A Letter to the Right Honorable the Lord Chancellor, on the Nature and Interpretation of Unsoundness of Mind, and Imbecility of Intellect

by John Haslam

A LETTER.

My Lord,

The present address originates in an anxious wish for the advancement of medical knowledge, where it is connected with those maladies of the human mind, that are referable to the court, wherein your Lordship has so long administered impartial justice. The disorders which affect the body are, in general, the exclusive province of the medical practitioner; but, by a wise provision, that has descended to us from the enlightened nations of antiquity, the law has considered those persons, whose intellectual derangement rendered them inadequate to the governance of themselves in society, or incapable of managing their affairs, entitled to its special protection. If your Lordship should feel surprized at this communication, or deem my conduct presumptuous,

the thirst of information on an important subject is my only apology; and I have sought to allay it in the pure stream that issues from the fountain-head, rather than from subordinate channels or distant distributions. Although personally a stranger to your Lordship, nearly thirty years of my life have been devoted to the investigation and treatment of insanity: of which more than twenty have been professionally passed in the largest receptacle for lunatics;—and the press has diffused, in several publications, my opinions and experience concerning the human mind, both in its sound state and morbid condition.

The medical profession, of which I am an humble member, entertains very different notions concerning the nature of UNSOUNDNESS of mind, and IMBECILITY of intellect;—and this difference of opinion has been displayed on many solemn occasions, where medical testimony has been deposed.

If a physician were to attempt to search into the existing records and procedures on insanity, to collect its legal interpretation, such investigation would probably be a waste of his time, the source

of abundant, and perhaps of incurable error; but to these inconveniences he will not be subjected in attentively considering your Lordship's judgments, of which I have availed myself on the present occasion, and which, having been taken down at the time they were delivered, may be presumed not materially incorrect. The documents to which I refer are the judgments of the 22d April, 1815, and the 17th December, 1822, on the Portsmouth petitions, together with the minutes of conference between your Lordship and certain physicians, on the 7th January, 1823. In the judgment on the petition of 1815, it is stated by your Lordship,[A] "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 idiot 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 of insanity, 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 idiot ex nativitate, as not being lunatic, but as being of UNSOUND MIND, importing by those words, the notion, that the party was in some such state, as was to be contra-distinguished from idiotcy, and as he was to be contra-distinguished from lunacy, and yet such as made him a proper object of a commission, in the nature of a commission to inquire of idiotcy, or a commission to inquire of lunacy. From the moment that that had been established, down to this moment, it appears to me to have been at the same time established, that whatever may be the degree of weakness or imbecility 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 of UNSOUND MIND, they have not established, by the result of the inquiry, 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 taken as 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 was, therefore, in that sense, imbecility, and inability to manage his affairs, which constituted unsoundness of mind."

The introduction of the term unsoundness, to denote a particular state of disordered mind, which is supposed to differ from idiotcy and lunacy, has

been the source of considerable perplexity to medical practitioners; and, in my own opinion, opens an avenue for ignorance and injustice. The application of figurative terms, especially when imposed under a loose analogy, and where they might be supplied by words of direct meaning, always tends to error and confusion.

When medical persons depose that the mind of an individual is unsound, (which character of intellect, if accredited by the jury, would induce them to find the commission,) they ought, at the same time, to define precisely what they mean by such term:—and the jury, when they "proceed to infer" this unsoundness, ought to be in possession of sufficient and well-defined premises, to warrant such inference. But where are these materials to be found? There is a strong presumption that this unsoundness remains an unsolved problem to the present hour, and it is exemplified in the difference of sentiment that prevailed on a late occasion,[B] between the most eminent of the medical profession; where the same opinions and conduct impressed certain physicians, that this nobleman was

of sound mind, and others that his mind was thoroughly unsound: so that the jury were to proceed to make their inference from the opposite testimony, deposed by the medical evidence, or to proceed to hold such evidence in little esteem from its contrariety on a subject which these physicians professed to illustrate. The term unsoundness, applied to designate a certain state of the human mind, hitherto undescribed, has not originated with medical persons; to them, therefore, we cannot refer for the solution of its import, and there can be no analogy between the definite unsoundness of animal and vegetable substances, and any condition of the intellect. Timber is said to be unsound, and although we may be little acquainted with the cause by which it is produced, yet its actual state of rottenness is evident:—a horse is unsound, in consequence of some morbid affection that can be pointed out by the veterinarian:—a dentist can detect an unsound tooth:—a physician, from certain well marked symptoms, concludes that the lungs or liver of an individual are unsound:—particular doctrines are held to be unsound, because they deflect from such as are orthodox, and it is presumed there may be an unsound exposition of the law. The human mind, how

ever, is not the subject of similar investigation; we are able to discover no virus by which it is contaminated—no spreading rottenness—no morbid leaven that ferments, or canker that corrodes it.

Although we may apply the word unsoundness, in a figurative or metaphorical sense, to the human mind, yet we cannot detect in it any of the marks or indications that characterize the unsoundness of substances acknowledged to be in that state: it is, therefore, under this conviction, and with the view of increasing our knowledge of the human intellect, that, on the behalf of the members of the medical profession, I venture to solicit your Lordship, on the first opportunity that may occur, to elucidate the nature of this UNSOUNDNESS OF MIND, so that physicians may be enabled thoroughly to ascertain its existence, and conscientiously depose to that effect, and also that it may be recognized by the jury, when they "proceed to make their inference," in order that, by their return, your Lordship may appoint the proper committees of the person and property.

Respecting the human intellect, two very opposite opinions prevail among physiologists and

metaphysicians. One party strenuously contends that the phenomena of mind result from the peculiar organization of the brain, although they confess themselves to be as "entirely ignorant how the parts of the brain accomplish these purposes, as how the liver secretes bile, how the muscles contract, or how any other living purpose is effected."—The other maintains that we become intelligent beings through the medium of a purer emanation, which they denominate SPIRIT, diffused over, or united with, this corporeal structure. The former of these suppositions is held by many grave and pious persons to be incompatible with the doctrines of the Christian Religion; and if I am not mistaken, your Lordship, on a late occasion, after having perused a work attempting to establish such principles, did incline, by "rational doubts," to suspect that these opinions were "directed against the truth of Scripture."

It is particularly fortunate that the arguments concerning the nature of unsoundness of mind and imbecility do not involve either of these presumptions:—if the most decided victory over their opponents were to be conceded to the fautors of organization, no advantage could be derived from

their philosophy by lawyer or physician, whose object is to ascertain the existing state of an individual's mind, and not to detect the morbid alterations of the cerebral structure by the scrutiny of dissection: nor is it necessary, for the elucidation of the present subject, to contend for the pre-eminence of the spiritual doctrine, as it would be extremely difficult, and perhaps irreverent, to suppose, that this immaterial property, this divine essence, that confers perception, reverts into memory, and elaborates thought, can be susceptible of unsoundness. These high attributes, proudly distinguished from perishable matter;—this sanctuary, which "neither moth nor rust doth corrupt," cannot undergo such subordinate changes, without an obvious degradation.

To the furtherance of that pure and substantial justice, which it has been the tenor of your Lordship's ministry to award, these metaphysical disquisitions will in no manner contribute; nor will they assist the medical practitioner in the attainment of his object, which is to ascertain the competence of an individual's MIND, to conduct himself in society, and to manage his affairs. By the abstract term MIND, is to be understood the aggregate

of the intellectual phenomena, which are manifested or displayed to the observer by conversation and conduct; and these are the only tests by which we can judge of an individual's mind. The boasted deciphering of the human capacities or moral propensities, by the appearances of the physiognomy, or by craniological surveys—the mysterious pastimes of anatomical prophets, will never be accredited in a court of justice while your Lordship guides the helm.

By conversation, is of course included the conveyance of thought by writing, which, on many occasions, is a more accurate criterion of the state of mind than oral expression.

Your Lordship seems to consider that we have derived some advantages by the issue of a commission to ascertain this unsoundness of mind, and without such due consideration, it is presumed you would not have adopted it; but the citation of your own accurate phraseology, as it appears in your judgment of 1815, on the Portsmouth petition, will best illustrate the subject. "It seems to have been a very long time before those who had the administration of justice in this depart

ment thought themselves at liberty to issue a commission, when the person was represented as not being idiot ex nativitate, as not being lunatic, but as being of UNSOUND MIND, importing, by these words, the notion, that the party was in some such state, as was to be contra-distinguished from idiotcy, and as was to be contra-distinguished from lunacy, and yet such as made him a proper object of a commission in the nature of a commission to inquire of idiotcy, or a commission to inquire of lunacy." These words clearly imply a morbid state of intellect, which is neither idiotcy nor lunacy, termed unsound mind, and yet the legal remedy for the protection of the person and property of the possessor of this unsound mind does not differ from that which is applied to idiot and lunatic. The process of law is the same. This undescribed state of unsoundness is contra-distinguished from idiotcy and lunacy; but we are left in the dark concerning the peculiar circumstances by which it is contra-distinguished, and under such defect the advantages of introducing a new and undefined term are not apparent. For what purpose "those who had the administration of justice in this department thought themselves at liberty" so to act, is

not explained: but your Lordship having adopted such practice, and highly commended the authority from whence it has been derived, can, doubtless, afford the necessary elucidation.

For those venerable authorities of the law, who have preceded your Lordship in this department of the administration of justice, I feel impressed with the utmost deference and respect; and these grateful sentiments will be rendered more intense whenever their reasons are promulgated. Medical practitioners, who have devoted their lives to the consideration and treatment of insanity, are disposed to doubt concerning the existence of any intrinsic or positive unsoundness of mind, as contra-distinguished from idiotcy and lunacy. Those who have accumulated the largest sum of experience in disorders of the intellect, have viewed the various forms under which they are manifested, as equally conducing to render an individual incapable of conducting himself and managing his affairs, whether the mental affection be termed madness, melancholy, insanity, mental derangement, non compos mentis, idiotcy, or lunacy; and, if it were necessary, a more ample catalogue might be introduced. Physicians may, perhaps, be ad

vantageously occupied in establishing nice shades of difference in the symptoms of mental disorder; and, if we do not already possess sufficient, may create new terms expressive of these modifications: and such extension of the nosological volume may have its practical utility: but the lawyer can have no interest in such speculations, he only looks to the medical evidence to demonstrate the existence of that morbid condition of intellect that renders the individual incompetent to conduct himself in society, and to manage his affairs.

Speaking generally, the state of idiotcy is well understood, although cases of an intricate nature may occasionally occur: but there is considerable probability, that the interpretation that has adhered to the term lunacy, more especially in the estimate of the lawyer, has been the source of considerable error, and has also tended to introduce the middle and undefined epithet of unsoundness. The old physicians, for whom modern practitioners entertain less reverence than lawyers feel for their predecessors, concurred, that lunatics were not only persons of disordered mind, but that their intellectual aberrations corresponded with certain changes of the moon: and this lunar hypothesis which had

beguiled the medical profession, will furnish a sufficient apology for its adoption by the lawyer. It is a necessary consequence, if the moon, at certain periods, shed a baneful influence on the human intellect, that the intermediate periods would be exempt from its contamination; or, speaking more technically, at certain phases of that luminary, a person would be visited by an insane paroxysm, and at others, experience a lucid interval. The belief in these alternations of insanity and reason, is perspicuously stated in your Lordship's judgment of 1815, on the Portsmouth petition. "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 of insanity, with reference to which it was necessary to guard his person and his property by a commission issuing."

Notwithstanding it must be admitted that

"There are more things in heaven and earth
Than are dreamt of in our philosophy;"

yet, in the present times, our faith in the influence of the lunar aspects has considerably abated, and we employ the term lunatic as a familiar expres

sion, to denote a person of insane mind, without any reference to its derivation, or supposed ascendency of the moon, which my own observations have tended to disprove:—but as the phrase lucid interval is, in its legal sense, connected with lunatic, some investigation of its meaning becomes absolutely necessary.

If it were the real character of lunacy, after the visitation of the paroxysm, to leave the patient in the possession of an extremely sound mind, this disorder would be rendered much less formidable than we now consider it, and might in its effects be compared to those violent storms of thunder and lightning that purify the atmosphere and dispense salutary refreshment; and it is not improbable, that some, gifted by nature with mediocrity of talent, but of a philosophical turn and aspiring pretensions, might regard the occurrence of such paroxysm as a desideratum, rather than an evil, on account of the extreme soundness they would experience afterwards: it is moreover evident, that however degraded the lunatic may be in the estimation of vigorous and enlightened intellects, yet this depreciated object, by the enjoyment of occasional periods of bright understanding, has abundant cause

for taunt and triumph over the victim of unsoundness; whose state is "contra-distinguished from lunacy," and as far as has been hitherto ascertained, does not revel in the luxury of a lucid interval. But these vicissitudes of intellectual obscurity and lustre have no real existence;—they are not the offsprings of observation and experience, but the abortions of hypothesis and precipitate deduction. Lunatics, from the excitation of various causes, become at times more violent or desponding, and these exacerbations are often succeeded by tranquillity and cheerfulness, they are more tractable, and less impelled to urge the subjects of their prevailing delusions: but this apparent quietude or assumed complacency, does not imply a renunciation of their perverted notions, which will be found predominant whenever they are skilfully questioned. Inexperienced persons judge of the insane state from the passions or feelings that usually accompany this disorder, and infer its aggravation from the display of boisterous emotions or afflicting apprehensions: the medical practitioner considers these sallies as the mere concomitants of a perverted intellect. This view of the subject is justified by a fact, of too much importance to be omitted on the present occasion. Many lunatics, whose dangerous pro

pensities it has been prudent to control by a stricter restraint, and for a lengthened period, eventually become harmless, and are safely permitted to enjoy many indulgences incompatible with their former state: yet these persons retain their original delusions, although they have acquired the habit of arresting the impulses which these delusions prompted. It may therefore be inferred, that a lucid interval is equivalent to the complete recovery of the patient, and implies the absolute departure of all those delusions from his mind, that constituted his lunacy:—leaving him in a condition to sustain a thorough examination, not shrinking from particular subjects, nor "blenching," though "tented to the quick;"—and clearly perceiving by contrast the delusions that had prevailed, and the reason that has supervened.

The term INTERVAL, by which the duration of rational discourse and conduct is to be estimated, although of sufficiently precise meaning, is yet susceptible of the most extended signification; and we speak with equal correctness when we say the interval of a moment and of a thousand years. The time necessary to comprise a LUCID interval has not, to the best of my belief, been limited by me

dical writers or legal authorities; it must however comprehend a portion sufficient to satisfy the inquirer, that the individual, whose intellect had been disordered, does not any longer retain any of the symptoms that constituted his malady; and this presumes on the part of the examiner an intimate knowledge of the unfounded prejudices, delusions, or incapacities with which the mind of the party had been affected, and also deliberate and repeated investigations to ascertain that they are wholly effaced.