Page:The New International Encyclopædia 1st ed. v. 10.djvu/735

* INSANITY. 649 INSANITY. magical retiioval of manifestations by specific drugs. All improvement is slow. Dietetics forms an important part of the regimen; as do regular exercise; judicious control or direction; diversion by means of games, music, or tlie play; occupation, which is of great importance ; isola- tion from worry, care, noise, coni[)any. or habit- ual environment; and the contact with the liealthy, hopeful, reasoning minds of nurses and j)hysicians. Drugs are indisi)ensable in many conditions of malnutrition, insomnia, disordered circulation, etc. Restraint by means of me- chanical contrivances is almost abolished in well-ordered asylums, except the restraint of con- finement and of legulations. But some form of iDechanical restraint is necessary and very help- ful in certain cases, such as absolute refusal to take food, or determined attempts at suicide. Most cases require sanitarium or asylum treat- ment. Medico-Legal Aspects of Issaxitv. The plea of insanity as an excuse for crime has been fashionable at internals. There are eases of im- perative impulse in partial degenerative insanity under which the lunatic commits an act which would be a crime in a sane man, but for which (he lunatic is irresponsible. Xo case occurs in which but one insane act is committed, while the person wa.s well balanced before that act and remains well balanced forever after it. In au- thentic cases, a well-marked history of insanity before the act can be elicited, and insanity continues thereafter. 'Temporary aberration' in an otherwise sane person does not occur. Am- nesic and irresponsible intervals occur in psychic epilepsy (see Kpilepsy), during which crime may be committed ; but the preceding and continuing epilepsy will be established. The knowledge of right and wrong is an improper basis upon which to judge the mental condition of a criminal. With a keen sense of right and wrong, a desire to do the right, and a dread of punishment, an insane person may obey and com- mit a crime under the all-powerful compulsion of an imjMirative impulse, in utter helplessness. But when insanity is established as the cause of a crime, the unfortunate perpetrator should be committed to an asylum in place of a jail. Lunatics should be. in general, confined in hos- pitals or retreats. Their prospect of improvement or recovery is never injured by incarceration in a proper institution. Society deserves protection from their acts, fraught with danger to them- selves or ethers. The physical and financial interests of their families desen-e consideration. Their individual interests are advanced by con- finement. Commitment of the Insane to Asylims or Hospitals. In many countries, and in most of the States in the Union, special safeguards are erected by laws to prevent the confinement of sane people in institutions for the insane, as well as to secure to the insane a full enjoyment of their rights. For instance, in the State of New York an alleged insane person may be com- mitted to an institution for the reception and care of the insane only after a complicated, though not public, process. In this State the word asylum is used no longer, but has been replaced by the term hospital. There are no more 'keepers;' but niirses and attendants have the immediate care of the mentally astray. A Commission in Lunacy controls all matters re- lating to the insane. This commission ia com- po.sed of a medical man of at least five years' e.perience in the actual care of the insane in an institution of some size, a lawyer, and a layman, all three appointed by the Governor of the State. These commissioners issue or revoke licenses to physicians or to State hospitals whereby they are permitted to conduct or for- bidden to conduct institutions for the care and treatment of the insane. Thej' also are charged with the duty of visiting all institutions, super- vising, and in a sense directing their govern- ment. Any judge of a court of record may appoint as an e.aniiner in lunacy a physician of whom he approves, who has been in the actual practice of his profession at least three years, and who is a permanent resident of the State. The commitment paper, as formulated by the New York State Commission, consists of five parts: (1). petition, to be made by a member of the family of the alleged insane person, by a person living in the house with him, or by a county officer, setting forth the reasons of "the petitioner for believing the person in.sane, and asking the court to act in the matter; (2) a certificate made under oath by two examiners in lunacy, giving the results of their joint examination of the patient; (3) a waiver of personal service of the order of court upon the person in question, to be signed by the commit- ting justice in his discretion, or a substitutional service: (4 1 an order f<jr a hearing before the justice, if in his opinion this be necessary or desirable, or be requested : ( i5 ) an order of a judge of a court of record committing the alleged insane person to the chosen hospital or retreat, after officially declaring him to be insane. In the case of indigent lunatics, who are partially or totally a charge upon the State, a further statement is made by .the justice concerning the patient's financial condition, far as can be ascertained. This entire proceeding may be con- cluded, with the exception of the hearing, with- out publicity or violation of the privacy that should surround family matters; yet it prevents a conspiracy to incarcerate a sane man as insane. Bibliography. Bucknill and Tuke, Psycho- logical Medicine (4th ed.. London, 1879) ; Ham- mond, Treatise on hixnnitii (New York, 1S83) ; Spitzka, Manual of Insanity (New York, 1889) ; Bevan Lewis, Text-book of Mental Diseases (Philadelphia. 18g9) : Mercier, inanity and In- sanity (New York, 1892); KirchhoflF, Hand- book of Insanity (New York. 189.5) ; Church and Peterson, Xervotis and Mental Diseases (2d ed.. Philadelphia. 1901). INSANITY. Technically, in law. a disea,se or disturbance of the mental faculties which may produce some effect on the legal character or quality of the insane person's acts. It may or may not render him jio/i compos mentis, that is, subject to legal restraint or control of his person and property. It may thus be distinguished from lunacy, which may be de- scribed as such mental unsoundness as to in- capacitate the insane person for all legal trans- actions and justify the State through the proper agency in taking charge of his person and prop- erty. The discussion of the legal control of the person and property of lunatics, or those who are iioii compos mentis, is reserved for the article on LiNACY. The law takes cognizance of insane