid interval, which in a former work[102:A]I have endeavoured to explain, as far as such state becomes obvious to the medical practitioner. Its legal force I do not pretend to calculate. According to the legal interpretation of a lunatic, he ought, in common justice, at those bright periods when he possesses anextremely sound mind, to be lawfully allowed the free and valid exercise of his volition. But having noticed in the work above mentioned that the termintervalis extremely indefinite, as applied both to time and space, it is the province of the law to define its duration and extent. As a constant observer of this disease for more than twenty-five years, I cannot affirm that the lunatics with whom I have had dailyintercourse, have manifested these alternations of insanity and reason. They may at intervals become 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 endeavour to effect some desirable purpose, and artfully conceal their real opinions, but they have not abandoned or renounced their distempered 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. To establish its sanity it must be assayed by different tests, and it must be detected to be as lucid on the subject of those delusions, which constituted its insanity, as on topics of a trivial nature. But the law alone must determine whether it willconsider an individual sane act as a lucid interval, and infer soundness ofmind, which is the abstract term for all the intellectual phenomena, and implies the aggregate of the ideas, of the individual, from a single and successful effort.