276
Art. V.?A CASE OF MORAL INSANITY.* By A. C. MUXRO, M.B., M.R.C.P.E., Soutliorn Counties Asylum, Dumfries.
of the first observations made by the tyro in the study diseases, that in insanity the moral powers are almost invariably affected as well as the intellectual. The selfishness, the ingratitude, and the animal propensities of the insane constitute one of the great discouragements of alien practice. It is further observed that in certain forms of disease the moral faculties are those principally affected. Thus Epileptic Insanity is, of all varieties, the most repulsive in its mental manifestations: in very many cases where the congenital existence, or long continuance, of the disease does not forbid any mental activity, the moral nature is seen to be entirely warped and distorted, all perception of right and wrong fades away as the disease progresses, the patient lies unblushingly, steals what he or she may, is shamelessly erotic, ravenously gluttonous, malicious, frequently homicidal, often assuming the next moment after an almost demoniacal outburst the demeanour of a saint and the loudest protestations of piety, such complete perversion being of most frequent occurrence in the female, predisposed to it by her dominant emotionalism. All this, as the asylum physician has often to point out to the indignant attendant, is purely the result of disease, and is no more, or very little more, under control than the preceding or succeeding convulsion. -It strikes one, in reading reports of medicolegal proceedings in which questions of epileptic responsibility have to be discussed, that sufficient prominence is not given to this consideration; while the automatic theory of the action of the patient or criminal which may have made them the objects of medico-legal attention, is pushed to its extremest limit. In Dipsomania, the most recently differentiated form of mental disease, the unhappy victim, while retaining his intellectual power, unimpaired or not noticeably affected, while indeed he may earn his living by good intellectual work, loses all sense of moral rectitude, all domestic affection, all sense of decency; he is typically a romancer ; his solemn word of honour is worth nothing; he heeds not though he knows his auditors disbelieve every word he says ; he cares not if the whole world go to rack, provided his own selfish wants are satisfied. Again, in that It is
one
of mental
*
July
Read before the Border Counties Branch of the British Medical Association, 1878.
A
CASE OF MORAL INSANITY.
277
borderland of is the entire
insanity, Hysteria, the most characteristic feature perversion of the moral nature : a girl of the highest intelligence and most affectionate disposition, whose training has been unexceptionable, under the blight of this sad malady takes the most intense pleasure?it is the one end and aim of her existence?in practising all manner of deceptions on her friends and medical attendant; formerly of the most truthful nature, she now, from the morbid craving for notice and sympathy, lies without shame, and supports her cunninglydevised tales of imaginary disease by the most ingenious and at the same time loathsome stratagems; and she often exhibits
entire want of natural affection. In the grosser and more marked cases which are generally held to have crossed the boundary line, she resorts to incendiarism, or, it may he, to the destruction of life itself, to gratify her perverted sensibilities. We are prepared, therefore, a priori, to anticipate the existence of a distinct form of insanity, characterised " by a morbid perversion of the natural feelings, affections, inclinations, temper, habits, and moral disposition, without any notable lesion of the intellect or knowing and reasoning faculties, and particularly without any hallucination." And we are perhaps inclined to wonder that it was not differentiated as moral insanity before Dr. Pritchard's time. Moral, Affective, or Emotional Insanity has been too long recognised as a distinct psychological entity to render argument of mine in favour of its separation necessary. At the same time, I cannot think the report of one more well-marked case can be an unprofitable task, considering the number of so-called cases which have been rejected by outside sceptics, as being either mere developments of viciousness, or as involving some impairment of the intellect, and being consequently referable to previously existing subdivisions of insanity. And the case I am about to record has the additional interest of being one in which acute ideational insanity has been again and again feigned with success, for the purpose of procuring admission to lunatic asylums all over the country, thus furnishing a satisfactory answer to the query put in an interesting paper on Dr. Nicholson (Journal of Mental Science,, Feigned Insanitvby " a man, morally insane, while in one of his : Can January 1820) impulsive moods, counterfeit symptoms of ideational insanity?" and I indeed feel some compunction at not having sooner exposed the imposture, for I find that after leaving this asylum the hero of the tale at once renewed what I may call his profession of feigning insanity. If in the record of the case I may seem to descend to trivial details, and adopt a rather gossiping style of narrative, I must plead that without these the portraiture of an
A
278
CASE 0F moral insanity.
the case would be incomplete?it would be impossible to bring out all the lights and shadows of the mental constitution of the
subject. Tiiomas Nuttley
was
admitted to the Southern Counties
Asylum, Dumfries, on the 3rd of February, 1877. Little or nothing could be ascertained as to his previous history. He had been found, the day before admission, in the market-place of Annan, where he was entirely unknown, stripping himself naked, and capering with all the antics of a monkey," as the Inspector of Poor described it. He was brought before the sheriff, who, with the aid of two medical men, pronounced him insane, and sent him to the asylum. The medical certificates set forth that he had an insane appearance," was restless, refused to answer questions, talked incoherently, saying that heaven and hell were all nonsense," and that he was chewing coals while being examined. He had written down several names on a slate, but finally adhered to the one given above. He was reported as having taken no food since apprehended. "
"
"
On admission his condition was as follows:?Of middle he is stoutly built and broad-shouldered; weight, 12 5 stones, pounds; muscular system excessively developed; fatHe is a typical example of the sanguinoness considerable. neurotic temperament; complexion, ruddy; teeth, white and regular; face fringed with luxuriant brown whiskers; hair, brown ; looks like a well-conditioned farm servant; aged apparently about 24 ; pulse, 80; temperature, normal; tongue, slightly coated ; appetite, deficient; special senses, normal; pupils dilated but mobile ; has lost the two terminal phalanges He sits silent and, of the middle finger of the right hand. apparently, self-absorbed?unconscious of and undisturbed by all around him?refusing to speak a word or be roused to attention. It is noticed that his eyes have a restless, furtive look. He could not be roused from his state of stupor to take any food on the day of admission. He slept well from the first, attended to the wants of nature, and was cleanly. Our conception of the case was that it was one of Acute Dementia succeeding Mania a jjotu. On the evening of the day after admission he had begun to brighten up a little, answering in a contused way to questions (speaking with an English accent), and appeared, to some extent, cognisant of his surroundings : he had taken his food on pressure. From this time improvement was rapid; day by day he brightened, and in a week or two was evidently as well as ever lie had been, and was the liveliest and brightest patient in the house. He
height,
A
CASE OF MORAL INSANITY.
279
open, pleasant face, and most ingenuous air: was and cheerful: sang comic songs with considerable obliging effect, and distinguished himself as the most agile dancer at the weekly balls, and soon became a general favourite in the house. He read and wrote with ease, and was fond of reading, was alert and intelligent, and had some musical talent?playing mostly by ear, however. He had, nevertheless, no taste for steady work, and on one occasion entirely rebelled against it. It was observed that he had great personal vanity, and was extremely fond of decorating his person and eager for admiration. As time passed a singular hysterical and emotional temperament discovered itself. He shrank from pain, even that of a scarified of a tooth was an gum, in abject fear, while the extraction he would have died from the shock. believe impossibility?I Often he would be found in some out-of-the-way spot bathed in if his heart were broken a flood of hysterical tears, sobbing as without being able to assign any cause as a rule, sometimes in he would burst into an consequence of an absurd trifle. Again, uncontrollable paroxysm of laughter on the least excuse or at some easily passing fancy; and lie was extremely hyper-aesthetic, tickled into a state of utter helplessness. Then, while usually a trifling insult would provoke a and had
a
frank,
good-natured
pleasant,
tremendous outburst of passion. From the time lie awoke out of his stupor he became very He was a native, he told everyone, of an communicative. in the same Highland county as the reporter, adjoining parish narrative of various on and, being questioned, he volunteered a
such as only one knowing my my family history, would have done: and he spoke familiarly of perHe I was cognisant. sons I knew and recent events of which his Highland and Gaelic of his lost knowledge had, he said, He was, however, accent from long residence in Birmingham. of want his where knowledge seemed ignorant on some points face his but any half-formed dispelled frank, open ;
episodes in family well
inexplicable suspicion.
Clouds, in time, began
to form
on
the horizon.
Suspicions
to the real nature of the case would insinuate themselves, and the likelihood of its turning out a case of feigned insanity We failed entirely to obtain any clue to his was discussed. as
no corroboration of his tale could be obtained; were returned by the Post-office authorelations his letters to
previous history; rities,
the
parties being
"
unknown;"
a
portmanteau containing
all sorts of valuables which he had lost in the train could not be heard of. So that everything about him was enveloped in mystery, and patient did not throw light upon it. His inveterate mendacity could not be restrained; lie amplified his story by fictitious
a
280
CASE
OF
MORAL
INSANITY.
details which
were either on the surface contradictory or could disproved ; he romanced about everyone be came in contact with, even when he knew his fiction must be exploded the first time two people came together. He luxuriated in the
easily
be
fictions he created. He exhibited no shame when detected in falsehood, but coolly, as if playing a game of chess, withdrew it and replaced it by another equally unfounded. The climax of his " mendacity was reached in a " History of my Life which he volunteered to write. Here his extraordinary talent for interweaving fact and fiction was displayed to the best advantage. From this veracious chronicle it appeared he had been pretty nearly everywhere in Great Britain and in France, everywhere distinguishing himself in athletic sports, attending which he had made his profession. So skilfully was this done that it was impossible to find a single discrepancy or inaccuracy. As an illustration of a kleptomaniac tendency he manifested I may mention the incident of his stealing a ring from one of the tradesmen, which was a well-known ornament among the staff, and then went about showing it to everyone with childish glee, and telling half a-dozen different stories about its acquisition. I need not detail the manner in which his former history was elucidated. Suffice it to say that the following facts were ascertained :?His proper name was Thomas Barton, and he had been born in a Liverpool workhouse. He was sent, in the early part of 1875, I think, to the Lancaster County Asylum from Lancaster Castle, whilst awaiting trial on a charge of felony, at the instance of the Secretary of State as an insane prisoner. His insanity was soon pronounced feigned, and he was discharged. He was next admitted, in June 1875, to t]ie Cumberland and Westmoreland Asylum as Daniel O'Neale. He had been found very excited and quite naked, and was reported as having hallucinations and delusions. When admitted to the asylum he was dull and stupid, and would only ahswer questions when hard pressed. During the first part of his residence he was noisy, tricky, and ill-conditioned, but soon quieted down, and was discharged September 1875. He is next heard of as Daniel Barton, under which name he was admitted to the West Hiding Asylum, Wakefield, in December 1875. After a few hours, it is distinctly recorded, he manifested no symptom of insanity, and was discharged in the course of a month. Again he was sent from Lancaster County Gaol to the county asylum. Once more, while awaiting trial for a felony, his insanity was at once pronounced an imposture, and he was sent back to gaol to serve out his sentence. Next he turns up at Woodilee Asylum, Lenzie, in the end of the While here he distinguished year 1876. himself by his erotic propensities, and also by charging an
A
CASE
OF
MORAL
INSANITY.
281
attendant with
an indecent assault. His insanity was recogfeigned and he was sent adrift. But he was very soon picked iip again by the police at his old game of stripping himself naked, in the streets of Glasgow, and behaving, in popular phrase, like a madman." Sent to Woodilee Asylum again, lie was at once discharged. He put in his appearance in Annan the day after. I found that he had carefully questioned
nised
as
"
the staff at Woodilee about me, and then determined what use he could make of the information he had acquired. Last entrance of all those known to me was at the West Riding Asylum again, where he was again admitted as Thomas Scott on the 24th of August 1877, with a well-marked history of maniacal excitement. He settled down in a few hours after admission. His case was diagnosed as one of Mania apotu. Feigning was not suspected, but he was taxed with having been formerly in the asylum as Daniel Barton. This he denied, giving a plausible story about that individual being a brother of his, and very like him. I believe he is at present " wanted by the county police of Lancashire. some of
to
see
"
Most of the cases of feigned insanity on record are those of criminals who have resorted to this ruse in order to escape from the consequences of their crime. This one was no doubt similar in its beginning, but it would seem as if?once having tasted the sweets of deception?patient was unable to exist without the excitement of a life of imposture. No doubt a natural vagabond tendency, and an indisposition for steady with this craving; but these would be
occupation, conspired than counterbalanced, one would think, by the irksome restraints and exacting discipline of asylum life. And it no doubt was the absence of apparent motive which led to the imposture being so often unsuspected. At Lancaster, where a possible motive lay on the surface, the bubble was at once burst. The form of alienation simulated bears testimony to the shrewdness and ideational soundness of the patient. Nothing could be better calculated to attract public attention and ensure the prompt attention of the authorities than the popularised form of mania which he adopted?stripping the clothes is a frequent and easy commencement of such impostures. And the chewing .pieces of coal in the presence of the general practitioners I regard as a masterpiece. It is to be observed that on each occasion he adhered to the same role, by practice, hoping, no doubt, to attain perfection in it. He recognised, more
282
A
CASE OF MORAL INSANITY.
however, that it was hopeless to carry out a simulation of mania with any hope of success under the eye of skilled observers, so on each occasion we find him relapsing into the negative state of stupor or acute dementia, which, from the absence of positive symptoms, may be regarded as the easiest to counterfeit. The one discrepancy in his representation was the restless look of his eyes. Finally, we have to observe the slow, steady, natural waking up out of his sluggish condition to alert brisk health? no doubt also the result of careful design. I think, taken as a whole, the case is a typical illustration of Moral Insanity, pure and simple. That in intellectual capacity he was above the average, the cleverness of the deception might be taken as sufficient testimony. Very few in his position in life could have written so intelligent a narrative as his autobiography. That there was utter want of moral sense is, I think, equally apparent. That lie was simply criminal
He before a scientific audience. his to own but oftener lied?sometimes, advantage, far his insatiable faculty of mendacity could not be pulled \ip at the point of expediency;?he lied apparently for the mere pleasure of the thing, and quite regardless of the inevitable detection : and the exposure of his frauds he received unabashed So he stole, but for the mere charm of stealing, and shameless. The hysterical maniand without any idea of ulterior profit. festations above related complete the evidence of the entire alienation and instability of the emotional side of his mental cannot for
a
moment be no
pled
doubt,
constitution. The differentiation of moral insanity has been characterised by the sceptical, that is, in this matter, the legal, section of the public, as " an apology for crime devised by the cunning of the mad-doctors," and it is by them believed that alienist physicians have a tendency and desire to shut up pretty nearly everybody in asylums. This is, of course, entirely a misconception : it is true that specialists are able to recognise the beginnings of insanity, and its development in milder form, where its existence has been unsuspected. But I am not aware that they arrogate to themselves the right of decision as to the disposal of those That is the function of the public at more or less insane. large. Therefore, when I proceed, in conclusion, to say a word as to the disposal of the morally insane, I give my opinion as one of the general public only. I believe that dipsomaniacs and the morally insane should not be grouped for treatment in ordinary lunatic asylums. I have seen a good deal of the results of the intermixture of dipsomaniacs and, as they have been called, by way of distinction, "decent lunatics," and I am convinced that the system is entirely an erroneous one. It is
A
CASE OF MORAL INSANITY.
283
greatly to the disadvantage of the proper inmates of asylums in many ways?their moral natures suffer from the contact, and the liberties the others, safely enough, obtain engenders persistent discontent. On the other hand, I am satisfied that the chance of eure (real cure) of dipsomaniacs is infinitesimal. Temporary improvement, resulting in discharge, docs take place, and on that basis no doubt the recoveries are generally calculated. But permanent recovery is a very rare occurrence. I am equally convinced that no system of treatment will give satisfactory results, either in dipsomania or moral insanity, until compulsory detention?let it be on the verdict of a popular jury on evidence, lay and medical?in an institution of a directly reformatory nature is adopted. The strictest discipline should prevail. The inmates should earn their bread, each one, and relieve their friends or the taxpayers of the burden of their maintenance by the labour of their heads and hands, and the sweat of their brows, while all infractions of the regulations should be treated by distinctly punitive remedies. It is not to be expected that even by such means the more marked cases shall develop a healthy, moral disposition: in some cases it has been congenital^ absent; but at any rate, an artificial regulating power of control may be produced which will ride the patient's future life to his own advantage, and no more to the detriment of society.
If the record of the present case be of no further use it will at least serve to put the medical officers ot asylums on their guard in view of a probable visit from one who apparently intends making a profession of feigning insanity. That he is not, though insane, a fit subject for asylum treatment is clear; nor do I think that his ultimate disposal in penal servitude is the proper, though it is the probable, solution of the difficulty, as the law at present stands.
Art. V.?A CASE OF MORAL INSANITY.* By A. C. MUXRO, M.B., M.R.C.P.E., Soutliorn Counties Asylum, Dumfries.
of the first observations made by the tyro in the study diseases, that in insanity the moral powers are almost invariably affected as well as the intellectual. The selfishness, the ingratitude, and the animal propensities of the insane constitute one of the great discouragements of alien practice. It is further observed that in certain forms of disease the moral faculties are those principally affected. Thus Epileptic Insanity is, of all varieties, the most repulsive in its mental manifestations: in very many cases where the congenital existence, or long continuance, of the disease does not forbid any mental activity, the moral nature is seen to be entirely warped and distorted, all perception of right and wrong fades away as the disease progresses, the patient lies unblushingly, steals what he or she may, is shamelessly erotic, ravenously gluttonous, malicious, frequently homicidal, often assuming the next moment after an almost demoniacal outburst the demeanour of a saint and the loudest protestations of piety, such complete perversion being of most frequent occurrence in the female, predisposed to it by her dominant emotionalism. All this, as the asylum physician has often to point out to the indignant attendant, is purely the result of disease, and is no more, or very little more, under control than the preceding or succeeding convulsion. -It strikes one, in reading reports of medicolegal proceedings in which questions of epileptic responsibility have to be discussed, that sufficient prominence is not given to this consideration; while the automatic theory of the action of the patient or criminal which may have made them the objects of medico-legal attention, is pushed to its extremest limit. In Dipsomania, the most recently differentiated form of mental disease, the unhappy victim, while retaining his intellectual power, unimpaired or not noticeably affected, while indeed he may earn his living by good intellectual work, loses all sense of moral rectitude, all domestic affection, all sense of decency; he is typically a romancer ; his solemn word of honour is worth nothing; he heeds not though he knows his auditors disbelieve every word he says ; he cares not if the whole world go to rack, provided his own selfish wants are satisfied. Again, in that It is
one
of mental
*
July
Read before the Border Counties Branch of the British Medical Association, 1878.
A
CASE OF MORAL INSANITY.
277
borderland of is the entire
insanity, Hysteria, the most characteristic feature perversion of the moral nature : a girl of the highest intelligence and most affectionate disposition, whose training has been unexceptionable, under the blight of this sad malady takes the most intense pleasure?it is the one end and aim of her existence?in practising all manner of deceptions on her friends and medical attendant; formerly of the most truthful nature, she now, from the morbid craving for notice and sympathy, lies without shame, and supports her cunninglydevised tales of imaginary disease by the most ingenious and at the same time loathsome stratagems; and she often exhibits
entire want of natural affection. In the grosser and more marked cases which are generally held to have crossed the boundary line, she resorts to incendiarism, or, it may he, to the destruction of life itself, to gratify her perverted sensibilities. We are prepared, therefore, a priori, to anticipate the existence of a distinct form of insanity, characterised " by a morbid perversion of the natural feelings, affections, inclinations, temper, habits, and moral disposition, without any notable lesion of the intellect or knowing and reasoning faculties, and particularly without any hallucination." And we are perhaps inclined to wonder that it was not differentiated as moral insanity before Dr. Pritchard's time. Moral, Affective, or Emotional Insanity has been too long recognised as a distinct psychological entity to render argument of mine in favour of its separation necessary. At the same time, I cannot think the report of one more well-marked case can be an unprofitable task, considering the number of so-called cases which have been rejected by outside sceptics, as being either mere developments of viciousness, or as involving some impairment of the intellect, and being consequently referable to previously existing subdivisions of insanity. And the case I am about to record has the additional interest of being one in which acute ideational insanity has been again and again feigned with success, for the purpose of procuring admission to lunatic asylums all over the country, thus furnishing a satisfactory answer to the query put in an interesting paper on Dr. Nicholson (Journal of Mental Science,, Feigned Insanitvby " a man, morally insane, while in one of his : Can January 1820) impulsive moods, counterfeit symptoms of ideational insanity?" and I indeed feel some compunction at not having sooner exposed the imposture, for I find that after leaving this asylum the hero of the tale at once renewed what I may call his profession of feigning insanity. If in the record of the case I may seem to descend to trivial details, and adopt a rather gossiping style of narrative, I must plead that without these the portraiture of an
A
278
CASE 0F moral insanity.
the case would be incomplete?it would be impossible to bring out all the lights and shadows of the mental constitution of the
subject. Tiiomas Nuttley
was
admitted to the Southern Counties
Asylum, Dumfries, on the 3rd of February, 1877. Little or nothing could be ascertained as to his previous history. He had been found, the day before admission, in the market-place of Annan, where he was entirely unknown, stripping himself naked, and capering with all the antics of a monkey," as the Inspector of Poor described it. He was brought before the sheriff, who, with the aid of two medical men, pronounced him insane, and sent him to the asylum. The medical certificates set forth that he had an insane appearance," was restless, refused to answer questions, talked incoherently, saying that heaven and hell were all nonsense," and that he was chewing coals while being examined. He had written down several names on a slate, but finally adhered to the one given above. He was reported as having taken no food since apprehended. "
"
"
On admission his condition was as follows:?Of middle he is stoutly built and broad-shouldered; weight, 12 5 stones, pounds; muscular system excessively developed; fatHe is a typical example of the sanguinoness considerable. neurotic temperament; complexion, ruddy; teeth, white and regular; face fringed with luxuriant brown whiskers; hair, brown ; looks like a well-conditioned farm servant; aged apparently about 24 ; pulse, 80; temperature, normal; tongue, slightly coated ; appetite, deficient; special senses, normal; pupils dilated but mobile ; has lost the two terminal phalanges He sits silent and, of the middle finger of the right hand. apparently, self-absorbed?unconscious of and undisturbed by all around him?refusing to speak a word or be roused to attention. It is noticed that his eyes have a restless, furtive look. He could not be roused from his state of stupor to take any food on the day of admission. He slept well from the first, attended to the wants of nature, and was cleanly. Our conception of the case was that it was one of Acute Dementia succeeding Mania a jjotu. On the evening of the day after admission he had begun to brighten up a little, answering in a contused way to questions (speaking with an English accent), and appeared, to some extent, cognisant of his surroundings : he had taken his food on pressure. From this time improvement was rapid; day by day he brightened, and in a week or two was evidently as well as ever lie had been, and was the liveliest and brightest patient in the house. He
height,
A
CASE OF MORAL INSANITY.
279
open, pleasant face, and most ingenuous air: was and cheerful: sang comic songs with considerable obliging effect, and distinguished himself as the most agile dancer at the weekly balls, and soon became a general favourite in the house. He read and wrote with ease, and was fond of reading, was alert and intelligent, and had some musical talent?playing mostly by ear, however. He had, nevertheless, no taste for steady work, and on one occasion entirely rebelled against it. It was observed that he had great personal vanity, and was extremely fond of decorating his person and eager for admiration. As time passed a singular hysterical and emotional temperament discovered itself. He shrank from pain, even that of a scarified of a tooth was an gum, in abject fear, while the extraction he would have died from the shock. believe impossibility?I Often he would be found in some out-of-the-way spot bathed in if his heart were broken a flood of hysterical tears, sobbing as without being able to assign any cause as a rule, sometimes in he would burst into an consequence of an absurd trifle. Again, uncontrollable paroxysm of laughter on the least excuse or at some easily passing fancy; and lie was extremely hyper-aesthetic, tickled into a state of utter helplessness. Then, while usually a trifling insult would provoke a and had
a
frank,
good-natured
pleasant,
tremendous outburst of passion. From the time lie awoke out of his stupor he became very He was a native, he told everyone, of an communicative. in the same Highland county as the reporter, adjoining parish narrative of various on and, being questioned, he volunteered a
such as only one knowing my my family history, would have done: and he spoke familiarly of perHe I was cognisant. sons I knew and recent events of which his Highland and Gaelic of his lost knowledge had, he said, He was, however, accent from long residence in Birmingham. of want his where knowledge seemed ignorant on some points face his but any half-formed dispelled frank, open ;
episodes in family well
inexplicable suspicion.
Clouds, in time, began
to form
on
the horizon.
Suspicions
to the real nature of the case would insinuate themselves, and the likelihood of its turning out a case of feigned insanity We failed entirely to obtain any clue to his was discussed. as
no corroboration of his tale could be obtained; were returned by the Post-office authorelations his letters to
previous history; rities,
the
parties being
"
unknown;"
a
portmanteau containing
all sorts of valuables which he had lost in the train could not be heard of. So that everything about him was enveloped in mystery, and patient did not throw light upon it. His inveterate mendacity could not be restrained; lie amplified his story by fictitious
a
280
CASE
OF
MORAL
INSANITY.
details which
were either on the surface contradictory or could disproved ; he romanced about everyone be came in contact with, even when he knew his fiction must be exploded the first time two people came together. He luxuriated in the
easily
be
fictions he created. He exhibited no shame when detected in falsehood, but coolly, as if playing a game of chess, withdrew it and replaced it by another equally unfounded. The climax of his " mendacity was reached in a " History of my Life which he volunteered to write. Here his extraordinary talent for interweaving fact and fiction was displayed to the best advantage. From this veracious chronicle it appeared he had been pretty nearly everywhere in Great Britain and in France, everywhere distinguishing himself in athletic sports, attending which he had made his profession. So skilfully was this done that it was impossible to find a single discrepancy or inaccuracy. As an illustration of a kleptomaniac tendency he manifested I may mention the incident of his stealing a ring from one of the tradesmen, which was a well-known ornament among the staff, and then went about showing it to everyone with childish glee, and telling half a-dozen different stories about its acquisition. I need not detail the manner in which his former history was elucidated. Suffice it to say that the following facts were ascertained :?His proper name was Thomas Barton, and he had been born in a Liverpool workhouse. He was sent, in the early part of 1875, I think, to the Lancaster County Asylum from Lancaster Castle, whilst awaiting trial on a charge of felony, at the instance of the Secretary of State as an insane prisoner. His insanity was soon pronounced feigned, and he was discharged. He was next admitted, in June 1875, to t]ie Cumberland and Westmoreland Asylum as Daniel O'Neale. He had been found very excited and quite naked, and was reported as having hallucinations and delusions. When admitted to the asylum he was dull and stupid, and would only ahswer questions when hard pressed. During the first part of his residence he was noisy, tricky, and ill-conditioned, but soon quieted down, and was discharged September 1875. He is next heard of as Daniel Barton, under which name he was admitted to the West Hiding Asylum, Wakefield, in December 1875. After a few hours, it is distinctly recorded, he manifested no symptom of insanity, and was discharged in the course of a month. Again he was sent from Lancaster County Gaol to the county asylum. Once more, while awaiting trial for a felony, his insanity was at once pronounced an imposture, and he was sent back to gaol to serve out his sentence. Next he turns up at Woodilee Asylum, Lenzie, in the end of the While here he distinguished year 1876. himself by his erotic propensities, and also by charging an
A
CASE
OF
MORAL
INSANITY.
281
attendant with
an indecent assault. His insanity was recogfeigned and he was sent adrift. But he was very soon picked iip again by the police at his old game of stripping himself naked, in the streets of Glasgow, and behaving, in popular phrase, like a madman." Sent to Woodilee Asylum again, lie was at once discharged. He put in his appearance in Annan the day after. I found that he had carefully questioned
nised
as
"
the staff at Woodilee about me, and then determined what use he could make of the information he had acquired. Last entrance of all those known to me was at the West Riding Asylum again, where he was again admitted as Thomas Scott on the 24th of August 1877, with a well-marked history of maniacal excitement. He settled down in a few hours after admission. His case was diagnosed as one of Mania apotu. Feigning was not suspected, but he was taxed with having been formerly in the asylum as Daniel Barton. This he denied, giving a plausible story about that individual being a brother of his, and very like him. I believe he is at present " wanted by the county police of Lancashire. some of
to
see
"
Most of the cases of feigned insanity on record are those of criminals who have resorted to this ruse in order to escape from the consequences of their crime. This one was no doubt similar in its beginning, but it would seem as if?once having tasted the sweets of deception?patient was unable to exist without the excitement of a life of imposture. No doubt a natural vagabond tendency, and an indisposition for steady with this craving; but these would be
occupation, conspired than counterbalanced, one would think, by the irksome restraints and exacting discipline of asylum life. And it no doubt was the absence of apparent motive which led to the imposture being so often unsuspected. At Lancaster, where a possible motive lay on the surface, the bubble was at once burst. The form of alienation simulated bears testimony to the shrewdness and ideational soundness of the patient. Nothing could be better calculated to attract public attention and ensure the prompt attention of the authorities than the popularised form of mania which he adopted?stripping the clothes is a frequent and easy commencement of such impostures. And the chewing .pieces of coal in the presence of the general practitioners I regard as a masterpiece. It is to be observed that on each occasion he adhered to the same role, by practice, hoping, no doubt, to attain perfection in it. He recognised, more
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A
CASE OF MORAL INSANITY.
however, that it was hopeless to carry out a simulation of mania with any hope of success under the eye of skilled observers, so on each occasion we find him relapsing into the negative state of stupor or acute dementia, which, from the absence of positive symptoms, may be regarded as the easiest to counterfeit. The one discrepancy in his representation was the restless look of his eyes. Finally, we have to observe the slow, steady, natural waking up out of his sluggish condition to alert brisk health? no doubt also the result of careful design. I think, taken as a whole, the case is a typical illustration of Moral Insanity, pure and simple. That in intellectual capacity he was above the average, the cleverness of the deception might be taken as sufficient testimony. Very few in his position in life could have written so intelligent a narrative as his autobiography. That there was utter want of moral sense is, I think, equally apparent. That lie was simply criminal
He before a scientific audience. his to own but oftener lied?sometimes, advantage, far his insatiable faculty of mendacity could not be pulled \ip at the point of expediency;?he lied apparently for the mere pleasure of the thing, and quite regardless of the inevitable detection : and the exposure of his frauds he received unabashed So he stole, but for the mere charm of stealing, and shameless. The hysterical maniand without any idea of ulterior profit. festations above related complete the evidence of the entire alienation and instability of the emotional side of his mental cannot for
a
moment be no
pled
doubt,
constitution. The differentiation of moral insanity has been characterised by the sceptical, that is, in this matter, the legal, section of the public, as " an apology for crime devised by the cunning of the mad-doctors," and it is by them believed that alienist physicians have a tendency and desire to shut up pretty nearly everybody in asylums. This is, of course, entirely a misconception : it is true that specialists are able to recognise the beginnings of insanity, and its development in milder form, where its existence has been unsuspected. But I am not aware that they arrogate to themselves the right of decision as to the disposal of those That is the function of the public at more or less insane. large. Therefore, when I proceed, in conclusion, to say a word as to the disposal of the morally insane, I give my opinion as one of the general public only. I believe that dipsomaniacs and the morally insane should not be grouped for treatment in ordinary lunatic asylums. I have seen a good deal of the results of the intermixture of dipsomaniacs and, as they have been called, by way of distinction, "decent lunatics," and I am convinced that the system is entirely an erroneous one. It is
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CASE OF MORAL INSANITY.
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greatly to the disadvantage of the proper inmates of asylums in many ways?their moral natures suffer from the contact, and the liberties the others, safely enough, obtain engenders persistent discontent. On the other hand, I am satisfied that the chance of eure (real cure) of dipsomaniacs is infinitesimal. Temporary improvement, resulting in discharge, docs take place, and on that basis no doubt the recoveries are generally calculated. But permanent recovery is a very rare occurrence. I am equally convinced that no system of treatment will give satisfactory results, either in dipsomania or moral insanity, until compulsory detention?let it be on the verdict of a popular jury on evidence, lay and medical?in an institution of a directly reformatory nature is adopted. The strictest discipline should prevail. The inmates should earn their bread, each one, and relieve their friends or the taxpayers of the burden of their maintenance by the labour of their heads and hands, and the sweat of their brows, while all infractions of the regulations should be treated by distinctly punitive remedies. It is not to be expected that even by such means the more marked cases shall develop a healthy, moral disposition: in some cases it has been congenital^ absent; but at any rate, an artificial regulating power of control may be produced which will ride the patient's future life to his own advantage, and no more to the detriment of society.
If the record of the present case be of no further use it will at least serve to put the medical officers ot asylums on their guard in view of a probable visit from one who apparently intends making a profession of feigning insanity. That he is not, though insane, a fit subject for asylum treatment is clear; nor do I think that his ultimate disposal in penal servitude is the proper, though it is the probable, solution of the difficulty, as the law at present stands.
