have also sudden determinations to act without any idea as to the direction in which the volition is to be directed. Thus it is there are impulses-acts out of all harmony to the thought of an individual, just as a sneeze is dissociated from the conduct of the individual. We find no more difficulty in believing in these sudden diseases, or rather sudden manifestations of disease, than we do in sudden death from heart disease. What we do believe is that a long course of disease is invariably antecedent to such impulsive acts, a long weakening of will, whether we refer to the automatic will which resides in all the tissues and makes them quiet reservoirs of energy, or the conscious will which regulates our conduct and our acts. Such impulses, too, are always out of harmony to the thought of the individual, and it is thus we find mothers kill the children that are dearest to them. But on this very ground their existence in relation to premeditation, to quarrel, to malice, to ill will, is to be denied. Again, such a disease as transitory mania-mania which suddenly appears and suddenly disappears-is, to our thinking, an impossibility. We are glad that although some medical men of eminence hold that a disease may manifest itself in one criminal act, and that such manifestation may at the same time be the cure of the disease,' others, with what seems to us truer conceptions of pathology, have denied the existence of such a disease. Thus Dr. Hammond remarks: "The doctrine that an individual can be entirely sane immediately before and after any particular act, and yet insane at the instant the act was committed, is contrary to every principle of sound psychological science. Even in the most striking instances of what is called transitory mania, or morbid impulse, the evidences of preexistent and subsequent disease of the brain will be found if they are looked for with skill and diligence and intelligence."2 Again Dr. Gray, another distinguished American physician, remarked: "I am not going to deny the existence of transitory paroxysms of insanity either in epilepsy or in the frenzy of melancholia, or in ordinary cases of

See Dr. Jarvis on Mania Transitoria, Am. Journal of Insanity, vol. for 1869–70. See also Prof. Kraft Ebing, Paper of 1870.

Insanity in relation to Crime, New York, 1873, p. 75.

3 Whenever we meet with isolated acts of violence, outrages on persons, homicide,

insanity, where paroxysms suddenly arise and suddenly disappear; but until I have seen more than I have yet seen, and until I read something more authentic than I have yet read— authenticated by symptoms-I must fail to see insanity in any case which arises when the premonitory symptoms of the disease run the rapid course of a few minutes, when the person commits a crime and then is well." These, then, strike one as being more cautious and rational opinions with regard to the nature of disease and the real etiology of impulse, than those which have been generally expressed by members of the medical profession.

2171. Characteristics of Impulse.-What we have said. with regard to the psychology of impulse would of itself lead one to suppose that the act which is thus involuntarily caused by a discharge of energy would bear some peculiar relation to memory, and that that relation might be of much use in the accurate diagnosis in this form of disease. This is actually the case, although the recognition of it has not been so general as we should have expected. Our own observation in such cases convinces us that there is always more or less forgetfulness after an act which has been done by disease, if we may use the expression. This is not of course true of delusions, where all the thoughts of the individual are centred on the one idea which, like Aaron's rod-serpent which swallowed up those of the magicians, has devoured the other crowding ideas of life, but it is true of the disease we are here considering. Memory is always retentive if attention has been concentrated. Attention is the true antiseptic of ideas. But in relation to the acts of impulse, attention was not related to them in any way. One has no memory One has no memory of the processes of digestion, of growth, of circulation, of nutriment, because these do not enter into consciousness, and attention has not been called to them. So in relation to all acts which, although once voluntary, have now become automatic. The

suicide, arson, which nothing seems to have instigated, and when, upon attentive examination and thorough inquiry, we find a loss of memory after the perpetration of the act, with a periodicity in the recurrence of the same act and a brief duration, we may diagnose larval epilepsy. Annal. Med. Psyc. Jan. 1873, p. 162.

Reprint from Am. Jour. of Insanity, p. 10. See also the remarks of Dr. Callender, Reprint, p. 19.

musician cannot call to mind all the motions which were necessary to the production of his performance. The thinker cannot on all occasions recall all the intermediate propositions by means of which he reached his conclusion. So in relation to the acts of impulse, the individual has generally a very defective memory, and the reason for this oblivion is the same as that which we have just indicated in relation to other automatic acts. But again there is another reason for this forgetfulness, which it is of much importance to recognize. A person is in the habit of recovering memories by means of an Ariadne-thread of association, When one thinks of a thing once experienced, he generally remembers it in relation to its cause. If he remembers a sorrow, he remembers the death that caused it. But as we have seen in disease, a man experiences sorrows, joys, fears, or hopes, without any consciousness of an external cause; and as he has been unconscious of them, he cannot remember them. But the very remembrance of the feeling, without a remembrance of its cause, gives the individual an idea of unreality in connection with it. It is not remembered as ordinary reminiscences are recalled. It is not in the anticipated association, and the individual consequently feels that somehow it is more like a remembered dream than a recalled reality. This is true in relation to those impulsive acts to which we have above referred. Another characteristic to be noted in relation to such acts is their relation to time. They are very often periodic in their recurrence. In another place, we have fully considered the organic law of periodicity, and if this physical law can impress itself upon voluntary thought, we should expect to find it impressing itself upon the involuntary actions which are called impulses.

172. General Remarks.—113 We believe that this explanation of an "irresistible impulse" is conformable to all the circumstances which attend their manifestation, as far as they have been accurately observed; and we further believe that, with such an explanation as the above, courts of law would, in connection with the various cases, be satisfied of the existence of morbid impulses; and it would be admitted that persistency of criminal tendency, and the commission of

criminal acts in spite of repeated punishments, and in spite of every human reason to believe that the connection between future acts of crime and punishment would be invariable-all point to the existence of disease. One important point may be noted here. Physiologists distinguish two kinds of action: the one initiatory, the other inhibitory; the one originating, the other controlling. Some are inclined to localize these two powers, which shape conduct and influence all action, in distinct centres. Now, it seems certain that just as the originating centres may be strengthened by indulgence, so may the inhibitory centres be made stronger by habit. A man in ordinary health is tempted, but he has the power to resist. A man in disease may be tempted by some unreal inducement, by some delusional belief, but it does not thereby follow that he is deprived of the power of control. A case which has been brought under our notice will show this. A medical man, who had himself had charge of insane persons, became insane, and entertained some false beliefs and an unfounded hatred of his father-in-law. He confessed to a brother physician that so far had this dislike carried him that upon many occasions he had taken his gun out of a morning and walked over half way to the old man's house with the intention of shooting him, but that somehow he had always thought of Jack Ketch before he got there, and turned back. We have ourselves repeatedly heard insane persons say to those who were about them: "I would kill you if it were not that I would be hanged for it." This indicates that the originating thought is still in the firm harness of inhibitory power in many cases of undoubted insanity, and that the inhibitory power can be strengthened by the fear of punishment. In such cases, it is evident that if a crime be committed, it would be wrong to forego the legal penalty. A few cases are added to show that the real ground for exempting from punishment has not been sufficiently understood, and to illustrate the phenomena of this disease.

173. Some Cases of Impulse.-"An only son of a weak and indulgent mother was encouraged in the gratification of every caprice and passion of which an untutored and violent temper was susceptible. The impetuosity of his disposition BR. INS.-19

increased with his years. The money with which he was lavishly supplied removed every obstacle to the indulgence of his wild desires. Every instance of opposition roused him to acts of fury. He assailed his adversaries with the audacity of a savage, sought to reign by force, and was perpetually embroiled in disputes and quarrels. If a dog, a horse, or any other animal, offended him, he instantly put it to death. If ever he went to a fête, or any other public meeting, he was sure to excite such tumults and quarrels as terminated in actual pugilistic encounters; and he generally left the scene with a bloody nose. This wayward youth, however, when unmoved by passion, possessed a perfectly sound judgment. When he became of age, he succeeded to the possession of an extensive domain. He proved himself fully competent to the management of his estate, as well as to the discharge of his relative duties, and he even distinguished himself by acts of beneficence and compassion. Wounds, law suits, and pecuniary compensations, were generally the consequences of his unhappy propensity to quarrel. But an act of notoriety put an end to his career of violence. Enraged with a woman who had used offensive language to him, he precipitated her into a well. Prosecution was commenced against him; and on the deposition of a great many witnesses who gave evidence to his 114 furious deportment, he was condemned to perpetual confinement in the Bicêtre."1 Although this case is recorded by Pinel, it seems to us anything but a satisfactory illustration of moral insanity; and it is somewhat strange that it has been quoted in that connection by some more recent writers on the subject. "Strong passions" seem to us all that is made out in the case just quoted; and if that plea is to open the door of a lunatic asylum instead of that of a prison, courts of law may shut their doors. That the strong passions were unrestrained in youth, that a defective education led to careless self-control, that the means of gratifying passions made them strongjust as in a country's economy, plentiful supply strengthens demand that habit strengthened more and more what tendency had made in clay, seems all that can be gathered from

1 Pinel, Sur l'Aliénation Mentale, p. 156, § 159.