himself from the window, or having been bled, removed the bandages, and death in either case ensued. In these and many other cases that might be put, though strictly speaking the assured may be said to have died by his own hands, the circumstances clearly would not be such as the parties contemplated when the contract was entered into." And further, the Court was of opinion that all that the "contract requires is that the act of self-destruction should be the voluntary and wilful act of a man having at the time sufficient powers of mind and reason to understand the physical nature and consequences of such act, and having at the time a purpose and intention to cause his own death by that act, and the question whether at the time he was capable of understanding the moral nature and quality of his purpose is not relevant to the inquiry further than as it might help to illustrate the extent of his capacity to understand the physical character of the act itself." And in the other leading case on this subject it was decided that the jury should be satisfied that he died by his own voluntary act, being then able to distinguish between right and wrong, and to appreciate the nature and quality of the act that he was doing, so as to be a responsible agent."

262. Burden of Proof.-In the case of Cleft v. Schwabe,' which has just been cited, it was also held that it lay with the insurance company which disputed the policy to prove that the person in respect of whose death it was claimed died by his own hand, but that when that had been proved, it was to be presumed that he so died by his own voluntary act, and in a sane condition, until that presumption is rebutted by proof.3

1 Cleft v. Schwabe. 3 C. B. 437; White v. The British Empire Ass. Co. 38 L J. Ch. 53; Stormont v. Waterloo Life Casualty Ass. Co. 1 Foster & F. 22.

3 C. B. 437.

* See chapter on Proof of Insanity, and see May on Insurance, 1873.

CHAPTER XI.

MELANCHOLIA.

? 263. Diseases of Exaltation and Depression.-There are two well marked classes of diseases those which are marked by the exaltation of the processes of health, and those which are characterized by a depression of these processes. Pleasure has been defined as a reflex of the spontaneous and unimpeded exertion of a power of whose energy we are conscious, and pain as a reflex of the overstrained or repressed exertion of such a power. There is much to be said for this definition, and it is, it seems to us, applicable to cases of mental disease as well as to mental health. To him who thinks, the more rapid succession of thoughts is pleasure; to him who feels, a quick train of emotions is enjoyment; and to him who sees, varying sights are a cause of happiness. On the other hand, if you deprive the man who thinks of thought, if you take away a cause of emotion from the man who feels, or if you shut the eyes of him who simply sees, you produce misery. Now, disease does this for men. In some forms, as we have seen, we have weakness which deprives a man of the power of thinking, feeling, or seeing, and deprives him to that extent of the capacity of pleasure and pain. In other forms, we find all the mental processes quickened. Thus, in mania, the incoherence of the individual is due not to an actual want of association in thought, but a want of adequacy in expression. There is an actual connected train of thoughts running through the head of the individual, but he can only express one here and there, and these seem disconnected or incoherent, just as the tops of hills do when seen above a

1 See Sir William Hamilton's Lectures, Metaph. II. 440; and see Aristotle's Nicomachean Ethics, Book 10.

mist. Then, again, in other diseases, we have an actual degradation of function in relation to organism. The thoughts come slowly: there is a want of variety: there is a sameness and monotony; and there is misery. This then is, in a mental point of view, the difference between mania and melancholia. The one is a disease of exaltation of function; the other, of depression of function.

264. Melancholia: Why Distinguished from other Diseases. Many writers have thought it unnecessary to distinguish melancholia from monomania. On the ground of many classifications of insanity, this would, as may be well understood, be reasonable enough. Where insanity is distinguished by the function affected by disease and not by the peculiar character of the affection, it is unnecessary to differentiate between mania and melancholia. It is evident that both of these would necessarily fall to some extent under the definitions of emotional insanity and intellectual insanity, for in both the feelings are more or less influenced by the morbid changes in the brain, and in both the intellect is to some extent impaired. Indeed, that is one good ground for holding that this classification is practically of little value. But as we have seen,' classifications, like Sunday, were made for men, and not men for classifications; and the practical usefulness of a classification is the true criterion of its excellence. It cannot be doubted by those who have been brought in contact with persons laboring under mental disease that this distinction between states of exaltation and states of depression is of daily value, and hence it is that we have adopted it here.

265. Kinds of Melancholia.-Some authors have asserted that melancholia could not properly be called a kind of insanity, but that it was to be regarded as a phase in all kinds of insanity; and although this view seems to be unsatisfactory, there is little doubt that very many of the forms of insanity which are distinguished by psychologists pass through an initiatory stage of melancholia. However, the

Chapter on Mental Unsoundness.

fact that dements are liable to attacks of excitement, does not make us deny the existence of dementia and assert its identity with mania, and the same reasoning holds good in relation to melancholia. We are in the habit of distinguishing simple melancholia from acute melancholia, and dividing the latter into hypochondriacal and religious monomania.

206. Simple Melancholia.-Melancholy, depression, sorrow, grief, are not indications of ill health. A mind which, like the face of the hero of Victor Hugo's novel, is always on the grin, has been manipulated by the cruel fingers of disease. A healthy mind is a repertory of tears as well as of smiles. Men in this varigated world must have sorrows as well as joys. There are causes enough of real, true, healthy sadness in this world; and he who cannot feel these, he who cannot mourn and weep when the stern circumstances demand such tribute, is less a man and more a stone than is consistent with perfect mental health. But although this is true, it is also certain that this world is not all of one color. It is not meant wholly for a valley of tears. The brightness of day succeeds the darkness of night; and so even the most poignant grief yields to the cheering influences of a busy world, with its thronging events, which bring other emotions to the sufferer. While grief is new, he who sorrows can see no end to it, but it wears out in a healthy mind, and is replaced by healthy joy again. In the mind diseased, however, the depression does not wear out, but, like a river-course, wears deeper. It is disproportioned to its cause both in intensity and duration. Simple melancholia not unfrequently has its origin in real grief, but the real grief in the unhealthy mind is not erased by the hand of time, and passes into the sorrow of disease. Simple melancholia is characterized by deep depression, by inconsolable sorrow, by weary grief, and yet withal the intellectual powers remain unimpaired. The individual reasons correctly, remembers accurately, but cannot reason him or herself out of the heavy despondency, and cannot remember the innumerable causes for joy that are to be found in the life of each. Still, in this form of the disease, there are no well-marked delusions. It is true, in a sense, that there can be no impairment of mind without the

generation of false beliefs. And even the simple melancholiac generally labors under erroneous impressions with regard to sins committed or deaths caused by misconduct which were really due to natural causes. We have seen a case of simple melancholia in which the individual was constantly impressed with a sense of impending death, and although in one sense this belief might not be called a delusion, in another and truer sense, it really is one. However, it is to be remembered that the prominent features of this disease are not delusions, but an inordinate grief and melancholy which is irremovable by the ordinary benign treatment of the world. We find a woman sorrowing for the death of a father who died twenty years before, full of years. We find a man weighed down, restless, uneasy, and always thinking of the misery of the present, and without hope of a better future. We find another looking forward with bleeching sorrow to the doom that the gloom of after-death may hide; and in all these cases we recognize simple melancholia.

We

? 267. Of the Mental Impairment of Simple Melancholia. We have said that mental impairment might easily be overlooked in those who suffer from simple melancholia. As a fact, it has often been overlooked by acute observers, who have asserted that this disease was unattended by any mental symptoms. This is, however, far from true. have seen that the characteristic of this disease is painful self-absorption, self-tormenting subjectivity. But that is unhealthy. The true man lives an objective existence. We have come to understand that poetry to be good must be objective; that moody speculation as to one's own inner life is apt to pass into sickly metaphysical sentimentality, and that a Shakespeare or a Burns are great in that they live in the world that we live in. But in relation to disease, as we have seen, this is its most striking characteristic. Insane persons substitute their own subjective impressions for objective realities, and we call these delusions, or they suffer emotions of sorrow, or respond to feelings of joy which are dependent upon subjective causes, and are not like healthy feelings associated with objective events. But this is not only indicative of disease, but it is a cause of disease. The world is