[58] A medical student, twenty years of age, was seized with mania, arising from the presence of worms in the intestines. He felt the most acute pains in the different regions of his body, appearing to him as if persons were driving arrows into him, more particularly in the palms of his hands and soles of his feet. This caused him to utter most distressing cries, to seek to be alone, and prevented him from walking. The intolerable pains and madness left him as soon as the worms were expelled.
[59] “When powerful feelings or passions are in active operation, in the insane or in the sane, they draw the muscles of the face into particular forms; and, if they continue for a length of time to be greatly predominant, they impress upon the countenance an appearance indicative of the character. This is felt and acted upon unconsciously in the common intercourse of life. A good countenance is a letter of recommendation; and we have, in spite of ourselves, an unfavourable feeling towards a stranger where this is absent. Now in the generality of suicidal cases, the desponding feelings are in constant and active operation; hence there is usually a melancholy and gloomy expression of countenance. This arises from no mysterious cause peculiar to insanity, but is perfectly intelligible on common physiognomical principles; but there are numerous instances where the most experienced physician would be unable to detect, by inspection only, the slightest mark of either a disposition to suicide or insanity. The absence of this expression must not, therefore, induce us to suppose that this disposition does not exist.”—Sir W. Ellis.
[60] Ellis on Insanity.
[61] Indications of Insanity.
[62] Journ. Gen. de Médecine, Juillet, 1822.
[63] “Pain is an evil; death, the deprivation of every hope or comfort in this life. No man in his senses will burn, drown, or stab himself; for these all produce what are called evils; neither can any of these actions be executed without the probability of pain in the convulsive action or struggles of death. As no rational being will voluntarily give himself pain, or deprive himself of life, which certainly, while human beings preserve their senses, must be acknowledged evils, it follows that every one who commits suicide is indubitably non compos mentis, not able to reason justly, but is under the influence of false images of the mind; and therefore suicide should ever be considered an act of insanity.”—Dr. Rowley.
[64] Lowness of spirits ought to be regarded and treated as insanity, says Ellis, and not dreaded as its forerunner. For it is at this stage that suicide is resorted to. Should this not be the case, specific hallucinations may speedily appear, and the agony of mind will be endured as a consequence of bankruptcy, the unfaithfulness of a friend, the persecutions of enemies, or the ravages of an incurable disease. No demonstration of the untenableness of such grounds, no picture of brighter and happier circumstances, will avail to refute or encourage. The sufferer clings to his hoarded misery. There is generally great loss of physical strength in cases of this kind, and the pale emaciated countenance, dull and sunken eye, and listless dejected form, tell as plainly as the querulous complaint, or the long intricate description of sorrows and anticipated evils, to what class the patient belongs.
[65] Vide Lord Dover’s Life of Frederick, and Ray on Med. Juris.
[66] Dr. J. Johnson.
[67] Hill on Insanity.