Medical Jurisprudence as it Relates to Insanity, According to the Law of England
Part 2
As the word BELIEF is important, it will not be considered unnecessarily digressive to attempt an investigation of its legitimate meaning. There are two modes of ascertaining the meaning of a word; either by referring to its etymology, to discover the cause of its application: or to collect the authorities which shew, that certain persons who are accredited, have so employed it. By turning to Dr. Johnson’s Dictionary the reader will find that the different authorities which he has cited have used this word in different acceptations. Without descending to the minutiæ of verbal examination, and tracing back its derivation to its Gothic or Saxon radical, it may be safely asserted, that to BELIEVE, originally implied to belove: to be attached or partial to, independantly of any evidence which would lead to demonstration. This belief is the immediate motive to action, and although incapable of becoming the subject of demonstration itself, is not to be set aside by the clearest and most forcible refutation.
“You may as well “Forbid the sea for to obey the moon, “As by an oath remove, or counsel shake “The fabric of his folly, whose foundation “Is pyld upon his faith.”
_Winter’s Tale._
It would be a curious and instructive enquiry to ascertain under what circumstances the mind admits as rules for action, those principles which do not admit of proof: because, if we could detect the manner in which the knot is tied, we might probably be able to unloose it. In the course of our education we are taught to adopt many maxims, the truth and expediency of which may not be very evident; however as we advance in life, experience and good sense gradually dispel many of these prejudices and erroneous adoptions. But in the insane mind the same process does not take place, and generally in proportion to the reasoning adduced to confute the delusion, or the demonstration employed to exhibit its absurdity, it becomes more strongly confirmed and inveterately fixed; and the logic brought forward for its refutation, is by the lunatic held as ignorance or misapplication. A person _in_ his senses may entertain and believe a number of unfounded and erroneous opinions, but on the exposure of their falsity he is capable of being convinced, but the madman never is; and this forms the great distinction between them. This incapability of being convinced of the GOOD and EVIL, RIGHT and WRONG, TRUTH and FALSHOOD of his BELIEF is that, which as an intellectual being, renders him different from other men, and constitutes his distemper. To our present purpose, it is immaterial how this arises, the knowledge of its existence is sufficient: and it concerns us but little to ascertain if this state depend on a morbid condition of the intellect itself, or of the organ destined for the display of its phenomena.
This belief appears physiologically to constitute his disorder; and the hope of placing this subject in a distinct point of view may be an apology for the relation of the very remarkable case of Nicolai of Berlin.[25:A] In consequence of a series of calamities which afflicted him with the most poignant grief he had in January and February of the year 1791, the additional misfortune to experience several very unpleasant circumstances which were followed on the 24th of February by a most violent altercation. “My wife and another person came into my apartment in the morning in order to console me, but I was too much agitated by a series of incidents which had most powerfully affected my moral feeling, to be capable of attending to them; on a sudden I perceived, at about the distance of ten steps, a form like that of a deceased person, I pointed at it, asking my wife if she did not see it? It was but natural that she should not see any thing, my question therefore alarmed her very much, and she sent immediately for a physician, the phantasm continued about eight minutes. I grew at length more calm, and being extremely exhausted, fell into a restless sleep, which lasted about half an hour; the physician ascribed the apparition to a violent mental emotion, and hoped there would be no return, but the violent agitation of my mind had in some way disordered my nerves, and produced farther consequences which deserve a more minute description.
[25:A] Vide Ferriar on Apparitions, P. 41.—As the Doctor has not cited whence he obtained this curious document, I have been under the necessity of employing perhaps his own translation.
“At four in the afternoon, the form which I had seen in the morning reappeared. I was by myself when this happened, and being rather uneasy at the incident, went to my wife’s apartment, but there likewise I was prevented by the apparition, which however, at intervals disappeared, and always presented itself in a standing posture: about six o’clock there appeared also several walking figures, which had no connexion with the first.
“I cannot assign any other cause of all this, than a continued rumination on the vexations I had suffered, which, though calmer, I could not forget, and the consequences of which I meditated to counteract: these meditations occupied my mind three hours after dinner, just when my digestion commenced. I consoled myself at last with respect to the disagreeable incident which had occasioned the first apparition, but the phantasms continued to increase and change in the most singular manner, though I had taken the proper medicine and found myself perfectly well. As when the first terror was over, I beheld the phantasms with great emotion taking them for what they really were, remarkable consequences of an indisposition, I endeavoured to collect myself as much as possible, that I might preserve a clear consciousness of the changes which should take place within myself; I observed these phantasms very closely, and frequently reflected on my antecedent thoughts to discover, if possible, by means of what association of ideas exactly these forms presented themselves to my imagination. I thought at times I had found a clue, but taking the whole together I could not make out any natural connexion between the occupations of my mind, my occupations, my regular thoughts, and the multifarious forms which now appeared to me, and now again disappeared. After repeated and close observations, and calm examination, I was unable to form any conclusion relative to the origin and continuation of the different phantasms which presented themselves to me. All that I could infer was, that while my nervous system was in such an irregular state, such phantasms would appear to me as if I actually saw and heard them; that these illusions were not modified by any known laws of reason, imagination, or the common association of ideas, and that probably other people who may have had similar apparitions were exactly in the same predicament. The origin of the individual forms which appeared to me, was undoubtedly founded on the nature of my mind, but the manner in which it was thus affected will probably remain for ever as inscrutable as the origin of thought and reflection. After the first day, the form of the deceased person no more appeared, but in its place there appeared many other phantasms, sometimes representing acquaintances, but mostly strangers: those whom I knew were composed of living and deceased persons, but the number of the latter was comparatively small. I observed the persons with whom I daily conversed did not appear as phantasms, these representing chiefly persons who lived at some distance from me. I attempted to produce at pleasure phantasms of persons, whom I knew by intensely reflecting on their countenance, shape, &c. but distinctly as I called to my lively imagination the respective shades of three of these persons, I still laboured in vain to make them appear to me as phantasms, though I had before involuntarily seen them in that manner, and perceived them some time after, when I least thought of them. The phantasms appeared to me contrary to my inclination, as if they were presented to me from without, like the phenomena of nature, though they existed no where but within my mind. I could at the same time distinguish between phantasms and real objects, and the calmness with which I examined them, enabled me to avoid the commission of the smallest mistake. I knew exactly when it only appeared to me that the door was opening and a phantasm entering the room, and when it actually opened, and a real person entered. These phantasms appeared equally clear and distinct at all times and under all circumstances, both when I was by myself and when I was in company; and as well in the day as at night, and in my own house as well as abroad; they were, however, less frequent when I was in the house of a friend, and rarely appeared to me in the street; when I shut my eyes these phantasms would sometimes disappear entirely, though there were instances when I beheld them with my eyes closed, yet when they disappeared on such occasions, they generally reappeared when I opened my eyes. I conversed sometimes with my physician and my wife of the phantasms which at the moment surrounded me; they appeared more frequently walking than at rest, nor were they constantly present. They frequently did not appear for some time, but always reappeared for a longer or a shorter period either singly or in company, the latter however being most frequently the case. I generally saw human forms of both sexes, but they usually appeared not to take the smallest notice of each other, moving as in a market place, where all are eager to press through the crowd; at times however they seemed to be transacting business with each other: I also saw several times people on horseback, dogs and birds. All these phantasms appeared to me in their natural size, and as distinct as if alive, exhibiting different shades of carnation in the uncovered parts, as well as in different colours and fashions in their dresses, though the colours seemed somewhat paler than in real nature, none of the figures appeared particularly terrible, comical, or disgusting, most of them being of an indifferent shape, and some having a pleasing appearance.
“The longer these phantoms continued to appear, the more frequently did they return, while at the same time they encreased in number about four weeks after they had first appeared. I also began to hear them talk, the phantoms sometimes conversed among themselves, but more frequently addressed their discourse to me; their speeches were commonly short and never of an unpleasant turn. At different times there appeared to me both dear and sensible friends of both sexes, whose addresses tended to appease my grief, which had not yet wholly subsided: these consolatory speeches were in general addressed to me when I was alone, sometimes I was accosted by these consoling friends while in company, frequently while real persons were speaking to me; these consolatory addresses consisted sometimes of abrupt phrases, and at others they were regularly connected.
“Though both my mind and body were in a tolerable state of sanity all this time, and these phantasms became so familiar to me, that they did not cause me the slightest uneasiness, and I even sometimes amused myself with surveying them, and spoke jocularly of them to my physician and my wife; yet I did not neglect to use proper medicines, especially when they began to haunt me the whole day, and even at night as soon as I awaked.
“At last it was agreed that leeches should be again applied to me, as formerly; which was actually done April 20th, 1791, at eleven o’clock in the morning. No person was with me besides the surgeon; but during the operation my chamber was crowded with human phantasms of all descriptions. This continued uninterruptedly till about half an hour after four o’clock, just when my digestion commenced. Soon after their colour began to fade, and at seven o’clock they were entirely white. But they moved very little, though the forms were as distinct as before: growing however by degrees more obscure; yet not fewer in number as had generally been the case. The phantoms did not withdraw, nor did they vanish; which previous to that time had frequently happened. They now seemed to dissolve in the air: while fragments of some of them continued visible a considerable time. About eight o’clock the room was entirely cleared of my fantastic visitors.”
This very interesting relation by the patient himself, is here introduced in preference to other cases which have fallen under my own experience: but all of which are inferior in interest, and accuracy of observation. Nicolai was a man of unquestionable veracity, of liberal education, and a distinguished author. Although he laboured under a delusion, by seeing and hearing those things which did not exist, yet his belief in their reality was never subscribed:—on the contrary, he knew them to be delusions,
“A false creation, proceeding from the heat-oppressed brain.”
These apparitions were obtruded on his vision, and their voices struck his ear. Notwithstanding these phantoms had the
“Power to cheat the eye with blear illusion,” “_And give it false presentments_,”——
still he was persuaded that his perception was beguiled. Had he believed in their existence and acted from a conviction of their reality he ought to have been deemed insane. But under Nicolai’s own relation of his capability to discriminate illusion from reality, the conclusion is fully warranted, that he was a being responsible for his actions.
It may here be proper to direct the attention of the reader to the motives which have frequently impelled those of unsound mind to the injury or destruction of their fellow creatures:—and from my own experience many have been prompted by a dream or vision, which has been so distinctly revealed and forcibly impressed, that it has carried the conviction of reality and divine command. Some hear voices and obey the mandates which are thus whispered from a BELIEF in the superior authority which has issued them; and after an outrage has been perpetrated by one of these maniacs, it is astonishing with what coolness and satisfaction he will attempt to justify its necessity, and even undismayed advance to the scaffold. If therefore, there be the same BELIEF in delusion as in reality—if the maniac be persuaded that his vision has brought him into the presence of the Almighty, or that the fancied voice is the divine command, he becomes the subject of pity and protection, but not of punishment. If he be acknowledged insane upon many subjects, and kills another, should he be supposed of sound mind on account of having committed such outrage? Is he to be judged from the state of his intellect, or by the atrocity of the action?
However the maniac may direct the sallies of his violence and resentment against the lives of others, frequently of those to whom he is nearest allied, or bound by obligation and friendship: yet there is another feature which his disorder assumes, and which always secures the commiseration of mankind. It more frequently occurs in the deranged state of these pitiable persons that they seek to revenge on themselves the supposed crimes they have committed. In our own country, there are more lunatics who destroy themselves, than attempt the lives of others; and in these cases the Coroner’s jury has always agreed on a merciful interpretation. Indeed there are but few instances of the impotent folly of degrading the carcass, excepting where self-destruction has anticipated the rigour of the law.
It is of frequent occurrence, that persons labouring under insanity, although of exemplary lives and unblemished character, shall believe themselves guilty of the most atrocious crimes;—reputation, the dearest possession of the sound mind is sacrificed without a regret by the despairing lunatic;—he accuses himself of cowardice, of fraud, of secret murder, or of a turpitude at which man revolts:—and others blessed with opulence, and enjoying those comforts which render life desirable, become apprehensive of terminating their existence in the work-house. Sometimes the desire of death is so ardent, that they will perpetrate any crime in order to be arraigned and condemned at the bar of justice. Of this extraordinary perversion I shall take the liberty to relate a very striking instance.
A woman about 36 years of age, who had been well educated, but whose conduct had not been exempt from some irregularities, in consequence of intemperance and manifold disappointments, became affected with madness. She was by turns furious and melancholic, and conceived she had murdered one of her children, for which she ought to suffer death. She detailed the manner in which she had destroyed the child and the motives which actuated her, so circumstantially, and with so much plausibility and feeling, that if I had not known her child to be living I might have been deceived. By her own hands she had repeatedly endeavoured to terminate her existence, but was prevented by constant vigilance and due restraint. Her disposition to suicide was afterwards relinquished; but she still persisted that for the murder of the child she ought to suffer death, and requested to be sent to Newgate, in order to be tried, and undergo the sentence of the law:—indeed she appeared to derive consolation from the hope of becoming a public example, and expiating her supposed crime on the scaffold. While in this state, and with a hope of convincing her of its safety, the child was brought to visit her. When she beheld it there was a temporary burst of maternal affection; she kissed it, and for a few moments appeared to be delighted:—but a look of suspicion quickly succeeded, and this was shortly followed by a frown of indignation, which rendered the removal of the child a measure of wholesome necessity. Perhaps, in no instance, was the buoyancy of madness more conspicuous over reason, recollection, and feeling. She insisted they had attempted to impose on her a strange child, which bore a faint resemblance to her own; however, by such subterfuges she was not to be deceived; she had strangled the child until life had totally departed, and it was not in the order of nature that it should exist again. The effect of this interview was an exasperation of her disorder,—she became more cunning and malignant, and her desire for an ignominious death was augmented. To render this more certain, and accelerate her projected happiness, she enticed into her apartment a young female patient, to whom she appeared to be attached, and having previously platted some threads of her bed-quilt into a cord, she fixed it round the neck of the young woman and proceeded to strangle her. Fortunately some person entered the room, and unloosed the cord in time to save her. When this unhappy maniac was questioned concerning the motive which induced her to attempt the destruction of a person for whom she had manifested kindness; she very calmly replied, that as the murder of her own child was disbelieved, she wished to exhibit a convincing proof of the ferocity of her nature, that she might instantly be conveyed to Newgate, and hanged, which she desired as the greatest blessing. With considerable satisfaction I may add, that in a few months, notwithstanding her derangement had been of three years duration, this woman perfectly recovered, and for a considerable time has performed the duties of an important and respectable office.
Influenced by curiosity, and a wish for the advancement of professional knowledge, I have always been induced to scrutinize as deeply as possible into the feelings of lunatics who have perfectly recovered; I therefore wished to be informed from this patient in her sane state, what were her feelings and opinions concerning her former condition. She recollected most of the circumstances which had transpired during her illness, but she was unable adequately to comprehend, or to give any account of her disorder—it seemed to her like a wearisome and protracted dream, but more distinct and connected—she almost doubted with her present feelings if she could be the same person, to have entertained opinions and resentments so different from her natural character. When questioned concerning her attempt to strangle the young woman, she rejoiced that no fatal consequences had ensued, yet she seemed to attach but little responsibility to any thing she might have committed in that frame of mind. Death, from which, as other human beings, she now shrunk with horror, was then the most desirable of all events.—Respecting the child, she observed her mind was as suddenly seized with the conviction that she had destroyed it, as a person is attacked with the shivering fit of an ague, and feels the sensation of cold in the hottest day of summer. On enquiring if these former impressions often recurred to her mind; she replied in the negative;—that although she could accurately recollect them when questioned, yet they now seemed removed to a vast distance from the natural range of her thoughts:—and that she found herself pleasantly occupied in contriving plans for the welfare and happiness of her future life.
It is therefore not the fear of death which can arrest the projects of the maniac mind; for on many occasions they seek it as the greatest consolation; and quietly submit to seclusion and its consequent privations sooner than renounce their opinions, or withhold their endeavours to accomplish that which appears to them, from the disordered state of their intellect, GOOD and RIGHT, and which by those of sane mind is denominated EVIL and WRONG. A very different opinion has however prevailed; and it has been conceived that the terror of example would deter lunatics from following the dictates of their distempered minds: and many worthy and pious persons who have been the stanch fautors of the dignity of our species, have maintained, that the Deity never so far abandons the being fashioned in his own likeness, and to whom he has imparted a ray of his intellectual light, as to deprive him of the power of discriminating between right and wrong. To such assumptions, unsupported by reason, and clashing with daily experience, the reader will not expect a serious reply—they must have originated in minds more confident of the perfection and endurance of the intellect, than grateful for its possession.
It is not the object of these pages to shelter crime under the pretence of insanity; or to suppose that some degree of derangement must exist in the mind of the perpetrator:—on the contrary, it is believed, because every day furnishes instances, that men of the highest attainments and most lucid faculties will deliberately commit acts of turpitude,—foreseeing the consequences, and feeling the criminality of the act. But, it would be as much the subject of regret and against the law, that a human being, under a delusion which he firmly believed, and in the persuasion that he was acting from the immediate influence or instigation of the Divine command, should undergo the sentence of the law to the disgrace of his family:—as that science should ever attempt to contaminate the source of justice, by shielding criminality under the cover of disease.