THE JURISPRUDENCE OF INSANITY. 51 



I don't know) that such cases are comparatively rare ; when they do 

 occur, it is manifest that if that be the weight of medical evidence 

 no judge would feel disposed to set it aside in favour of a finding of 

 mental unsoundness by reason of rational conduct in the person so 

 aflPected. Conduct is deceptive and can be simulated when the 

 indicia of disease cannot be concealed. The important part of Dr. 

 Hammond's evidence is the following : — 



Q. What has been your experience in cases of this character ending in 

 mental disorder ? — A. I have known several cases where that has occurred, 

 one especially, that of a distinguished actor, under my charge for several 

 years with Locomotor Ataxia, and not shewing any mental aberration until 

 towards the last of his life, when there was decided mental disorder. 



Q. Does the mental aberration you refer to point toward any particular 

 form of mental disorder ? — A. I should say distinctly, no, it does not, but 

 there is a disease of the brain that occasionally resembles in its ataxic symp- 

 toms Locomotor Ataxia. There is a cerebral form of Locomotor Ataxia, 

 which is not common, and a spinal form of general paralysis of the insane. 

 In the one case, the mental symptoms are superadded to the spinal ; in the 

 other, the spinal are superadded to the mental. 



Q. Is it the exception or the rule that in disease of Locomotor Ataxia the 

 brain becomes affected through the medulla oblongata ? — A. The brain may be 

 affected in two days in Locomotor Ataxia, either by extension through the 

 medulla oblongata or indirectly through the sympathetic nerve. 



Q. In case the brain is affected by the former, what symptoms are present ? 

 — A. Irregular action of the heart ; nausea and vomiting ; difficulty of swal- 

 lowing, and irregular respiration. Locomotor Ataxia sometimes ends life 

 suddenly, before the morbid symptoms reaches the brain. 



Q. Does any implication of the medulla oblongata necessarily suppose men- 

 tal disease ? — A. It does not. 



Q. What percentage of cases of Locomotor Ataxia coming under your ob- 

 servation resulted in mental disease ? — A. I should say not one per cent. In 

 the sixth edition of my book on nervous diseases, I did not call attention to 

 insanity as a symptom of the disease. Locomotor Ataxia. This may be be- 

 cause my attention was not specially directed to it, and since such sixth 

 edition, I have seen seven or eight cases. My sixth edition was written four 

 years ago, and my new book, soon to appear, will express my views upon this 

 point. The recognition that there are sometimes symptoms of insanity ac- 

 companying Locomotor Ataxia, is a fact comparatively recent. 



Q. What would you regard as the best indication that a patient affected 

 with Locomotor Ataxia was progressing towards insanity ? — A. The recurrence 

 of delusions. 



Q. Are there any other psychical symptoms ? — A. A change in the emo- 

 tional characteristics of the patient. He laughs and cries without sufficient 

 cause, and becomes suspicious of those about him. These are the most prominent. 



