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which, opinions seem to be as unfixed and practice as uncertain in the United States as in our own country. These cases, in fact, often form the most embarrassing ones which can come before a jury, even now that the public and the legal profession have acknowledged, in many instances, the existence of moral insanity ; for, while humanity forbids the condemnation of an unfortunate individual whose only crime is disease, the protection of the public from the consequences of a too easy reception of proofs of the existence of this, is a duty no less urgent, and humanity no less genuine. The present strong feeling prevailing in this country against the validity of the punishment of death even in cases of murder, contributes another element of difficulty-juries finding insanity in many cases in which they otherwise would not, were they not fearful of entailing death as a consequence. So much is public opinion divided upon these questions, that it is seldom that the decisions of our tribunals give that general satisfaction, which is so commonly the case in relation to other subjects.
“ The great difficulties and mistakes that have occurred on this subject," Dr. Brigham observes, “have arisen, we believe, from courts attempting to de fine, what cannot be correctly defined, viz. insanity; and to establish what does not exist, a certain test of insanity by which the existence of this disease can be recognized. This statement, we think, is fully confirmed by a brief history of the attempts of courts to define ipsanity, and to furnish juries a rule to guide them in determining the question of responsibility."
The old doctrine, as laid down by Coke and Hale, was, that for exemption on the ground of insanity, a total deprivation of memory and understanding must exist. Erskine admitted this on the trial of Hatfield in 1800 ; but his client was not in this predicament, and was acquitted on the ground of the existence of delusion, this being therefore established as the true character of insanity. However, it did not save Bellingham ten years later, who, had he been tried in our own times, would have certainly been acquitted as insane. The test laid down on that occasion by Gibbs, and admitted by Mansfield, was the ability of the accused to distinguish right from wrong, even though he might be incapable of conducting his own affairs.
“ Since then the law, that is the decisions of the higher courts of England, have been loose and fluctuating. Generally the ability to distinguish right from wrong has been insisted upon more or less strongly. Not unfrequently, however, it has been partially or entirely abandoned, as it must have been on the trial of M'Naughten for killing Mr. Drummond in 1843. In this case it was found that the prisoner had good memory and understanding, and was capable of transacting business correctly, and there was no evidence that he did not understand the distinction between right and wrong at the time he committed the act for which he was tried and justly acquitted.
“ Within a few years the English House of Lords have endeavoured to obtain from the Judges of the Law Courts their views of the law relating to insanity, or rather a legal definition of insanity, which should henceforth furnish a rule for the guidance of courts and juries whenever in criminal cases the plea of in, sanity might be set up. The answer of the Judges to the questions propounded to them must be regarded as a signal failure in this respect. Their answer was in fact but the repetition of the dictum we have mentioned, that a man is respons sible if he is capable of knowing right from wrong. As was predicted at the time
Plea of Insanity.
it was disregarded immediately after, as it had been in M‘Naughten’s case just before. It was not at the time satisfactory to some of the most enlightened members of the House of Lords. Lord Brougham complained that the test was vague and unsatisfactory, and doubted whether the juries before whom the question is tried really comprehended what is meant by it. It has been disregarded in England in numerous instances since."
Certainly the solemn assemblage of the judges which took place on the occasion in question was one of the happiest examples of the Mountain in Labour which modern times have afforded. That conclusions in which nothing was concluded should follow the deliberations of a body of men so little accustomed to an enlarged contemplation of human nature, and so religiously respectful of precedents and technicalities, is far less surprising than would have been the laying down any intelligible and comprehensive principle.
The decisions in the U. S. Courts alluded to by Dr. Brigham, seem to be nearly as uncertain and unstable, as guides for the future, as our own. In reference to the test already alluded to, he adds :
“ Although judges appear to think that it is easy for juries to decide whether the prisoner was able to distinguish right from wrong at the time, we are of opinion that there are few more difficult. Separate froin the fact that no being short of Omnipotence always knows right from wrong, and that what is right in one age or nation is considered wrong in another, how are the jury to decide that, at the precise moment of committing a homicide, a man can or cannot distinguish right from wrong? What kind of evidence establishes this? The legal presumption is, that a man does know; but in case he does not, how is this to be proved? We certainly do not know, and believe, with Lord Brougham, that ‘juries do not really comprehend what is meant by the question.'
“ We have endeavoured at various times to ascertain from the insane them-' selves their ability to distinguish right from wrong, and for this purpose have questioned on the subject in various ways several hundreds, and we cannot better exhibit its inapplicability as a test of their responsibility, than to say what the truth enables us to say, that a large proportion of the insane now in asylum appears to understand its distinctions as well as persons in the community at large. We also believe this to be true of most of the insane we have seen elsewhere; and we confidently assert that this will be found to be the opinion of every person who has had the charge of an institution for the insane, and seen many deranged persons. But the cases we have already mentioned show the utter worthlessness of this as a test of the responsibility of the insane. One of the women killed her own child for the purpose of procuring her own death by execution. She certainly knew she was doing a wrong act, and one for which she expected to be punished. Others commit hoinicide from a sudden impulse, who have not previously exhibited any wrong conduct or intellectual aberration. A mother kills her only child, or a man his wife and family, to whom he is known to be ardently attached; or a child a parent, as in the instances we have mentioned. To such cases none of these tests of insanity apply, and yet they are among the most palpable and unquestionable cases of that kind of mental disease which should be an excuse for criminal acts.
“Notwithstanding the great improvement within the last fifty years, that has been made in the treatment of the insane, owing to an increased knowledge relating to insanity, it is still a fact that some of the most deplorable forms of this disease are not even now allowed to annul responsibility. Although it is the law of this and every civilized country, that it is the reason of man which makes him accountable for bis actions; and that the deprivation of reason acquits him of crime; yet it is a lamentable fact that, at the present time, courts of justice do not acknowledge the existence of some of the worst forms of mental alienation, and which, in the opinion of those acquainted with the insane, are as well established as any other. In the words of an enlightened Judge of this State, the law upon the subject of Insanity in its slow and cautious progress still lags far behind the advance of true knowledge.'
Far from us is any desire to skreen the guilty by the plea of insanity, and no one can regret more than us to see this plea improperly set up, as this must tend to jeopardize it when justly made. But we cannot resist the conviction that, by the different constructions given by courts to the law of insanity, that the rights both of the insane and of the community may be in danger. That in one case, when popular feeling is much excited against the accused, the strictest rules of law and the severest tests of insanity known to the common law of England are enforced, and notwithstanding strong proof of insanity conviction follows; while in another case, with little proof of insanity, but with popular sentiment in favor of the prisoner, other constructions are given to the law, and he is acquitted.”
We have quoted much more largely from this Report than is customary with us in respect to similar documents : but the contents, as our readers may now judge, are of no ordinary value.
M. BRIERRE DE Boismont on ESTABLISHMENTS FOR THE INSANE
IN BELGIUM, HOLLAND AND England.
The opinions of foreigners upon our institutions when matured by suficient information and delivered with candour, are always valuable and acceptable, confirmatory as they frequently are of advantages already enjoyed or suggestive of desirable improvements. M. Brierre, already well known to our readers as an able practitioner in this department of medicine, has recently paid us a flying visit, and has published in the " Annales d'Hygiene,” the impressions which his inspection of the metropolitan asylums produced. Before noticing these, however, we may advert to the account he furnishes of the singular Belgian establishment at Gheel, wbich he visited during the same tour. He reports that the provisions for the insane in Belgium and Holland are lamentably defective and far behind those of the rest of Europe in all the appurtenances for comfort and treatment.
The Insane Colony at Gheel.-Gheel, although still termed a village, is well entitled to the appellation of a town, inasmuch as it numbers from 7 to 8000 inhabitants, and is now a flourishing place, forming a marked contrast with its wretched condition as described by Esquirol a quarter of a century since. The entire number of lunatics dispersed over the village and adjoining hamlets amounts to about 800; the sum paid for them varying from 624 to as low as 24 francs per annum. Taking the mean of the entire number, the daily cost per head is only halfa-franc. The sum fixed by authority is from 170 to 200 francs per annum. A very limited number who live with the better classes of citizens pay from 15 to 1800. On examining the abodes of the pea. sants in which the lunatics resided, M. Brierre found them clean and comfortable, one patient only for the most part being consigned to each 1847)
Establishments of Belgium and England.
house. As the peasants are very anxious to retain these guests, and consider their reinoval at the instance of the Inspector casts a stigma upon them, it becomes their interest to treat and feed them well. There is, however, no special place for the treatment of the patients, and no medical treatment, save for incidental maladies, is put into force, while coercion is employed in certain cases to an extent utterly discountenanced in the rest of Europe. Thus, although the mass of the patients have liberty to go out and in when they choose, and to walk as freely about as the sane, M. Brierre observed some of these had heavy rings on their legs or hands just like galley-slaves, such having heretofore made attempts at escape : so too in the houses he observed large iron rings for the attachment of restive patients. At the time he visited Gheel there were not more than twenty under any restraint, and this was above the usual number. He heard no cries of suffering, even during the silence of a very hot night. Several of the patients pursued occupations, the majority however being unwilling or unable to work. The sojourn of these patients does not seem to have operated injuriously upon the inhabitants of the place, who become very rarely insane, and that usually from the ordinary causes. The promiscuous intercourse of the insane of opposite sexes also has not given rise to the production of illegitimate births-a circumstance which the author explains by the active surveillance the peasants maintain, and the moral and phlegmatic character of the Flemings. It is evident that, although the lunatics are well and kindly treated, just as if they were members of the respective families they reside in, there their advantages end. No attempt at physical or moral treatment is made, and no appliances for these exist; and the colony can be looked upon as little else than a comfortable abode for incurable patients.
“ However we may reply to the questions of what are the advantages or inconveniences of this establishment; whatever benefits accrue from it, and whatever may be its future destination, we at least cannot but remark that, while the insane in France & England and many other countries, were imprisoned, chained and buried in cages and huts just like wild beasts, there had existed for ages in a lonely and unknown part of Belgium an establishment where hundreds of the insane were free and abandoned to themselves. Simple good-sense had revealed to these poor peasants that mildness and kind treatment should form the basis of their relations with this strange description of guests, and that force should not be resorted to save in case of danger.”
The English Asylums.—Dr. Brierre's attention was confined to Bethlem, St. Lukes's, Hanwell, and one or two private asylums. His general opinion of Bethlem is highly favorable, save in respect to its situation within the metropolis. Among the few observations he makes of a qualificatory character are the following.
"There is nothing particular in the medical treatment adopted. In the galleries there is a small apartment with the warm, cold, and surprise baths; but its narrow dimensions would only admit of one or two being bathed at a time; and we have the full conviction that this means, although employed, is not so frequently applied as in France. Medicinal substances seem to constitute a large portion of the treatment, and I do not wish to deny their importance; but attendance upon great numbers of the insane leaves no doubt in my mind of the greater importance of baths in this affection; and I have elsewhere* shown that, by their aid, we can abridge the duration of certain forms of insanity, but for this end many baths and appliances are requisite.
“ At the present day, when the rules which should govern this description of establishments are agreed upon, there is no physician who would not admit that, ere long, this of Bethlem must be removed away from the metropolis to some agreeable locality. Another important amelioration would be the residence of the physicians in the establishment itself; but for this purpose a liberal salary should be accorded to them. Another measure, no less desirable, would be the appointment of certain special pupils, who should pass several years within its walls, and for whom it would be but just to secure appointments to provincial asylums upon their leaving this one. The conduct of France in this particular seems to me deserving of imitation; for almost all the asylums founded by the law of 1838, have been entrusted to physicians, whom M. Ferrus, Inspector-General of Asylums, has selected from those who have exclusively devoted themselves to the study of mental disease.
" The number of patients to be consigned to the care of the physician is not a matter of indifference: and if we consulted our own experience we would limit this to 100, 70 chronic and 30 acute cases.
Dr. Brierre gives a somewhat detailed account of the Criminal Wing at Bethlem, as being likely to prove most interesting to his readers in France, where it seems no such provision for the separation of this description of lunatics prevails. At the period of his visit there were 97 patients (77 m. and 20 w.), the causes of whose detention are thus distributed. Crimes against the State, 2. Crimes against the person, 63. Crimes against property, 32. “I may be mistaken, but I have the conviction that the prospect of a sojourn in such a place would be more likely to deter a true criminal than the perspective of the scaffold.”
Quite agreeing with the author, that the Criminal Lunatics should be separated from those of other descriptions, we would carry the principle farther still, and have a separate establishment under the control of Govern. ment, erected for them in a part of the country remote from the metropolis. Their detention at Bethlem is mischievous to the other patients, by reason of their more noisy dispositions, the prison-like aspect they give the place, and the limitation of accommodation they entail. It is no less injurious to the public interests. Located in an establishment under the
governance of the city authorities who have free ingress to it, they become a sort of raree show to all the fashionable idlers and visitors of the metropolis, for whose morbid appetites our worthy citizens have ever shown themselves most desirous of catering, whether by the exhibition of the poor wretches alluded to, or by the revolting proceedings at the condemned sermon or condemned cell in Newgate. It is true public opinion has of late sternly condemned these procedures, but we have no security of their non-revival but the removal of such high trusts from such incompetent hands.
The mischief done to the moral sense of the community, and the stimulus given to the morbid desire of imitation so rife in the
* For an account of M. Brierre's opinions of the curative agency of prolonged warm baths in acute insanity, see Rev. Medicale, Nov. 1847, and Med.-Chir. Rev. N. S., Vol. V., p. 282.