insanity consists in some delusion which is not likely to influence the ordinary conduct of the individual, it is not difficult for [289] the insane person to conceal the erroneous belief, or to deny his belief in it when he is charged with it. One case has been communicated to us which illustrates this difficulty. A man was placed in a lunatic asylum. He claimed an interview with the superintendent, and when it was granted, he said with perfect calmness, "Doctor, I am not mad: I believe in omens. I had a dream in which I thought I saw some one who told me to try and convert a neighbor. I thought that this dream ought to influence my conduct, and I endeavored by every fair means to convince my neighbor of the truths of religion. I confess I believe in omens, but am I to be shut up in a lunatic asylum for that? Dr. Johnson and Sir Walter Scott did the same." For three months this man remained in the institution, and during all that time he conducted himself like a rational being, and showed no other symptom of insanity than what appears in the above sentences. At the end of that time he was discharged, for although the medical superintendent was convinced in his own mind of the mental unsoundness, he could have given no sufficient reason for his belief; and the belief in omens and the prophetic character of dreams is no more a sign of insanity than the belief in spiritualism is. The man was discharged, and in six months he returned to the asylum in a state of acute mania.

425. Difficulty of Distinguishing between Delusions and Sane Beliefs.-Besides, it is very often difficult to discover whether a belief is a delusion or not. A pauper lunatie was a short time ago admitted into an asylum, and during the visit of the medical superintendent this patient said he had been in Australia at the gold-diggings. The medical man pointed this out to his assistant as a delusion, because he diagnosed the existence of incipient general paralysis. His assistant, however, who had seen the relieving officer, said it was a fact that the man had been at the diggings. The superintendent was, however, dissatisfied, from the way the man spoke of the "gold," the "fine gold," and the quantity of gold. He still regarded it as a delusion; and when,

shortly afterwards, the patient was visited by his wife, it was ascertained that he never had been out of England. This shows that there is much difficulty in distinguishing between true beliefs and delusions. So minute was this patient's account of his Australian experiences, that it had deceived the medical man who had signed the certificate, the relieving officer, and the medical assistant at the asylum in which he was confined.

8 426. ination.[290] In many cases which have come into courts of law the utmost difficulty has been felt in determining whether lunacy does really exist or not. A remarkable case of this kind was referred to by Erskine in the Hadfield case. A person who had been confined in a lunatic asylum prosecuted his brother and the keeper of the asylum for false imprisonment and duress. Erskine was informed that the man was undoubtedly insane, but he was not told the particular form which the malady assumed. The prosecutor, himself a witness in support of the indictment, was put into the witness box and examined, and when Erskine came to cross-examine him, he found his evidence clear, distinct, collected, and rational. He tried to discover some alienation of mind, but during a cross-examination, conducted with all the skill and sagacity of which he was master, for nearly an hour he was completely foiled: the answers were perfectly rational-there was not the slightest sign of mental alienation. A gentleman, however, who had been accidentally detained, came into court, and whispered in Erskine's ear that the witness thought he was the Saviour of mankind. On receiving the hint, Erskine made a low bow to the witness, addressed him in terms of great reverence, and respectfully begged to apologize for the unceremonious manner in which he had treated a person of his sacred character, and called him by the name of Christ. The man immediately said: "Thou hast spoken truly, I am the Christ." And Pinel relates a similar case.

Insane Reticence will Resist even Cross-exam

427. Case of Concealed Insanity.-A case in which the insane person was most anxious to be considered of sound mind came before our courts of law, and is interesting

and instructive in more ways than ono. The prisoner was indicted for shooting at his wife with intent to murder her. He was defended by counsel who set up the defence of insanity. The prisoner, however, objected to such a defence, asserting that he was not insane, and he was allowed by the Judge to suggest questions to be put by his Lordship to the witnesses for the prosecution to negative the supposition that he was insane; and the Judge also, at the request of the prisoner, allowed additional evidence to be called on his behalf for the same purpose. They, however, failed in showing that the defence was an incorrect one: on the contrary, their evidence tended to establish it more clearly, and the prisoner was acquitted on the ground of insanity in spite of himself.1 ? 428. Other Cases of Counterfeited Sanity. Thus, Lord Eldon related a case in which, after repeated conferences and much conversation with a lunatic, he was convinced of the soundness of his understanding, and prevailed on Lord Thurlow to supersede the commission. The lunatic calling immediately afterwards on his counsel to thank him for his exertions, convinced him in five minutes that the worst thing he could have done for his client was to get rid of the commission. And Mr. Haslam has given the case of an Essex farmer who so well counterfeited sanity as to procure his liberation from the asylum in which he was confined, but who was almost immediately sent back; and he gives the following account of the conduct of this individual: "At the examination he managed himself with admirable address. He spoke of the treatment he had received from the persons under whose care 291 he was at that time placed as most kind and fatherly; he also expressed himself as particularly fortunate in being under my care, and bestowed many handsome compliments upon my skill in treating this disorder, and expatiated on my sagacity in perceiving the slightest tinges of insanity. When I wished him to explain certain parts of his conduct, and particularly some extravagant opinions respecting certain persons and circumstances, he disclaimed any knowledge of such circumstances, and felt himself hurt that

Reg. v. Pearce, 9 Car & P. 667.

Ex parte Holyland, 11 Ves. Rep. 11.

my mind should have been poisoned so much to his prejudice. He displayed equal subtlety on three other occasions when I visited him; although by protracting the conversation he let fall sufficient to satisfy my mind that he was a madman. In a short time he was removed to the hospital, where he expressed great satisfaction in being under my inspection. The private madhouse, which he had formerly so much commended, now became the subject of severe animadversion: he said that he had there been treated with extreme cruelty, that he had been nearly starved and eaten up by vermin of various descriptions. On inquiring of some convalescent patients I found (as I had suspected) that I was as much the subject of abuse when absent as any of his supposed enemies, although to my face he was courteous and respectful. More than a month had elapsed since his admission into the hospital before he pressed me for my opinion, probably confiding in his address, and hoping to deceive me. At length he appealed to my decision, and urged the correctness of his conduct during confinement as an argument for his liberation. But when I informed him of circumstances he supposed me unacquainted with, and assured him that he was a proper subject for the asylum which he then inhabited, he suddenly poured forth a torrent of abuse, talked in the most incoherent manner, insisted on the truth of what he formerly denied, breathed vengeance against his family and friends, and became so outrageous that it became necessary to order him to be strictly confined. He continued in a state of unceasing fury for more than fifteen months."

429. The French Method of Discovering the Existence of Concealed Insanity.-With the view of arriving at a correct conclusion with regard to the existence of insanity or not, the French have recourse to what they call the interrogatory, the continued observation, and the inquest. Method in such matters is, of course, of the greatest use, and it has [292] been said by some writers that the efficacy of the French system is proved by the admirable way in which it works.

1 Haslam on Madness, 53.

% 430. The interrogatory embraces all that will be considered in the chapter which will be devoted to the examination of lunatics. And it is instituted with a view to obtaining all the information which can be had from the individual himself, or from any one who has had opportunities of becoming acquainted with his past history, and of observing his conduct. When the examination of the lunatic or interrogatory fails to establish the existence of insanity, and not unfrequently this will be the case where moral mania or imbecility alone are present, the French have recourse to the second method

431. Continued Observation.-The importance of a careful observation of a person supposed to be insane extending over a long course of time can scarcely be exaggerated. At any visit of a medical man the patient may be on his guard and may manage to conceal his insanity, but very few insane persons can continue to act the part of sanity for a long time. They will inevitably be off their guard now and then, and the true mental symptoms will manifest themselves. Observation when the patient is unconscious that he is watched will often throw light upon actual mental disease which is most carefully hidden when he is in the presence of others. It seems as in the case of criminals who cannot, even when assisted by the discipline of a prison, remain "good" for long, but must have their "outbreaks," so it is with the lunatic who would conceal his delusion. The probability is that he raves when he imagines himself unobserved. Opportunities of observation should therefore be secured and care taken to note all his habitual acts which may be within the range of the influence of delusion, as it is in those acts which are automatic that the morbidity is most likely to be observed. We have in another place pointed out the importance of examining the writings of those who are suspected of lunacy.' 8 432. The inquest, according to the French method, im

1 In the State of Maine (U. S.) it is customary in any case in which insanity is suspected, and where it is likely to be set up as a defence in the trial of a criminal charge, to commit the accused to asylum while awaiting trial. See Am. Journal of Insanity, Oct. 1872.