RESPONSIBILITY IN MENTAL DISEASE. 85 



and bodily symptoms which, our experience has taught us, corre- 

 spond with complete paralysis of will. 



A lunatic may unquestionably commit a crime under ordinary 

 motives. It can not be contended that every mental oddity and 

 isolated delusion is to put a man beyond the pale of the law, but 

 it is to be remembered that a really isolated delusion is a rarity, 

 and that most delusions are but local manifestations of a consti- 

 tutional vice, involving weakening of will. Most lunatics are, it 

 has been said, mad to their finger-tips ; and what appear to be 

 their sane acts are generally more or less tinctured with insanity. 



I can not pause here even to sketch the several stages of men- 

 tal dissolution, but I would suggest that there are practically three 

 levels of these in connection with lunatic crime. They are the 

 ideational level, the impulsive level, and the automatic level. On 

 the first, the ideational level, the criminal act is committed under 

 the influence of an insane motive or a delusion or hallucination, 

 with consciousness at the time and remembrance afterward of all 

 that has taken place, but in consequence of a diminution of inhibi- 

 tory or resisting power. On the second, it is committed under 

 the stress of a sudden and irresistible impulse, which is often a 

 reversion to a mere animal instinct, with vague or imperfect con- 

 sciousness at the time, obscure remembrance afterward, and under 

 a still more grave paresis of inhibitory power. On the third, it is 

 committed under the influence of accidental or reflex suggestion, 

 without consciousness at the time or remembrance afterward, and 

 during the complete abrogation of inhibitory power. As illustra- 

 tions, I may mention on the first level the case of a man who kills 

 his friend with elaborate preparation to spare him suffering, be- 

 cause he has been told by the archangel Michael that the death of 

 that friend is necessary to the extinction of Freemasonry, which 

 is the curse of the human race, and who afterward describes the 

 homicide' in detail, and with evident pride and satisfaction; on the 

 second level, the case of a puerperal woman, who, seeing a glitter- 

 ing knife by her bedside, suddenly cuts her baby's throat, without 

 afterward having any clear recollection of the event or being able 

 to say why she did it, although the knowledge that she had done 

 it fills her with grief and remorse ; and on the third level, the case 

 of an epileptic, who, while recovering from a fit, kills whoever 

 happens to be nearest to him, while still unconscious, and who 

 retains afterward no trace of recollection of the tragedy. 



It seems to me that nothing has more retarded an approach to 

 a just appreciation of the relations of responsibility and disease 

 than the assent, tacit or explicit, generally given to the dogma 

 that the existence of insanity is a question for men of common 

 sense a question which they are quite as capable of deciding as 

 medical men or experts. The late Lord Shaftesbury, who, by his 



