A Case of Moral Insanity With Repeated Homicides

8/2/2019 A Case of Moral Insanity With Repeated Homicides

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A C A SE O F M O RA L IN SA N ITY W ITH R EPEA TEDH O M IC ID ES A N D IN CEN D IA R ISM A N D LA TE D E -V E LO PM EN T O F D E LU S IO N S .1

B y H EN R Y R . STE D M A N , M . D. , B R OOKL INE , MASS.O n O cto be r 30 , 1901 , J. T ., a p ro fe ssio na l nu rse , abo u t fo rty -

five years of age, single, and born in th is cou n try , w as a rres tedon th e charge of murdering Mrs. M . G . a t C at au me t b y p ois on in g,on th e 13 th o f th e p reced ing A ugu st. T he re w as su ffic ien t g ro undfo r be lie f th a t sh e had a lso fa tally p o iso ned , w ith in th e p reced ingsix weeks, an entire family of three persons who w ere rela ted toM . G . Th e duration of the las t illness o f M rs . M . G . w as no tov er s ix teen hou rs. T he sym ptom s, w h ich w ere sim ilar in a ll thecases , w ere tho se o f n arco tic po ison ing . M . G . w en t unexp ec ted lyin to a som nolen t con d ition from w hich she cou ld n o t be rou sed ,and com a and d ea th soo n fo llow ed . T he re lativ es w ho , a s it w asbe liev ed , m et dea th a t J. T .s hand s w ere M r. and M rs. A . P . D .,her father-in-law and his wife, and Mrs. H . G ., th eir d au gh te r , ona ll o f w hom she had been in constan t atten dance from the firs t.

Mrs. D . d ied on July 4 , a fte r an illne ss o f eleven days. T hei ll ne ss w as c ha ra ct er iz ed by in term itten t com a, o ccasion ally deep .In the intervals: drowsiness w ith occasio na l rou sing u p and pa r-tia l co nsc iou sness. P up ils co n trac ted , bu t no t f irm ly , w ith d u lleds en si bi lit y to lig h t. O n on e o ccasion im provem en t w ith ratio na l-i t y, s u cc e ed e d by profound coma and death .

Mrs. H . G ., w ho d ied July 31, was ill ten d ay s o r tw o w eek s,w ith sim ila r sym p tom s. S h e becam e du ll and stu p id , m opedaround the house, and finally went to sleep and never woke up.

M r. D . d ied A ug . 9 , a fte r an illne ss o f seven hours in w hichsomnolence predominated, and complete unconsciousness rapidlysupervened.

T hey had a ll been in g ood hea lth be fo re th e ap pearance o f these

R ead A p ril 2! , 1904, be fo re the B osto n Soc ie ty o f P sy ch ia try andN euro log y , an d the A m . M edico -P sycho lo g ica l A ssn , M ay , igo

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27 6 A CA SE O F M ORAL INSAN ITY [Oc t .

sym ptom s. Th e nurse had fo r yea rs been o n an in tim ate foo tin gw ith the fam ily , w ho w ere a ttached to h er an d regarded her aso ne o f th em se lves. H er se rv ices w ere offe red a t som e sugg estionof hers o r the irs regard ing triv ia l a ilm en ts, rea l o r fanc ied . Sh eg av e en em ata free ly , an d o ften adm in is tered m ed ic ines in tha tway .

Th ese short and fa ta l illn esses , so m uch a like and o f such anunusua l n a tu re , occurr in g as they d id , o ne after ano ther, in th espace o f a few w eeks , f in ally aroused su sp ic ions of fo u l p lay ,w h ich na tu ra lly cen te red in J. T . w ho had nu rsed and dosed thev ictim s , and h ad on ly sum m oned th e p hys ic ian w hen they w erea t the po in t o f d ea th . Tha t she w as w e ll aw are o f the sen tim en tag a in st he r the re is no room fo r d oub t, as she w as no t o n ly p o in t-ed ly q uestioned on the sub jec t by severa l pe rson s bu t w as ac tua llyto ld by a re lativ e o f o ne of the deceased th at she w as su spec ted ofcau sing the d eath s. N o tw ithstand ing th is , w e find he r in he r o ldhom e on ly a fo rtn igh t la te r in L . in attend ance o n M rs. B ., an o ldlady and friend , w ho is sud den ly an d unexp ected ly taken ill soo nafter J. T .s a rriva l, and d ies w ith in fo rty -eigh t hours o f the f irs tappearance of a tra in of sym ptom s c lo se ly resem bling tho se in thecase of M rs. M . G . The an alys is by D r. E . S . W ood , p ro fe sso ro f chem istry at the H arva rd M ed ica l Sch oo l, o f th e o rg an s o ffo u r o f the b od ie s rev ealed the p resen ce in each of m o re thansu ff ic ien t m orph in e to cau se d eath . In th e.live r o f the o th er b ody ,th at o f M rs. D ., h e fou nd v e ry d istin ct trace s o f m orph in e. Itw as the o n ly o ne n o t em balm ed , and as it h ad been buried n ea rlyfou r m on th s the o rgans w ere in an adv an ced s tag e o f d ecom -posi t ion .

O n e of th ese p erson s h eld a no te o f J. T .s to the am oun t, it isrepo rted o f seve ral h und red do lla rs . S he w as a lso accu sed afte rh e r a rres t o f hav ing sto len from th ree o f the o the rs , sum s ofmoney w hich w ere m issed a fte r th eir death s, b u t the re is no proofo f the tru th o f th ese ch a rges. T he re w as no su sp ic ion o f the ftfrom the o the r v ictim , and in the sea rch fo r a m otiv e in he r casea th rea t o f ex posu re w as adv an ced by the re la tive s. W h ile M rs.B . w as in th e m ids t o f h er illne ss a de tec tive called at the ho use ,and in th e room below the sick cham ber questio ned 3 . T . a t leng thabou t the d ea ths o f he r las t fo u r pa tien ts , o s ten sib ly w ith thev iew of fa sten in g th e g u ilt o f m u rd er upo n ano the r pe rson .


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1904] HENRY R . ST EDM AN 27 7

T hroughou t the en tire in te rv iew she w as calm and self-p osse ssed ,show in g no trace o f an x ie ty and talk ing free ly and p lea san tly .S he m ad e no a ttem pt to im p lica te o the rs . N o t lo ng afte r th is sh eto ld one o f he r friend s tha t a s tate d etec tive had to ld he r tha tshe w as susp ec ted of the c rim es an d m us t p rep are to de fendherself .

S h e rem a ined h ere abou t a m on th , en te rta in in g he r fr ien ds,-.in th e m ean tim e w riting th e phy sic ian o f on e o f he r C a taum e tv ictim s, I h ave been tak ing m y vaca tion and am w illing to com eb ack any tim e fo r a case . O n Sep tem ber 29 an d 30 , 1901, sh em ad e tw o a ttem p ts to p o iso n h erse lf, p rob ab ly w ith m o rp h ine , thela st an app aren tly de te rm ined one . A n em etic g iv en a fte r an hou rand a h a lf w as fo llow ed by retu rn o f con sc iousn ess. S h e g avela ter , a s he r rea so n fo r these a ttem p ts , th at she w as jea lous anddesperate because a man of seven ty years , a conn ec tio n of M rs.

w as ve ry a tten tive to one w hom he has sin ce m arried . A s afina l attem p t to indu ce h im to b reak o ff th is in tim acy J. T . w ro teh im , from the loca l h osp ita l w he re sh e w as sen t im m ed ia tely a f terth ese attem p ts , an absu rd and ab usiv e le tte r in w h ich she accusedh im of b e ing the fa th er o f h er unb orn babe .

A fte r leav ing the ho sp ita l sh e m ade a v is it to som e fr ien ds ina ne igh boring sta te, o f w h ich she has late ly w ritten : I n eve rev en th ough t o f the inv estig a tio n abo u t the m urde r w hile at A .un til I w as a rre sted . I w as h av ing a fine tim e ou t the re. I d ontth ink I ev er en joyed m yself a s I d id tha t fa ll. T he re w as a jo llylo t o f peop le th e re , and I had th e k ind of tim e I lik e to have . Irem em ber pe rfec tly w e ll th e d etec tive read ing the w arran t an dsay in g , I hav e com e to a rre st you fo r the na rco tic po ison in g ofM rs. G ., an d ev en th en I can no t th in k it m ade m uch im pressiono n m e. Th e funn ies t th in g abou t it w as tha t I w as ann oyed be -cause the d etec tive in sis ted on rem a in ing in m y room w hile I w asgetting ready, and I di d not th ink it w as v ery gen tlem an ly . S heleft the house, on he r arre st, w ith p erfec t com posure and w itho u tthe sligh tes t rem onstrance. O n th e long tr ip to the jail sh e w as a tf irs t tho ugh tfu l, b u t la te r talk ativ e and in go od sp ir its . S h e ta lkedfree ly to th e o ff ice rs ab ou t h erse lf, and seem ed en tire ly w illing ,then an d a t the jail, be fo re see ing he r cou nse l, to adm it he r g u ilt,and show ed little o r no rea liza tion o f he r situa tion , a con d ition ofm in d w hich she m a in ta ined th ro ughou t he r im prisonm en t and


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27 8 A CA SE O F M OR AL IN SA N ITY [Oc t .

tria l. S he w as in d ic ted fo r the m urde r o f th ree o f he r C a taum etp a tien ts , bu t he r tr ial w as up on on ly on e coun t, th at o f the m u rde ro f M rs. G .

O n M arch 3 , 1902, ab ou t four m onths a fte r her a rrest, th ep ro secu tion and de fence effec ted an a rrangem en t w h ereby D r.G eo . F . Je lly , D r. Q u inb y and the w rite r w ere called up on to con-jo in tly exam in e an d report u pon the m en ta l co nd ition o f thep rison er w ith re ference to he r resp on sib ility . T hus the q uestionw as p rac tica lly su bm itted to a com m issio n at law , w h ich allow edthe exam ine rs free in terchange of op in ion s and im partial s iftin go f all o b ta inab le ev idence on bo th sides. In fac t, it reso lveditse lf in to a m ed ica l co nsu lta tio n on the d iagn osis o f a case o fa lleg ed d isea se . A m ore p rac tica l an d sa tisfac to ry m e thod , andone m ore in k eep in g w ith th e p rin c ip le s o f sc ien tific inqu iry , cou ldno t have b een chosen , and its adop tion by the a tto rney -gene ra l insuch an im portan t case w ou ld seem to b e a lon g s tep tow ard abo l-ish ing , in c rim in a l ca se s at lea st, the opposite an d cus tom ary p rac -tice w hich has d one so m uch to d isc red it exp ert op in ion .

Th e ev idence u pon w h ich ou r o p in io n w as ch ief ly based w as inp a rt fu rn ished b y th e p rosecu tion an d in p art co llected by ou r-se lves. S ince the pa tien ts com m itm en t o the r facts an teda ting he ra rres t have been brou gh t to ligh t, an d are he re in trodu ced fo rthe sake o f u n ifo rm ity and com ple teness.

H er orig ina l nam e w as H onora K elly . In 1863 , w hen abou t four yearso f ag e, she an d a siste r w ere p laced in a foun d lin g asy lum by her fa th e r,an eccen tr ic m an w ho drank hard to the tim e of h is dea th . S he h as tw oliv in g s iste rs; one , a respec tab le and cap ab le w om an som e y ears o lderw ho correspond s regu la rly w ith J . T ., the o th e r, a ch ron ic dem en t in one ofour s ta te asy lum s. A th ird s is te r w as adop ted b u t tu rn ed o u t o f d oorsw hen fou nd to have an illeg itim ate ch ild . S he led a d isso lu te life an dd ie d re cen tly .

W hen abou t s ix y ears o f age H ono ra w as appren ticed to M rs. T . o ninden tu re p ap ers, and to ok the nam e by w hich sh e h as since been know n.She w as g iv en a good educa tion , p ro v ing in te lligen t and qu ick to lea rn .M rs. T . b ro ugh t her up as a daugh te r and she w as m ade m uch of bythe fam ily . U n til J . T . w as a w om an sh e w as unde r g ood m ora l and re -lig iou s in flu en ces, hom e su rroun d ings and d isc ip line an d h ad good asso -c ia te s , bu t he r inco rrig ib le propens ity fo r dece it, fa lseho od and troub le-m akin g , neve r ab sen t from th e firs t, p ro ved too m uch to con ten d aga ins t,and h er m o the r f in ally re fu sed to a llow her to rem ain lon ger in the fam ily .


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1904] HENRY R . ST EDM AN 27 9

H er im po ss ib le ta les and her lie s, o ften sense less an d dogged ly pers is ted in ,desp ite pos itive proo f o f th eir fa ls ity , a re w ell rem em bered in the ne igh-borhood .

A t tw en ty -e igh t she b eg an her ca ree r as nurse by four years o f train in gan d se rv ice in tw o g en eral h osp ita ls. T here sh e sh ow ed m uch capab ili tyin the tech n ica l p art of her d u ties . S he knew how to take good care ofhe r p a tien t bu t d id no t lik e to w ork . A lthou gh no t o f attractiv e ap pea r-ance , sh e had a p lea san t m anne r, an d w as w ond erfu lly c leve r in ingratiatinghe rse lf w ith such p atien ts and phy sicians as sh e w ished to p lea se , and re-m ark ab ly sk ilfu l in escap in g th e co nsequen ces o f w ron g-do in g and in im -p lica ting o thers . H er hosp ita l life rev ea led her earlie r tendenc ies, bu taggrava ted in fo rm and m ore se r ious in resu lts by reason of the grea te roppo rtun ity fo r the ir exerc ise. A m ong the nurses, a lso , she m ade friends .O ne o f them sta tes , n ev erth e less, tha t she w as loo ked upon as queerand pecu liar by her fe llow -w o rkers because of h er u nfounded andabsu rd su sp ic ions , ta le -bearing , sland erous g oss ip an d con sequ en t m isch ie f-m ak ing , as w ell as h er p leasu re in inv en tin g fabu lous ta les. In severa l w e llau then tica ted cases she attem pted , by charges a fterw ards fo und to befalse , to p rocure the rem ova l o f pa tien ts from th e in stitu tio ns, and suc-ceed ed in tw o ins tan ces . [In conn ec tion w ith on e o f these cases sh e w ro teon e of the pa tien ts friends , w ho had m et her on ly casua lly , a pecu lia r le tte r,sta ting th at as he h ad m ade in qu iry abou t her fam ily (w hich he had no td one), tha t she w as q u ite w illing to tell h im tha t her b ro ther w as in aninsane asy lum . S he then w en t fu lly in to her fam ily h isto ry .] O n the o therhand , she is k now n to have pro lon ged the illness o f favorite pa tien ts w homsh e w ished to keep in the ho sp ita l, by reporting sym ptom s tha t d id n o tex is t an d fa lsify ing tem pera tu re record s. In o ther cases sh e recorded fa lsetem peratu re s fo r no obv ious rea son . D u rin g he r te rm of se rv ice a t o neof the hosp ita ls m any articles w ere m issed : sum s o f m oney , s ta tionery ,ap ro ns, u n ifo rm s, e tc., and sh e w as suspec ted of s tea ling th em , bu t he rfriends sp oke so w ell o f her and she w as so adro it tha t th e su sp ic ion w en tno fu rthe r, in sp ite o f the ev id en ce aga inst he r. In adm in is te ring m edic in essh e w as ex trem ely reck less an d frequ en tly gave la rg er d oses than h ad b eenprescr ibed . E ven at tha t tim e sh e w as o ften hea rd to say th at th ere w asno use in k eep in g o ld peo p le a live (a favo rite sen tim en t w ith her s ince).She w as a lso fond o f a sk ing ab ou t po iso no us d rug s an d the ir an tid o te s .

In v iew of th e lo ng w ake of sudden and m yste rious dea ths o f pa tien ts ,w hich fo llow ed th is w om an th roug hou t he r ca ree r a s a n urse , the fo llow -ing in cid en t o f he r h osp ital life is a t lea st w o rth y of p assing no tice . M issD ., a nu rse , w ho had a sligh t illne ss , w as pu t un der her charge by dayand w as soo n se ized w ith sud den and ex trem e co llapse . B y m uch effo rt shew as brou gh t ou t o f dang er in the co urse o f the n igh t.- W hen J. T . cam eon du ty th e nex t day the sam e sym ptom s reap peared . A no ther n urse w aspu t in cha rg e an d the pa tien t recov ered . S om e tim e a fterw ard J. T . a sk eda head-nu rse if she had heard th a t M iss D .s con d itio n had been due topo ison .


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280 A CA SE O F M O R A L IN SA N ITY [Oc t .

S h e w as a t tha t tim e , and has often s in ce been , suspec ted of the o p iumhab it, becau se of her s trange conduc t. T h is is o f cou rse possib le , bu t ca re -fu l in qu iry , as w ell as lon g observa tio n of h er at tim es w h en such a prac ticeif p rev ious ly ind u lged in to a grea t ex ten t w ou ld h av e been revea led in thecharac te ristic sym p tom s w h ich fo llow sudd en depriva tion of the drug ,has fa iled to show any such ad d ic tion . M oreo ver, he r genera l co nduc thas since been the sam e o r m ore m arked in situa tio ns w here op ium -tak ingw as im possib le . N o tend ency to sexu al im m ora lity o r to d rin k ing hab itsw as ever no ticed in her so fa r as w e can lea rn .

S he w as d isch arged from both hosp itals , in one ins tance ju st as she w asabo u t to gradu ate from the tra in ing scho o l.

O n leav in g the hosp ita l she took up p riva te nurs ing in w h ich she w asfo r m any years very success fu l, in sp ir in g cer ta in fam ilies, no t a few o f themof h igh soc ia l pos ition , w ith co nfidence in her sk ill and affec tion fo r herse lf,in sp ite o f cau tion from physic ians w ho knew her record . S he w as grea tlyliked and trus ted by one fam ily w ho unsuspec ting ly em plo yed her a fte rthe d ea th of one o f the ir num ber at he r hand s. E xperienced an d ab lephys icians recom m ended her fo r a tim e on accoun t o f her capab ility . H erow n fr iend s w ho know her be tte r speak of her jealou s and v ind ic tive na tu rean d b ad tem per. H er con duc t w as con sidered s trange by no t a few -ju st in wha t w ay th ey canno t spec ify . A s to her p ro pensitie s fo r fa lsehoodone person repo rts : Sh e had an ex trao rd inary fac ility fo r inven ting liesand rem em bering the lies tha t she to ld o thers . A nother: S he is a con -s titu tion al and c lever lia r, b u t I d id no t f in d it ou t un til tw o years ago .H er pass io n fo r troub le -m ak ing fo r its ow n sake , by carry ing ta les true andfa lse and ins id io usly fom en ting enm ities fo r no apparen t reason , th oughfar less read ily and g en erally rea lized than w hen sh e w as a t the hosp ita l,cam e gradua lly to ligh t. She borrow ed m oney from patien ts o r the irre la tiv es w h ich she n ev er rep aid and , a ltho ugh sh e earn ed a g ood liv ing ,had m any d eb ts , w h ich , how ever, gave her little concern . O ccas iona lly ,sm all sum s of m oney and articles o f c lo th ing d isapp eared w here sh e w asem plo yed , bu t she w as ra re ly su spec ted and never de tected in the ft no r,to ou r know ledg e, d irectly accu sed of it. A ccep ting h er g u ilt in th is re -spec t a s p ro ven , how eve r , the fac t tha t, excep t in a few in stances , theyw ere all pe tty th efts , and th at in m any cases no th in g w hatever w as m iss ing ,p la in ly sh ow s tha t m oney ga in w as no t a con tro lling m otive fo r h er hom i-c id es. S he u ndoub ted ly pro longed som e cases fo r p ro fit, bu t on th e o therhand cu t sh ort m any tha t m ig h t have proved equa lly luc ra tive , by p o ison in gthe pa tien t. S he se t four fires , bu t gav e the a la rm and he lp ed v igoro uslyto p u t them out. Tw o w ere se t in th e sam e house in o rder to fr ig h ten anerv ous pa tien t an d re ta rd h er im p rovem ent. T he o thers o ccurred inco ttag es o f h er f rien ds.

H er genera l condu ct tow ard the end of her ca reer as n urse is sug gestiveof inc reasing dem o ra liza tio n . H er s to ries g rew m ore sen sa tiona l an d pre-po ste rous . S he cau sed , fo r exam ple , som e cons te rn ation by an u tte rlybaseless repor t o f a severe ep id em ic of typho id in a n eigh boring sem inary .


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1904] HENRY R. STEDMAN 281

She repeated ly m alig ned physic ians w ho had em plo yed h er to o the r ph ysi-c ians and to pa tien ts, and even critic ised th e m etho d of treatm en t in thep resence of phys ic ian and pa tien t. In sp ite o f th is, she reta ined to th e lasta num ber of f rien ds w ho tho rough ly b elieved in her.

W e have a lso been ab le to sa tisfy ourse lves tha t to c row n th is ca ree rof c rim e and d iso rdered condu ct J . T . com mitted 20 homic ides , 12 of w hichshe adm itted a t the tim e of ou r exam ina tion . W hile in ja il she m ade alis t o f 3 ! o f her v ic tim s , fo r h er co unse l, g iv ing n am es and addresses o ro ther m eans of iden tify ing th em . H er s ta tem en ts regard ing the 20 homi -cides a re abundan tly verified in 4 b y th e charac te r o f the sym ptom s an dby au top sy ; 12 are su ffic ien tly p rov en by carefu l accou n ts o f th e tra in ofsym p tom s m agnan im ous ly an d free ly g iv en the w rite r by the attend ing phy -sic ian in each case , w h ich w ere in every in stance bu t on e charac ter is tic o fnarco tic po ison ing , and w hich they n ow agree to h ave b een the cause o fdea th ; and 4 have b een fu lly , an d w e be liev e fa ith fu lly , desc rib ed by im -m edia te re la tive s. O f th e ii dea ths reported by her, ab ove th is num ber , 4a re y et to be inv es tiga ted , bu t seem susp ic iou sly like the o the rs in caus-a tion ; in 2 the w h ereab ou ts o f the fam ily are now unknow n; w hile in 5th ere is to o m uch unce rta in ty as to the p recise cause o f dea th to w arran tinc lud ing them am ong her v ic tim s . S pace w ill no t adm it o f fu r th er de-sc rip tio n of th ese cases . T h e m anifesta tio ns w ere s trik ing ly sim ila r. A llb u t on e of th e cases -in w hich s trychn ia w as p la in ly th e cau se of d ea th -show ed a ll o r m o st o f the fo llow ing sym p tom s: d row siness, fu ll, s low pulse,co n trac tion of p up ils, ste rto rous b reath ing , cy an osis and slow resp ira tion .A no t in freq uen t fea tu re w as the su bsidence o f the com a for o ne o r m orein te rva ls , an d the pa tien ts re tu rn to fu ll o r partial co nsc iousness un tilf inal ly pu t to dea th . A num ber o f he r v ic tim s w ere pa tien ts o f one o f h erch ief b en efacto rs and inc ludes on e o f h is co nnec tions .

A m ong h e r effec ts a m uch-w orn tex tbo ok on po iso ns w as foun d w hichfe ll open a t the chap ter on o p ium .

A t ou t firs t in terv iew a t the ja il, sh e seem ed fo r a tim e som ew ha t se rio usan d d istru stfu l, bu t soo n b ecam e a t ease an d ta lked free ly , vo lu b ly andin te lligen tly . S he appeared qu ite ind iffe ren t to her situa tion an d seem edto rega rd ou r visits ch ie fly a s p lea san t b reak s in he r m ono tono us life . H e rta lk w as m ore o r le ss ram bling and rath e r irre lev an t. H e r u tte r m endac ityand d isp osition to speak slu r rin g ly of even h er b es t f rien ds and to makeaccusa tions aga in st them , a lm os t w itho u t excep tio n -to pra ise one m inu tean d b lam e the n ex t-w as very m ark ed . W e the re fo re so on found tha t w esho u ld be ob lig ed to depend la rg ely fo r ou r o p in io n u pon fac ts ob tain edfrom oth ers , accep tin g as true on ly such o f h er s tatem en ts as w ere corrob -o ra ted by re liab le ev id en ce .

S h e to ld m any ta le s w h ich w e knew to b e shee r inven tions, am ong them ,a sto ry o f h e r pa ren tag e, he r a lleged fa the r hav ing in rea lity lived inChina for tw o years im m ed ia te ly preced ing her b irth ; ano ther, o f her ho rro ro f the dead w hich w as so grea t tha t sh e som e tim es fe ll sen se les s a t the


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28 2 A CA SE O F M ORAL IN SAN IT Y [Oc t .

s igh t o f dead b od ies, even those tha t had d ied a na tu ra l d ea th , the fac t b e in gth at she had often la id ou t b od ie s w ith he r ow n hand s as a m a tter o f cou rse .H er a ttem pts a t su ic ide she n arra ted w ith g lee , b u t adm itted tha t the las tw as a seriou s o ne , and fo r the m o st part adhered to her sto ry th at jea lousyha d prompted them . Sh e a lso stou tly d en ied tha t she had eve r sto lenany th ing or b een d ishon es t in m oney m a tte rs , a ltho ugh adm ittin g tha t sheh ad fa iled to repay loans of m oney and tha t sh e had alw ays been s lackan d m ixed up in m oney a ffa irs . A t firs t she d en ied a lso tha t she w asgu ilty o f th e h om ic id es w ith w hich she w as charged , bu t fina lly , and by nom ean s unw illing ly , co nfessed (a lthou gh adv ised no t to inc rim ina te h erse lf)tha t she h ad po isoned tw elve p a tien ts and had m ade tw o unsuccessfu lattem pts to po iso n o thers. S he a lso adm itted tha t sh e h ad set fo ur fires,tw o of th em at the residence of a p atien t u nder her charg e. S he to ld ofth e d ea ths w ith ca lm ness , add ing eu log is tic rem arks. T he po isono us agen tem ployed w as , accord ing to her sto ry , a lw ays m o rph ia , occas iona lly com -b ined w ith a fa ta l dose of a tro p ia . S he cou ld no t rem em ber the de ta ils ina ll cases becau se , as she rem arked , po ison ing had b ecom e a h ab it o f herlife.

[The fac ts: first, tha t he r favo rite m eth od of adm in istra tion o f th e d rugw as in H unyad i w a ter o r by enem a ta because th e drug co u ld in th ese w ay sbe g iven w ith ou t the k now ledge o f the pa tien t; second , tha t w h en possib leshe d id no t sum m on the phy sic ian un til th e v ic tim w as m or ib und : andf in ally , tha t she som etim es so com b in ed d rugs in k in d and pro portion tha tth e ir resu ltin g ef fect w as an unusu a l and perp lex ing se t o f sym ptom s,m ade it m o st d ifficu lt and in som e ins tances im possib le fo r th e ph ysic ianto asce rta in the tru e na tu re o f th e p atien ts illness . A requ es t fo r anau topsy by the phys ician , m oreover, invariab ly m et w ith re fusa l th ro ughJ. T .s v igorous oppo sition to the su ggestion . T h is accou n ts in la rg e m eas-u re fo r her long im m unity from detection , an d it seem s probab le tha t ifshe h ad no t, in her inc reasing m enta l dem ora lization , so fa r abandonedhe rse lf to he r c rav in g fo r po ison -g iv in g as to pu t to d ea th w ith th e sam edrug or d rugs fo ur pa tien ts in on e fam ily w ith in fo rty days, m any m orev ic tim s m igh t have been added to th e list.1

In p lan n ing an d carry ing o u t her hom ic ida l ac ts sh e w as , she asser ted ,a lw ays ca lm and c lea r-h ead ed . A fte r adm in iste ring the po ison she a lw aysexp erien ced grea t re lie f and w en t to b ed and slep t sound ly . In one caseshe is know n to h av e taken to bed w ith her the ch ild o f her v ic tim afte radm in is ter in g th e fa ta l dose , an d in ano ther, accord ing to her sta tem en t,she lay on the bed w ith the pa tien t w hom she h ad jus t po isoned and hada long s leep . W hen it w as too la te to undo h e r w o rk sh e w ould w orklike a T ro jan to save the pa tien t, altho ugh in o ne case , a t least, she to okth is op portun ity to repeat the dose and m ak e sure of her v ic tim . In tw oins tan ces she c la im ed to have been se ized w ith com punc tion , and le ft thecase a fter s en d ing fo r ano the r nu rse . O ne o f th e pa tien ts w as sav ed incon sequence . F or m uch o f th e tim e during th e in te rv iew s sh e m anifesteda lack of se riou sness and often a lev ity w hich w as in m arked co n tra st to


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1904 ] H EN RY R . STED M A N 283

w hat w as to b e ex pected of on e w ho had been bro ugh t to confess so m anyhe inou s c rim es . S he unders tood c lea rly th at she had done w rong , bu t d idno t m an ifest th e s lig h tes t s ign of r em or se for her c rim es, no t, a s it seem edto us , th roug h any sp irit o f b ravado bu t fo r the reaso n th at she d id n o tcom prehend th e eno rm ity o f her ac ts ; she pro fessed to ta l ind iffe rence asto the o u tcom e o f h e r tr ia l ex cep t tha t she p refe rred the priso n to theasy lum . E lec trocu tion ap paren tly had no te rro rs fo r her. W hen I try ,she sa id , to p ic tu re it, I say to m y se lf, I have p o ison ed M ., m y dearfr iend ; I have po isoned M rs. G .; I have po isoned M r. D . an d M rs. D .T h is does no t con vey any th ing to m e, an d w hen I try to sense the con d itionof th e ch ild ren an d a ll the co nsequ en ces I canno t rea lize w ha t an aw fu lth ing it is. W hy dont I fee l so r ry and g riev e o ver it? I canno t sense ita t a ll.

T he ques tio n as to w ha t p rom pted her ac ts w as the sign al fo r the sham e-less rec ita l o f a sto ry of sexua l exc item en t occurr in g in the p resence of ady ing p erson , as th e m o tive -a s ta tem en t w hich w as a ll the m ore s tar tlingby rea so n of th e ab sence of sexua l im mora lity from her h isto ry , so fa r a scou ld be asce rtain ed . F or a tim e w e w ere o f th e be lie f tha t irre sis tib lesexu al im pu lse m igh t be the rea l ex p lana tion of a t least som e of her ac ts ,b u t on fu rthe r exam ina tion , h e r rep resen ta tion s as to the na tu re o f th isim pulse and the cond itions a ttend in g it w ere foun d to be so co nflic tingand so at va riance w ith an y know n fo rm of sexu al pe rve rsio n th at fe ign in gw as suspec ted , and at th e las t in te rv iew , she adm itted , as s ta ted in our re -port, tha t she d id n o t kn ow w hy she k illed these peop le , and tha t it w asno t from desire to exp er ience sexu a l exc item en t. It w as fina lly apparen ttha t the sto ry w as a pretense th roug hou t, con co c ted , an d m ost un necessa rilyas it happened , in o rd e r to p rov e he r insan ity an d irre spo nsib ility by reasono f irre sis tib le sex ua l im pu lse . T he re seem ed to be a n ea rer ap proach to th etru th in the sta tem en t th at fo r a t lea st the yea r p as t she h ad been tem ptedto do a ll so rts o f c rim in a l ac ts, and d uring the p reced ing sum m er espec ia llyshe had le t he rse lf go . A m ong o thers she had s trong im pulses to se tf ires an d cou ld ge t no relie f from her fee lin g of uneas in ess bu t b y y ie ld ingto the tem pta tion . I t is a fact tha t w hen once they w ere sta rted , how ever,she w ork ed he r ha rd est to pu t them ou t. Sh e fin ally sa id , in reg ard to he rh om ic ides, I seem to h av e a sort o f para lys is o f tho ugh t and reason .S om eth ing com es o ve r m e, I don t k now w ha t it is . I h av e an uncon tro ll-ab le d es ire to g ive po ison w ith ou t reg ard to th e conseq uences. I h ave noob jec tion aga in st te lling m y fee lings , bu t d ont know m y ow n m ind . Idon t know w hy I do these th ings . T h e last s tatem en t ca rried an air o ftru th w ith it in the m ann er o f its te lling and seem ed to acco rd w e ll w ithh er gene ral m en ta l con d ition .

S o fa r from h av ing d elu sions o f enmi t y or pe rsecu tion , sh e spok e of m o stof her v ictim s as her friend s, and den ied any hos tility o n e ithe r her side orth eirs . In fac t, all ou r ef fo rts fa iled to revea l any th ing of the n a tu re o fd elus ion o r ha lluc ina tio n in her m en ta l cond ition at any of the in te rv iew s .H er behav io r a lso w as th e op pos ite ex trem e of tha t o f m o st p atien ts w ithco ncealed de lusio ns, w hose re ticence and d is tru st a re m ark ed featu re s.


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28 4 A CASE OF M ORAL INSAN ITY [Oct .

T he m a in po in ts in the sum m ary o f ou r o p in io n as to the p ris -on ers m en ta l con d ition , w h ich conc lud ed ou r report to the atto r-ney -gene ra l and coun se l fo r- th e de fen ce , w ere in substan ce asfo l lows:

i . T he prison er , J. T ., com es of a fam ily in w h ich in tem per-ance and m en ta l w eak ness an d d iso rd er are p rom inen t d is ea sefeatures.

2 . H er u tte r lack of m oral sense has b een ev iden t from ch ild -hoo d in he r in co rr ig ib le p roc liv ity to falseh ood , d ish onesty , m is-ch ie f-m ak in g , gene ral u n reliab ility and p rob ab le th eft. T he g oodm o ra l, m en ta l an d re lig iou s train ing w hich sh e rece iv ed in he ryou th re su lted in no m odif icatio n o f he r cha rac ter , and w ere p rac -tically th row n aw ay on h er in tha t re spec t.

3 . H er m ora l in sensib ility is fu r th e r ap pa ren t in the absenceof sense o f fea r be fo re, d u rin g or a fte r th e com m is sion of h ercrimes, an d of rem orse, so rrow or genu ine affec tion at any tim e.Th is d efect is even m ore fo rc ib ly show n by the fact tha t he r ch ie fv ictim s w ere h er espec ia l friends .

4 . H er lack of an y ap prec ia tion o f he r situ a tio n , he r lev ityu nd er such c ircum stances, and h e r inab ility to rea lize th e en orm ityo f he r deeds a re stro ng ev idences o f m en tal w eakness.

5 . T ha t an irres is tib le p ropens ity p rop e lled he r to c rim es o farson and m urder is show n by the grea t freq uency and varie ty ofsuch ac ts and he r co n tinu an ce in them , rega rd le ss o f co nsequen ces.

6 . There is an ab sen ce o f an y appa ren t m otiv e fo r he r cr im -in a l ac ts in som e cases , and inad eq uacy of m otive in m any of th eo the rs . Th is is sh ow 4l in the to ta l lack o f ev id ence of pecun ia ryg a in o r sa tisfac tion in rev en ge as a ru le, excep t m inor the fts an dtransien t enm ity . Th ese w ou ld be pow erless w ith sane c rim ina lsa s incen tive s to hab itu a l h om ic ide .

7 . The priso ners d isease -h is to ry and presen t m en ta l sta teco rrespo nd w ith a w ell-recog n ized fo rm of m enta l de fec t o f am oral ty pe du e to con gen ita l degene ratio n , in w hich th e re m ay b elittle o r no in te llec tua l d is tu rb an ce th a t is ap pa ren t to the o rd ina ryobserver .

T he re fo re , w e are o f the o p in io n tha t sh e w as in sane and irre -spo nsib le a t the tim e of the hom icid es w ith w hich she is ch arged ,an d is so now ; th at, he r di sea se be ing co nstitu tio na l, sh e w ill neve r


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1904] HENRY R. STEDMAN 285

recover, and tha t if eve r at la rge ag ain she w ou ld be a constan tm enace to the com m unity .T he sa lien t fea tu res o f th e case w hich ind ica ted m ore espec ially

ir respo nsib ility w ere: lack of m ora l und erstand ing , of na tu ral fee l-in gs and o f the o rd ina ry m otives fo r conduc t in clu d ing crim in alacts, a lso the g enera l ab sence in her o f su ffic ien t se lf-con tro l tores tra in her f rom crim e , and her d is regard of consequences asshow n , fo r exam ple , in co n tinu ing to po ison p atien ts in fu ll k now l-ed ge tha t he r gu ilt in o the r recen t ca se s w as su spec ted ; b y he rd esire to con fe ss h e r gu ilt a t th e o u tse t; he r in d iffe rence to herfate , e tc . T hese fac ts seem ed to u s to ev idence h er in ab ility , b o thto he lp do in g w hat she d id an d to b e affec ted by pun ishm en t, con -d ition s w hich are th e best te s ts o f accoun tab ility .

T he resu lts o f the an th ropom etrica l m easurem en ts and phys ica l exam -ina tion of th e pa tien t by D r. H . W . M ille r, pa tho log is t o f the T aun to nInsane H osp ital, a re as fo llow s:

P h ys ic al E x am i na ti on .- H ei gh t, ft. 3 in . ; w eigh t , 166 /2 lb s .A w ell d ev elo ped and w ell n ourished w om an . H air b lack , streaked w ith

g ray . C om plex ion som ew hat sa llow .C ra ni om et ri c E xa tn in ati on .- Cir cu m fe re nc e of head , .8 cm .; an te ro -

p oste rio r d iam ete r, 17 .8 cm .; g rea tes t tran sverse d iam ete r, 13 .6 cm .; cep ha licindex , 77 .6 cm . (sligh tly do lich ocepha lic ); n aso -occ ip ita l arc, 31 .5 cm . ;b regm ato -lam bdo id arc, ii.8 cm .; b inauricu la r a rc , 31 .5 c m.; b in au ricu la rdiameter , ii.8 cm .; fac ia l leng th , 11 .7 cm .; m id-fron ta l d iam ete r, 13 .5 cm . ;b read th be tw een pup ils, 6 .6 cm .; leng th of ea rs, righ t, 64 cm .; leng th o fea rs , le ft, 6 . cm . T hese m easurem en ts a re a ll w e ll w ith in phys io log icalva r ia t ions .

* The ab ility to d isc rim ina te be tw een rig h t and w rong as th e so le tes to f resp ons ib ility fa ils in th is case fo r the sam e conc lusive reason s th a t hav erendered it va lue less in a g reat m any o thers , and have caused it to be re -jec ted by a ll alien ists and m o st ju rists o f to -day . It takes no cogn izanceof the pow er o f p e rso na l re stra in t and inh ib ition . A n in san e p e rso n , a s allpsych ia tris ts kn ow , m ay know rig h t from w rong in the abs tract, m ay under-stand tha t a ce rta in act is un law fu l and w icked , bu t m ay be u nab le to con-tro l h im se lf th roug h w eakened w ill pow er (th e resu lt o f hered ita ry defec tor d isea se ), o r w hen goaded to despe ratio n by persis ten t de lus io ns and ha l-lu cin ations . In fact, the cases o f insane cr im ina ls in w hom th e re is n oknow ledge of righ t an d w ro ng o r w ho do no t know the n atu re an d qu alityo f the ac ts they com m it a re very few indeed . -(M cPherson .) It w as on eof th e h ighest lega l au tho ritie s o f E ng land , Lo rd C hie f Justice Cockburn ,w ho dec la red tw en ty years ag o th at the p ow er of se lf-con tro l w hen d e-s troyed or susp en ded by d isease w as an essen tia l e lem en t o f respo nsib ility .


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28 6 A CASE O F M O RAL INSAN ITY [Oc t .Ear s : de ta il w e ll de fined w ithou t s tigm ata .E yes: b row n , pa lpebra l fissu re o f norm al w id th . N o lim ita tion of norm al

field.Pa la te : low and broad bu t sym m etrica l.N ose : no dev ia tio n or anom aly .T ee th : fa lse set in u pper jaw , th ose in low er jaw reg u lar .N o fac ia l asym metry .E x trem ities : sym m etrica l. F orea rm s , 40 .2 cm . f rom elbow to tip o f

m idd le finger. M idd le fing er, 10 cm . o n bo th hands , la st ph alanx of thum b3 cm . on bo th th um bs . Th e little fing er on each hand is flu sh w ith the las tjo in t o f the th ird finger. F inger na ils norm al.

N o gen eral body anom alies .S pec ia l sen ses: hear in g acu te ; sm ell an d tas te norm al; s ig h t un im -

pa ired ; co lo r -sense k een .G enera l sensory co nd itio n : E x am in ation of tactile , pa in , p ressu re, and

m u sc le -sense offe rs no ab norm ality .N o erro rs o f m otility .N o trop h ic d istu rbances .G en era l fee ling o f w e ll-b e ing .Reflexes: no th ing of sign ificance . K nee jerk s: sharp . N o rm al p lan ta r

flex io n . Pu p ils eq ua l and regu la r, reac tin g prom ptly , d irec tly , an d consen-sua l ly .

A few trem ors o f tong ue and ex ten ded fingers w ere presen t a t tim eof exam ina tion b u t w ere tran sien t.

R esp ira to ry and c ircu la to ry system s revea l no th ing of no te .A bdom in al o rgans h ea lthy .M ens tru a tion irreg u la r fo r tw o y ears (ev ery tw o w eeks) . P rev io us to

tha t every four th w eek .

W hatev e r v iew m ay be taken of th is rem arkab le case , the re canb e n o qu estio n tha t the m o ra l m on ster th us far dep icted is astr ik ing illu stra tion of so -ca lled m ora l in san ity , a cond ition d e-sc r ibed in m os t w orks by reco gn ized au tho ritie s , from P ritch a rdto K raepe lin an d Wern icke , as a p ro bab le fo rm of m en ta l d isea seo r d efec t. Its ex istence as a defin ite m orb id cond ition has beenrepea ted ly q uestioned , an d its nam e critic ised as inadequa te andincorrec t . M oral in san ity , how eve r, h a s so fa r he ld its ow ntha t a ll a lien ists o f to -d ay recog n ize tha t the te rm m ean s a certa incond ition or k in d of m en ta l abnorm ality w hich is . cu i g en er is . Itf its no o ther fo rm of m enta l un sou ndness. T he p rogress o f psy-ch ia try has seen so m any no so lo g ical te rm s d iscarded tha t it isrem arkab le tha t m ora l in san ity shou ld rem ain an d flourish ,thu s d em onstra ting its p rac tica l u tility as a te rm and its real va lue


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1904] HENRY R. STEDMAN 28 7

as a m o rb id m enta l cond ition . M o ra l im bec ility , a m ore accur-a te d es igna tion in som e resp ec ts an d in use by certa in au tho rs,app aren tly has no t been fou nd su ffic ien tly desc r ip tive o f eve ryg rad e of m o ra l lun atic to secu re gen era l ad op tio n . T he tru eund erstand in g of m ora l in san ity has been greatly obscu red b y co n-fo und ing it w ith pure ly sym ptom a tic co nd itio ns, syn drom es andstages o f o the r fo rm s o f m en ta l d isease ; fo r ex am p le , th e m ora lob liqu ity u naccom pan ied by app aren t in te llectu al pe rv e rsio n w h ichsom e tim es occurs a s a d istin ct s tage o f d em en tia p recox , o r a s anequ iv alen t o f th e m an iaca l ph ase o f m an ic -dep res sive insan ity ,o r a s th e p rodrom al stage o f gene ral pa re sis .

M oral in san ity b elo ngs to the g roup know n as in san ities o fdeg en era tion , and is b ette r te rmed deg enera tive insan ity o f th emo ral typ e . I t sh ou ld be ex clu sive ly re se rved to d esig na te aco ngen ita l, p r im ary , co nstitu tiona l and p erm anen t m en ta l con d i-tion a ffectin g the m ora l na tu re and unassoc iated w ith ev iden tin te llec tua l im p airm en t. T hese pa tien ts have g ood m em o ry andund erstand ing , ab ility to reason an d co n trive , m uch c leverness andcun n ing , an d a gene ra l app ea ran ce o f ra tiona lity , coex isten t w ithv ery deficien t con tro l, ab sen ce o f m ora l sense and hum an sen ti-m en ts and fee lin gs, pe rv erted an d b ru tal in stin cts , an d propens itiesfo r c rim ina l acts o f va rio us k in ds w h ich m ay be pe rp etra ted d elib -e ra te ly and c leve rly p lann ed , y e t com m itted w ith little o r no m o-tive and reg ard le ss o f th e con seq uences to them se lves an d o th ers .Th is la tter p o in t is im portan t a s ind ica tive o f a pe rv ersio n of th efu ndam en ta l in stinc t o f self-p re se rva tion (K ello gg) . In th e irgene ra l con duc t, a lso , th ese in d iv id ua ls a re ra rely in flu enced bythe sam e m otiv es tha t g ove rn sane p eo p le , w he the r c rim ina ls o rno t, an d it is o ften d ifficu lt to see w h at the m otive is . T h ey com -m it c rim e fo r c r im es sak e . E squ iro ls rem ark tha t c rim e isa m eans fo r the c rim in al and th e en d fo r the lun atic , is e sp ec ia llyapp licab le to th ese cases . In J. T . m ost of th e cla ssic m an ife sta -tion s o f the d isea se a re typ ica lly and fa ith fu lly rep ro duced . T ha tno ne of th e phy sica l s tigm a ta o f d eg en era tion shou ld be pre sen tis no tew o rth y bu t no t excep tion al, a s L om bro so , fo r exam p le,f inds anom alie s o f th e c ran ium and phys iogn om y absen t in 58 pe rcen t and 64 p er cen t o f m o ra l lun atic s , re spec tive ly . O f th at d is-

L H om m e C rim ine l. (T r. from the Ita lian .) 189 5 . V ol. ii, p . 8 .


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28 8 A CA SE O F M ORAL IN SAN IT Y [Oc t .

tinc tive and nega tive featu re o f the d isease, the a lm os t com ple teabsence of in te llec tua l im p airm en t, H ack T uk e4 goes so fa r a s tosay , I t is pe rfectly ce rtain th at it m ay be p rac tica lly im possib le tode tect the in te llectu a l f law , an d ye t a ph ysic ian m ay be driven todec ide tha t a pe rson is in sane , and it is a recogn ized fac t tha t,w h ile a few o f th is cla ss fall sho rt o f the ave rag e ind iv idua l in in -te lligence , m any a re fu lly u p to it an d a lim ited n um ber even su r-pass it. O the rs u rge , an d our exp e rience in clin e s u s to ag ree , tha tca re fu l in vestiga tion w ill a lw ay s revea l in te llectu al in vo lv em en t ingen u ine cases, soon er o r la te r, and such pa tien ts ce rta in ly sha resom e tra its in com m on w ith the im bec ile ; w itness th eir cha rac te r-istic prop en sity , w h ich seem s to be a n ecessity from w h ich th ey canno t escap e, fo r te lling purpose less lie s and , like ch ild ren , inven tingfab u lou s ta les . Th is is m arked in J. T ., bu t still m o re in th is lineo f m en ta l d e fec t is he r in na te an d irresis tib le ben t fo r tro ub le andmischief-making which she fina lly ca rr ied to such an ex ten t as tod elibe ra te ly a liena te her friends and ben efacto rs am ong phy sic ian s-a w eakm inded sense le ssness o f con duc t w h ich show ed fata l d is-regard of h e r ow n in te re sts . If he r friend s w ere b lind to he rg lar in g fau lts and dangerou s propens itie s it is ha rd ly to b e w on-dered a t tha t they sho u ld fa il to recogn ize tha t u nderly ing in te l-le ctu al d efect [in m ora l in san ity ] w h ich , to q uo te W estph al,is o f a pecu lia r k ind , is o f ten con cea led under a m ask of p er -verted m o ra l sense and requ ires tim e and pa tien ce o n the pa rt o fthe p hysic ian fo r its de tec tio n . J. T .s fund am en ta l in tellec tua lw eakn ess is fu rthe r and strong ly em ph as ized in he r ho sp ita l h is-to ry , a s w ill be seen .

B u t in w ha t respect th is ca se an d o the rs o f its c la ss d iffe r fromm ere c rim ina lity is , o f co urse , th e m a in q uestion . W e can , at thesta rt, read ily e lim in ate the o ccasion al cr im in al, th e c rim in al byp ass ion , the hab itua l, p ro fe ssion a l c r im ina l; bu t to d ifferen tia teb etw een the m ora lly insane and the instin ctiv e c rim in al, e spec iallyin th e ligh t o f Lom b roso s ex positio n o f the ir ana log y , is a d iffi-cu lt m a tte r. It is this question tha t is and a lw ays w ill be a ba ttleg ro und fo r the c rim ino lo g ist, the alien ist, and the ju r is t, in sp ite

D ic t. P sy cho l. M ed ., p. 81 4M cPh erson , M en ta l A ffection s, p . 301 .

B en . k lin . W ochensch rif t, 18 78 , N o . i5 .


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1904] H EN RY R . STED M A N 289

o f Lom broso s conc lu sion th at bo th v iew s a re r igh t and th at theya re on e and the sam e th ing . To our m ind th e v ery te rm im plie s am en tal f law , fo r w h at is in stin ctiv e c rim ina lity bu t pe rv erted in -stinc t, th e v ery na tu re o f w h ich has m ade these pe rso ns lifelo ngenemies to so cie ty , and has rende red im poss ib le a na tu ra l m anne rof fee ling and ac ting , to the ex ten t tha t in sp ite o f good educa tio nand env ironm en t, h ab itu ally w ro ng co nduc t and ac tua l c rim e be-com e righ t to a ll in ten ts an d purp oses and the ru lin g princ ip le o f -life? It seem s to u s to re so lv e itse lf in to a questio n o f deg ree , andif Lom broso an d h is sch oo l shou ld gaug e instin ctiv e c rim ina lityby th e p rop ortiona te ex ten t in each o f these in d iv id ua ls o f o rd i-na ry c rim e and cu lpab ility on th e one h an d and of m en ta l de fec tan d pe rv e rsio n on th e o th er , w ide d iffe ren ces w ou ld ce rta in ly ap -pear w h ich w ou ld com pel th em to c las sify m any as indu b itab lecr im in al lu na tics , an d o the rs a s m ere crim in als , leav in g an in te r-m ed ia te o r bo rde rlan d c las s w hose cond ition cann o t be sa tisfac -to rily d iffe ren tia ted . Th is is v ery ev iden t in the enum eration bythe g rea t cr im ino log is t o f m any and m arked sym p tom s w hich h eadm its th at sub jec ts o f m oral insan ity sh are w ith those w hom heackn ow ledges and c la ssifie s as in sane c rim ina ls .

N o abso lu te ru le ca n b e la id dow n by w hich w e can d ifferen tia tebe tw een m o ra l in san ity and m o ra l d ep rav ity , and the re is no o the rd is ea se in w hich th e study ensemble of its m an ifesta tions is soim portan t. O ne m ay sing le ou t s ep ara te ac ts o r se ts o f ac ts o f asu b ject o f m oral in san ity , an d see in th em m ere ly the m an ifes ta-tions o f o rd ina ry c rim ina lity . It is o n ly w h en these a re v iew ed inth e ir en tire ty and in re la tion to the h e red ity , env iro nm en t, edu ca -tion , soc ia l s ta tu s, m en ta l and p hysica l o rg an izatio n and d isease -h isto ry o f the ind iv idu al h im se lf tha t w e can dec ide h ow fa r h isac ts are und e r h is con tro l, an d w heth er o r no t he is in sane an d irre-sp onsib le. I t w ou ld be as q uestionab le to labe l an d treat a s in sanecerta in o f th e lea st p rono unced sub jec ts o f th is c la ss a s it w ou ldbe w rong , bo th e th ica lly an d sc ien tif ic a lly , to stam p as m ere lycu lpab le c rim ina ls and to send to p riso n the ex trem e and typ ica lon es like J. T . T he fo rm er, w hose con d ition app ro aches m orenea rly the b orde rland of san ity , a re fo r tha t rea son m o re sus-cep tib le to pun ishm en t and o the r in cen tiv es to r igh t conduc t.T h ey b ea r p riso n life w e ll and a re non e the w orse fo r the d isc i-p lin e. Th e w e ll m arked , d istinc tly pa tho log ica l case s, how eve r ,


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290 A CA SE OF MORAL IN SANITY [Oc t .

a re fo r the m ost p art tu rbu len t, cra fty and unm anageab le in theex trem e, can no t b e a ffec ted b y pun ishm en t, g rea tly in te rfere w iththe d isc ip lin e o f o the rs and are the desp air o f p rison offic ia ls .Because of their d efectiv e co n tro l and suscep tib ility to cr im in alim pu lse s, the as soc ia tions an d pun itive m easu re s o f the p risona lso tend to m ak e th em de ter io ra te fa ster an d to g row m ore in -tractab le. Th e ord ina ry h osp ital fo r th e insane is equa lly unsu it-ab le fo r th em , as th ey unsettle and ex cite the ir fe llow p a tien ts andin te rfere w ith the ir m anagem en t and im provem en t. B esides, a sso -cia tion w ith c rim ina ls ad ds an o the r te rro r to insan ity . T he spe -cia l a sy lum fo r the crim in al in san e is , the re fo re , th e o n ly p rop erp lace fo r them , and it is s till ano th er a rgum en t fo r the ir insan ityand irre sp onsib ility th at ev ery crim in o log ist adv ocate s such con -fin em en t fo r them w ith th is , the w orst, cla ss o f th e insan e. T he reis , un fo rtun ate ly , n o sp ec ia l p ro v isio n in M assachu se tts fo r th ecare o f fem a le c rim ina l in sane , a s the ir num ber is so sm a ll.

O n Ju ne 3 , 1902 , J. T . w as tr ied an d fou nd no t gu ilty by reaso no f insan ity , an d the reu pon com m itted to a sta te in sane hosp ita lfo r life . H e r a ttitude a t the tr ia l w as m ore tha t o f an in te res tedand ap prec ia tive sp ec ta to r th an of a p riso ne r on tria l fo r he r life .

T hrou gh m any v isits to the pa tien t du rin g th e past tw o yearsan d free acces s to th e reco rds o f the T aun ton Insan e H osp italw he re sh e is confined , w e have b een ab le to fo llow her case , w h ichhas un de rg one a s trik in g d ev e lopm en t, a s w ill b e seen .

O n h e r adm issio n sh e ta lked f ree ly abou t herself to the ho sp ita l phys iciansand , a ltho ugh sh e show ed h er in born ten dency to d ece it and fa lsifica tio nin m any w ays, th e fac t th a t she had no long er any th ing to ga in b y m is le ad -in g o the rs w ith reg ard to h e r m en ta l con d ition g iv es a ce rta in w e igh t tothe m ost cons isten tly m ain tain ed of h er sta tem en ts . S h e relu c tan tly ack -now ledg ed , a s sh e does to -day , tha t she po ison ed 3! pa tien ts . S he w ou ldno t say tha t she w as no t in sane bu t w ished to know w ha t h er insan ity con-s is ted o f. I d ont appea r like these o th e r pa tien ts . I can read a bookin te lligen tly , I dont have bad though ts , so I don t see w here m ora l degen-e racy com es in . W hen asked if she had no ticed any chang e in d ispos itionin recen t y ea rs sh e sa id , N o ; I fee l ab so lu te ly the sam e as I a lw ays w as.I mi gh t say I f ee l h il ar io us , b ut t ha t m ay express it too stro ng ly . A s toth e fee ling of fear , she rep lied , A s fa r as I have any know ledge o ftha t fee ling , I n ev er show ed it. I canno t reca ll any tim e th at I w asfrig h tened . I used to be the w onde r o f m y m other. I have never fe lt itth rou ghou t th is affa ir . S h e h as ce rtain ly n eve r been affec ted excep t p lea s-


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1904] HENRY R . STEDMAN 29 !

urab ly by sudden exp lo sions or th rea ts o f pa tien ts on th e w ards from th efirst.D uring the first y ear of he r life a t the h osp ital sh e w as, a s a ru le , soc iab le ,

qu ie t, ch eerfu l, am iab le and spasm odica lly h elp fu l, an d spen t m uch of h ertim e in read ing . Th e ch an ge from the sec lusio n o f the ja il to th e m oreac tiv e life o f a large h osp ital w ard in te re sted h er , and th e a ir o f d isc ip linew as effec tive in tem po ra rily rep ress ing he r tend en c ies . In th is pe riod sh egrew fat, w as in exce llen t ph ysica l cond ition , and w ro te h e r sis te r: Ju stth in k , Ive been h ere a year and fin d m y se lf fond of the peop le and w arm lya ttach ed to the p lace in som e w ay s. Y es , w e are w e ll cared fo r , k in d lyand con side ra te ly . S he soo n deve lop ed a fond ness fo r the com pany ofthe pa tien ts , e sp ec ia lly the m ost dem ented , in p re fe rence to th at o f th enurses .

Th e following statement by D r. J . P . B row n , th e M ed ica lS u pe rin ten den t, is the ho sp ita l reco rd o f A pril 22 , 1903, about ayea r from the tim e of he r com m itm en t. It p rac tically rep resen tsth e op in ion of the en tire m ed ical sta ff a s to he r co nd itio n at tha tt ime :

M y stu dy an d obse rva tion of J . T . s in ce she h as b een in th e hosp ita lg ives m e the op in ion th a t he r m en ta l d isease sho u ld be c la ssed as m o ra l o ra ffec tive insan ity . S he seem s to m e to b e w ho lly devo id o f m o ra l sense ,o r a clea r ap preh en sion of w ha t is righ t o r w ron g as to her re la tions too ther peo p le o r to soc ie ty . In a ll m y conversa tio ns w ith her respec tingthe hom icid es , w h ich she freely adm its , she h as exp re ssed no rem o rse ,reg ret o r so rrow for an y o f them , bu t ra the r a sen se o f p ride an d sa tis-factio n tha t the n um ber w as so la rge as to g ive he r d is tinc tion ab ove a llo the r p o iso ne rs w hose h isto ries a re k now n.

T h is lack of pity and so rrow fo r o the rs in trou b le o r d istre ss has b eenev id en t w henever any d ifficu lty has occurred on th e w ard be tw een pa tien ts ,o r be tw een a nu rse and p atien ts . A t su ch tim es she has m an ifes ted a g ooddeal o f g lee , and laugh ed like a silly ch ild , bu t never has exp ressed anysym pathy or p ity fo r the p atien t o r p erson in d istress o r tro ub le . T roub leo r p ain fo r o th ers seem s to exc ite in he r m err im en t and joy instead o fsorrow.

In he r a sso cia tion w ith o the r p a tien ts she has exh ib ited a spec ial fon d-n ess fo r th e dem en ted , an d esp ec ia lly fo r on e w ho h as open ly pract icedself-ab use ; an d on ce she go t in to bed w ith h er a f ter th e pa tien t had b eenpu t to bed fo r the n igh t .

In sp eak in g of the hom ic ides, sh e says tha t a t the tim e she com m ittedth em she w as no t conscio us o f com m ittin g any crim e or do ing any w rongfo r w h ich she shou ld ju stly be pun ished ; th at the tho ugh t o f do in g w rongd id no t en te r he r m ind , and gav e h er no co ncern w ha teve r; and at th ep re sen t tim e she ap pa ren tly h as n o com p rehen sion th a t the decree o f th e

20


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29 2 A CASE O F M ORAL INSAN ITY [Oc t .

cou rt in com m itting h en to th e h osp ita l w as rig h t and ju st, an d m ust b eob ey ed ; an d she asks fo r h er freedom as th ough it cou ld be gran ted onthe sam e bas is as tha t o f any o ther pa tien t.

R ecen tly , du ring th e pas t th ree or fo ur m onths , she has seem ed m orem oody and em otio na l, e ithe r depressed or exh ila ra ted a t sho rt in te rv als , andh as exh ib ited less se lf-con tro l, and w ith it sh e g iv es on e the im pression tha th er m in d is w eak en ing , and tha t she h as less m en ta l g rasp of pas t and p res -en t even ts , an d of her rela tion to her su rro und ings . O f th is she seem sto be pa in fu lly conscio us h erse lf. She has been observed to be laug h ingim m odera te ly to herself, and w hen it is n o ticed by o thers she b lush es asth oug h she w ou ld con cea l it, and seem s con fu sed .

T h is w eaken in g of h er m in d as tim e goes o n is w ha t is to be exp ec ted ,and w ill p robab ly con tinue . In every case of m ora l o r a ffec tive insan itythe re m us t be m o re o r less im pa irm en t o f w ha t a re ca lled the in te llec tua lfacu ltie s in d is tinc tion from the m ora l, e sp ec ia lly reaso n , and judgm ent tod ec ide e th ica l q uestions presen ted to the m ind , o the rw ise the m ora l ob li-qu ity and perv ersion w ou ld be co n tro lled , and the crim ina l ac t averted .

F rom m y exam ina tion and observa tion of her since sh e has been underm y care , and m y know ledg e of her p rev ious h isto ry as m ade know n toth e cou rt be fo re h e r sen tence , I am of the o p in ion th a t she is in sane andirrespon sib le , and th a t her m en ta l d isease resu lting as it p ro bab ly does fromances tral v ice and degeneracy , w hich h er fam ily h is to ry so fa r as know nclea rly ind ica tes, is incurab le .

E ven a t th is tim e an undercu rren t o f susp ic iou s thou gh t cam e to th e su r-face in doub ts o f the in ten tions of p eop le tow ard her. S he ev en w ro te hers iste r in C hicag o , S om etim es it s tr ik es m e you are o ne of the g ang . Ifyou have foo led m e a lso I sha ll say d-n . O h d-n anyw ay .

H er ind iffe rence to the charac te r o f her su rrou nd ings , from the firs t,he r frivo lo us ta lk , con trad icto ry sen tim en ts, frequen t, cause less laugh te r,open p leasu re a t the troub le o f o th ers , g lee a t situa tio ns of obv io us p er-son al d iscom fo rt to herse lf, and genera l and u tter lack o f m o re than o cca-s io na l se riou sness a t he r situa tio n , p resen t and fu tu re , o r ac tions in thepas t, show m ost p la in ly a dom inan t tone of m en ta l w eakness such as ison ly to be foun d in th e im bec ile . T h is is w ell show n by ex trac ts from herle tte rs : Ive had a rea l g ood tim e in th e sew ing-ro om for the past tw oday s. I n ev er can say tha t I like to do a th ing un til I ge t som e fun ou t o fit, and I rea lly had qu ite a lo t o f fu n . I sup pose it has b een h ere [ in m e]ev er s ince I have been here , bu t I havent seen it T ru ly , I h ad a grea t,go od tim e a t the B arnstab le ja il a fte r the f irs t ten days , even then I d idno t have a bad tim e . Jun e 28 , 1903, re fe rring to an in ciden t w hen on av is it to a friend : It has le ft m e ro llin g on the floor [w ith laugh te r].I beg in to fee l like ro lling on th e f lo or now . I like to fee l tha t w ay . Iam hav ing a b ig tim e , b ig [in th e sew ing room ]. M arch 8 : D ontever ask m e in you r le tte rs w ha t I m ean by w hat I w rite , I dont kn ow m y-self- Im ta lk ing th ro ugh m y ha t. N e llie to ld m e on ce tha t you said I


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1904] HENRY R . STEDM AN 293

m ade you d izzy w hen I go t to ta lk ing an d laug h ing . I laug h now , M ary .I nearly bus t m y se lf lau gh ing th is pas t w eek . I d ont like the locality Ilive in e ith e r. Ju ly 8 , 1903, afte r g rea tly d is tu rb ing the w ard a t n igh tw ith a v io len t fit o f scream ing fo r no obv iou s cause : I m ed ita te andpraise and pray a ll the tim e , and sha ll be read y a t the end to tak e vow sand b ecom e M other H onora of the Sev en W ounds . In one o f herthough tfu l m oods she w rites, I do grieve to be in th is s ta te , I d o ,w hen I have tho ugh t fo rce eno ugh to th in k it ou t . W hen I am disco n-ten ted I ask m yse lf w ha t I w an t and I dont know . A chang e of any k in dseem s to rtu re to m e even to th ink of and w hy I w ant to live th is w ay Idon t k now N ev e r m ind , M ary , the fac t rem ains tha t I have had abu lly tim e in life in sp ite o f eve ry th in g . I neve r fee l tha t I am hav in g area l goo d tim e w hen Im b eh av ing . O c t. I am still fu rn ish ingm ateria l fo r the d ram a of the unpopu la r lady . I d o w ish I co u ld behavem yse lf fo r it a ll tire s m e so now , b u t I shant p ro bab ly till m y las t b rea th .

By December , 1903, sh e had becom e genera lly an tagon is tic tow ard a llabo u t her, as w ell as h igh ly susp iciou s and irritab le . Sh e w ro te vo lum in-ous tirades ag ains t the h osp ita l and its m an ag em en t, trea tm en t o f pa tien ts,e tc ., m ak ing w holesa le an d absu rd accu sa tions an d denunc ia tio ns, som e ofan en tire ly de lus io na l na tu re . S he w rites h er siste r, fo r exam p le : D oyou know , the superv iso r p u t som e po ison in m y tea . A pa tien t saw herand to ld m e and I d id nt tou ch it. T he lady h eard the su perv iso r say sh ehad fixed J . T . th is tim e . A p ropos of spec ia l d ie t o ffe red her she w rites ,N o , I thank you , D r. B row n, I w ill st ick to bean soup and keep safe aboveground an d ou t o f D r. M ille rs [the pa tho log is ts] hands . S om e s teaks trikes som e peop le righ t. T h is s teak is su re dea th . A g a in , in a le tte rto he r fo rm er co unsel, she speaks o f h im as on e of th e gang w ho ism anag ing he r case , a ll the phy sician s and nurses o f the h osp ita l be in g in -c lu ded . S he con tin ued to w rite in th is stra in a lthou gh to ld tha t such le ttersw ou ld n o lo nge r b e fo rw arded . D r. B row n a lso reports th e fo llow in gsta tem en t m ade to h im by th e pa tien t: I don t w ish to asso c iate w ith thelow and vu lga r p eo p le tha t a re em plo yed in th e sew ing room . T hey ta lkedabou t m e befo re the o ther pa tien ts in a low and vu lgar m anner. Sh ethen d esc ribed a revo lting scene , im possib le on its face , as enac ted by thetw o em ploy ees in cha rg e, se lf-re sp ec ting , m od es t w om en , and gave a c ircum -stan tia l accou n t o f ta lk and actio ns on the ir p art o f the v iles t k ind , in am anner h ig h ly sug gestive o f d elu sion s o f p ersecu tion and ha lluc ina tions o fh earing . A t th is tim e, a lso , she is reported to have grow n very neg lectfu lo f her perso na l app earance , even hav ing to be to ld to w ash h er face. Sh eh ad becom e ve ry abu sive to the nurse s, defy ing the ir au tho rity and in citingpa tien ts to do the sam e, go ing so fa r as to sh ou t to a m elan ch o lic w hom th enu rse w as try ing to feed , no t to eat the food as it w as po ison . H er phys icalcon d ition h ad fa llen off g rea tly . S he had los t fifty pounds in w eigh t in afew m onths , in con sequence of her refusa l o f food becau se of fa lse b elie fin rega rd to it. O w ing to her w eak co nd ition she w as rem oved to th ein firm ary . T here she becam e m ore d istu rb ed as w ell as des truc tiv e and


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294 A CA SE O F M ORAL IN SANITY [Oc t .

d irty in hab its , en raged and som ew hat v io len t, th rea ten ing to k ill he r nu rses ,e tc . B y F ebruary , xgo she w as g reatly em ac iated , h av ing los t o ver e igh typounds, o r abo u t h alf he r no rm al w eigh t, and w as so w eak th a t fo rcedfeed in g w ith the tube w as reso rted to fo r severa l days , since w h ich tim esh e h as eaten vo lun ta rily , bu t just enou gh to avo id be ing fed aga in . T heartific ia l feed ing w as em ploy ed on ly afte r p ersisten t persuasion and ev erypo ss ib le m easure to in duce h er to ea t had been tried , inc lud in g spec iala rtic les o f d ie t from th e superin tenden ts tab le. A tho rough phys ica l ex -am ina tion revea led no ev idence o f bod ily d isease.

O n a recen t v is it, M arch , she w as foun d by the w rite r in goodsp irits, ta lk in g v o lub ly and a im lessly at the nurses. S he began a t once o na tirad e aga inst the hosp ita l, its o fficers and a ll its be lon g ings . Sh e ins is tedtha t every th in g w as ro tten , tha t the m ea t w as em balm ed beef, e tc ., etc.She persis ted in these com pla in ts a fter be ing to ld tha t w e had just ea tensom e of the d inn er p rov ided fo r her w hich w e fo und nu tritious an d pa la t-ab le . E very th in g w as filthy , she sa id , even the brick w alls w hich m ust besatu rated w ith the filth o f y ears ; the w ate r supp ly (w hich is tak en froman a rtes ian w e ll) w as p o llu ted w ith sew age ; the vege tab les w ere rankpo iso n . Sh e sp oke ra the r anx ious ly abou t a genera l feeling o f n um bness,an d ask ed w ha t w as the cause of it. S he w as en tire ly inaccess ib le toex p lana tion , argum en t, o r ev en pos itiv e pro of as to the im poss ib ility o f h ers ta tem en ts . O ccas iona lly sh e w ould burst ou t u nexpec ted ly w ith pecu lia rand p iercing shrieks of laug h te r w hich w ould seem im po ss ib le to one inher w eak cond ition .

M any of her ind isc rim ina te and sen se less charg es seem ed to be ra the rthe exp ress io n of an insane m alig n ity tow ard everyo ne than the ou tcom eof genu ine be lie f tha t they w ere true . B u t w e w ere , a t th e sam e tim e ,conv in ced beyond a doub t tha t sh e w as a lso su ffe ring from strong andgenu in e de lusion s o f persecu tion by po ison ing , becau se her be lie f in th isregard so co nsis ten tly in fluenced h er conduc t th a t he r re fu sa l o f food hadprac tically reduced her to a sk ele ton , and repea ted , fo rc ib le feed ings hadno effec t in chang ing her conv ic tions . H er p ersecu to ry id eas vary instreng th from tim e to tim e , bu t th e d elus ions of susp ic ion from w hichthey spring rem ain u nsh ak en . T he fo llow ing le tte rs ev iden tly com ing fromthe heart, a re charac te ris tic o f de lus iona l in san ity ;

MARCH 16 , 1904 .Dea r -: I am th e v ic tim o f ne rv e p ara lysis , the resu lt o f foo d . I

have to ea t o r I am fed w ith a tube w ith nerve-para lyz ing food tha t Ichoo se from the tray . O h , I th ink tha t y ou and - w ere crim in als topu t m e th rough th is . It w as an aw fu l th ing to do to any hum an be ingand I have m y opin ion of every body w ho tak es a hand in it. I th ink it h b een a m o st nob le (? ) p iece o f w ork . I th ink as the n erves of m y bodyge t m o re b enum bed m y bra in b ecom es c lea re r to the ou trag eo us coursetha t has been taken w ith m e. I supp ose th e nex t th ing , som eth in g w ill b eg iven to pu t m e ou t o f the w ay a ltog e th er . T ha t w ou ld be a m ercy toth is J-T -.


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F IG . 3 . F IG . 4 .

T H E A M E R IC A N JO U R N A L O F IN S A N IT Y , V o l. L X I, N o . 2 . - PLATE XXVI.

F IG . 2 .FIGs. 1 AN D 9 .-Appearance during first year a t the ho sp ita l.

F IG s . 3 AN D 4 .-A ppearan ce d uring second yea r a t the ho spi tal, a fter a p eriod of refusalo f food du e to d elu sio ns o f p o ison ing .


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TAU NTON LUNAT IC H oSP ITA L , Ju ly 4 , 1904.DOC TOR S TEDMAN : I w ish to in fo rm you th at I am alive in sp ite o f the

de le ter iou s foo d w h ich has been se rv ed to m e. M any effo rts have been m adeto po ison m e in th is in stitu tio n of tha t I am ve ry sure. I am th in an dvery hungry a ll th e tim e . E very nerve is ca llin g fo r food . W hy can t Ihave he lp? I a te a p in t o f ice c ream and four o ranges S a tu rday andSund ay . T ha t w as a ll. J - T -.

NO R AH KELLEY .I t is w or th y of n o te th at, a s w ould be exp ected in an insan ity o f

th e hered ita ry -d egenera tion gro up , the m en ta l d e te rio ra tion takesin th is case the fo rm of de lusion ra the r than d em entia .

In th is a fte r-h isto ry w e find , b roug h t in to bo ld re lie f, th e inh er -en t, und er ly in g d efect o f w eakm indedness w hich w as no ted , bu ton ly ob scu re ly seen ea rlier , fo r w an t o f op portun ity fo r p rop erob se rv atio n , and a lso th e ou tg row th the re from o f p ro nouncedin te llec tua l chang e in the sh ape o f po sitive de lusio ns. These ,to ge the r w ith th e o th er and ch aracte r is tic m an ife sta tion s, affo rdthe s tronges t conf irm ation of th e pa tien ts insan ity , in te llectua l an dmora l .

T he deve lopm en t o f a de lusion al state in th e co urse o f m oralin san ity is, ap paren tly , no t u ncom m on, and affo rds an o ther ands trong arg um ent fo r th e con ten tion tha t in te llec tua l invo lvem entin som e form is an essen tia l fea tu re o f the d isease , o r , in o therw ords, th at th ere is n o such th ing as a m en ta l d iso rd er affec tingthe m ora l sphere a lo ne . D elus ions a re repo rted as occurring la tein the d isease , if a t a ll, sug gesting a secondary cond ition o r stage .C om parative ly few d escrip tions of m ora l in san ity inc lude th isfea tu re, pe rh ap s because the few cases th at reach the hosp ita l fo rthe insan e e ithe r a re no t c losely ob served la te in the d iso rd er o r,if fo llow ed up , a re no t reco rded , and th us the p ic tu re o f the en tired isease -p rocess , so to sp eak , as revea led in a ce rta in p ropo rtion ofcases is lef t un fin ished . A no th er and , to ou r m ind , w eig h ty reasonis tha t m os t o f th e m ora lly insane are sen t to p rison w here th eyrarely com e und er the observa tion of a lien is ts. W hen the ir insan -ity h as fu lly and unm is takab ly d eve lo ped th ey are , p erhaps trans-ferred to in s titu tions fo r th e ch ron ic o r cr im ina l insane , w herethey pass fo r cases o f ch ron ic d e lusion al in san ity o r d em en tia .T ha t th is v iew is no t ove rd raw n is p lain , ev en from L om b ro so sT

O p . c it., vo l. ii, pp . 20-26.


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296 A C A SE O F M O R A L INSANITY [Oct .

accoun ts o f the h is to ry o f a num ber o f p rison ers o f th is c lass w ithrefe rence to the ir in te lligence , in som e of w hom de lus ions o f su s-p ic ion and persecu tion are no ted and in o thers a dec ided parano iactend en cy is ev iden t. Sch #{252}le say s of them , th ey m ay deve lopn euro ses, som nam bulism , pe rio d ical in san ity , h ypo ch ond ria .D agone t even finds acu te de lir ious m an ia and ha lluc ina tions inth e co urse o f th e d isease. A rnaud #{176} co nc ludes a recen t and in -s truc tive chap te r o n m ora l insan ity w ith an accoun t o f a typ icalcase w ith a late m an ife sta tion o f de lusion s o f persecu tio n m oreor le ss sy stem atized an d hypochondriaca l ideas. In th e op in ionof the d isting u ish ed and prac tical psy ch iatr is t, H ack Tuke , the recan be no doub t tha t in a num ber o f case s o f seem ing m ora l in san -ity th e re d ev elo p in course o f tim e de fin ite d elu sions , esp ecia lly o fsusp ic io n . A ccord in g to F o lsom , it is the ru le tha t the irdoub ts , im ag ina tion s an d susp ic ion s deepen in to activ e insane de lu -sion s, the ir m en ta l im pa irm en t ad vances to n o ticeab le dem en tia ,the ir m ora l d ete r io ra tion goes o n to su ch a d eg ree o f d ep rav itytha t eve ry body w ond ers w hy th ey had no t been seen to b e insan elo ng ago , an d they a re seclu ded in an asy lum o r e lsew here .

F urth e r resea rch in th is d irec tion can ha rd ly fa il to en la rge o urknow led ge o f th is in trica te d iso rde r and its a ff ilia tion w ith pa ra -no ia.

T he str ik ing pa ralle lism be tw een th is an d the on ce fam ous caseo f C hris tiana E dm und s, w ho w as p ro nounced to be in sane b yM auds ley an d seve ral o th er d isting u ished alien ists , is su ffic ien tex cu se fo r re ferrin g to it h ere . T he ex trac t is taken from anaccoun t o f the case u quo ted b y B lan dfo rd an d c ited as ty p ical o fmoral in san i ty :

C hris tiana Edm unds is an ex am ple o f a pe rson utterly devo ido f m ora l sense o r m ora l fee ling in m atte rs re la ting to herse lf ,th oug h theo retica lly she do ub tle ss knew tha t m u rd er w as a w rongth in g . Th at she k new perfectly w e ll w ha t she w as do in g , in pu r-chasing p o ison an d d issem ina ting it b ro adcas t th ro ugh th e tow n

G e ist. K ran khe it (1 881 ).#{149}a Fo lie M ora le, 1 878 . B a lle t: P ath o log ic M en ta le ( ig o3 )) , p . 652.D ic t. P sy ch o l. M ed ., p . 81 4Mental Diseases, Boston, 1886 , p . z B la nd fo rd : Insan ity and its T reatm en t. 3d ed ., p. n8 .


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by m eans o f po isoned cho co late c ream s an d tha t she knew shewa s there in doing w rong w ere eq ua lly b ey ond d isp u te . H erw ho le co nduc t be fo re the crim e , an d h er perfec tly ra tiona l con-versa t ion in jail, clea rly p rov ed she cou ld have taugh t a schoo l-room of ch ild ren in th e Ten C om m andn ien ts , and exp lain to th emc lea rly th at it w as a w ick ed ac t to b reak an y o f th em , an d a m o stw ick ed act to b reak th e S ix th C om m andm en t. B u t no on e cou ldh av e ta lk ed w ith he r in jail w ithou t b ein g co nv in ced th at in he row n case she h ad no rea l fee ling o f the w icked nature o f her a cts,and tha t sh e w ou ld hav e p o iso ned a w ho le city -fu l l o f p eo p lew ithou t hesita tion , com punc tion , or rem orse . Indeed , it m ay bedoubted whether in h e r la te r ex pe rim en ts she w as rea lly so m uchin fluenced by the inadequa te m otive , w hich no doub t in s tiga tedthem a t the beg in n ing , a s b y a m orbid p leasu re in poison ing fo rits ow n sa ke , an d in th e sensatio n w hich he r sec ret cr im es exc ited .T he terrib le sto ry o f in san ity in he r fami ly fu rn ish ed the rea lexp lana tion o f h er s ta te o f m in d ; she h ad the he ritag e o f th ein sa ne te mp era me nt.

D r. O rang e, the S up erin tend en t o f B roadm oo r, un de r w hoseca re C hrist ian a E dm und s h as been ev er s ince he r tria l, say s , tha tshe ha s been regard ed a s o f unsound m ind by all th e m edica lo fficers o f the a sy lum w ho have been he re du ring the las t fiv eyea rs. S h e is a t p resen t fa irly tran qu il, an d he r co ndu c t is m u chbetter than fo rm erly ; b u t I do no t reg ard h er a s b eing sane , o r fitto be tru sted to keep ou t o f m isch ief. S he fo rm e rly had per iodso f depressio n alte rna ting w ith p eriods o f suba cu te m ania , bu tlatterly her condition has been more equable. 14

The italics are ours. H. R. S.

A Case of Moral Insanity With Repeated Homicides

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