is small, though this may not be very noticeable because of
over-development of the jaws. A heavy lower jaw particularly, because
of the principle of bone-development that size depends on functional
action and reaction, may lead to over-thickness of the skull at the
point of articulation. The {275} jaw articulates with the base of the
skull, and as a consequence the cranial capacity of these individuals
is distinctly less than normal. Besides this, there is commonly some
abnormality in the shape of the head, or the cranium is distinctly
asymmetrical. It has been noted that criminals have a large orbital
capacity, that is to say, the bony framework surrounding the eye is so
large as to encroach much more than usual upon the space left within
the cranium for nervous tissue. The bones of the skull are likely to
be thicker and heavier than usual, thus also limiting the cranial
capacity. The superciliary ridges often project and give the beetling
brow that is sometimes so remarkable. The jaws are heavy, and
especially the lower jaw is apt to be large and prognathic, that is,
projecting. This may extend even to the existence of a so-called
lemurian appendix of the jaw. The zygomatic process is apt to be
prominent, in keeping with the heaviness of the upper jaw. The nose is
usually somewhat flattened, and may be crooked. This peculiar
development of the nose puts most of the internal parts of that
important organ within the skull itself. This further encroaches upon
the cranial capacity. The ears are asymmetrical, often unevenly placed
at the sides of the head, sometimes adherent at the lobule, sometimes
very prominent. The displacement of the soft tissues is due to the
existence of asymmetry of the skull. As may be seen, all of the
characteristics of the criminal type, pointed out by Lombroso, may
practically be summed up in the one expression, there is diminished
amount of intracranial space.
With regard to many cranial deformities, and especially various
thickenings of the cranial bones, it must not be forgotten that they
are not the expression of physical heredity, but are often
pathologically acquired. Certain diseases of children are accountable
for many of them. Various disorders of nutrition in the early years of
life express themselves in bony deformities, and the skull is not
spared. Rickets, for instance, is well recognised as a cause of such
deformities. Owing to a wrong etymology of this word, by which it is
supposed to be derived from the Greek word [Greek text], meaning the
spine, rickets is sometimes scientifically {276} called rachitis. The
connection, then, between the cranial deformity and some underlying
nervous disturbance might be assumed. It does not exist, however.
Rickets is an English word, the derivation of which is unknown, but
probably it is _wricken_, twisted, deformed, and its use has crept in
because the disease was first described in England, and is indeed
often spoken of on the continent of Europe as an English disease. Not
that it is any more frequent in England, however, but was there first
recognised as a distinct pathological entity. As the result of this
affection the children, usually of poor parents, suffer from
gastro-intestinal disorders of various kinds, and develop symptoms of
malnutrition, affecting especially bone tissue. The ends of the long
bones at the wrists and at the ankles, where the effects of the
disease can be noticed particularly, become more thickened and nodular
than usual. The ends of the ribs, where the bones join the cartilages,
also become nodular, so that a series of beads can be seen down each
of the child's sides, a condition described as the rickety rosary. In
a similar way the bones of the skull become thickened, especially at
the edges of the fontanels, that is, the openings in the child's head
before complete ossification of the skull has taken place. As a
consequence of this thickening these openings do not close as they
should, and the head becomes markedly deformed in some cases.
Indeed, as has been shown by experts in children's diseases, many of
the peculiarities that have been pointed out by over enthusiastic
craniologists as indicating criminal degeneration, are really the
results of the rickety process on the skull. Needless to say, however,
this does not change the character of the individual, nor is there any
good reason why such deformities should have any special connection
with criminality. It happens that many of the criminal classes suffer
from malnutrition in their early childhood, and as a consequence there
is a faulty bony development of the skull. It is observations of this
kind, particularly, that have served to discredit craniology as an
independent science.
With regard to habitual criminals, the question of criminality must be
discussed from the standpoint, not of those who theorise, but of those
who know from actual {277} observation most about the criminal
classes. In an article in _The Nineteenth Century and After_ for
December, 1901, Sir Robert Anderson discusses how to put an end to
professional crime. Sir Robert has been Chairman of the Criminal
Investigation Committee of the English Parliament for many years. His
opinion, then, is worth weighing well and is very strikingly different
from those of the criminologists who would find a very large
proportion of criminals among mankind. He says:
"I am not turning phrases about this matter, or dealing in rhetorical
fireworks. I am speaking seriously and deliberately, and I appeal to
all who have any confidence in my judgment and knowledge of the
subject, to accept my assurance that if not 70,000 but 70 known
criminals were put out of the way, the whole organisation of crime
against property in England would be dislocated, and we should, not
ten years hence but immediately, enjoy an amount of immunity from
crimes of this kind that it might to-day seem Utopian to expect. The
criminal statistics cult blinds its votaries. It is the crime
committed by professional criminals that keeps the community in a
state of siege. The professional criminals are few and I may add they
are well known to the police. The theory that these men commit crimes
under the overpowering pressure of habit, or of impulse, is altogether
mistaken. They pursue a career of crime because, as Sir Alfred Wills
expresses it, they calculate and accept its risks. And just in
proportion as you increase the risks you will diminish the number of
those who will face them. True it is that the army of crime includes a
certain number of wretched creatures who have not sufficient moral
stamina to resist the criminal impulse. I believe there are fewer of
this class in England than abroad, but I know that these are not the
sort of criminals whose crimes perplex the police. The high-class
criminal is a different type of person altogether."
Sir Robert gives an extract from one of the morning papers of the day
on which he wrote these lines, in order to show how different is the
status of every ordinary habitual criminal from that which the
enthusiastic criminologist supposes it to be:
{278}
"Hewson Patchett, 48, was sentenced yesterday for obtaining seven
pounds and a gold watch by false pretenses. He urged it was his first
offence, but a London detective informed the court that there were
about two hundred cases against him for housebreaking."
Sir Robert adds: "If Patchett is a cool-headed, deliberate criminal,
the whole proceeding is a farce. And if he be one of those miserable,
weak creatures who can not abstain from crime, the sentence is
barbarous."
Such experiences as Sir Robert hints at as occurring frequently in
England, are certainly by no means uncommon in this country. Within
the past year in at least four cases in New York City, in which a
burglar, besides committing robbery, wounded or killed some one,
either in the commission of the crime itself or in endeavouring to
avoid arrest afterwards, there were more than two convictions
registered against the criminal in his previous life. There can be no
doubt that criminality becomes for some men a sort of mania, and that
society must protect itself against their actions quite as it does
against those of the insane by confining them under surveillance. It
seems very clear that while a man may, under stress of circumstances
or because of some specially tempting opportunity, be induced to
commit burglary or some other crime by violence in order to obtain
money, this will not happen a second time, except in the case of
certain individuals whose moral tone is so perverted that reformation
is practically hopeless. If a second conviction for burglary,
therefore, is secured, a longer sentence than is now the custom should
be inflicted, and the individual should not be allowed to go from
under the surveillance of the authorities until he has demonstrated,
for at least five years, his willingness and capacity to earn an
honest living.
This may seem a drastic method. It may also appear to some that there
would be consequent upon this system of regulating criminals a very
undesirable increase of our present rather extensive system for the
care of criminals. Here is where Sir Robert Anderson's experience is
of value. The confirmed criminals are not near so many in number as is
usually supposed, or as is even claimed by certain heedless {279}
statistical experts in criminology. There is no doubt, however, that
these men succeed in drawing others around them and in organising most
of the crimes of violence that are committed. There is a certain
glamour about the successful burglar that allures the young man and
starts him in the downward path of criminal tendencies from which he
may not be able later easily to withdraw.
If those who are most deeply interested in the reform of the criminal
classes would unite in an effort to secure legislation to the effect
that the habitual criminal should receive, not a definite sentence but
an indeterminate sentence; that is to say, that on his second
conviction for burglary, he should be sent to jail until such a time
as, in the opinion of officers of the institution where he has been
confined, he shows signs of a disposition to become a worthy member of
society, and that then he should be allowed to be at liberty only
under such circumstances as would permit of reports with regard to his
conduct for a time equal at least to the years spent in prison, then
there would be much less need of the theoretical considerations with
regard to the heredity of criminal traits, and the supposed all
powerful influence of environment in fostering criminal tendencies.
There is in this matter a very worthy field for the development of
philanthropic qualities, and the student of the abnormal man will find
many opportunities for the exercise of a large-hearted charity, rather
than the facile condemnation which places all violations of law under
the head of criminality.
Those who have made special studies with regard to criminals have, as
a rule, come to the conclusion that our modern method of treating
those convicted of crime is eminently irrational. It is a rare thing
to pick up a newspaper without finding that a crime by violence has
been committed by some one who has previously been in state's prison
for a similar crime. Most of the burglars have a police record.
Pickpockets and others continue to pursue their avocations,
notwithstanding a series of convictions. It is clear that a sentence
of a year or two, or even more each time that a crime is committed,
does not act as a deterrent. Such people are differently constituted
from those who are influenced by {280} public conviction of crime and
restraint of liberty. There is something radically wrong with their
moral sense. It would seem that the proper way to treat them is after
the same fashion as the method used with those who are mentally
impaired.
After a man has shown, by a second conviction of a crime by violence,
that he is one of those whose moral sense can not be restored by
punishment to a realisation of his action, then an indeterminate
sentence, somewhat as in the case of the mentally unstable, who are
allowed to leave the asylum but are kept under observation, is the
only proper method.
Men like Sir Robert Anderson are sure that this procedure could be
adopted with regard to quite a liberal number of leading criminals
whose influence induces others to crime. There would be much less need
for all machinery of the criminal law than at the present time, and
the community would be better protected. This is certainly true as
regards the large cities, where crimes against property are almost
without exception committed by those who have been previously
convicted for such crimes, or who at least have been in intimate
association with such convicted criminals.
This view of the criminal, as one against whom society must protect
itself just as it does against the insane, is comparatively modern. It
must be borne in mind, however, that insane asylums are by no means an
old institution, and that the present restraint of very large numbers
of the insane is something unknown before in history. It seems not
unlikely that if this newer aspect of criminology could be made
popular great benefit would follow, not only to the peace of the
community and the freedom of its members from fear as to such crimes,
but also a number of the weaker individuals, who are now influenced
and led astray by clever criminals, would be saved from commission of
crime and the necessity of punishment, with the degradation and
lifelong stigma that this involves.
This is an aspect of criminology with which the Christian clergyman
can be in sympathy, and that does not smack of the utter materialism
which was at the foundation of much of the discussion of the so-called
criminal type. The {281} recognition of moral perversion as a form of
insanity requiring treatment and then constant observation for many
years, just as in the case of mental disequilibration would be a
distinct advance over our present crude methods of dealing with
criminals.
JAMES J. WALSH.
{282}
XXVI
PARANOIA, A STUDY IN CRANKS
Of late years the crank, in the various forms in which he or she may
occur, has became a subject of great popular as well as scientific
interest. As a matter of fact, the queernesses of people are a more
absorbing study to the neurologists and psychologists than are any
forms of insanity. It not infrequently happens that individuals of
peculiar tendencies are prone to have special affinity for religious
ideas, and strange applications of Christian formulae of thought. Even
when they do not become absolutely insane in their religiosity, they
may often go to extremes. It must be remembered, too, that some cranks
are mentally affected in but mild form, and it may be difficult to
determine whether their oddity is really the result of a certain
amount of mental torsion, or merely intellectual tension.
Such persons are more likely to be brought in close contact with their
pastors and other clergymen and with religious Superiors of various
kinds than even normal individuals. They often put their confessors,
particularly, in serious quandaries in the matter of spiritual advice.
A review, then, of the accepted ideas of experts with regard to such
people is likely to be of special service to those who would
understand these cases as well as possible, though the present state
of medical knowledge, here as elsewhere, leaves much to be desired.
A distinguished authority in mental diseases once said, half in jest
though he meant it to be taken at least half in earnest, that a great
many more of us are cracked than are usually thought to be, only that
most of us succeed in concealing the crack quite well. The frequency
of the crank adds to the {283} interest of his study, which is by no
means a department of medical science of recent growth. While interest
in this class of persons has become much more intense in recent years,
eccentric individuals have been an object of close observation and of
serious study almost as far back as history goes. When Quintilian said
that genius was not far separated from insanity, he meant to record
the conclusion of his time, that men of genius are apt to seem
inexplicable in their ways to those who come closely in contact with
them. Eccentric persons, however, are by no means always undesirable
members of a generation. It has been noted by historians in all ages
that to the refusal of eccentric individuals,--often thought at the
beginning, particularly, to be little better than insane--to accept
the traditions of the past, we owe many of the privileges which we
enjoy at the present time. Their refusal to think along old lines of
thought often makes them valuable pioneers in progress.
Definite knowledge with regard to the pathological basis of crankism,
or eccentricities, has not yet been obtained. What has been learned,
however, has enabled the neurologist to distinguish various forms of
mental perturbation, to recognise the probable influence of certain
conditions and environments on the future action of eccentric
individuals, and to foretell the probable outcome of the cases. All of
this information is of very practical importance to religious
Superiors and others in positions of religious confidence, who are
sure to be brought, even more than the rest of the community, in
contact with the eccentric class. It has seemed advisable, then, to
condense some of the recent knowledge on this subject into popular
form for the use of confessors, spiritual directors, and those in
religious authority.
How recently medical knowledge on this important subject has developed
along strictly scientific lines may perhaps best be appreciated from
the fact that Professor Mendel of Berlin, to whom we owe the term
_paranoia_, the recognised scientific designation for crankism, is yet
alive and continuing his lectures on neurology at the great German
university. The term, from the Greek word [Greek text], meaning
alongside of, and {284} [Greek text], mind, expresses the fact that
the mental faculties of individuals designated by it are beside
themselves, that is, the mental powers are not entirely under the
control of the individual, so that they only come near voluntary
intellection in its highest sense. In a word, the term contains a
series of expressive innuendos by its etymological derivation.
Professor Berkley of Johns Hopkins University says that the word
paranoia was first adapted by Mendel from the writings of Plato, to
indicate an especial form of mental disease occurring in individuals
capable of considerable education, at times of brilliant acquirements,
yet possessing a mental twist that makes them a class apart from the
great mass of humanity.
Professor Peterson, the President of the New York State Commission of
Lunacy, gives a very good definition of the condition which, though
couched in somewhat technical terms, furnishes the most definite idea
of the essential properties of paranoia. He says: "Paranoia may be
defined as a progressive psychosis founded on a hereditary basis,
characterised by an early hypochondriacal stage, followed by a stage
of systematisation of delusions of persecution, which are later
transformed into systematised illusions of grandeur." He continues:
"Though hallucinations, especially of hearing, are often present, the
cardinal symptom is the elabourate system of fixed delusion."
In a word, the paranoiac is a crank usually descended from more or
less cranky ancestors, with an overweening interest in his health to
begin with, who later develops the idea that many people are trying to
do him harm, or at least to prevent his rise in the world, and who
finally becomes possessed of the notion that he is "somebody," even
though those around him refuse to acknowledge it and pay very little
attention to the claim. Such people not infrequently hear things that
are not said. That is, not only do they hear the voices of the dead,
of spirits good and evil, but also the voices of living persons, who
are at a distance from them and sometimes even when those living
persons are present, but have said absolutely nothing. These delusions
of hearing, however, are not so important as the self-deception forced
upon them by their {285} mental state with regard to their importance
in the world and their relations to other people.
The most significant consideration with regard to paranoia is the fact
that it is practically always hereditary. Krafft-Ebing said that he
never saw a case of true and reasonably well developed paranoia
without hereditary taint. This does not imply, of course, that the
same symptom of delusions exists in several generations, but some
serious mental peculiarity is always found to exist in the preceding
generation. Other authorities are not quite so sweeping in their
assertion of heredity for these cases, though practically all are
agreed that in over 80 per centum of the cases, some hereditary
element can be traced without overstretching the details of family
history that are given.
Paranoia occurs a little more commonly in females than in males. As it
is of hereditary origin, it is not surprising to find that the
peculiarities are noticed very early in life, though they may not be
sufficiently emphasised to attract the attention of any but acute
observers, who are brought closely in contact with the patients. Even
in childhood, patients who subsequently develop serious forms of
paranoia, usually have been shy, backward, inclined not to play
readily, irritable, peculiar, precocious, prone to spend much time in
study at an age when they ought to be interested mainly in sports, and
they are generally old beyond their years. A typical example of this
was Friederich Nietzsche, the German philosopher, who died a few years
ago in an insane asylum.
Olla Hanssen, Nietzsche's biographer, who carefully collected the
family accounts of the philosopher's childhood, said that he did not
talk until much later in childhood than is usual. "As a boy he was
retiring and solitary in his habits. During his school days he was
always interested in books not in sports, in lonely walks not in young
companions." A history of this kind will be found in the early career
of many queer folk. Very often these old-fashioned traits are a source
of pleasure to parents and sometimes even to teachers. During
childhood, however, the sports of childhood should satisfy the child,
and abnormalities of interest in things outside of childhood's sphere
are always suspicious. The growing {286} organism needs, first of all,
muscular exercise, and after that the freedom of mind that comes with
spontaneous play. It may be said, in passing, that the walk of a city
child with its maid, when even the child's choice in the matter of
where it shall walk is not consulted and the maid's will is constantly
imposed, is the worst possible training for spontaneous action or
volition in later life.
In the cases that develop early in life it will practically always be
found that infantile cerebral disorders of some kind are a prominent
feature of the history. The mother's delivery was difficult perhaps,
and the child was for some time after birth unconscious, or infantile
convulsions occurred. It may be remarked here that a history of
convulsions in childhood is now considered by physicians as of serious
import for the future nervous and mental life of the child. It has
recently been announced, for instance, that so-called idiopathic
epilepsy,--that is, epilepsy without some directly immediate
cause,--very seldom develops later in life in persons who have not had
in childhood convulsive seizures as the result of some extreme
irritation. This does not imply that every child that has convulsions
will suffer from some serious nervous or mental condition later; but
every child whose mental and nervous equilibrium is not stable,
because of hereditary elements of weakness, will almost certainly
suffer. Injuries to the head in childhood are nearly of as great
importance as the actual occurrence of convulsions.
There are usually three stages of paranoia described by authorities in
mental diseases. These have been called the prodromal or initial
period, which is also, because of the set of symptoms usually most
prominent in it, often called the hypochondriacal stage of the
disease. The patient occupies himself with his feelings and his
sensations. He is concerned very much about the state of his health
and is prone to think himself affected by diseases that he reads about
or hears described. This set of symptoms, by itself alone, is not an
index of enduring mental disturbance, but may be only a manifestation
of a passing mental perturbation in sympathy with some slight physical
ailment. This state may indeed be nothing more than the result of too
persistent introspection. {287} Most medical students suffer from a
certain amount of hypochondria during their early acquisition of a
knowledge of the symptoms of disease.
In the true hypochondriac, however, every bodily sensation, or as it
is technically called, somaesthetic sensation, is translated to mean a
significant symptom of serious disease. A slight feeling of fatigue
becomes to the patient's mind the "tired feeling" of a dangerous
constitutional disorder. Any peculiar feeling, such as that of the
hand or foot going to sleep, is set down at once as a symptom of a
serious nervous disease, or if the patient has heard that in old
people numbness of the extremities is a forerunner of apoplexy, he is
sure to conclude that apoplexy is threatening in his own case.
Subjective sensations of heat and cold set him to taking his
temperature and his pulse, and even slight variations in these are
magnified into important physical signs of disease.