Puslapio vaizdai
PDF
„ePub“

§ 320. We are also to bear in mind, that a considerable number recover only to a certain point. They recover so far as to be free from all delusions, to maintain unremitting selfcontrol, and transact their customary business correctly and shrewdly, but never regain confidence in those who favored their confinement or restraint, though their part in it was prompted by kindness and managed discreetly and considerately. This state of feeling varies from tacit distrust and aversion, to a deep malignity that leads to violence and litigation. Having regained all their natural shrewdness, they have no difficulty in enlisting the sympathies of those -and they constitute the greater part of mankind—who are ever ready to yield their faith to any statement that is uttered with a certain plausibility of manner. Whether actuated by a kind of pride that refuses to acknowledge that they have been the subjects of so humbling an infirmity as insanity, or an obscurity in their recollections of the past, that leads them to mingle the real and imaginary, and confound the scenes with the cause of their suffering, they persist in referring the mental tortures they endured, to the measures that were meant for their mitigation, and attributing their various discomforts to the cruelty or neglect of others, rather than to the disordered condition of their own minds. Even when they fail to convince the world that they were never insane, for of this fact there may have been too many witnesses, they often leave the impression that they have been unjustly, if not cruelly dealt with.1

[ocr errors]

§ 321. It has been already remarked that in most in

1 A memorable case of this description - memorable for the success which followed the representations of the patient, and the utter groundlessness of the charges which he brought-occurred but two or three years ago, in Philadelphia. A man named Hinchman who was placed in the Friends' Asylum for the insane in Frankford, because, as the evidence showed beyond a doubt, he was violently and dangerously insane, brought an action of conspiracy against every individual the least concerned in the measure, — his mother, sister, cousins, the sheriff, a passing traveller, the physicians of the Asylum and the physician who signed the certificate, and others, and he succeeded in obtaining heavy damages.

[ocr errors]

stances, recovery takes place gradually, and is completed only after a period, more or less long, of convalescence. Nothing, therefore, can be more chimerical than the idea of fixing on any precise moment when all disease has departed and perfect health is established; and yet this is what we are called upon to do when required to determine, as we sometimes are in criminal cases, at what time the accused began to be responsible. To contend that a convalescent maniac may be irresponsible one day and responsible the next, would be no less absurd than to say to one recovering from inflammation of the lungs, that, as he valued his life, he must not leave his room to-day, though to-morrow he might safely expose himself to the severest inclemency of the weather; and to believe that the former is perfectly sound, because laboring under no hallucination and attacked by no fits of fury, would be as erroneous, as to consider the respiratory functions of the latter sound and vigorous, because we hear no cough and see no difficulty of breathing. The time that has elapsed since the unequivocal insanity of the accused, is therefore an important element in the determination of his mental soundness. Just as exposure to bad weather, a week after an attack of inflammation of lungs had begun to subside, would be more likely to reproduce the disease, than it would a month afterwards; so the longer the time since an attack of insanity has been apparently cured, the less likely is the cerebral irritation to be renewed by sudden provocations or other causes that tend to produce it. Ample time must be allowed to cover the period of convalescence, and if it be difficult to fix upon the exact duration of this state, so much greater the necessity of caution in determining the responsibility of the accused. Here it is often a merit to doubt, and justice requires that the accused should have the benefit of our doubts.

CHAPTER XIV.

LUCID INTERVALS.

§ 322. It is well known that many diseases-especially of the class called nervous-observe a law of periodicity which is not uncommon in the actions of the animal economy. One effect of this curious law consists in an intermission of the outward manifestations of the disease, so complete as to bear the appearance of a perfect cure, and this, in the present state of our knowledge, is all that we can, with certainty, say of it. As to the change that takes place in the organic condition of the part affected, during the intermission, we can at best hazard nothing more than a rude conjecture. We have no warrant for believing that the pathological affection itself entirely disappears with the symptoms that arise from it, and perhaps never shall have, until we are able to explain why, after such disappearance, the tendency of the disease to return at certain intervals should still remain; or, in other words, wherein the final, perfect cure differs from the temporary intermission. But in view of the established fact that organic disease often exists without producing its ordinary symptoms, or revealing itself by any appreciable signs, it seems the more probable supposition, that the pathological condition of the affected organs does not disappear entirely during the intermission, but continues with perhaps a modified intensity.

§323. The slightest examination will convince us, that in the most complete intermission of any disease that affects the whole system to some extent, the patient is far from enjoying sound health, or free from every indication of morbid action. A greater contrast in the matter of health, can scarcely be presented in the same individual, than

that between the paroxysm and the intermission of a quotidian fever; yet none will say, after the former has passed off, and the patient is no longer shaking with cold nor parched with heat, but is able to arise and give some attention to his duties, that he is entirely well. Better, no doubt, he is; but his mind is weak, his stomach declines its once favorite food, a little exertion overcomes him, a certain malaise not easily described, pervades his whole system, and which, though not excessively painful, is something very different from the buoyant sensation of health. We are therefore bound to believe, that the disease still exists, though its external aspect has changed. And here it may be as well to remark, that we must not be led by an abuse of language to attribute that to the disease-to the pathological condition which belongs only to one of its symptoms.' When the epileptic, a few days after one of his frightful convulsions, appears to have regained his customary health, no intelligent physician imagines that the proximate cause of this disturbance has vanished with the fit, leaving the organ it affected as sound as ever. The fit itself which is a mere symptom, is indeed of periodical occurrence, but the pathological condition on which it depends, continues, slowly and surely though imperceptibly, to undermine the powers of the constitution. The general expression of all our knowledge on the subject of the intermission of diseases is, then, that certain pathological conditions give rise, among other phenomena, to some that disappear for a time, only to recur after an interval of more or less duration.

§ 324. That insanity, or rather mania, is one of the diseases that are subject to this law of periodicity, in some respects, is universally admitted; but to what extent the law operates, is a point on which there is much diversity of opinion. There are few cases in which we may not observe various periods in their course, when the severity of the symptoms is greatly alleviated; when calmness takes the place of fury, and a quiet and sober demeanor succeeds to noisy and restless agitation; when reason, driven from her throne, seems to be retracing her steps and struggling for her

lost dominion. In all this, however, there is nothing different from what occurs in many, if not the greater proportion of chronic diseases. In mania, but in no other form of insanity, this abatement of the severity of the symptoms may amount to a complete intermission, when the patient is conscious of his true condition, converses rationally, and admits his having been insane. But that the intermissions of mania are ever so complete, that the mind is restored to its original integrity, would seem scarcely probable, from the fact, that the very seat of the pathological changes is the material organ on which the manifestations of the mental phenomena depend. For if the mind be rendered as sound as before the attack, it necessarily follows that the brain is equally restored, since in point of health they stand to each other in the relation of cause and effect. But as there is no proof that such is the case, and as the supposition is not supported by what we do know of pathological actions, we have no right, at present, to conclude that the physical condition on which mania depends is entirely removed during the intermission. We are thus led to scrutinize a little more closely these periodical restorations of the insane mind, or lucid intervals, as they are called, in order to ascertain if possible, what is the actual state of the mind at these times. But before doing this, it will be proper to show what is understood in law by lucid intervals, as explained by eminent legal authorities.

§ 325. D'Aguesseau, in his pleading in the case of the Abbé d'Orleans, says, "It must not be a superficial tranquillity, a shadow of repose, but on the contrary a profound tranquillity, a real repose; it must be, not a mere ray of reason, which only makes its absence more apparent when it is gone, not a flash of lightning, which pierces through the darkness only to render it more gloomy and dismal, - not a glimmering, which joins the night to the day; but a perfect light, a lively and continued lustre, a full and entire day interposed between the two separate nights, of the fury which precedes and follows it; and, to use another image, it is not a deceitful and faithless stillness which follows or

[ocr errors]
« AnkstesnisTęsti »