The following suggestions may be of assistance in forming a diagnosis as to the existence or non-existence of this form of madness:—
1. Previous history of the individual.—Melancholy, eccentric, morose, &c.
2. Absence of motive.—Gain, jealousy, revenge, hatred, &c.
3. A number of victims are often sacrificed at one time.—The murderer, on the other hand, seldom sheds more blood than is necessary for his success.
4. Proceedings of the murderer before and after the crime.—Absence of attempts at concealment or escape on the part of the madman.
5. Character of the victims.—Not infrequently, in the case of madmen, their victims are those whom, when sane, they loved most, and to whom they were most attached.
Suicidal Monomania, or the Propensity to Suicide.—Much discussion has arisen on this subject. Suicide is not always the result of unsoundness of mind. Some, like M. Esquirol, are inclined to consider suicide as always a manifestation of insanity. In the present day, the dislike of coroners‘ juries to bring in any other verdict but that of “suicide whilst in a state of unsound mind” is proverbial.
MELANCHOLIA
This condition is associated with mental depression and delusions. In its simple form, marked depression of spirits, apprehension of evil, sleeplessness, loss of appetite, and impaired alimentation with constipation are evident.
Delusions of ruin, of the committal of acts contrary to the laws of God and man—“the unpardonable sin”—a marked inaptitude to carry on the ordinary duties of life, indecision, and often unutterable misery, are commonly exhibited. The delusions are fixed and may be multiple. They may comprise persecution, by friends or others; that things are happening which powerfully influence the person‘s life and body, or, as is often the case, concern religious matters, and everlasting punishment.