8z THE POPULAR SCIENCE MONTHLY. 



commends itself to medical men was never more clearly and suc- 

 cinctly expressed than by Lord Bramwell when in the Dove case 

 he asked, " Could he help it ? " Could he or she help it ? That is 

 the real practical question at issue in every case in which the 

 defense of insanity is set up. Was the lunatic free to choose, or 

 under the duress of disease ? Was his will incapable or inept ? 

 But Lord Bramwell and those who think with him argue that 

 it is sufficiently proved that the lunatic could help it if he knew 

 the nature of his act viz., that it was killing ; the quality of his 

 act viz., that it was a crime ; and also that it was wrong in the 

 sense of being forbidden by law. Whereas medical men, almost 

 without exception, maintain that a lunatic may be able to know 

 and express the nature and quality of an act and its wrongness, 

 and yet be as unable to resist doing it as he is to abstain from 

 j limping under a smart electric shock ; and that knowledge of the 

 nature and quality of an act and its wrongness is not in the 

 regions of pathology any measure of will-power. And not only 

 medical men, but judges, have perceived this. The late Lord 

 Chief -Justice Cockburn said, " The power of self-control, when 

 destroyed or suspended by mental disease, becomes, I think, an 

 essential element in the question of responsibility." And Mr. 

 Justice Stephen has said, " It ought to be the law of England 

 that no act is a crime if the person who does it is at the time 

 when it is done prevented by defective mental power, or by any 

 disease affecting his mind, from controlling his own conduct, unless 

 the absence of the power of self-control has been produced by his 

 own default." This statement of the law, which has been verbally 

 amended by Dr. Bucknill, really covers all that medical men have 

 ever contended for, and, having received it from so high an au- 

 thority, it is their duty to do their best to secure its acceptance, 

 and provide trustworthy tests of loss of self-control. 



Now, impairment of will, or loss of self-control, more or less 

 pronounced, is, according to medical men, the first, last, and uni- 

 versal element in insanity, and ranges from a trifling reduction in 

 the check-action which we exercise on the ordinary currents of 

 thought and feeling down to paralysis of the sphincters. Dissolu- 

 tion and insanity is dissolution implies a reversal of evolution, 

 and in insanity we have, as Dr. Hnghlings Jackson has taught us, 

 a process of undevelopment, or taking to pieces, in the highest 

 centers, which are the crown or climax of nervous evolution. In 

 it we have " a descent from the least organized, most complex, and 

 most voluntary, toward the most organized, most simple, and least 

 voluntary." There is in every case of insanity impairment of vol- 

 untary control, and as a consequence of this there is more or less 

 license given to those lower mental functions which are during 

 sanity under voluntary control, and which become then overactive, 



