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 insanity: 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