1

prefer deck-work to going aloft often feign epilepsy. An examination of [285] the hands during the seizure will generally show whether it is real or not. The thumb of the real epileptic is invariably held down into the palm by the other fingers. A practiced ear ought to be able to distinguish the cry which upon all occasions accompanies the seizure. "A late German trial," says Wharton without giving any authority for his statement, "brings before us a state of facts well worthy of being considered by those concerned in religious and moral education. The parents of two young girls, one eleven and the other fifteen, claimed public relief on the ground that the latter were subject to epileptic fits. The patients were for months subject to medical scrutiny, and were received into an hospital where, during intermission, as well as of paroxysm, they were under constant observation. The elder, in particular, was affected by the disease in its worst shape, being prostrated by convulsive attacks of extraordinary violence, which afterwards left her in a state of entire exhaustion. Suspicion, however, was aroused as to the entire sincerity of the patients, and one of the hospital officers, against the vehement protestations of the medical attendants, threatened the eldest (sic) of the two with severe discipline in case she should have another fit. The attempt was successful. No fit was repeated; and the children confessed that partly to excite sympathy, partly to obtain money, the disease had been simulated."

? 420. Simulated Disease may lead to Real Disease.— We have seen that vice leads to insanity, and experience teaches us that the peculiar vice of simulation not unfrequently, and as if in practical justice, is the means of inducing an accession of the disease feigned. A careful consideration of the circumstances will make this explicable enough. Occasionally pretended epilepsy has passed into or been merged in the real. Many acts which have been planned by

1 Mental Unsoundness and Psychological Law, § 445.

* Dr. Browne on the Mental Condition of Epileptics in Crichton Institution-Reports, 1853, p. 12. Dr. Laurent also points out the tendency which feigned insanity has to become real, and gives a case in which this actually took place, which came under his own notice. Ann. d'Hyg. 1866, 2, 460. There is an interesting essay on monomania induced by imitation in the first volume of the American Journal of Insanity, p. 116.

will, pass out of the domain of will. You can make a habit, but it masters you when it is made. It has been asserted, with some reason, that the marvellous power which some insane persons have of simulating diseases may be due not only to the perversion of muscular volition obtained by habitual exercise, but also to an exaltation of the powers of coordination due to the diseased condition.

421. Feigned Melancholia.-It is somewhat curious that the attempts made to simulate melancholia are not more frequent. It is the form of insanity in which it is most difficult to distinguish the real from the counterfeit. The possession by the mind of one fixed idea or delusion, and the profound and brooding melancholy which are characteristic of this disease, are, without great difficulty, reproduced even by one possessed of only small histrionic ability, and requires no such efforts as the faithful rendering of an attack of mania. Here it is evident that the marks of effort, of planned disorder, of occasional signs of healthy mental action and ordinary human interests, will not suffice as marks by which to know the true from the false. But the reason for its nonadoption by enterprising impostors seems to be that it is not sufficiently demonstrative. Their circumstances are such that they must force the knowledge of their insanity upon the people about them: they cannot afford to wait until it is discovered, and it is somewhat lucky that this is so, for it would in many cases be most difficult to prove the deception. In many of the forms of partial intellectual mania, 1286) as we have before shown, irresponsibility should not be admitted; and in cases in which the delusion was connected with the crime of which the individual is accused, or where the melancholy is so profound as to deprive the accused of any power of choice; in such cases a careful observation by medical men, extending over a considerable portion of time with a view of marking the progress which the disease, if unfeigned, will make in one direction or another, would not fail to discover an artifice, if it exists, or to establish the fact of real disease. In all cases, the family and individual history, if it can be ascertained, will afford some presumption which will be of use in the investigation.

2422. Feigned Moral Mania.-In moral mania, which, according to Hoffbauer, "may exist uncomplicated with mental delusion, and is, in fact, only a kind of mental exaltation (tollheit,) a state in which the reason has lost its empire over the passions and actions by which they are manifested to such a degree that the individual can neither express the former nor abstain from the latter"- in this kind of insanity, where the chief ground for believing in the existence of mental unsoundness is the character of the acts committed, and very often nothing more than the character of the single act of which the criminal is accused, the difficulty of distinguishing what is real from what is feigned is exceedingly great. Up to the present time courts of law have been very unwilling to admit moral mania, as proved only by the quality of the act of which the individual is accused, as a good plea in criminal cases; and it has done so upon what seems good grounds. That a criminal act may be the first symptom of insanity is true, but that the brutal quality of the act should be admitted as sufficient proof that it resulted from an insane impulse is absurd. The science of evidence may be superseded in time to come, but while it is still looked upon as a science, and still regarded as the only guide in the decision of all questions of criminality and responsibility, not to say, what would be true, all questions in life, to allow the act itself, with which an individual is charged, to be an all-sufficient proof of the insanity of the accused, is impossible. It may be true that the man is mad, as in many other cases it is true that fatal blows have been struck in self-defence, but, as in the latter case, if the self-defence could not be proved by facts other than the deed, so in the former case the insanity cannot for a moment be permitted to be proved by the atrocity of the crime alone. The result of the admission of such a doctrine would be to add to the atrocity of every crime; and an individual who wished to commit murder on a neighbor would, to secure his immunity from punishment, cut a few more throats. It is, however, in many cases, unlikely from other circumstances, that a sane man could commit a crime without any motive: it is certain that no sane man does anything without a motive, and, although the motive may not be good, it is invariably rational. Where, therefore, these cir

cumstances can be and are brought out, as in a case where an individual in a good position in society, in circumstances which would lead most men to live easily contented, suddenly kills another, never having seen him nor communicated with him before, by whose death he is in no way advantaged, and from the consequences of whose death he sees no probability of escape; in such a case, even although there may be no delusion, the presumption of insanity is very strong, and upon suitable medical testimony the individual ought to be held irresponsible. Such cases, however, will not fall under the notice of him who is studying feigned insanity, and if capability of judging of motive is looked at as the only guide in deciding all questions of responsibility, although an occasional error may be committed, as in all other inquiries, few persons will escape from punishment by simulating moral mania, unless they are very vigorously seconded in their efforts by injudicious medical gentlemen.

CHAPTER XXII.

CONCEALED INSANITY.

423. Concealed Insanity.-288] Insane persons are very often influenced by motives just as the sane are. In many instances, the motives which influence them are utterly mistaken, and sometimes have no objective existence; but at other times they are influenced in precisely the same way that persons in possession of their reason are. If you laugh at a lunatic on account of his delusion, you may not succeed in eradicating the erroneous belief, but you may succeed in making him conceal its existence. On a similar principle to that expressed in the proverb which says that "a sin hidden is half forgiven," it might be thought that "a delusion concealed was half cured." But although in some cases the concealment would indicate a progress towards recovery, in others the secrecy is a part of the disease. But not only will the fear of ridicule induce insane people to feign sanity, but other fears, such as that of being put in an asylum, or being deprived of the management of their affairs, will influence these persons to conceal those symptoms which they have learned that others account indications of insanity. Of course, the maniac will rave, the idiot will drivel, and the dement will stand and stare. In such cases, there can be no concealment. It is only in those cases where the disease is less virulent that any efforts at concealment will be made, and in such cases efforts may be made with so much ingenuity and ability as to deceive many persons who are intimately acquainted with the characteristics of mental disease. Even experts have been hoodwinked by clever lunatics.

2424. Delusions are often Concealed.-That this would not be difficult to do in many cases is evident. Where the