You notice, gentlemen, that I speak of the mind as grasping the error, and I suppose it to do so independently of the free will’s command. But when the error is voluntary; when a man clings to it simply because he loves it; when he hugs a delusion to his heart, this shows not mental but moral obliquity; it is not insanity but self-deception, and it is by no means of rare occurrence. In a well-reasoned article on “The Metaphysics of Insanity,” written by Mr. James M. Wilcox and printed in the “American Catholic Quarterly Review” for January, 1878, some very severe and no less true strictures are made upon the readiness of a vast multitude of people to practise this wilful self-deception. “Self,” he writes (p. 54), “is the prolific origin of such errors; and so indulgent are we to its faults that we try secretly to hide them even from our own eyes, mostly with success; and where success is not perfect, we make a second effort to hide the imperfection. Repeated efforts of this kind, from which we but half turn away, are crowned in the end, and we soon forget what successful hypocrites we have been. Our numerous passions, the complexities of our desires, the tenacity of their grasp, and the pleasant gentleness of its touch explain an infinity of temptations followed by wilful successes in blindness, all of which are nothing less than guilty acts of self-deception.”
7. It oftens[**] happens in real insanity that mental derangement manifests itself upon one error or one group of errors only, while for all the rest the patient appears to be quite rational. Such a man is called a monomaniac. But he is truly an insane man; for the essence of insanity is in him. It is usually found that a monomaniac will, sooner or later, exhibit signs of mental unsoundness on other matters as well; and even while he has given no such signs, it still remains true that a mind cannot be trusted, but has something radically unsound about it, if it is really unhinged at any point at all.
But then you must be very careful not to confound monomania with eccentricity. The distinction is as important as it is real. Eccentricity is a conscious aberration from the common course of life; it consists in peculiarities in reasoning, words, and actions, which are wilfully indulged, in defiance of popular sentiment. The eccentric man knows that he is eccentric; he is willing to be so, and to take the consequences; but he is not insane.
As this matter is of frequent occurrence before the courts of justice, and the validity of last wills in particular often depends on the view that judges and expert witnesses take of it, I think it well to refer the earnest student for further information to Wharton’s and Stillé’s “Medical Jurisprudence,” in the volume on “Mental Unsoundness and Psychological Law;” in particular to secs. 29, 38, 39, 40.
8. We must now return to the consideration of the manner in which the disturbance of the brain may affect the mind. The brain is a storehouse of records of things formerly noted there by the imagination, either as the results of sense perception or of arbitrary combinations of phantasms; it is a library of facts and fancies. And these are not single, but grouped together, so that when one is stirred it will arouse others as well. When the brain is affected, whether by an acute or a chronic derangement, its images may become so disordered that records of mere imaginations get mixed up with records of real perceptions in inextricable confusion. You may have had occasion to notice the process in the case of a man who is becoming intoxicated and then passes on to mania or delirium tremens: he gradually proceeds to mix up brain-pictures with realities, and after a while he speaks and acts like a very crazy man. He is in a kind of dream; his imaginations are wild and disconnected, his language is incoherent.
The delirium arising from violent fevers, for instance from typhoid fever, is very similar to that arising from the excessive use of intoxicants and narcotics; similar in these respects; that the mania is only temporary, and that the exciting cause is not altogether unknown.
The bacilli of the infection, like the alcohol, the opium, the morphine, or other drugs, are accountable for the disordered action of the brain. But I do not pretend to know, nor do medical writers generally pretend to understand, how the poison, or whatever causes the disease, gets to affect the brain. Does it do so directly, or by means of the alteration it causes in the whole nervous system or in the blood? We do not know; nor does it matter for the purposes of Medical Jurisprudence.
IV. The questions with which the courts of justice, the lawyers, and the expert witnesses are concerned are these: Is the man really insane? Or was he insane at a given time when he performed a certain civil or criminal act? Is he now, or was he then, so far controlled by his mental unsoundness as to be incapable of acting like a rational being accountable for his actions? Even if he is now, or was then, a monomaniac, can the deed in question be traceable to his monomania as to its real cause?
1. When we know that a man is suffering from a fever, or has been drinking to excess, or has been addicted to the use of morphine, opium, cocaine or to similar deplorable practices, it is then easy enough to conclude from this that he is not in his right senses; knowing the cause, we can fairly estimate the effect. But in many cases of delusional insanity the cause is hidden; neither pulse nor other medical test betrays it. Whether the mind is sane or not is then to be found out from the man’s words and actions; and these may be affected for a purpose: he may play the fool to escape punishment.
2. Phrenologists have pretended that the peculiarities of a person’s mind could be known by the conformation of his brain, and even by the elevations and depressions of the skull. But brain and skull do not always correspond with sufficient closeness; and besides, Sir William Hamilton has shown conclusively, I believe, that phrenology is quackery; its principles are not scientific and its observations not reliable. He points out, among other errors, that while women as a class are more religiously inclined than men, what phrenologists call the bump of reverence, an important element in religious sentiment, is generally more developed in men than in women, and is often most conspicuous in reckless criminals.