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ness; and in this sense an insane delusion is a fixed belief in the mind of the patient of the existence of a fact which has no objective existence but is purely the flgment of his ini-iglnation, and which is so extravagant that no sane person would believe it under the circumstances of the case, the belief, nevertheless. being so unchangeable that the patient is incapable of being permanently dis- alinsed by argument or proof. The characteristic which distinguishes an "iusane" de- lusion from other mistaken beliefs is that it is not a product of the reason but of the liuagiuation, that is, not a mistake of fact induced by deception, fraud. insuificient exi- dence, or erroneous reasoning, but the spontaneous conception of a perverted imagination, having no basls whatever in reason or evidence. Riggs v. Missionary Soc.. 35 Hun (N. Y.) 658; Buchanan v. Pierie, 205 Pa. 123, 54 At]. 583, 97 Am. St. Rep. ‘T25; Gass v. Gass, 3 Duuipli. (Teun.) 283; Dew v. Clarke, 3 Add. 79 In re Bennett's Estate, 201 Pa. 485. 51 Atl 336; In re Scott's Estate. 128 Cal 57. 60 Pac. 527; Smith v. Smith, 48 N. .1. Eq. 566, 25 Atl. 11: Guiteau’s Case (D. C.) 10 Fed. 170; State v. Lewis, 20 Nev. 333, 22 Pac. 2-11; In re Ivhite, 121 N. Y. 406. 24 N. E. 935: Potter r. Jones. 20 Or. 239. 25 Pac. T09. 12 L. R. A. 161. As to the dlstiuctions between "Delusion" and "Illuslou" and "Hai- lncination," see those titles.

Form: and varieties of insanity. Without attempting a scientific classification of the numerous types and forms of insanity, (us to which it may be said that there is as yet no final aureemeut uruong psychologists and aiienists either as to analysis or uouienclature_.) definitions und exulauitions will here be appended of the compound and descriptive ‘terms most com- monly met with in medical jurisprudence. And, hrst, as to the origins or causes of the disease: Traumatic insanity is such as results from a wound or iujiiiy. particularly to the head or brain. such as iractnre of the skull or concussion of the hruiu.—Idiopnthic insanity is such as results from a disease of the brain it- self, lesions of the cuitex. cerebral nucmia, etc. —Cnng'enitn.l insanity is that which exists from the birth of the afient, and is (in la") properly callcd "idiocy.’ See supra.-Gratin- luu is a fonn of imperfect or urrssted mental dciclopmcnt, which may amount to idiocy, with physical degenriitcy or deformity or lack of development; cndci.u.ic in Svritzerl-ind und some other parts of Europe, but the term is applied to simii.-ir status occurring elsewhere.—Pella- gran: insanity. Insanity caused by or Ileprived from pellagra, which is an endemic disease of southern Europe. (though not confined to that region.) characterized by erythema. digestive derangement, and nervous aifections. (Cent. DIct)—Polynen1'ltic insanity la insanity arising from an inflammation of the nerves, of the kind called "polyneuritis" or "mul- tiple neuritis" because it involves several ncru-s at the same time. This is often preceded by tuberculosis and almost always by alcaholisin. and is characterized specially by delusions and falsitication of the Lucumry. It is otherwise cal "KoissahotE’s disease." (Kraepelin )— Clmreic insanity is insanity arising from (.'b|)II.fl the latter being a nervous disease, more commonly attacking children than adults. char- o.ctcrize(l by irrz=_';nlar and involuntary twitch- mfis uf the muscles of the limbs and face, popu-

633

INSANITY

larly called "St. Vitus’ da.uce."—Pnsx-per-3.1 insanity is mental derangement occurring in women at the time of child-birth or immediately after; it is also called "eclampaia partim'.entium..'—Fulie Izrlghtiqnn. A such term sometimes used to designate an access of insanity resulting from nephritis or "Bright's dis»- ease." See In re l\IcKcan's Will, 31 Misc. Rep. 703. 66 N. Y. Supp. .—Delir-inni tremens. A disease of the nervous system, induced by the excessive and protracted use of intoxicating liq- uors, and ulfecting the brain so as to produce incoherence and lack of continuity in the intellectual processes. a suspension or perversion of the power of volition, and delusions, particular- ly of a terrifying nature, but not generally prompting to violence except in the eifoit to escape from imaginary dangers. It is recognized in law as a form of insanity, and may be of such a nature or intensity as to render the patient legally incapable of committing a crime. United States v. McGlue. 1 Curt. 1. 36 Fed. Cas. 1003; Insurance Co. v. Deming, 123 Ind. 38-}, 24 1\’. E. 86: Macounehey v. State. 5 Ohio St. 77: Erwin v. State. 10 Tex. App. 700; Carter v. State, 12 Tex. 500. 62 Am. Dec. 539. In some states the insanity of alcoholic intoxication is classed as "tei;uporary," where induced by the voluntary recent use of ardent spirits and carried to such a degree that the person becomes incapable of judging the consequences or the moral aspect of his acts, and "settled." where the condition ls that of dz-liriimi tremens. Settled insanity, in this sense, excuses from civil or criminal responsibility; temporary insanity does not. The ground of the distinction is that the former is a remote effect of imiiihiu alcoholic iiquors and ls not valunturily inciirre. while the latter is a direct result voluntarily sought for. Evers v. State, 31 Tex. Cr. B. 318, 20 S. W. 44. 18 L. R. A. 421. 37 Am. St. itep. 811: Maconnehey v. State. 5 Ohio St 77. —Syphilitic insanity is prircsia or progressive imbecility resulting from the infection of oyphwlia. It is sometimes called as being a se- quence or result of that disease) ‘metnay/philis" or "pm-«.91/pIu'Iis."—Ta.Iietic dementia. form of mental derangement or Insanity complicated with "tabca dorsalia" or IO[II7fl0tD1' atmtiu, which generally precedes, or somvfimes follows, the mental attack. As to insanity resulting from cerebrai embolism, see mLaoLIsM; from cpilepsy, sec EPILEPSY As to chronic alcoholism as a form of insanity. see ALcoi-ioI.- rsii.

General descriptive and clinical terms. —.Afi"ective insnnity. modern comprehensive term descriptive of all those fonns of insanity which affect or relate to the feelings and emotions and hence to the ethical and social relations of the i.ndividual.—Xnvolntional in- ‘ That which sometimes accompanies voluiinn" of the physical structure and physiology of the individual, the reverse of their "evolutiou." hence practically equivalent to the imbecilily of old age or senile dcmeutin.—Ma- niacal-depressive insanity. -\ form nf insanity characterized by alternating periods of high maniacal excitement and of deprcssud and stilprous conditions in the nature of or resembling nielonr-hnlia. nftnn occurring as a series or c_\cle of lsolatcd att'ir-ks, with more or loss complete restoration to lIF"llll.] in the intervals. lliraepelin.) This is otherwise calieil "cii-ciilnr insanity" or "circular stupor."—Oirculnr insanity. Another name for maniacal ilnpressive insunitv, which aci>.—Piu'tin1 insanity, as a legal term, may mean either nionomanin (see infra) or an intermediate stage in the develop- ment of mental dcrnugement. lo the former sense. it does not relieve the patiint from responsibility for his acts. except where ilJStl£llted directly by his particular delusion or ol ~ession. Com. v. Mosler, 4 Pa. 2204: Cam. v. Harnci. 199 Pa. 335, 49 All. GO; Trich v. Thr- 163 Pu. SS6, 30 AH. 10.33. In the latter sense,

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