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MEDICAL JURISPRUDENCE,
AS IT RELATES TO
INSANITY,
ACCORDING TO
THE LAW OF ENGLAND.
BY JOHN HASLAM, M.D.
LATE OF PEMBROKE HALL, CAMBRIDGE.
FORMERLY PRESIDENT OF THE ROYAL MEDICAL, NATURAL HISTORY
AND CHEMICAL SOCIETIES OF EDINBURGH.
London:
PRINTED FOR C. HUNTER, LAW BOOKSELLER, BELL YARD;
J. HUNTER, ST. PAUL’S CHURCH YARD; AND TAYLOR AND
HESSEY, FLEET STREET.
1817.
PREFACE.
The consideration, that in our own language, no work existed on the
subject of Medical Jurisprudence, as it relates solely to Insanity,
urged me to the present performance. Previously to this undertaking
manifold impediments were foreseen, and these difficulties have
augmented in every page of its progress:—the apprehensions from
this arduous attempt, have, however, been mitigated by the consoling
reflection, that in a novel enterprize criticism would be tempered with
candour.
The following sheets are addressed to the readers of different
pursuits, law and medicine:—from the latter, I have heretofore
experienced much indulgence and encouragement, when the result of my
professional labours has been submitted to their judgment:[i:A]—to the
former I am little known: and here feel it necessary, by a distinct
avowal, to assert that I have in no manner presumed to encroach on
their province. Although the title may seem to imply an incorporation
of the two sciences, yet it is not to be considered as the combination
of definite proportions of legal and medical knowledge. It has been
modestly conceived that the general phenomena of disordered intellect,
and the criteria of insanity, would not be unacceptable to the
advocate; who might thereby become enabled to adapt the facts in
nature to the scale of justice. Furnished with such information, he
will be instructed to institute appropriate enquiries for the discovery
of truth, and to ascertain what is the duty of the medical evidence
to supply:—so that he may not be pressed beyond his resources, nor
the depths of his intelligence be left unsounded. On the practitioner
of my own profession I have ventured to impress the importance and
moral obligation of his evidence before the tribunal of justice, and
to enforce, that the value of medical opinion becomes enhanced by
perspicuity of conveyance, and derives authority from the exposure
of its foundations. It has likewise been my object, to direct his
attention to those leading points which usually constitute the subjects
of his deposition, or are presented for his solution during the course
of legal examination.
[i:A] Vide Observations on Insanity, 8vo, 1798.—Observations
on Madness and Melancholy, 8vo, 1809.—Illustrations of
Madness, 8vo, 1810.—Considerations on the Moral Management of
the Insane, 8vo, 1817.
The technical language of the learned professions is commonly
inveloped in mysterious obscurity:—persons for the most part acquire
names without investigating their force and legitimate import; and
currently employ them rather from habit than comprehension: it has
therefore been my anxious endeavour to scrutinize words of important
meaning; and to convey the manifestations of mind and the symptoms of
disease, by expressions generally understood, and emancipated from the
thraldom of professional nomenclature.
To complete the plan I originally projected, there still remains to
submit to the notice of the public, “The consideration of insanity in
a political view,” enquiring how far human wisdom, properly directed,
might become the instrument to diminish this severe and encreasing
affliction,—and especially to point out the desiderata for a _bill_
to protect the insane, and regulate the receptacles wherein they may
be confined. Notwithstanding the heterogeneous mass which has been
authoritatively diffused on this important subject, the necessary
materials have not yet been collected. Those who will probably attempt
to frame this measure, have much to learn, and more to dismiss. The
production of a wise and salutary bill requires ample research and
temperate reflection: and therefore can never be the offspring of minds
void of information, and saturated with prejudice. As Insanity is a
disease, by the unanimous concurrence of physicians, most certainly
to be remedied at the commencement of its attack: it ought to be a
leading object with those who possess the power to legislate, to afford
every facility to the medical attendant, that he may have an early
access to the treatment of this malady, for the restoration of the
patient, and for the security of the public. But if the practitioner
is to be pinioned by threats, or deterred by obloquy—if his skill
is to be circumscribed by ignorance, and his experience subjected to
wild hypothesis, and baseless conjecture; then, the enactment will be
oppressive in its operation, and incompetent to meet the exigences of
intellectual calamity—a bill, calculated to confirm and aggravate the
horrors of madness—to invite suicide, and multiply murder.
JOHN HASLAM.
_1st December, 1817,
51, Frith Street, Soho Square._
ON
Medical
JURISPRUDENCE,
_&c. &c._
Medical Jurisprudence has been assiduously cultivated by the different
nations of the European Continent; and many works of great value and
esteem have been produced by foreign professors of medicine on this
important subject. In our own country this department of medical
science has been comparatively neglected.[1:A] It is not my intention,
in the present tract, to enter generally on the subject of Forensic
Medicine: but to confine my investigation to that particular branch
which relates to persons of insane mind, and who under the visitation
of this dreadful calamity commit acts of violence which subjects them
to be arraigned before the tribunal of Justice, or to have their
property vested in trust by finding a verdict on a writ de Lunatico
inquirendo.
[1:A] Vide an Epitome of Juridical or Forensic Medicine,
by George Edward Male, M. D. a work of great excellence
and scientific discrimination; also Tracts on Medical
Jurisprudence, by Drs. Johnson, Bartley, and Farr.
Although of the utmost consideration, the extent of this enquiry would
seem to be very limited, and contained in this simple question. Is the
person accused, of insane mind? If he be insane he will be acquitted on
the _proof_ of his insanity—if he be not of insane mind, he must be
treated as an ordinary delinquent. In those cases where the prisoner
is so bereft of his reason, that any twelve men would not entertain
a different opinion, where numerous evidences appear to testify to
repeated acts of insanity, which are so manifest that they cannot be
otherwise interpreted; and where he has been confined and treated for
this malady, the physician will have an easy duty to perform: but it is
in cases which appear to be involved in difficulty, where the disorder,
although existing and directing the actions, is not so ostensibly
developed that the medical evidence becomes important, and capable by
sagacity, experience and truth, of explaining and characterizing the
state of the person’s intellect.
The important duty which the medical practitioner has to perform,
when he delivers his testimony before a court of justice, should be
clearly defined, conscientiously felt, and thoroughly understood,—his
opinion ought to be conveyed in a perspicuous manner; he should be
solemnly impressed that he speaks upon oath, the most sacred pledge
before God between man and man—and that the life of a human being
depends on the clearness and truth of his deposition. He is not to
palm on the court the trash of medical hypothesis as the apology for
crime; neither should the lunatic receive his cure at the gallows by
the infirmity of his evidence—but above all his opinion should be
so thoroughly understood by himself; so founded in experience and
fortified by reason, that it may resist the blandishments of eloquence
and the subtil underminings of cross-examination. The physician should
not come into court merely to give his opinion—he should be prepared
to explain it, and able to afford the reasons which influenced his
decision:—without such elucidation, Opinion becomes a bare Dictum,
and endeavours to claim precedence, without courtesy or obligation to
science.
It is to be regretted that on many occasions where several medical
practitioners have deposed, there has been a direct opposition
of opinion:—this difference has sometimes prevailed respecting
insanity,[5:A] but more frequently in cases of poison. It is not
intended to account for this contrariety of evidence: much will depend
on the sagacity of the counsel to institute the proper enquiries;
and still more will be incumbent on the medical evidence, in order
to explain and establish his testimony. On one side the evidence
will be positive; and it is to be presumed that no member of the
medical profession would directly state an individual to be insane
without being able, satisfactorily to his own reason and conscientious
feelings, to exhibit from his conversation, his actions or his
writings unequivocal proofs of his derangement. To such well founded
illustration, negative evidence would but little avail.
[5:A] Vide my Illustrations of Madness.
The Lawyers object is the interest of his employer, and for the
fulfilment of his duty he is frequently compelled to resort to a
severity of investigation which perplexes the theories, but more
frequently kindles the irritable feelings of the medical practitioner.
This distrust on the part of the lawyer, however unpalatable, is fully
justified: most witnesses going into court, not with a wish to be
examined, but with the preconcerted intention of _proving_ to a certain
extent;—and those most conversant in the history of human testimony,
have been extremely scrupulous of admitting it as uniform truth until
it has been carefully sifted. Guarded with these precautions and armed
with professional experience, the medical practitioner may approach
the tribunal of justice with confidence, and advantage to the cause
of truth. However dexterous he may shew himself in fencing with the
advocate, he should be aware that his evidence ought to impress the
judge, and be convincing to the jury. The most experienced physician
who has seen insanity in all its forms, and viewed its more delicate
shades, must in a question of this nature submit his opinion, to the
comprehension and feeling of the ordinary persons who are to appreciate
his deposition. Their BELIEF of the alleged insanity must be
the test by which his scientific opinion is to be established. That
which may be deemed by the medical evidence, clear and unequivocal
madness, may not hit the sense of the gentlemen of the long robe, nor
carry conviction to the jury.
It may here be important to investigate the sources from whence
the popular feeling and intelligence concerning madness have been
derived; or in other words, what are the foundations for the opinions
of the generality of persons, on the subject of insanity? Patient
enquiry, daily communication with deranged persons and attentive
observation of their habits, confer the means of judging on medical
practitioners, and more especially on those, who have for a series
of years, solely confined their practice to this department of the
profession. The information of the lawyer is principally deduced from
the writings of those great legal authorities to which he refers with
confidence;—although these grave authorities have laid down _no
definition of madness_, nor given any directions how to discover it.
The ordinary class of persons, who are usually summoned to act as
Jurymen; and who are sufficiently virtuous and intelligent; have in
common with the mass of mankind formed their opinions of that state of
mind which is denominated madness, and it should be observed that such
opinions are not very easily removed or altered. It will be a curious
and instructive enquiry, to investigate the circumstances which have,
in all probability, contributed to fix their notions on the subject
of insanity. They have wanted the means of direct information, and
consequently have adopted the popular and floating opinions on this
disease. That dramatic representations have forcibly operated for
this purpose there is little reason to doubt: and some of the plays
of Shakespear exhibit many of the forms which this malady is supposed
to assume. Among such characters, none have more strongly fastened
on the general mind, than the outrageous Lear, and the distracted
Ophelia; the subtil craziness of Hamlet leaves it doubtful if his
alienation of mind be real, or conveniently assumed—and to the
ordinary observer conveys more of fiction, than the avowed counterfeit
of Edgar. Romances, the literary food of the idle and thoughtless,
abound in descriptions of intellectual calamity;—but these artificers
of fancy, like many unskilful performers, are too prone to strain the
loftier impressions of feeling, and distort the energies of passion,
into mental derangement. Something of affecting interest may be
excited by the weaknesses and wanderings of Maria, but Cervantes has
exhibited the happiest and most correct picture of systematic insanity;
although the vehicle of chivalry in which it is conveyed, has, to our
own countrymen, blunted its interest as a physiological portrait of
madness:—his sallies have provoked mirth, and so keen is the relish
for the ridiculous, that in the luxury of laughter, the reader has
forgotten the tribute of commiseration. Within my own recollection
Bethlem Hospital gratified the curiosity of the vulgar of both sexes;
these visitors were most eager to penetrate into the recesses of the
furious and naked maniac: the hideous howlings of those violently
affected, forcibly arrested their attention. With the insane of a
milder cast, they were but slightly interested; except the singularity
of their actions, or incoherence of discourse were calculated to
excite their merriment. They were much delighted with the archness of
retort and ridiculous buffoonery which often forms a striking feature
in the character of the insane. They were particularly gratified at the
manner in which they frequently ornament their persons: a straw crown
or sword of the same material pleasingly occupied their attention;—but
they passed over the silent and melancholic, and usually retired with
the impression, that the quiet and orderly were convalescent, or
improperly confined. To impress ordinary persons with the existence of
insanity, some prominent and strongly marked features are absolutely
required; as the popular feeling and intelligence concerning madness
is the result of those glaring exhibitions, those caricatures of
disease which the stage represents or romances propagate. Of methodical
madness, of systematic perversion of intellect, the multitude can
form no adequate conception, and cannot be persuaded that insanity
exists without turbulent expression, extravagant gesture, or phantastic
decoration. The converse of this has likewise, not unfrequently
obtained; and even among those who might be supposed to possess
superior information.—Hesitation of speech, nervous and convulsive
affections—uncouth gestures resembling St. Vitus’ dance, absence
of mind—dulness in comprehending a question, with tediousness and
embarrassment in affording the reply, have often induced the mistaken
supposition that the party was insane.
On those occasions where the madman has been tried in a criminal court,
the counsel for the prosecution has usually and gravely enquired of
the medical evidence, whether the prisoner on ordinary topics and
on subjects unconnected with his insanity, would not converse in
a rational manner: and also whether he did not possess sufficient
understanding to discriminate between GOOD and EVIL, RIGHT and WRONG?
When a medical person is employed concerning any one to whom insanity
is imputed, his principal enquiry is concerning his _in_sanity: it
is not his object to ascertain how much reason he possesses, but how
far, and on what topics he is insane. And having gauged his insanity
he has performed his duty. If it should be presumed that any medical
practitioner is able to penetrate into the recesses of a lunatic’s
mind, at the moment he committed an outrage; to view the internal play
of obtruding thoughts, and contending motives—and to depose that he
knew the GOOD and EVIL, RIGHT and WRONG he was about to commit, it
must be confessed that such knowledge is beyond the limits of our
attainment. It is sufficient for the medical practitioner to know
that his mind is deranged, and that such state of insanity will be
sufficient to account for the irregularity of his actions; and that in
a sound mind, the same conduct would be deemed criminal. If violence
be inflicted by such person during a paroxysm of rage, there is no
acuteness of metaphysical investigation which can trace the succession
of his thoughts, and the impulses by which he is goaded for the
accomplishment of his purpose. And it will be shewn hereafter that in
some instances he is not himself conscious of his actions. Should an
equal injury be inflicted by the crafty and deliberate machinations
of systematic insanity, where the motives to action are delusions,
the scrutiny into the exact procession of thought which produced the
motive, or excited the determination is likewise beyond the reach of
the medical practitioner. As it would be difficult in a person of the
soundest mind to detect the succession of thoughts, tracing that which
was most remote _from_, to that which was proximate _to_, the action;
it can less be expected that the medical evidence should be capable of
noting the consecutive irregularities of a disordered intellect.
Respecting the quantum of reason which the lunatic possesses, the
physician may safely conclude, where he betrays no derangement, that on
such topics he is of sound mind; and the fact is firmly established,
that those who are insane on particular subjects, will reason correctly
on ordinary and trivial points; _provided they do not become associated
with the prevailing notions which constitute their insanity_. Ordinary
persons have been much deceived by this temporary display of rational
discourse, and it generally occurs that we are disposed to form a hasty
conclusion, in proportion to the paucity of our knowledge on any given
subject:—most minds feel more invited to indulge in the convenience
of a syllogism, than to undergo the toil of induction. Although an
insane person may be calm and apparently rational at the beginning
of an interview, yet when least expected his disorder breaks forth,
and in many instances, there seems to be no cause for this conversion
from apparent sanity to evident derangement. In the commencement of
the conversation the lunatic shall evince a healthy perception of
existing objects, and institute a just admeasurement of the subject
under contemplation; or in other words shall reason correctly; if he
be placed in the society of other madmen he is able to detect the
folly and aberration from reason which characterize their peculiar
phantasies, and will often endeavour to convince them of the absurdity
of their prevailing opinions, yet in a moment his mind launches into
the regions of fiction, its admired clearness becomes obscured, and
its seeming regularity exhibits a confused assemblage or violent
distortion.—There is no intermediate condition which separates these
states: and the transition very much resembles the last connected
glimpses of our waking thoughts, followed by the abrupt creation of a
dream.
This occasional display of rationality, although admitted by all who
have had experience of the insane, excites a doubt in the minds even
of learned and intelligent persons who have merely speculated on this
disease. They have conceived, from the existing philosophy of the
intellect, that reason is the directress of human actions,—that this
high arbiter of thought is an undivided principle,—that where the
rudder is attached the ship may be steered—and that he who reasons
must be rational: and so he is, _as long_ as he _does_ reason. But the
inference of the integrity of the reasoning faculty in consequence
of occasional gleams, is a gratuitous and groundless supposition. It
often happens that persons may converse for some time with a lunatic,
and find him apparently composed and rational; he will discuss the
floating topics of the day as another man,—accord with the most
enlightened on the general principles of morals, and correctly estimate
the light and shadow of human conduct. If the observer should here
retire he might be convinced of his sanity: but let him protract the
discourse, let him touch the fatal string which throws his mind into
discord: let him draw the hair-trigger which inflames the combustible
materials of his disease, and he will be surprised if not alarmed at
the explosion. The sweeping tyranny of madness scorns the demarcation
which limits the sober mind; and it should likewise be taken into
account that the subjects which constitute the insanity of a person,
are the prominent features of his mind, and are more frequently
recurred to than any other. It is true he may discuss ordinary topics
like other men; but this to him is a species of bye-play, and he soon
reverts to the interest or catastrophe of his drama. Whatever may be
the subject of discourse, and however rationally he may appear to treat
it, the experienced practitioner will expect, and he will not often
be disappointed, to find that by some unaccountable association, even
ordinary topics are linked with his darling delusion,—the map of his
mind will point out that the smallest rivulet flows into the great
stream of his derangement.
On a more attentive consideration, there appears to be something latent
and perhaps mischievous, in the terms GOOD and EVIL, RIGHT and WRONG,
as applied to cases of insanity. If an _insane_ person be responsible
for his conduct, I know of no law which sanctions his confinement. If
he can discriminate between GOOD and EVIL, RIGHT and WRONG, on what
pretence is he to be deprived of his liberty? Is it humane to suppose
him in his senses when he becomes most outrageous? Is it christian-like
to deem him responsible, because the violence of his disorder tears
down the fences of the law, or snaps the ties of natural affection?
Ought he to be punished when he is most to be pitied? If it be supposed
that the terror of example will prevent the sallies of the maniac, it
is a lamentable mistake. His belief in the GOOD of his principle, his
faith in the RIGHT of his actions, are superior to arguments,—his
motive cannot be controlled by reason, nor baffled by the fear of
punishment. Impressed with a _belief_ in the truth of his delusion,
he hurries forward to its accomplishment: and in the pursuit of the
phantom cannot be diverted by the most awful consequences. He is of
those
“quem neque pauperies
“Neque mors, neque vincula terrent.”
It is this firm belief, this fond indulgence of opinion which makes him
prefer seclusion to liberty; and leads him rather to forego existence
than renounce his delusion. It is the same principle, which in a good
cause, cheered the martyr at the stake, and raised his exultation while
the flame consumed him. It is this BELIEF, however erroneous, which
kindles enthusiasm in a cause, and arms us to defend it.
As the word BELIEF is important, it will not be considered
unnecessarily digressive to attempt an investigation of its legitimate
meaning. There are two modes of ascertaining the meaning of a word;
either by referring to its etymology, to discover the cause of
its application: or to collect the authorities which shew, that
certain persons who are accredited, have so employed it. By turning
to Dr. Johnson’s Dictionary the reader will find that the different
authorities which he has cited have used this word in different
acceptations. Without descending to the minutiæ of verbal examination,
and tracing back its derivation to its Gothic or Saxon radical, it may
be safely asserted, that to BELIEVE, originally implied to belove: to
be attached or partial to, independantly of any evidence which would
lead to demonstration. This belief is the immediate motive to action,
and although incapable of becoming the subject of demonstration itself,
is not to be set aside by the clearest and most forcible refutation.
“You may as well
“Forbid the sea for to obey the moon,
“As by an oath remove, or counsel shake
“The fabric of his folly, whose foundation
“Is pyld upon his faith.”
_Winter’s Tale._
It would be a curious and instructive enquiry to ascertain under what
circumstances the mind admits as rules for action, those principles
which do not admit of proof: because, if we could detect the manner
in which the knot is tied, we might probably be able to unloose it.
In the course of our education we are taught to adopt many maxims,
the truth and expediency of which may not be very evident; however as
we advance in life, experience and good sense gradually dispel many
of these prejudices and erroneous adoptions. But in the insane mind
the same process does not take place, and generally in proportion to
the reasoning adduced to confute the delusion, or the demonstration
employed to exhibit its absurdity, it becomes more strongly confirmed
and inveterately fixed; and the logic brought forward for its
refutation, is by the lunatic held as ignorance or misapplication. A
person _in_ his senses may entertain and believe a number of unfounded
and erroneous opinions, but on the exposure of their falsity he is
capable of being convinced, but the madman never is; and this forms the
great distinction between them. This incapability of being convinced of
the GOOD and EVIL, RIGHT and WRONG, TRUTH and FALSHOOD of his BELIEF
is that, which as an intellectual being, renders him different from
other men, and constitutes his distemper. To our present purpose,
it is immaterial how this arises, the knowledge of its existence is
sufficient: and it concerns us but little to ascertain if this state
depend on a morbid condition of the intellect itself, or of the organ
destined for the display of its phenomena.
This belief appears physiologically to constitute his disorder; and
the hope of placing this subject in a distinct point of view may be an
apology for the relation of the very remarkable case of Nicolai of
Berlin.[25:A] In consequence of a series of calamities which afflicted
him with the most poignant grief he had in January and February of
the year 1791, the additional misfortune to experience several very
unpleasant circumstances which were followed on the 24th of February
by a most violent altercation. “My wife and another person came into
my apartment in the morning in order to console me, but I was too much
agitated by a series of incidents which had most powerfully affected
my moral feeling, to be capable of attending to them; on a sudden I
perceived, at about the distance of ten steps, a form like that of a
deceased person, I pointed at it, asking my wife if she did not see
it? It was but natural that she should not see any thing, my question
therefore alarmed her very much, and she sent immediately for a
physician, the phantasm continued about eight minutes. I grew at length
more calm, and being extremely exhausted, fell into a restless sleep,
which lasted about half an hour; the physician ascribed the apparition
to a violent mental emotion, and hoped there would be no return,
but the violent agitation of my mind had in some way disordered my
nerves, and produced farther consequences which deserve a more minute
description.
[25:A] Vide Ferriar on Apparitions, P. 41.—As the Doctor has
not cited whence he obtained this curious document, I have been
under the necessity of employing perhaps his own translation.
“At four in the afternoon, the form which I had seen in the morning
reappeared. I was by myself when this happened, and being rather uneasy
at the incident, went to my wife’s apartment, but there likewise I was
prevented by the apparition, which however, at intervals disappeared,
and always presented itself in a standing posture: about six o’clock
there appeared also several walking figures, which had no connexion
with the first.
“I cannot assign any other cause of all this, than a continued
rumination on the vexations I had suffered, which, though calmer,
I could not forget, and the consequences of which I meditated to
counteract: these meditations occupied my mind three hours after
dinner, just when my digestion commenced. I consoled myself at last
with respect to the disagreeable incident which had occasioned
the first apparition, but the phantasms continued to increase and
change in the most singular manner, though I had taken the proper
medicine and found myself perfectly well. As when the first terror
was over, I beheld the phantasms with great emotion taking them for
what they really were, remarkable consequences of an indisposition,
I endeavoured to collect myself as much as possible, that I might
preserve a clear consciousness of the changes which should take
place within myself; I observed these phantasms very closely, and
frequently reflected on my antecedent thoughts to discover, if
possible, by means of what association of ideas exactly these forms
presented themselves to my imagination. I thought at times I had
found a clue, but taking the whole together I could not make out any
natural connexion between the occupations of my mind, my occupations,
my regular thoughts, and the multifarious forms which now appeared to
me, and now again disappeared. After repeated and close observations,
and calm examination, I was unable to form any conclusion relative to
the origin and continuation of the different phantasms which presented
themselves to me. All that I could infer was, that while my nervous
system was in such an irregular state, such phantasms would appear
to me as if I actually saw and heard them; that these illusions were
not modified by any known laws of reason, imagination, or the common
association of ideas, and that probably other people who may have had
similar apparitions were exactly in the same predicament. The origin
of the individual forms which appeared to me, was undoubtedly founded
on the nature of my mind, but the manner in which it was thus affected
will probably remain for ever as inscrutable as the origin of thought
and reflection. After the first day, the form of the deceased person no
more appeared, but in its place there appeared many other phantasms,
sometimes representing acquaintances, but mostly strangers: those whom
I knew were composed of living and deceased persons, but the number of
the latter was comparatively small. I observed the persons with whom I
daily conversed did not appear as phantasms, these representing chiefly
persons who lived at some distance from me. I attempted to produce at
pleasure phantasms of persons, whom I knew by intensely reflecting on
their countenance, shape, &c. but distinctly as I called to my lively
imagination the respective shades of three of these persons, I still
laboured in vain to make them appear to me as phantasms, though I had
before involuntarily seen them in that manner, and perceived them some
time after, when I least thought of them. The phantasms appeared to
me contrary to my inclination, as if they were presented to me from
without, like the phenomena of nature, though they existed no where
but within my mind. I could at the same time distinguish between
phantasms and real objects, and the calmness with which I examined
them, enabled me to avoid the commission of the smallest mistake. I
knew exactly when it only appeared to me that the door was opening and
a phantasm entering the room, and when it actually opened, and a real
person entered. These phantasms appeared equally clear and distinct at
all times and under all circumstances, both when I was by myself and
when I was in company; and as well in the day as at night, and in my
own house as well as abroad; they were, however, less frequent when I
was in the house of a friend, and rarely appeared to me in the street;
when I shut my eyes these phantasms would sometimes disappear entirely,
though there were instances when I beheld them with my eyes closed,
yet when they disappeared on such occasions, they generally reappeared
when I opened my eyes. I conversed sometimes with my physician and my
wife of the phantasms which at the moment surrounded me; they appeared
more frequently walking than at rest, nor were they constantly present.
They frequently did not appear for some time, but always reappeared for
a longer or a shorter period either singly or in company, the latter
however being most frequently the case. I generally saw human forms of
both sexes, but they usually appeared not to take the smallest notice
of each other, moving as in a market place, where all are eager to
press through the crowd; at times however they seemed to be transacting
business with each other: I also saw several times people on horseback,
dogs and birds. All these phantasms appeared to me in their natural
size, and as distinct as if alive, exhibiting different shades of
carnation in the uncovered parts, as well as in different colours
and fashions in their dresses, though the colours seemed somewhat
paler than in real nature, none of the figures appeared particularly
terrible, comical, or disgusting, most of them being of an indifferent
shape, and some having a pleasing appearance.
“The longer these phantoms continued to appear, the more frequently did
they return, while at the same time they encreased in number about four
weeks after they had first appeared. I also began to hear them talk,
the phantoms sometimes conversed among themselves, but more frequently
addressed their discourse to me; their speeches were commonly short
and never of an unpleasant turn. At different times there appeared
to me both dear and sensible friends of both sexes, whose addresses
tended to appease my grief, which had not yet wholly subsided: these
consolatory speeches were in general addressed to me when I was alone,
sometimes I was accosted by these consoling friends while in company,
frequently while real persons were speaking to me; these consolatory
addresses consisted sometimes of abrupt phrases, and at others they
were regularly connected.
“Though both my mind and body were in a tolerable state of sanity all
this time, and these phantasms became so familiar to me, that they did
not cause me the slightest uneasiness, and I even sometimes amused
myself with surveying them, and spoke jocularly of them to my physician
and my wife; yet I did not neglect to use proper medicines, especially
when they began to haunt me the whole day, and even at night as soon as
I awaked.
“At last it was agreed that leeches should be again applied to me,
as formerly; which was actually done April 20th, 1791, at eleven
o’clock in the morning. No person was with me besides the surgeon; but
during the operation my chamber was crowded with human phantasms of
all descriptions. This continued uninterruptedly till about half an
hour after four o’clock, just when my digestion commenced. Soon after
their colour began to fade, and at seven o’clock they were entirely
white. But they moved very little, though the forms were as distinct
as before: growing however by degrees more obscure; yet not fewer in
number as had generally been the case. The phantoms did not withdraw,
nor did they vanish; which previous to that time had frequently
happened. They now seemed to dissolve in the air: while fragments
of some of them continued visible a considerable time. About eight
o’clock the room was entirely cleared of my fantastic visitors.”
This very interesting relation by the patient himself, is here
introduced in preference to other cases which have fallen under my own
experience: but all of which are inferior in interest, and accuracy of
observation. Nicolai was a man of unquestionable veracity, of liberal
education, and a distinguished author. Although he laboured under a
delusion, by seeing and hearing those things which did not exist, yet
his belief in their reality was never subscribed:—on the contrary, he
knew them to be delusions,
“A false creation, proceeding from the heat-oppressed brain.”
These apparitions were obtruded on his vision, and their voices struck
his ear. Notwithstanding these phantoms had the
“Power to cheat the eye with blear illusion,”
“_And give it false presentments_,”——
still he was persuaded that his perception was beguiled. Had he
believed in their existence and acted from a conviction of their
reality he ought to have been deemed insane. But under Nicolai’s own
relation of his capability to discriminate illusion from reality, the
conclusion is fully warranted, that he was a being responsible for his
actions.
It may here be proper to direct the attention of the reader to the
motives which have frequently impelled those of unsound mind to the
injury or destruction of their fellow creatures:—and from my own
experience many have been prompted by a dream or vision, which has
been so distinctly revealed and forcibly impressed, that it has
carried the conviction of reality and divine command. Some hear voices
and obey the mandates which are thus whispered from a BELIEF in the
superior authority which has issued them; and after an outrage has
been perpetrated by one of these maniacs, it is astonishing with what
coolness and satisfaction he will attempt to justify its necessity, and
even undismayed advance to the scaffold. If therefore, there be the
same BELIEF in delusion as in reality—if the maniac be persuaded that
his vision has brought him into the presence of the Almighty, or that
the fancied voice is the divine command, he becomes the subject of pity
and protection, but not of punishment. If he be acknowledged insane
upon many subjects, and kills another, should he be supposed of sound
mind on account of having committed such outrage? Is he to be judged
from the state of his intellect, or by the atrocity of the action?
However the maniac may direct the sallies of his violence and
resentment against the lives of others, frequently of those to whom he
is nearest allied, or bound by obligation and friendship: yet there is
another feature which his disorder assumes, and which always secures
the commiseration of mankind. It more frequently occurs in the deranged
state of these pitiable persons that they seek to revenge on themselves
the supposed crimes they have committed. In our own country, there are
more lunatics who destroy themselves, than attempt the lives of others;
and in these cases the Coroner’s jury has always agreed on a merciful
interpretation. Indeed there are but few instances of the impotent
folly of degrading the carcass, excepting where self-destruction has
anticipated the rigour of the law.
It is of frequent occurrence, that persons labouring under insanity,
although of exemplary lives and unblemished character, shall believe
themselves guilty of the most atrocious crimes;—reputation, the
dearest possession of the sound mind is sacrificed without a regret by
the despairing lunatic;—he accuses himself of cowardice, of fraud,
of secret murder, or of a turpitude at which man revolts:—and others
blessed with opulence, and enjoying those comforts which render life
desirable, become apprehensive of terminating their existence in the
work-house. Sometimes the desire of death is so ardent, that they will
perpetrate any crime in order to be arraigned and condemned at the bar
of justice. Of this extraordinary perversion I shall take the liberty
to relate a very striking instance.
A woman about 36 years of age, who had been well educated, but whose
conduct had not been exempt from some irregularities, in consequence
of intemperance and manifold disappointments, became affected with
madness. She was by turns furious and melancholic, and conceived
she had murdered one of her children, for which she ought to suffer
death. She detailed the manner in which she had destroyed the child
and the motives which actuated her, so circumstantially, and with so
much plausibility and feeling, that if I had not known her child to be
living I might have been deceived. By her own hands she had repeatedly
endeavoured to terminate her existence, but was prevented by constant
vigilance and due restraint. Her disposition to suicide was afterwards
relinquished; but she still persisted that for the murder of the child
she ought to suffer death, and requested to be sent to Newgate, in
order to be tried, and undergo the sentence of the law:—indeed she
appeared to derive consolation from the hope of becoming a public
example, and expiating her supposed crime on the scaffold. While in
this state, and with a hope of convincing her of its safety, the child
was brought to visit her. When she beheld it there was a temporary
burst of maternal affection; she kissed it, and for a few moments
appeared to be delighted:—but a look of suspicion quickly succeeded,
and this was shortly followed by a frown of indignation, which rendered
the removal of the child a measure of wholesome necessity. Perhaps,
in no instance, was the buoyancy of madness more conspicuous over
reason, recollection, and feeling. She insisted they had attempted
to impose on her a strange child, which bore a faint resemblance to
her own; however, by such subterfuges she was not to be deceived; she
had strangled the child until life had totally departed, and it was
not in the order of nature that it should exist again. The effect of
this interview was an exasperation of her disorder,—she became more
cunning and malignant, and her desire for an ignominious death was
augmented. To render this more certain, and accelerate her projected
happiness, she enticed into her apartment a young female patient, to
whom she appeared to be attached, and having previously platted some
threads of her bed-quilt into a cord, she fixed it round the neck
of the young woman and proceeded to strangle her. Fortunately some
person entered the room, and unloosed the cord in time to save her.
When this unhappy maniac was questioned concerning the motive which
induced her to attempt the destruction of a person for whom she had
manifested kindness; she very calmly replied, that as the murder of her
own child was disbelieved, she wished to exhibit a convincing proof
of the ferocity of her nature, that she might instantly be conveyed
to Newgate, and hanged, which she desired as the greatest blessing.
With considerable satisfaction I may add, that in a few months,
notwithstanding her derangement had been of three years duration, this
woman perfectly recovered, and for a considerable time has performed
the duties of an important and respectable office.
Influenced by curiosity, and a wish for the advancement of
professional knowledge, I have always been induced to scrutinize as
deeply as possible into the feelings of lunatics who have perfectly
recovered; I therefore wished to be informed from this patient in
her sane state, what were her feelings and opinions concerning her
former condition. She recollected most of the circumstances which
had transpired during her illness, but she was unable adequately to
comprehend, or to give any account of her disorder—it seemed to
her like a wearisome and protracted dream, but more distinct and
connected—she almost doubted with her present feelings if she could
be the same person, to have entertained opinions and resentments so
different from her natural character. When questioned concerning
her attempt to strangle the young woman, she rejoiced that no
fatal consequences had ensued, yet she seemed to attach but little
responsibility to any thing she might have committed in that frame of
mind. Death, from which, as other human beings, she now shrunk with
horror, was then the most desirable of all events.—Respecting the
child, she observed her mind was as suddenly seized with the conviction
that she had destroyed it, as a person is attacked with the shivering
fit of an ague, and feels the sensation of cold in the hottest day of
summer. On enquiring if these former impressions often recurred to her
mind; she replied in the negative;—that although she could accurately
recollect them when questioned, yet they now seemed removed to a vast
distance from the natural range of her thoughts:—and that she found
herself pleasantly occupied in contriving plans for the welfare and
happiness of her future life.
It is therefore not the fear of death which can arrest the projects
of the maniac mind; for on many occasions they seek it as the greatest
consolation; and quietly submit to seclusion and its consequent
privations sooner than renounce their opinions, or withhold their
endeavours to accomplish that which appears to them, from the
disordered state of their intellect, GOOD and RIGHT, and which by those
of sane mind is denominated EVIL and WRONG. A very different opinion
has however prevailed; and it has been conceived that the terror of
example would deter lunatics from following the dictates of their
distempered minds: and many worthy and pious persons who have been the
stanch fautors of the dignity of our species, have maintained, that the
Deity never so far abandons the being fashioned in his own likeness,
and to whom he has imparted a ray of his intellectual light, as to
deprive him of the power of discriminating between right and wrong.
To such assumptions, unsupported by reason, and clashing with daily
experience, the reader will not expect a serious reply—they must have
originated in minds more confident of the perfection and endurance of
the intellect, than grateful for its possession.
It is not the object of these pages to shelter crime under the pretence
of insanity; or to suppose that some degree of derangement must exist
in the mind of the perpetrator:—on the contrary, it is believed,
because every day furnishes instances, that men of the highest
attainments and most lucid faculties will deliberately commit acts of
turpitude,—foreseeing the consequences, and feeling the criminality of
the act. But, it would be as much the subject of regret and against the
law, that a human being, under a delusion which he firmly believed, and
in the persuasion that he was acting from the immediate influence or
instigation of the Divine command, should undergo the sentence of the
law to the disgrace of his family:—as that science should ever attempt
to contaminate the source of justice, by shielding criminality under
the cover of disease.