366 



SCIENCE. 



systematized delusions of social ambition; the delu- 

 sion being often the outgrowth from a dream, or from 

 an actual hallucination. These men usually imag- 

 ine themselves the worst enemies of mankind, or are 

 social reformers, inventors, poets, &c; but as Spitzka 

 remarks, it is often noticed, especially with patients of 

 high culture, that the delusions are not so monstrous 

 as to lead to an error in the patient's sense of identity, 

 but limited to his self-esteem in the abstract. 



Systematized delusions may also be of an expansive 

 erratic character, when the patient constructs an ideal 

 of the other sex, and may on some occasion discover 

 the incorporation of his ideal, in an actual personage, 

 usually in a more exalted position than his own. 

 Systematized delusion may also be of an expansive 

 religious nature, or lastly of a depressive character. 



We would like to give our readers a formula by 

 which they might detect a systematized delusion, but 

 although alienists are specific in their language and 

 ample in their detail, brevity is not attempted, as 

 perhaps not possible in treating so complicated a sub- 

 ject. 



When, however, we see an individual without any 

 manifest disturbance of his emotional and effective 

 states, in full possession of the memories accumulated 

 in the receptive sphere, and able to carry out most or 

 all of the duties incident to his social position, yet 

 firmly believing in the reality of that which from his 

 education and surroundings, we should expect him to 

 recognize as absurd, or radically wrong, the probabil- 

 ity is that the phenomenon is due to a systematic de- 

 lusion. 



The one fundamental character which distinguishes 

 the delusions of systematic delusional lunatics, is the 

 correlation with their surroundings, or of their unele- 

 vative physical status. However falsely the patient's 

 sensations and external circumstances may be inter- 

 preted, yet, after all, there is a pseudo logical chain 

 running from them to the delusion which they keep to 

 create and to sustain. This is absent in the case of 

 patients exhibiting unsystematized delusions. Again, 

 up to a certain stage, the systematized delusion is an- 

 alogous to a healthy conception, this is never the case 

 in an unsystematized delusion. 



The factors engaged in producing the systematized 

 delusion are two fold. One, the predisposition we 

 have recognized as presumably based upon anomal- 

 ous condition of the brain, and the other some excit- 

 ing cause which must be studied. 



For instance; the general mental tone of the 

 patient. If he be ot sanguine disposition, the delu- 

 sion is often the outgrowth of a day-dream, on the 

 plan of the saying that the wish is father to the 

 thought. If he be of a suspicious turn, delusions of 

 persecutions are apt to arise. 



Again, the physical state may influence the patient. 

 If this be fair, delusions are apt to be expansive, and 

 to involve social and sexual matters. 



And lastly, the circumstances of the patient, as the 

 age in which he lives, the education he receives, his 

 social condition. All these modify the character of I 



the delusions of this class of the insane. It is ad- 

 mitted that while all these factors are of the highest 

 importance, they will never create a systematic delu- 

 sion, unless the cerebral predisposition exists. 



Of the unsystematic delusions we shall be brief, as 

 they are characteristic of the acuter insanities, and 

 are, therefore, more easily recognized. The patient 

 exhibiting them never acts in strict accordance with 

 his assumed character, and there is no consistency in 

 his behavior. The unsystematized delusional luna- 

 tic will tell you that he is possessed of a million 

 dollars, but he cannot account for his being richer to- 

 day than he was yesterday. 



It is pointed out that the great line of demarcation 

 between the two classes of delusions lies in the 

 fact, that, in the systematized delusion all the powers 

 of logic and mental qualities that the man ever had 

 are utilized by him in the construction and defense of 

 his delusion, and as Spitzka points out is of great 

 medicolegal importance, are also utilized in the carry- 

 ing out of his schemes of defense or revenge. Oh the 

 other hand, the unsystematized delusionist is de- 

 prived of his logical power, and apart from his hallu- 

 cinations is unable to specify any support for his 

 morbid ideas, and his actions betray that same lack 

 of system which his delusions do. 



We are indebted to two papers* by Dr. Edward C. 

 Spitzka in presenting this classification of delusions 

 of Monomaniacs, and we are somewhat surprised to 

 find that he appears to ascribe all these classes of 

 delusions to direct cerebral troubles, in fact he ridi- 

 cules their being attributed to functional complications 

 and diseases of other organs of the body. 



The expert alienist can no doubt draw the distinc- 

 tion, and decide correctly on the true source of the 

 mental disturbance, but it cannot be doubted that 

 much error in this respect is exhibited by the inex- 

 perienced, for delusions of every kind are manifested at 

 least temporally in many forms of disease, which in 

 some cases may be so persistent as to appear chronic. 

 As Dr. Spitzka himself frequently protests in his papers 

 on the indiscrimate power which courts and physicians 

 possess, who often consign " useful members of society 

 to the living tomb of an asylum, and to the tender 

 mercies of an ex-horse car conductor, or ex-night 

 watchman or other politician," he will excuse the ex- 

 ception we take to the too ready desire of many per- 

 sons to place in the category of " maniacs," men who 

 are merely hypochrondriacal or depressed and vicious 

 in disposition. 



We have indicated the form of insanity, which may 

 be ascribed to the case of Guiteau, but we have no 

 desire to prejudge the case. The crime was barely 

 committed before Cabinet Ministers, Physicians, 

 Editors, and a large portion of the public, immediately 

 jumped to the conclusion that the assassin was mad; 

 that such a verdict was hastily given all must now ad- 

 mit. Whether the evidence, which will undoubtedly be 

 produced at the trial, will justify the first impression, 

 and release the prisoner from the responsibility of this 

 crime, will be a matter to be watched with considerable 

 interest. 



♦Insane delusions, their mechanics and their dragnostic bearing. The 

 Journal of Nervous and Mental Disease, January, 1881. Monomaniac or 

 " I'rima;re Vcrruccktheit." Read before the Neurological Society, Nov. 

 5, 1880. Reported in St. Louis Clinical Record. 



