Part 4

The employment of terms in an ambiguous sense has ever been the bane of philosophy, and the obstacle to its advancement. Without the meaning of important words be accurately defined, no general reasoning can be established. On some occasions the term UNSOUND MIND has been introduced, and considerable emphasis has been laid on it by lawyers; as possessing an intrinsic meaning, and designating a peculiar state of morbid intellect, not _precisely similar_ to insanity, but of equivalent effect in depriving a person of the management of himself and affairs. It is of the utmost importance that the term _unsound mind_ should be fully and accurately considered. Had this term originated from medical persons, it is most probable they would, at least have endeavoured to explain it; but it is of higher descent, and adopted by those luminaries of the law to whom we look up with confidence and respect. The force and extent of the term unsound mind are described in the luminous judgment of the present Chancellor on a recent case. Of this learned exposition of the law, every medical practitioner should be informed, as it will serve to guide him, when he is called to give his deposition on the state of a patient’s intellect. In the judgment adverted to, his Lordship observes, “I have searched, and caused a most careful search to be made into all the records and procedures on lunacy which are extant. I believe, and I think I may venture to say, that originally commissions of this sort were of two kinds, a commission aiming at, and enquiring, whether the individual had been an ideot ex nativitate, or whether, on the other hand, he was a lunatic. The question whether he was a lunatic, being a question, admitting in the solution of it, of a decision that imputed to him at one time, an extremely sound mind, but at other times an occurrence of insanity, with reference to which, it was necessary to guard his person and his property by a commission issuing. It seems to have been a very long time before those who had the administration of justice in this department, thought themselves at liberty to issue a commission, when the person was represented as not being ideot ex nativitate, as not being lunatic, but as being of _unsound mind_, importing by those words, the notion, that the party was in _some such state_, as was to be contradistinguished from idiotcy, and as he was to be contradistinguished from lunacy, and yet _such_ as made him a proper object of a commission _in the nature_ of a commission to enquire of idiotcy, or a commission to enquire of lunacy. From the moment that that had been established, down to this moment, it appears to me however to have been at the same time established, that whatever may be the degree of weakness or imbecility of the party—whatever may be the degree of incapacity of the party to manage his own affairs, if the finding of the jury is only, that he was of an extreme imbecility of mind, that he has an inability to manage his own affairs; if they will not proceed to infer from that, in their finding upon oath, that he is of _unsound mind_, they have not established by the result of the enquiry, a case upon which the Chancellor can make a grant, constituting a committee either of the person or estate. All the cases decide that mere imbecility will not do; that an inability to manage a man’s affairs will not do, unless that inability and that incapacity to manage his affairs amount to evidence that he is of unsound mind; and he must be found to be so. Now there is a great difference between inability to manage a man’s affairs, and imbecility of mind taken as evidence of unsoundness of mind. The case of Charlton Palmer in which this was very much discussed, was the case of a man stricken in years, and whose mind, was the mind of a child, it was _therefore in that sense_, imbecility and inability to manage his affairs which _constituted_ unsoundness of mind.” This is the law, the principle established for the regulation of medical opinion; and it will be immediately perceived, that the burthen of this ponderous machine, turns on the explanation which may be given to the term unsoundness of mind. As far as the term unsound is employed and understood by medical persons, it signifies a morbid condition of the human constitution, or a morbid state of some particular organ, and this state of unsoundness is inferred to exist from particular and well marked symptoms, which experience has detected to indicate, constitutional or local morbid affections. If this term be transferred to mind, it is equally incumbent on the person who employs it, to point out the particular symptoms or mental phenomena which characterize this unsoundness of the individual’s mind. It ought to be well considered that our knowledge of the intellectual faculties, and of their operations is very limited, and that the progress of the philosophy of mind, has borne no proportion to the rapid advances which have been made by Anatomy, Physiology and Pathology, in the structure, offices and morbid alterations of the body. All that we can know of the mind of an individual is from the communication of his ideas in terms or signs which are conventional between us, in order to be intelligible, or from his actions. Thus by discourse, which is imparted to the ear, or by intelligible characters presented to the eye, which convey his thoughts, and by his conduct, we are enabled to estimate the character of his mind. The lawyer has been accustomed to receive mental phenomena as the only evidences of the state of an individual’s intellect: he would be dissatisfied, and in my own opinion, properly, with any bodily symptoms, such as peculiar conformation of the head, excessive determination of blood thereto, protrusion or glistening of the eye, increased pulsation of the Carotid arteries, &c.—these may be indications to medical persons in the treatment of insanity, but they do not constitute any direct evidences of mind. On the scale of intellectual capacity there is an extensive range, some are eminently gifted, and others so sparingly supplied that they are unfit for the common purposes of life, and require to be protected. These are Ideots ex Nativitate. If it be attempted to teach them, they are deficient of the capacity to acquire sufficient to manage the property they may be possessed of, or to conduct themselves. Is it here incumbent on the medical practitioner to state that this natural deficiency of intellect arises from unsoundness of mind, or that the unsoundness is the effect of such deficiency: in order that the individual may experience the wise, politic, and humane protection of the law?—It frequently occurs that those of extensive capacity and high attainments are by an apoplectic or paralytic attack suddenly deprived of their intellectual faculties, and reduced to the state of an ideot ex nativitate. Is it in this case necessary, for the legal protection of the party, to insist on the hypothesis of unsoundness? Is it insufficient to detail the miserable remnants of his former state, and exhibit to the jury the shocking spectacle? Must there be a compulsion to infer, that this abolition of the faculties amounts to evidence of the unsoundness of his mind? We are acquainted with the mind from the phœnomena it displays; but the cause of these phœnomena is to us inscrutable: by discourse and conduct we infer its soundness, by the same evidences its unsoundness must be detected. This appears however to militate against the dictum of law, which states, “Whatever may be the degree of weakness or imbecility of the party—whatever may be the degree of incapacity of the party to manage his own affairs, if the finding of the jury is only that he was of an extreme imbecility of mind, that he has an inability to manage his affairs: if they will not proceed to infer from that, in their finding upon oath, that he is of _unsound mind_, they have not established, by the result of their enquiry, a case, upon which the Chancellor can make a grant constituting a committee either of the person or estate.” Is not this extreme imbecility of mind and inability to manage his affairs the only evidence of his unsoundness of mind? if not, what further is required? for it is not necessary, according to law, that he should be a lunatic. If these be insufficient to constitute him of _unsound mind_, then the inference is clear and warranted, that he may be of extreme imbecility, and have an inability to manage his affairs, and, notwithstanding all this, may be of _sound mind_: and if _unsoundness_, be _some such state_, as may be contradistinguished from idiotcy and lunacy, then an ideot and a lunatic may be of _sound mind_.

In the case referred to of Charlton Palmer, who was a man stricken in years, and “whose mind was the mind of a child, it was _therefore in that sense_ imbecility and inability to manage his affairs, which _constituted_ unsoundness of mind.” Here the imbecility and inability to manage, _did_ constitute the unsoundness: the words _therefore, in that sense_, evidently refer to his mind being “the mind of a child,” which is perhaps a mode of expression more familiar than accurate; as no one could properly infer, that the mind of a child was necessarily unsound.

If the word unsoundness be particularly examined, and for that purpose we consult Dr. Johnson’s Dictionary, we shall find it employed in three different senses, but no one in which it implies any particular condition of mind:—the adjective unsound has a dozen different meanings, but none in the sense of vitiated intellect. From authority therefore we obtain no information. If we proceed to its derivation, we shall find that our Anglosaxon ancestors by the word SUND (whence our SOUND) meant precisely the Latin SANUS. UNSUND Anglosaxon, or unsound English, would therefore be of equivalent meaning with the Latin INSANUS.

In those instances where the word unsound is used in our own profession, it designates something cognizable by the senses. An unsound tooth bears in its external character or internal feeling, sufficient evidence of its unsoundness. A fistulous sore may appear to be healed, but the skill of the surgeon can readily detect that it is unsound at the bottom: and both the dentist and the surgeon can give sufficient reasons, as the foundation of their opinion. Unsound doctrine, differs from that which is orthodox in certain particulars or essential points, which constitute its unsoundness.

Superadded to these, let the facts be examined as they are recorded in nature and experience. Of the human intellect there can only be three states: sound mind, insanity, and idiotcy. Of these states there may be different degrees. The mind of one man may be relatively more sound than another; his attention may be more fixed and enduring—his memory more retentive; his judgment may be clearer, and possess superior vigour; and his imagination shall exhibit a brighter flame. Notwithstanding this exalted capacity, the individual who is removed many degrees lower on the scale, may possess sufficient soundness for the purposes of his nature:—he may be capable to conduct himself, and likewise to manage his affairs. Insanity, is another condition of the human mind, and of this state there are various forms and different degrees; and when a morbid state of intellect prevails, under which a man cannot conduct himself, which implies that he is not safe to be trusted with his own life, nor with the life of another—that in his motives to action he cannot discriminate between right and wrong, or without motive is irresistibly impelled to act, and therefore becomes a being, not responsible for his conduct, and is incapable of managing his affairs—such state implies the necessity of being guarded by the instrument of the law: and this state of insanity, which includes all the various terms of madness, melancholy, lunacy, mental derangement, &c. necessarily evinces the unsoundness of the individual’s mind. Lastly, idiotcy, which, whether it be ex nativitate, or supervene at any period of life, implies a deficiency of intellectual capacity, to an extent which renders him incapable of the mental offices, which enable a man to conduct himself, and manage his affairs, and which of necessity infers the unsoundness of his mind, and the propriety of legal protection.

Those are the states of the human intellect which have a distinct and separate existence, and which are capable of being described from their manifestations; there can be no intermediate state, and certainly no abstract or independant unsoundness: which, when it is acknowledged, must, on the one hand, be derived from insanity, or from idiotcy on the other. But the law has established a different system, and it is observed that “It seems to have been a very long time before those who had the administration of justice in this department, thought themselves at liberty to issue a commission, when the person was represented as not being ideot ex nativitate, as not being lunatic, but as being of unsound mind, importing by those words, the notion, that the party was in _some such state_, as was to be contradistinguished from idiotcy; and as he was to be contradistinguished from lunacy, and yet _such_ as made him a proper object of a commission, _in the nature_ of a commission to enquire of idiotcy, or a commission to enquire of lunacy.” Accepting this with great humility as the law, it is equally dutiful to endeavour to discover on what facts or experience it was established: and the only clue to this investigation is found in the words “_in some such state_,” as was neither idiotcy nor lunacy, but “such” as disqualified him from exercising the volition of an ordinary man, by an instrument “in the nature” of a commission applicable to ideot or lunatic.

If this undefined unsoundness of mind, can thus dispossess the individual of his liberty, and of the use of his property, under the issuing of a commission, it performs sufficient; but it may be respectfully enquired, what would be the general opinion, or that of the commissioners of the College of Physicians, if a medical practitioner were to give a certificate to confine a person in a madhouse, declaring he was neither an ideot nor a lunatic, but of unsound mind?—And what attention would the judge and jury give to a physician in a criminal court who came to prove that a man who had committed murder was not responsible for the crime, because he was neither an ideot nor a lunatic, but of unsound mind; importing by these words that he was in _some such state_ as was to be contradistinguished from idiotcy, and as he was to be contradistinguished from lunacy? After having taken this view of the subject, which is the result of extensive experience in this department of the profession, and of diligent enquiry into the nature of the human mind; it appears to me, that the medical practitioner may safely and conscientiously infer unsoundness of mind, if such term be legally insisted on, whenever a morbid condition of intellect prevails, to an extent which deprives the mind of its natural and healthy offices, by producing an incapacity or inability in the individual to conduct himself and manage his affairs.

From the observations which have been detailed concerning unsoundness of mind there is, according to legal construction, an evident connection between unsoundness and imbecility. My object, however, is not the interpretation of law, but the exposition of nature and fact. It alone interests me to describe the phœnomena of mind—to compare the performance of its offices in a sound and morbid state—and to measure by the accredited standard of common sense and intelligible reasoning, the degree of imbecility, inability, or incapacity, which disqualifies an individual to conduct himself and manage his affairs.

The necessity of legal interference and protection in cases of insanity, having been sufficiently adverted to; it now remains to shew that a person from imbecility of mind may be equally incompetent to the management of himself and affairs. The mind may be weak from birth, or it may at any period of life become enfeebled by disease. Like the body it has its regular periods of growth and development, of maturity and declension: but they are not periodically connected. An unusual precocity of mental vigour has been occasionally remarked; and in advanced age the wisdom of the man frequently survives the infirmities of the body. Men are relatively competent, wise or foolish, learned or ignorant, compared with others. On the scale of intellectual being, we may place the philosopher at the summit, at the bottom the degraded ideot: and in the population of this world the intermediate range is adequately filled up. There are many considerations which demand attention on this important subject. To state that certain acquirements were to be attained as the proof of competency, would be an imperfect criterion. Much might be acquired _memoriter_, which the learner would not understand: a very feeble intellect, insufficient for the purposes of human affairs, might be trained to answer correctly a string of known questions, without being able to comprehend or adapt them to any useful purposes. It should likewise be considered that the different departments of employment require very different degrees of mental capacity. A person might be able to manage duly a small income, who would be inadequate to the distribution of a large revenue: a man might be competent to keep a shop, who would become overwhelmed and distracted in the learned professions: a country squire might gallop hospitably through life, without being able to discharge his duty as a magistrate. It is not the want of acquirement that should disqualify an individual; many persons from distaste, indolence, from neglect of parents and guardians, remain lamentably ignorant in the current acceptation of the words—they are unable to write or read, they are unacquainted with the symbols which represent numbers: yet with these deficiencies they are enabled to conduct themselves in the world. Speech itself is not absolutely necessary; because a person born deaf, and consequently dumb, if he understood the signification of characters, called letters, and their composition, termed words: if he comprehended that such words were significant of such things, so that when the object was presented he could select the appropriate word, and alternately when he saw the word could point to the thing:—moreover, if he had learned to form these characters, he would possess a sufficient substitute for speech, and become capable of intelligible communication—as a correspondent he would be on a level with him who enjoyed the utmost fluency of speech. So bountiful has the author of nature been in the construction of the human frame, that when one avenue to knowledge has been impervious, it has been transmitted through the medium of another; sufficiently to constitute the person an intelligent being and a moral agent. It is the _capacity_ of acquirement to which we are to direct our investigations. If a scale were constructed, and a certain degree fixed as the point of competency, the circumstance of his not having arrived at such point, ought not to disqualify the person. It ought to be _determined_ that he is unable to acquire so much. It is true a man may be ignorant as far as certain acquirements, which we term learning, are concerned, and which form the basis of ordinary education; he may know nothing of what has passed in the world, which we denominate the history of our species; but he may be an attentive observer of the objects in nature, and know fully the purposes to which they are applied. Such a man, although ignorant, does not want the capacity to acquire, and therefore ought not to be disqualified. It has occurred to me in many instances, to be consulted concerning persons whose minds have been naturally weak, or enfeebled by disease; and it always appeared that by patient enquiry, a satisfactory estimate of their capacity might be instituted. It would extend far beyond the limits of the present work to detail the whole of the circumstances connected with this subject; but it may be briefly stated that the person exercising his judgment ought particularly to ascertain the power of his attention; as his knowledge of objects, and his memory of them, will depend on the duration of his attention; and it will be indispensably necessary to investigate his comprehension of numbers, without which the nature of property cannot be understood. If a person were capable of enumerating progressively to the number ten, and knew the force and value of the separate units, he would be fully competent to the management of property. If he could comprehend that twice two composed four, he could find no difficulty in understanding that twice, or twain ten, constituted twenty. This _numeration_ also presumes he comprehended that so many taken from ten, or substracted which is the converse, would leave so many as the remainder—without such capacity, no man, in my own opinion, could understand the nature of property, which is represented by numbers of pounds, shillings, and pence. Indeed the capacity to acquire this knowledge seems to constitute the preeminence of man in the creation, as an intellectual being. The same imbecility of mind is often produced in adults, and in those of advanced age, by paralytic or epileptic attacks, and from various affections of the brain, and requires the same accurate investigation, to determine on the competency of such persons, to be entrusted with the management of themselves and affairs.

From the foregoing remarks, it appears indispensably necessary that some criterion should be fixed as the test of sufficient capacity. In the case even of an ideot ex nativitate, it must be ascertained that he is really an ideot; and the same process of investigation, which enables us to determine this fact, will apply to the intermediate gradations of human capacity. All ideots are not of the same degree of intellectual depravity; some possess more memory than others, and display a talent for imitation;—they will whistle tunes correctly, and repeat passages from books, which they have been taught by ear; but they are incapable of comprehending what they repeat.

There is a degree of intellect, although mean, when compared with superior minds, which will enable a human being to take charge of himself, and transact his affairs; and there is also an inferior degree, which incapacitates him from the performance of those offices: and patient examinations at repeated interviews will enable the observer to ascertain his competency, and to afford a satisfactory evidence of the state of his mind: for the mind of every man may be gauged, both as to its acquirements and capacity. By imbecility, therefore, which may be either natural, or induced by a variety of causes, it will be seen, that I mean a state or degree of mental incapacity equivalent to ideotcy, a degree, which renders him incompetent to the management of himself and affairs:—and which degree, by observation and enquiry, may always be ascertained. This degree, satisfactorily measured, does, in my own opinion, amount to unsoundness of the individual’s mind: as it includes all the mental evidences which constitute unsoundness.