Transitory Mania 
WITH ITS 
MEDICO-LEGAL BEARING 
A PRIZE ESSAY 
Read before the Medical Society of the State of California, 
April 17th, 1885 
BY 
WASHINGTON AYER, AID. 
Member of the “ Harvard Club;" Ex-President of the Medical Society of the 
State of California; Ex-President of the Medical Society of the City 
and County of San Francisco; and Ex-President of the 
San Francisco Medical Benevolent Society 
SAN FRANCISCO: 
JV. S. Buncombe, Publisher 
jo Post Street 
i 88 5 dedication. 
TO THE HON. J. D. MURPHY, 
JUDGE OF THE SUPERIOR COURT, 
CRIMINAL DEPARTMENT OF SAN FRANCISCO, 
THE FOLLOWING PAGES 
ARE RESPECTFULLY DEDICATED 
BY THE AUTHOR. PREFACE. 
In preparing this “essay” I have endeavored to show, by 
introducing various subjects connected with physics, that all 
mental alienations are dependent upon changes and develop- 
ments of the brain, and not upon the mind itself as an essence 
emanating from the crucible of Omnipotent Will, to be measured 
and weighed as the weird offspring of unrelenting fate. 
While not intending to criticise law as a science, the medico- 
legal bearing of the subject has led me to give such interpreta- 
tion to special law, and criticise its application to specific cases, 
as would enable me in the most forcible manner to present 
reasons for the labor and burden of proof against the theory 
of mania transitoria I have undertaken. 
Feeling that public sentiment has too often and too long been 
outraged by the admission of this theory into the pleadings for 
the benefit and protection of those who have most wantonly 
committed homicides, I have devoted my time to the investiga- 
tion of the subject, with no motive beyond a wish to serve the 
interests of the public by endeavoring to make the murderer 
responsible for his crime, and to show that if legal penalties are 
not inflicted upon the guilty, all virtue and morality will soon be 6 
trodden under foot, and communism or anarchy will put at de- 
fiance the majesty of law. 
I have cited several noted cases that have come into our courts, 
for the purpose of showing the importance of instituting a thorough 
investigation of this subject; and have referred to many facts con- 
nected with the changes that take place in the brain to prove that 
the mind is not of itself diseased, and cannot possibly become 
diseased; for the human mind is the individualized offspring of 
the Creative Mind, which gave birth to worlds and brought 
order out of chaos, and must forever remain unchanged. What- 
ever is subject to disease is also subject to decay and death; but 
the mind is a part of the Immortal Essence, which survives de- 
cay and will never die. A Prize Essay and Monograph 
UPON 
TRANSITORY MANIA 
WITH ITS 
MEDICO-LEGAL BEARING. 
Mr. President, and Fellows of the Medical Society of the State of 
California: 
‘ ‘ The labor of life is a constant struggle between the acts of 
conscious volition and the automatic impulses of the emotional 
regions of our being,” and as we are borne along upon the hur- 
rying breath of time, how much we see to do, and yet how little 
we accomplish ! While we pursue the study of the brain and 
search for the seat of mental activity, the shadows of ignorance 
and doubt give way to the fulfillment of prophetic knowledge, 
whose stream leads on to the “ocean of truth” and “ineffable 
light.” We live in an age of investigation, an age in which 
declaration, unsupported by demonstrative knowledge, is of no 
value, and it is the right of every man to differ from his neigh- 
bor. 
And now, in a spirit which cherishes love for justice, reverence 
for law, and sympathy for the unfortunate, I invite your attention 
to the subject of Mania Transitoria, with its medico-legal bearing. 8 
Fully conscious of the many difficulties surrounding the intelli- 
gent discussion of this question, I shall not confine myself strictly 
to a synthetic line of argument, but shall call attention to such 
subjects as occur to me to be of importance to the profession in 
this connection; such as expert testimony, questions of law and 
rulings of courts upon questions of irresistible impulse, emotional 
insanity, and moral obligations to society, as the subject is of 
special legal importance, and involves many of the perplexities 
of jury trials. I shall also present such reflections as naturally 
arise as the outgrowth of my argument, without claiming for 
them original scientific conclusions, hoping to awaken some new 
thoughts in the mind of the careful student upon this subject. 
With the results of the investigations of Brown-Sequard to 
guide us in our inquiries, as well as many other authors who 
have written upon the subject of nervous and mental diseases, 
and the researches of Luys upon the “ Functions of the Brain,” 
aided as they have been by experiments in vivisections, there can 
be no doubt of the localization of nervous disease and mentality 
within the cerebral hemispheres and medulla oblongata; and the 
correctness of the theory of the proliferation, of brain cells, and 
that they are the seat of mental activity and repositories of mem- 
ory and knowledge, can hardly be doubted. With this view ot 
the subject, and our knowledge of the functions of the brain in 
their control of all physical functions, we are led to conclude that 
the advantage one has over another in scholarly acquirements 
lies in his greater receptivity as the result of achievements in 
scholastic learning. 
It is frequently asked how it occurs that one in advanced years 
remembers the things of childhood with more freshness than the 
things of yesterday. This can be explained upon the theory ol 
the proliferation of brain cells as the seat of mental activity. To 
make the explanation simple, we will assume that the cells are 9 
never separated, but remain intact, and form a pyramid or cone, 
the base representing youth, and the apex, age. Now, as light 
falls upon the eye to produce an image upon the retina, or sound 
comes to the ear, the optic and auditory nerves vibrate and put 
these spiral columns in motion, and the greatest displacement 
will be at the base, the largest axis of spherical action, and the 
point where the first impressions of lisping childhood are made; 
each lobe and convolution of the brain, with its millions of cells, 
being assigned for special memories; and where the vibration is 
greatest the memory will be aroused first and strongest, while 
the effect upon the apex will be scarcely disturbed and soonest 
obliterated. Hence, the memory of childhood impressions are 
soonest brought before us in age. 
As we are dealing with physical functions which control and 
enable us to classify mental activities, the discussion of mental 
disturbances justifies the introduction of this theory of thought 
impressions upon proliferated brain-cells as a basis of further in- 
vestigation, and a means of obtaining experimental knowledge 
of the psychic laws which make man a responsible being. 
Until within the past few years, brain-cells were considered 
only a “ shapeless mass of protoplasm but now they are known 
to be delicately constructed, and possibly contain the realistic 
germs of life-forces which survive physical decay. 
In-this connection, as a matter of speculation, we may be justi- 
fied in saying that within these microscopic cells, thought im- 
pressions are made, and there remain till interrupted by disease 
and decay, as impressions of objects are made upon the glass 
or other polished surfaces within the camera, to be again trans- 
ferred ; or as sound is collected to be reproduced by the phono- 
graph at the will of the operator; and it seems to me possible 
that men may yet learn that the elastic atmosphere is forever 
vibrating with vocal strains as an evidence of the realisms await- ing the intellectual enjoyments of etherealized matter, called 
mind. 
In the reverberation of the clouds, in the tumult of the air, in 
the commotion of waves, in the summer calm, and wherever we 
turn, we find the expression of a living thought, begetting inspi- 
ration and urging man to investigate the causes of the wonders 
he beholds, and appropriate his knowledge to advance his hap- 
piness and comfort, and no obstacle seems too great to be over- 
come. 
In the study of the mind and the effects of physical disturb- 
ances upon mental activity, we seem treading in the path of the 
“unknowable,” and grow bewildered as we cautiously attempt 
to lift the veil that conceals all, to gain a glimpse of primeval 
causes. Though we cannot paint the dying refrain of summer 
upon the canvas with the woods and fields, resonant with song 
and redolent with the perfume of flowers, it will continue to 
live in the unknown recess of mind, to be reproduced again 
and again, and add to the pleasures of the future through the 
memory of the past. But there yet remains much we can learn 
in the vast fields of discovery, and can accomplish and know, 
what is now unknown and full of seeming mystery, awaiting the 
voice of science to be declared to man while he struggles amid 
the unmeasured forces of life in search of new truths, amazed 
in the contemplation of the wonderful works of a Creative In- 
telligence. 
But we cannot think and speak much in advance of the times 
in which we live without some accusation of heresy being hurled 
at those who dare oppose the teachings of the present age, 
whether such teachings be in the line of legitimate medicine 
or opposed to popular theology, or the ethics and precepts of 
law ; yet an honest effort cannot be without its ultimate merited 
reward. 11 
The mind grows weary and unsteady in its volitional manifest- 
ations in abeyance to the laws of physical inertia, as a general 
proposition—exceptions to be noted—and the conscious volition 
then fails to direct the eliminating forces of intellectuality in the 
pathway of mental activity and reason, being governed by the 
same laws which apply to the disordered functions of physical 
life, dependent upon lesions of the brain and spinal cord, or me- 
dulla oblongata, as witnessed in myelitis and the various forms 
of paralysis ; and whenever the pons varolti, crus cerebri, corpora 
striata, or any of the nerve centres are over-stimulated or pressed 
upon, we shall invariably witness either a loss of motion and sen- 
sation, and loss of will power upon the parts affected at the same 
time, or an error of judgment; and no one can reasonably doubt 
the intimate and inseparable relations of will and motion as a 
physiological proposition in all healthy bodies, except such mo- 
tions as are or may be governed by their own specific ganglia, 
and those which are from their nature involuntary, as pulsation 
of the heart, nictation, respiration, paristole, etc. 
In all the civil and social relations of life, where there is wit- 
nessed refined tastes and polished manners, we must acknowledge 
the importance of a clear mental capacity to appreciate in the 
selection of companionship. No question connected with medi- 
cal science more deeply concerns the best interests of society 
and social life than that which is known as “ mental diseaseyet 
how little is known by a majority of medical gentlemen upon so 
important a subject. 
The literature upon this special department of scientific knowl- 
edge seems to be ample as a basis of investigation, to enable the 
analytical mind to make such delicate and clear distinction be- 
tween mens sana, aid no7i, that, when we are called into criminal 
courts as experts, the learned members of the bar and the judges 
upon the bench may be answered intelligently and with credit to 
the profession we represent. 12 
Works upon medical jurisprudence only partially treat upon 
this subject, presenting it in its medico-legal bearing, and leave 
the important functions of the brain and effects of molecular per- 
turbation on mental forces to be investigated in another depart- 
ment of learning; and intelligent juries now look to the physi- 
cian to aid them in determining the difference between an invol- 
untary and unconscious action and a voluntary act. As a simple 
illustration, winking may be an involuntary action, while closing 
the eyes to slumber is a voluntary act. Walking, talking, and 
singing while asleep are unconscious voluntary acts, while the same 
exercises when awake constitute conscious voluntary acts; for in 
a healthy body the suspension of volition would be followed by a 
suspension of motion, as witnessed in paralysis. This is axiom- 
atic. 
J. H. Belfour Browne is generally considered authority upon 
forensic medicine, but a careful analysis of some of his statements 
will show he is not always correct. He says : “Dementia is an 
exaggerated enfeeblement of age, a more ruinous dotage. It is 
dependent upon exhaustion and torpor of the mind, that the 
mental house is in ruins, etc.”—Page 276. This, however, is not 
correct, for dementia is the enfeeblement of the forces of mental 
activity, dependent upon cerebral disturbances of various kinds. 
Again he says: “Dementia is the inertia of rest—mania the 
inertia of motion.”—Page 279. Now there is nothing in medi- 
cine nor in physics to support these statements, and give them 
any importance in a court of justice. 
As intelligent testimony is the motor power applied to the 
machinery of law, which weaves facts into every conceivable 
fabric, and coloring to be presented for judicial inspection, and 
to juries to enable them to return just’verdicts, if the physician 
would become a valuable witness, and assist criminal courts in the 
administration of wholesome laws, he should make himself famil- iar with the medico-legal bearing of mental disease upon crimi- 
nal acts, before going upon the witness stand to give his testi- 
mony. 
For the benefit of the younger members of the profession, I 
would say, we must always be on the qici vive while in court, as 
hypothetical questions are often asked, interwoven with paradox- 
ical theories to test the competency of a witness, rather than to 
elicit any material lacts connected with the subject of insanity. 
1 o obviate the embarrassment that naturally follows upon an 
evasive or confused answer, a common estimate of the value of 
symptoms should be formulated and agreed upon, as the result 
ot experience, observation and careful investigation. 
At the present day a large number of the intelligent people ol 
our country are inclined to look with disfavor upon all medical 
expert testimony before juries, and a majority seem to regard 
the proceedings of our criminal courts, in many cases, as farcical 
dramas brought upon the judicial stage, before the bar of justice 
m opposition to the spirit of the higher codes of law, which in- 
flicts punishment upon the guilty; and justice stands behind the 
proscenium taking no part in the proceedings, and leaving the 
criminal with his weakness and errors to the sympathy of juries, 
often composed of men incompetent to tell the difference between 
a hypothetical question and an axiom of law. This is especially 
the case when the criminal is being tried for homicide, and the 
defense puts m the plea of irresponsibility, on the ground of 
transitory or emotional insanity. Who is responsible for the 
lailure to convict in such cases but the medical expert, and those 
who mis-apply and mis-interpret facts? There are but few emi- 
nent writers upon this subject who give unqualified endorsement 
to the theory of transitory mania, yet the sophistry of learned 
attorneys and the testimony of pliant medical witnesses, carry 
conviction to the minds of jurors that the murderer is not re- 
sponsible under such alleged conditions for his act. This was illustrated in the suit of the People vs. Laura D. Fair, 
one of the most noted cases that appear upon the records of our 
criminal courts of the State of California, where the plea for the 
defendant was transitory or emotional insanity, “and the act was 
non-volitional. ” In this case the effect upon the jury of the tes- 
timony of the/physicians who were called as experts on the first 
trial, was not such as to receive any favorable comment, as it did 
not appear to be wholly in accordance with the facts sought to 
be presented; nor was it free from the appearance of bias, a con- 
dition of mind most unfortunate for a witness in a court of justice. 
On the second trial the effect of expert testimony on the part of 
the physicians was such that it could not be overcome by the 
eloquence of polished rhetoric, finished oratory, and scholarly 
argument, and the prisoner was acquitted. 
MURDER OF CHAS. DE YOUNG. 
Nothing could be more injurious to church ethics, or more in- 
sulting to Christian precepts, and more demoralizing to the youth 
of a populous city, than the example presented by the killing ol 
Mr. Chas. De Young, by Kalloch, a minister of the gospel. 
In this case we find the law was made a creature of sym- 
pathy by a maudlin sentiment that echoed from the bells upon 
the church towers along the corridors and through the aisles of 
the temples of worship, until it reached the ears of the jury and 
deprived justice of its executive authority; and a greater outrage 
upon offended law can scarcely be conceived than was witnessed 
in the result of this trial. Here the expert testimony was much 
more declamatory than logical, and was in no wise entitled to the 
position it occupied in the category of evidence for the defendant. 
The great effort of prominent members of the bar appears to 
be to protect the criminal against the law, rather than secure the 
enforcement of its penalties, and this is the hoc opus which tends to make crime rampant and subvert good government. Expe- 
rience and daily observation teach us that it needs no forensic 
oiatory, no long recitations from Shakespear, no quotations from 
Milton’s Paradise Lost, no quotations from Young’s Night 
Thoughts, whose windows of light were forever darkened,&or 
from Cowper, to inform a jury that 
“ Unnumbered throngs on every side are seen, 
Of bodies changed by various forms of spleen,” 
and that the prisoner charged with homicide is not guilty, pro- 
vided handy witnesses are secured, and the right kind of men 
are placed in the jury-box. 
You may ask, “What have medical gentlemen to do with 
this ?” Let me assure you we have much to do with the convic- 
tion of the guilty, by giving testimony, supported by the facts 
presented by the laws of physiology and psychosis, which dig- 
nify and control human action. & 
The study of nervous diseases and mentality, and inquiries 
into the forces governing the functions of the brain, by those who 
have had large opportunities for experimenting upon the lower 
animals m vivisections, have called in exercise new reflections, 
and given new encouragement to the investigation of mental dis- 
eases. And while mind cannot be examined, only by logical de- 
ductions, much that controls its functions can yet be learned, as 
we learn the nature of imponderable agents, by their effect upon 
animate and inanimate objects, as reason lifts the veil beneath 
which volition dwells, and discloses the working of the forces 
that direct and control the acts of men, and define his responsi- 
bility in every individual act. 
It is a maxim in common law that “all persons are presumed 
to be innocent until proven guilty.” Judge S. H. Dwinell, in 
his charge to the jury in the case of the People vs. Laura D. Fair, 
says: “All the presumptions of law, independent of evidence' are in favor of innocence, and every person is presumed to be 
innocent of crime until he is proven to be guilty.” But the law 
really does no such thing in its application; if it did, it would 
not arm its officers with authority to arrest and hold persons in 
duress until such time as they may be brought into court to prove 
their innocence. Otherwise the rights of individuals would be 
taken away, without any possible redress at law for inconvenience 
and hardships endured ; for no person can justly be restrained 
of his liberty unless he is presumed to be guilty or insane—ex- 
cept he be restrained as a witness in the interest of justice—and 
officers making arrests would be liable to be charged with being- 
governed by an improper influence—malo animo—in the dis- 
charge of their duties, and this would be a conspicuous error. 
In dealing with crime, ‘‘Justice a priori'ascribes responsibility 
to all who commit it,” and consequently must look with suspi- 
cion upon all placed under arrest, whether sane or insane, and the 
condition of the mind in its capability to determine right from 
wrong must alone decide the responsibility in any individual 
case, for ignorance of law is no excuse for wrong doing. Ignor- 
antia legis neminem excusat. 
When the maxim referred to is the ruling of the court, for the 
purpose of arresting a popular verdict in any case before it has 
been tried, it is well enough as tending to prevent meddlesome 
interference with the proceedings of the trial. But we have no 
dealings with maxims in the abstract which apply to the guilt or 
innocence of any party ; and all the court and jury want us to do 
is to make a clear statement of facts relating to mental conditions, 
and nothing more in cases of alleged insanity. 
We must not only have ideas, but must have positive facts 
upon which to base our testimony. 
An Idea.—An idea is an element or condition of mind as it re- 
lates to sanity or insanity, and develops rapidly into various ex- pressions of language and acts, which may be rational or not, 
according to the varying circumstances upon which it is depend- 
ent. 
Impulse.—lmpulse is a sudden feeling different from that which 
is controlling the action of the individual at the time it occurs; 
and while it is not voluntary, and cannot be brought into play 
by any force of the mind, it is subjective to the will when mani- 
fested ; and this is in accordance with the experiences of daily life. 
It differs from an impression in this: An impression is the 
consciousness of the existence of something, while an impulse 
relates to an action or desire to act. 
Impulse is not the product of thought which springs from or 
enters into the domain of mind, but is developed by some ex- 
traneous or concentric action of the vital aiira, or surrounding 
■erethism of the body; while many of the moral feelings are the 
offsprings of thought, such as sorrow or joy, and sometimes 
thought—-very emphatic—is the offspring of pain, as experienced 
in gout or neuralgia, and this paradoxical condition is depend- 
ent upon the Ilex and reflex nervous action, stimulating certain 
cerebral nerve centers. But “ impulse ’’ is exhausted the moment 
it is felt, and gives birth to reflection, which urges one on to 
uncontrolled action; but never irresistible in its nature, as re- 
flection is always rational in character, and must be subjective 
to the will. 
Upon this is based all of the theory of transitory mania, which 
is only a convenient myth—a huge joke on ethics and crim- 
inal law—merely a word-structure of defense without a possible 
reality; and the learned members of the bar do not believe in its 
existence. 
A more ridiculous burlesque upon justice cannot well disgrace 
the procedure of criminal courts than is witnessed in a trial 
when the argument for the defense is based alone upon this theory; for it is not within the reach of psychic reasoning, or the 
logic of presumption, and is little more than nonsense, imbeded 
in metaphysics, without a ray of intelligent possibility to dignify 
an argument in its favor, and is far more quixotic than the 
Rosicrucian philosophy, or the animisms of Stahl. 
This theory not only aims to encourage crime, and relieve the 
criminal from responsibility, but lessens public respect for the 
Temple of Justice. 
And in this we see justice struggling— 
“ See physic beg the Stagyrites’ defense— 
See metaphysics call for aid on sense.” 
With this view of the subject, I am conscious of invading the 
domain of cherished opinions of some of the eminent writers 
and opposing their theories, yet I do so not in a spirit of hostility, 
but with a desire to advance justice and the interests of the pro- 
fession. 
Oh, common sense, divinest child of earth ! 
May reason’s choral voice thy praise prolong, 
Till nature, wearied, sinks beneath the song. 
Judge Hoffman's opinion of emotional sanity and transitory 
mania.—ln the case of Mary Jane Sweeney, the defense begged 
leniency in consideration of Sweeney’s emotional insanity. The 
Judge replied: “This plea of emotional insanity, or transitory 
mania, or whatever name the excuse may be given, has become 
almost ridiculous.” “ Our experience in California in respect to 
this subject has led us to regard the present aspect which the in- 
sanity plea has assumed, as repulsive to justice and fatal to 
society.” 
In further support of the statement that the learned members 
of the bar have no confidence in the correctness of this theory, I 
will call your attention to the following remarks of Prosecuting 19 
Attorney J. N. E. Wilson, in a case recently tried in one of our 
Superior Courts, of the People v. Kennedy. He says ; “ Rumor 
has it that defendant s counsel possesses one of the finest medical 
libraries on the coast. Rumor also says that the honorable gen- 
tleman boxed it up and stowed it away when he commenced this 
case, because he was fully aware that no such thing as ‘ emotional 
insanity could be found in it. But he goes on with the case, 
and instead of calling it ‘ emotional insanity,’ gives it the title of 
disoidered mental design.’ ” This satire would probably have 
been enjoyed by the learned attorney had his position been re- 
versed in this case, as on a former occasion he had evoked an 
adverse decision from the Supreme Court upon a question in- 
volving a similar theory. 
In the 62, California Reports, page 123, in the case of the 
People vs. T. J. Hein, Judge McKinstry, in giving his decision, 
says : “ It will be seen that the English courts have refused to 
recognize the co-existence of an impulse absolutely irresistible, 
with capacity to distinguish between right and wrong with refer- 
ence to the act. It cannot be said to be irresistible because not 
resisted. Whatever may be the abstract truth, the law has never 
recognized an impulse as uncontrollable, which yet leaves the 
reasoning powers, including the capacity to appreciate the na- 
ture and quality of the particular act, unaffected by mental dis- 
ease. No different rule has been adopted by American courts.” 
This was concurred in by Morrison, C.-J., Myrick, Sharpstein, 
Ross, and McKee, J.J., and was a complete answer to a question 
asked by Judge Darwin pending the trial. 
The New York courts hold to the same doctrine, as appears in 
the New York Reports in the Court of Appeals, page 469, in the 
case of Mark Flannagan, Plaintiff in Error v. the People: “In 
this case all the judges except one concurred in the opinion of 
Judge Tindall, C. J., and the case is of the highest authority; and 20 
the rule declared in it has been adhered to by the English 
courts.” 
IRRESISTIBLE IMPULSE ILLUSTRATED. 
When the staging gives way, the irresistible force of gravita- 
tion causes the laborer to fall to the ground ; and when this force 
is overcome by inflating a balloon with a much lighter air than 
that which surrounds the earth, those who leave in the basket 
prepared for an aerial flight, are irresistibly borne far away 
among the clouds. In one case the irresistible force is a fixed 
law of nature ; the other simply a relative force, subjective to 
chemistry and mechanics, and is a part of experimental life. But 
by taking the necessary precaution, the voluntary danger and 
the involuntary act of falling may both be averted. This simile 
will apply to the so-called irresistible impulsive acts of men, 
which are no more than unresisted acts, which may be avoided. 
In one case the act is voluntary, in the other involuntary; but if 
the party falling is injured, he is responsible in the one case by 
his folly, in the other by his carelessness, and cannot escape 
responsibility in either ; for vigilance and prudence would have 
enabled him to remain unharmed, since he could not be raised 
into the basket nor lifted upon the staging by any irresistible 
force, while knowing the act he was performing (idiots always 
excepted). If a man is seized with a spasm of anger and kills 
his brother, he must be held responsible, and should be sent to 
one of the lunatic asylums for life, for he voluntarily steps into 
the basket to be borne away by the balloon, inflated with rage ; 
or, his voluntary involition causes him to fall. 
It would be a dangerous doctrine to establish, to say a person 
was competent to determine right from wrong in any particular 
act, and at the same time was impelled by an irresistible foe, un- 
seen and unappreciable, which was urging him on, vis a tergo, 
to commit a crime which he was capable of appreciating, and 21 
realizing the consequence of its commission, and yet was not 
responsible for the act. 
No man arms himself with a pistol or knife and visits the house 
of another party whom he suddenly kills, without knowing what 
he is doing, and what he intended to do before leaving on his 
mission of crime, unless he was insane before and remains insane 
after the act. 
Alfred Swain Taylor, in his work on Medical Jurisprudence, 
says : “ The main character of insanity in a legal view, is said to 
be the existence of a delusion, i. e., that a person should believe 
something to exist which does not exist, and that he should act 
upon this belief.” 
But if the theory of mania transitoria be correct, the party so 
attacked does not have time to indulge even in a belief of a de- 
lusion, but steps out of himself for a moment to give the body an 
opportunity to act and kill some one, and then steps back again 
just in time to take the body away in a perfectly healthy con- 
dition, uninjured by the sudden transition, from a subjective 
agent to an independent actor and vice versa. Now can any- 
thing be more absurd? Yet many intelligent medical gentlemen 
have been upon the witness stand as experts, and testified be- 
fore courts and juries to the existence of this mental condition— 
this psychic ledgerdemairi which is beyond the reach of mental 
philosophy to explain. 
Such testimony is the opprobrium medicorumoi the profession, 
while the atmosphere is redolent with inquisitive objections to 
such assumptions of learning. The highest medical authority 
has never undertaken to prove by any known physiological or 
psychic laws, how such a mental condition can possibly have an 
existence as transitory mania. 
But in a strictly medical view, insanity does not exist in the 
mind per se, for that is not ipse facto diseased, but is dependent 22 
for its aberrations upon some abnormal condition of the physical 
man, which may be either organic or functional, and usually 
found in a change in the structure of the brain and the surrounding 
tissues. By reflex action the erethism of remote organs may be 
conveyed to the brain, over-stimulating the whole mass, or cer- 
tain ganglia corresponding to the seat of nervous activity, which 
supplies the organs effected with their sentient and motive sensi- 
bility, or automatic consciousness. And often the dyscrasia ot 
the party, without any localized morbid change, effects the vital 
aiara and periphery of the entire nervous system, producing 
hypersemia of the brain, followed by disordered mental manifest- 
ations. 
As before stated, the mind is not, ipse facto, diseased.' Here, 
I apprehend, lies much of the error and perplexity experienced 
by witnesses who attempt to define a disease of something that 
exists but has no length or breadth, the same as they would de- 
fine the disease of the atmosphere, which is rendered toxic by 
the introduction of noxious gases during respiration of animals 
or vegetation, or from the exhalations of forests, or other causes, 
by which the oxygen is displaced and a new compound formed, 
that enters the lungs ; or by heat, which lessens the volume of 
oxygen without changing its ratio as the air becomes rarified and 
expanded. Such a course of logic cannot be maintained, for the 
elements of mind are not tangible, like the odor of flowers. The 
difficulty of imderstaiiding this question and not being under- 
stood,, is in consequence of not recognizing the truth of the adage, 
mens sana in corpore sano. 
Cases of insanity following the use of alcohol or opium are 
always preceded by delirium, showing that changes do take 
place in the brain from over-excitement, until a permanent lesion 
is formed and becomes localized. The same may be said of in- 
sanity arising from cerebro-typhoid fever, supervening upon dis- 23 
appointment and business losses, all of which are the psychic 
manifestations of physical disease. 
After carefully studying the functions of the mind, which ren- 
der it voluntary or involuntary, I fail to find any evidence to 
prove the existence of transitory mania, beyond the declarations 
of the criminals themselves. 
Such opinions, which have become quite too popular for the 
public good, and upon which often rest verdicts of juries, appear 
to have been formed and agreed upon to meet certain cases after 
deeds of violence had been committed, and are purely ex post 
facto. When there is a temporary suspension of the conscious 
action of the will, affecting' any of the moral sentiments, no harm 
can possibly be done; for the consciousness of an idea to act is 
lost. And when the suspension of the will-power, from what- 
ever cause, affects the physical forces, motion is irregular, and 
seldom in a direct line of action; the motor nerves always mani- 
festing a volitional disturbance, as witnessed in paralysis agitans, 
and it is not possible for the will to be suspended in the middle 
ot an arc, being described in the act of a blow and before its com- 
pletion, and again suddenly regain its full force the moment the 
act is performed. Such doctrine would be dangerous, and, if 
maintained, would render our criminal courts powerless to ad- 
minister justice, and the physician should be held largely respon- 
sible for encouraging it. 
In this theory we find all that supports the argument in favor 
ol transitory mania, which in a spirit of great generosity should 
be considered only as transitory cussedness, in distinction to other 
vicious traits, and differing from moral depravity in many.of the 
essentials by which man is recognized as being endowed with a 
moral and physical nature. 
We are told that “ charity is kind and of long suffering, ” and 
that it is better that “ten guilty persons should go free than that 24 
one innocent party should suffer.” This, as an expression of a 
Christian mind, and in accordance with church ethics,' is well 
enough; but when we devise some theory by which the 
guilty may go unpunished, we encourage the infraction of law 
and degrade public morals, which is not in accordance with the 
teachings of the gospel of Christ, or any sentiment of morality. 
Whatever theories are advanced in regard to the insane, there 
must survive a consciousness of some sentiment in the mind ot 
every intelligent person, and a feeling of regret for the wrongs ot 
the aggressor, which leads one to desire to remedy all within 
human power that is wrong ; and to be just, we must remember 
the offended have rights that must be respected, and we must be 
prepared to prove the existence of some conscious reality behind 
every act, as well as that which follows a crime, and vice versa. 
As we become more familiar with the social influences of life, 
which shape the course of individual action, the more we are 
impressed that life itself is a mimicry as related to the daily 
affairs in which we are most interested; and it is of the most 
profound importance that we should make ourselves familiar 
with all the possible details of pathology, that we may become 
competent judges of the functions of health and disease, and be 
able to determine their influence over the moral and mental 
forces which determine the nature of human action. Here is 
where we can maintain an honorable distinction above the 
average witness, and render valuable service to an honorable 
and learned profession in the halls of justice, in the interest of 
public morals and human safety. 
What is involuntary action, and what emotional ? Involuntary 
action is witnessed in respiration, nictation, pulsations of the 
heart and spasms of tetanus. Emotional action is seen in weep- 
ing, sighing, and laughing. The difference is found in the fact 
that the former acts are without any conscious effort of the will; 25 
while the latter acts are dependent upon impressions made upon 
the mind by surrounding influences, as reading, seeing, or hear- 
ing some sad or mirthful story. And while these manifestations 
cannot be wholly controlled by the will at the moment of occur- 
rence, they are not involuntary, since the volition is active and 
conveys impressions to the seat of the mind, which arouse reflec- 
tions of pleasures or pain. 
If the prism through which the rays of light pass is defective, 
there will not be a homogeneity of colors produced, and this 
condition will confuse and antagonize the science of dioptrics, 
and of the solar spectrum in the simple multiple rays or factors, 
which unify the rays of light around us, or separate them into 
primitive colors; and this theory holds good in the various 
cognate branches of science, and in mental pathology. 
We do not see light, but realize its presence, and recognize 
distances by the eye ; nor do we see mind, but recognize its force 
by the effect it has upon others in the silent language of inven- 
tion, and social and political leadership, and realize its chano-es 
by the tone of the voice, the laugh, the smile, the tears or sighs: 
and can read the unwritten law, governing mind by voluntary 
action, as wejudge of heat and magnetism by their effect upon 
vegetable and animal life. All disorders of the mind are so 
many evidences of molecular perturbations of physical forces, de- 
pendent upon some positive lesions of the anatomical structure 
of the brain, or of those organs and functions which exercise a 
strong controlling influence over the same. Hence we may reason- 
ably infer there can be no insanity arising from the mind per se, 
beyond its influence upon some of the physical functions; and all 
the manifestations of anger, hate, frenzy and impulse, or emotion 
of whatever nature, are volitional, and subjective to a proper exer- 
cise and control of the will, and man is responsible for their con- 
sequences. 26 
DUTY OF PHYSICIANS. 
It is as much the province of the physician to endeavor to 
have the criminally insane taken care of, as to advise measures 
for the care of those who are incapacitated from any of the cas- 
ualities of life, and I would recommend that the committee of 
this society on legislation be especially instructed to endeavor 
to secure the passage of an act, to provide for the care of the 
insane criminal in a separate building from the morally insane. 
I would also recommend that the law of Massachusetts upon this 
subject shall form the basis of such legislation. 
The law reads as follows, viz: 
Sec. 20.—“When a person indicted for murder or manslaughter is 
acquitted by the jury by reason of insanity, the court shall cause such 
person to be committed to one of the State lunatic hospitals during his 
natural life.” 
Sec. 21.—“Any person committed to a State lunatic hospital under 
the foregoing section may be discharged therefrom by the Governor, by 
and with the consent of the Council, when he is satisfied that such person 
may be discharged without danger to others.”—General Statutes, chap- 
ter 214.. 
In kleptomania there can be no real motive to wrong another 
or acquire the stolen property, for motive must be prompted by 
an idea of revenge, or some possible advantage, and things are 
often stolen which can be of no possible benefit to the parties who 
steal. In pyromania the party applies the torch to the building 
without a motive to harm another. In the former case the 
stolen goods are concealed, and in the latter the property is de- 
stroyed, and no benefit is to be gained by the commission of 
crime to either party, nor is there any fixed motive for the crime. 
But the absence of a motive to be benefited or to injure another 
does not make the offense less punishable under common law 
by placing the parties under restraint. 
Then, admitting the theory of transitory mania to be correct, 27 
and that homicides are committed without a motive of gain or 
injury to another, and the absurdity of the law that punishes the 
former and acquits the latter is readily apparent, and the theory 
of transitory mania is made to appear ridiculous. 
Taylor (page 674) remarks: “It cannot be denied that the 
doctrine of ‘ irresistible impulse ’ has been strained in recent times 
to such a degree as to create a justifiable distrust of medical evi- 
dence on these occasions.” 
“ It is obviously easy to convert this into a plea for the exten- 
uation of all kinds of crime for which motives are not apparent, 
and thus medical witnesses often expose themselves to severe 
rebuke. They are certainly not justified in setting up such a 
defence unless they are prepared to draw a clear and common- 
sense distinction between impulses which are unresisted and those 
which are irresistible." 
This irresistible theory would deprive a man of his individu- 
ality, and make him a frail instrument in the hands of an un- 
known foe, and subvert public morals, pervert the purest prin- 
ciples of law, and endanger human life. 
Maudsley says : “ Many cases of the so-called transitory mania 
are really cases of mental epilepsy,” and cites a case of a patient 
in the French Asylum at Avignon. A similar case is related by 
Esquirol of a Swabian peasant who killed his mother (page 234). 
Falret describes epileptic vertigo as a sort of petit mal, or tran- 
sitory disease, with no pathology : “ These peculiar states of epi- 
leptic consciousness are not only of great psychological interest, 
but also of practical consequence in relation to the question of 
responsibility, for it is obvious that deeds might be done by an 
individual when in an anomalous state of consciousness, of which 
he might have no remembrance when in his really normal 
state, and for which he could not justly be held responsible. ” 
Maudsley, page 238. 28 
It seems from the foregoing that the author considers 
transitory mania to be of an epileptic nature entirely. From this 
view of the question I do not dissent, it being one of the 
paroxysmal manifestations of a disease known to exist, as de- 
lirium is the result of fever and hyper-stimulation of the brain 
in intoxication, and nothing more. 
In all such cases there are prodromata, or physical conditions 
existing, which affect the normal status of the will, and which 
antedate acts of violence; and those thus affected do not find 
their remedy and cure in the act itself, as has been often alleged 
by those who desire to acquit the homicide upon the plea of 
transitory mania, and who declare the actor is instantly restored 
to consciousness after a deed of violence is committed. 
J. H. Balfour Browne, page 170, says: “Again, such a disease 
as transitory mania, mania which suddenly appears and suddenly 
disappears, is, to our thinking, an impossibility.” 
Dr. Hammond remarks: “The doctrine that an individual 
can be entirely sane immediately before and after any particular 
act, and yet insane at the instant the act was committed, is con- 
trary to every principle of sound psychological science.” 
Even in the most striking instances of what is called transitory 
mania or morbid impulse, the evidence of pre-existent and subse- 
quent disease of the brain will be found if looked for with dili- 
gence and intelligence. 
Dr. Gray, a distinguished authori y, says ; “ I am not going 
to deny the existence of transitory paroxysms in insanity, either 
in epilepsy or in the frenzy of melancholia, or in ordinary cases- 
of insanity where paroxysms suddenly arise and suddenly disap- 
pear ; but until I have seen more than I have yet seen, and until 
I have read something more authentic than I have yet read, I 
must fail to see insanity in any case which arises when the pre- 
monitory symptoms of the disease run the rapid course of a few 
minutes, when the person commits a crime and then is well.” 29 
E. C. Spitzka, in his work on Insanity, published 1883, page 
Ts4>saYs“ “Numerous instances are recorded where persons, 
previously of sound mental health, have suddenly broken, out in 
a blind fury or confused delirium, which, passing away in a few 
minutes or hours, left the subject deprived of a clear, or any, 
recollection of the morbid period, and generally concluded with 
a deep sleep.” These conditions are witnessed in cases of con- 
cussions of the brain, when a person remains unconscious for a 
longer or shorter period, and upon being restored to conscious- 
ness has no recollection of what has occurred, with the exception 
that no fury is manifested. 
This author says “observers designate this condition as tran- 
sitory mania.” “Others term it transitory melancholia, and 
others class it among epileptic disorders.” But to our thinking 
it should be classed with hysteria, dependent upon the inhibition 
of the nerve centres and reflex action. 
The same author says, page 155; “But it would have to be 
considered a remarkable form of epilepsy in which there was but 
a single epileptic attack.” “Transitory mania, or frenzy, is a 
•comparatively rare affection, so rare that many asylum physi- 
cians have never seen a case of it; the writer has likewise never 
had that fortune.” According to the same author, “ Foville, in 
his ‘Annales Medico-Psychologiques ’ of 1874, declares moral 
insanity and mania transitory false, absurd, ridiculous, and above 
■all, unworthy of being received by the courts.” 
Cook, another author, claims that “ transitory mania is a cereb- 
ral epilepsy.” 
Kinnon says: “You cannot prove the epilepsy; you can 
prove the mania, and it is transient;” “and is it not as easy to 
accept the theory of transitory mania as it is to go wandering 
after a far-fetched forced explanation ? ” In reply I would say, 
T is easier to accept this declaration than to undertake the labor 30 
of proving or disproving its correctness ; but it is not in accord- 
ance with the spirit of fair inquiry to admit anything that is not 
proven, for no axioms upon these questions are presented for our 
guidance that have not been tested in the crucible of science. A 
simple declaration of the existence of anything does not establish 
a fact, any more than the declaration of an action constitutes an 
act. We are not prompted by any spasm of curiosity or ag- 
gressiveness, but are investigating this subject in a spirit of great 
kindness and sympathy for the unfortunate, and that we may be 
better prepared to assist the courts in the just administration of 
the law when called upon, when the plea of the defence is transi- 
tory mania ; for now there seems to be a greater effort to shield 
the guilty than to protect the innocent. 
From our knowledge of the functions of the brain and the 
media through which psychic and volitional forces pass, we have 
before us evidence to show that outward manifestations of vio- 
lence are in consequence of a disturbance of the vaso-motor 
centres which lie along the floor of the fourth ventricle, and are 
imbedded in the gray corticle of the spinal cord, and from an 
over excitation of all or any of the cerebral ganglia, and whatever 
disturbs the substance of the brain. 
The daily panorama of the changing scenes of life is forever 
making impressions upon the mind for pleasure or pain, as the 
strong rays of the sun produce photophobia or give pleasure as 
one gazes upon the scenes of an outspreading landscape. Or the 
brain may become so acted upon that the mind will lose its power 
of discriminating judgment of colors, forms, and objects, through 
the defective medium of sight, occasioned by straining the eve , 
or in astigmatism, or double dyplopia, when errors of vision be- 
come provocative causes of mental alienation, as the optic lobes 
are falsely stimulated by the imperfect image upon the 
retina coming through the refractive media of an astigmatic 
eye. 31 
This effect is not wholly confined to the optic lobes. Stimuli 
if sufficiently strong, applied to the afferant nerves, will inhibit'. 
l- e., “ will retard or even wholly prevent reflex action” (Pastor 
Page 419). These facts may be applied to the reflex action of 
psychic forces which awaken another train of errors in judgment 
and can only be overcome by a careful course of reasoning. But 
an error of judgment, however persistently followed, must not 
be received as an evidence of insanity. 
DELUSION AND HALLUCINATION. 
Delusion is a deception as regards the existence of truths. 
Hallucination is a deception as regards the existence of things. 
The former relates to abstract, the latter to concrete sub- 
jects. For instance, I am told of the existence of a great con- 
flagration, and believe it, but afterwards I find it did not exist 
and that I was deluded; again, I think I see a conflagration and 
repeat my impressions of its magnitude, but afterwards find it did 
not occur, and then learn I was laboring under an hallucination. 
All that appeals to reason and judgment through mental 
activity alone, that is not true, is a delusion—all that is presented 
to the mind through physical senses, that is not true, is hallucina- 
tion. 
Delusions arise frequently from physical causes, as one with an 
astigmatic eye, which is unassisted by proper lens, regards ail 
J ound objects or circles as oblong ; also, where there is an imperfect 
formation of the membrana lympani, sound awakens an error 
°f judgment as to its intensity and kind. When odoriferous 
Particles fall upon the olfactory epithelium the sensation of smell 
18 produced; but if this membrane be diseased, there will be m 
orror conveyed to the sensorium, the same as occurs when there 
13 a deformity of the retina in the objective sphere of vision. 
These are some of the external and concentric causes of error 
0 Judgment, and serve to illustrate how disease or over-excitation 32 
■of the cerebral nerve centres produce insanity or strong- 
emotional feelings, according to the various media through 
which the vibratory excitement passes, but do not show where 
responsibility ceases. 
Who cannot recall the memory of childhood with its scenes of 
pleasure or fear of parental discipline. At will, the whole 
panorama of life, with its daily etchings and embellishments, is 
brought before us to be with its original thought again com- 
pressed amid the subtle forces of an undefined existence; and 
we search nowhere but the brain for the forces which give 
character and direction to all the affairs of life, and hold all in re- 
serve for the use of memory. 
Physiologists distinguish two kinds of nervous action; one 
initiatory, the other inhibitory—the one originating, the other 
controlling. Now, just as the originating centres may be strength- 
ened by indulgence, so may the inhibitory be made stronger by 
habit; hence, a man in ordinary health may be tempted by some 
false inducement to act, but he does not lose his power to resist 
the action. So a man may be tempted while suffering from dis- 
ease, by some unreal object, some delusional belief, but it does 
not thereby follow that he is deprived of the volitional power of 
control over his acts, and that he is irresponsible for what he does 
on this account; for the originating thought is the force that con- 
trols all subsequent action. 
“ It is the feelings that reveal the genuine nature of an individ- 
ual and the nature of his acts ; it is from the depths of one’s 
inner nature that the impulses of action come, while the intellect 
guides and controls ; and accordingly in a perversion of the effec- 
tive life is revealed a fundamental disorder, which will be exhib- 
ited in acts rather than in words.”—Reynolds, page 592. 
And here we find a ready solution to the problem of psychic 
forces, which prompt and lead on to unresisted criminal action, 33 
the will relaxing its hold upon fortitude and right; but not be- 
cause the unseen is an irresistible foe that compels the unfortu- 
nate to the commission of crime, but by reason of the failure to 
exercise the moral faculties which creative energy has bestowed 
upon man. 
Not an author which I have consulted has. attempted to prove 
the pathology of transitory mania, or given any psychic or phys- 
iological reasons for their conclusions ; the ipse dixit of the indi- 
vidual said to be so affected, is the only evidence given in sup- 
port of the theory. And certainly this cannot be considered of 
any value in a court of justice; and it is surprising that any of 
the eminent writers upon this subject should attach so much im- 
portance to the declarations of parties judged to be insane but a 
moment before and at the time of a criminal act. Ido not refer 
to the spasmodic homicidal impulse of known epileptics, or of 
the known insane, but have special reference to the mushroom 
development and decay of a sui generis type of insanity called 
transitory mania. 
Wharton and Stille, page 710, say: “Mania transitoria is a 
sudden insane frenzy.” As frenzy disconnected with physical 
suffering can have no possible pathology,perse, it cannot properly 
be held to be insanity, and should not be offered as an extenuating 
excuse for crime; for, being considered as a purely mental dis- 
turbance, it is only an increased state of unresisted passion. 
Chitty, Forsyth, and J. T. N. Fontblanque make no mention of 
transitory mania. 
Allan McLane Hamilton, physician to the Insane Asylum of 
New York, says (page 209): “When a crime is not to be ac- 
counted for, and completely inconsistent with the antecedents of 
onc who is not known to be epileptic or insane, and when it is 
accomplished in a moment of fury, then we should examine 
whether these are aborted or nocturnal attacks of epilepsy.” 34 
“ Maniacal rage of short duration is often epileptic in character, 
and its true character is often mistaken.” 
This author does not treat of transitory mania beyond this 
epileptic form of disease, and is wisely cautious about admitting 
its possibility, rendering nis opinion of doubtful value upon any 
medico-legal question. 
Ray, in his work entitled “ Contributions to Medical Path- 
ology,” page 259, in the case of Bernard Congley, says :“ It 
must have been a paroxysm of transitory mania, suddenly begin- 
ning and as suddenly ending, after the briefest possible duration. 
The cases of this kind of mania on record, though few, certainly 
are so well attested that we can scarcely deny the existence of the 
form of insanity which they illustrate. And it is a noticeable 
feature of most of them that the patient is bent on destroying 
life.” 
If bent upon committing murder, that fact implies the exercise 
of the will to accomplish some specific object; consequently his 
theory, if analyzed, would scarcely bear the crucial test, so as to 
be entitled to any more importance to the profession than the 
declaration of some less learned gentleman. 
REPORT OF TRIAL OF SAMUEL M. ANDREWS, BEFORE THE 
SUPREME COURT OF MASSACHUSETTS. 
Dr. Edward Jarvis (page 173) testified; “Sudden manias 
vary; sometimes they commence and terminate in a violent 
outbreak. They may come suddenly and cease as abruptly.” 
In the same case, page 187, George H. Choate testified; “I 
have had about 3,600 cases under my charge.” “ I have never 
known a case of insanity originating and terminating in a single 
act of violence. I don’t believe such a case exists.” 
Page 188: ‘‘There is a moment when insanity begins. There 
is a gradual increase of symptoms, and it does not reach uncon- 
sciousness without increasing symptoms.” 35 
Here we have directly opposite opinions Irom two eminent 
medical gentlemen, the one having the greater advantage over 
the other by his superior opportunities for observation, and he 
positively denies the possible existence of transitory mania. But 
ike all other authorities upon insanity, they make no attempt to 
prove, by any method of reasoning, why this condition may or 
cannot exist as a sequence of functional or organic disturbances. 
ns is a part ol the labor I have undertaken in preparing this 
paper. & 
in order to obtain an expression upon this subject from those 
best qualified to judge, I addressed a “circular letter” to the 
Superintendents of all the Insane Asylums of our counfry, and 
requested them to answer the following interrogatories, viz ; 
n ffowiong have you been connected with any institution for the 
treatment of the insane ? 
dent noon I™ of transitory mania that was not depon- 
ent upon some form of insanity, and that did not present itself as a 
maw testation of previously existing* ciiseu.se 
palhk disea“e?"Sider “ P°rtWe ,ransitorj’ n,i"'ia to occur as an idio- 
4. How many insane persons have you had under your care5 
Remarks. 
l o these questions I have received the following replies. To 
avoid repetition I will place the answers in the order of 1, 2, 3 
and 4, as the questions were given : 
years. 2—l do not recollect such a case. 3-Possible ; not 
probable. 4 650. Remarks : I have been of the opinion that tran- 
a7/7 TY7CZr’ bUt in Very excePti°nal cases.—H IVardner, 
IJ., .Sufi/. Hospital for the Insane, Anna, 111. 
I haTf r yearS' 2—one" 3 Think not. 4-4.946. Remarks: 
I have also seen 25,000 patients m other asylums, but no case of tran- 
si ory mama.—E. T. Wilkins, All)., Resident Physician of Napa (Cali- 
fornia/) State Asylum for the Insane. 36 
i—Two years. 2—No. 3—No. 4—3,787.— IT. B. Fletcher, M.D., 
Insane Asylum, Indianapolis, Ind. 
I—Fifteen1—Fifteen years. 2—No. 3—No. 4—2,000.—/*. Mac Donald, 
..S'/aW Asylum for Insane Criminals, Auburn, N Y 
I—Seven1—Seven years. 2—Never. 4—1,500. Remarks: Transitory mania 
I think is of rare occurrence ; that it does sometimes occur I think there 
is no doubt.—C. IV. King, M.D., Dayton, Ohio. 
I—Nine1—Nine years. 2—Have not. 3—Do not. 4—2,000. Remarks :I do 
not believe mania transitoria exists, per se.—Randolph Parksdale, M.D., 
Supt. Insane Asylum, Petersbnrgh, Va. 
I—Twelve1—Twelve years. 2—No. 4—Several thousand.—D. M. Wise, Supt 
Willard Asylum for the Insane, N. Y. 
I—Sixteen1—Sixteen years. 2—Most assuredly not. 3—No. 4—3,000. Re- 
marks : Such a proposition as transitory mania is irrational, absurd, and 
opposed to every theory of advanced psychistry.—E. A. Kilburn, M.D., 
Med. Supt. Insane Hospital, Elgin, 111. 
I—Twentyl—Twenty years. 2—Never. 4—7,000. Remarks : To be insane 
there must be actual disease of the brain, which is not transitory.—H. A 
Gilman, M.D., Supt. Insane Asylum, Mt. Pleasant, lozva. 
I—Ten1—Ten years. 2—No. 3—No. 4—200. Remarks : I fully concur 
with your views on the subject.—R. C. Chenault, M.D., Med. Supt. E. 
V. L. Asylum, Lexington, Ky. 
I—Sixteen1—Sixteen years. 2—Never. 3—No. 4—3,602.—John W. Ward, 
M.D., Trenton, N.J. 
I—Eleven years. 2—No. 3—No. 4—1,297.—J. W. Jones, Supt. In- 
sane Asylum of Louisiana. 
I—Twenty-fivel—Twenty-five years. 2—No. 4—2,500. Remarks: While my ex- 
perience, as shown above, is against the existence of what you call mania 
transitoria, my views of the nature of mind make such a condition scien- 
tifically possible.—P. Bryce, M.D., Tuscalusa, Ala. 
I—Eight years. 2—No. 4—5,000. Remarks : I have no reason to 
doubt the authenticity of some reported cases of transitory mania. Ma- 
nia transitoria differs somewhat as treated by different authors, and the 37 
name does not sufficiently explain what is meant.— JI. B. Goldsmith, 
M.D., Danvers, Mass., State Asylum. 
I—Thirtyl—Thirty years. 4—Several thousand. Remarks : Transitory mania 
as an idiopathic disease is not probable, judging from experience. I have 
never seen a case of so-called transitory mania.—John B. Chapin, M.D., 
Supt. Hospital for Insane, Phil. 
I—Seven1—Seven years. 2—No. 3—No. 4—699. Remarks : Daily average 
never less than 660. Your position is correct.—C. A. Miller, M.D., Supt. 
Insane Asylum, Carthage, Ohio. 
I—Sixteen1—Sixteen years. 2—No. 4—7,000.—R. M. Wigginton, M.D., Supt. 
State Asylum, Winnebago, Wis. 
I—Eleven1—Eleven years. 2—No. 3—No. 4—2,500. Remarks: Ido not be- 
lieve there is such a condition as transitory mania, and think the use of 
the term should be abandoned.—G. H. Hill. M.D., Supt. of Insane 
Asylum, Independence, lowa. 
I—l1—1 hirteen years. 2—No. 4—2,700. Remarks; My judgment in 
suspense ; no such cases come to asylums.—Richard Dewey, Kankakee, 
in. 
I—l1—1 wenty-seven years. 2—No. 3—No. 4—About 6,000. Remarks: 
I think it possible that there might be temporary mental aberration ; 
should not call it disease, but functional disturbance.—C. K. Bartlett, 
M.D., Supt. Minnesota Hospital for Insane, St. Peters, Minn. 
I—l wo years. 2—No. 3—l do not. 4—Some thousands. Re- 
marks; When any well-marked neurosis, particularly epilepsy, can be 
shown, it would be difficult to disprove transitory mania.— W. H. Mays, 
M.D., Assistant Physician State Asylum, Stockton, Cat. 
Remarks : Have never seen a case, and I do not believe in the theory 
of transitory mania.—A. H. Talcott, M.D., Middleton, N. V. 
I—Fifteen1—Fifteen years. 2—No. 3—No. 4—Some thousands.—James D. 
Moncure, M.D., Supt. Insane Asylum, Williamsburgh, Va. 
I—Thirty years. 2—No. 3—No. 4—5,000. Remarks : Do not con- 
sider it possible for transitory mania to exist as an idiopathic disease. 
Yet I would not deny the possibility of transient maniacal phenomena 38 
as a consequence of temporary physical conditions.—Pliney Earle, M.D., 
Supt. of the State Lunatic Hospital at Northampton, Mass. 
I—Twelve years. 2—No. 4—About 1,500. Remarks: Cannot say 
what is or is not possible.—H. P. Stevens, M.D., Retreat for the Insane, 
Hartford, Conn. 
I—Forty-twol—Forty-two years. 4—8,000.—H. A. Buttolph, M.D., Morris Plims, 
New Jersey. 
Accompanying this reply is a highly interesting letter, in which 
the author doubts the theory of transitory mania, and thinks the 
term should be dropped and “insane impulse” be used in its 
place. 
I—Twenty-eightl—Twenty-eight years. 2—Have never seen such a case. 3—No. 
4—3,000. Remarks : Neither experience nor reading lead me to think 
it possible. The only cases which have come to my knowledge claimed 
as transitory mania have been supported by very questionable evidence. 
—J. P. Bancroft, M.D., Supt. Insane Asylum, Concord, N. H. 
The gentlemen who have kindly furnished me with the fore- 
going statistics are highly esteemed by the medical profession 
for their learning in psychological medicine, and their statements 
are entitled to the fullest confidence as authority upon the sub- 
ject ; and, in justice to offended law, we must conclude that the 
theory of mania transitoria to the criminal is like the signal of 
the mariner, far out to sea upon a sinking vessel, with no reason- 
able help in view ; it is the only hope of relief, when human 
sympathy alone comes to the rescue, powerless to save the inno- 
cent from the perils of the wave, yet holds the guilty in the em- 
brace of social life, though he can never be fully restored to the 
confidence of the people. 
In the revised edition of the “Medico-Legal Papers,” page 
189, Dr. Wm. A. Hammond says : “ The sympathetic system of 
nerves has a most important office to perform in the organism, 
and one which in its relations to the subject is of very great mo- 39 
ment. It is the organ by which the size of the blood-vessels is 
regarded.” And on page 190, xxi : “ Now, what is the condi- 
tion known as transitory mania ? 1. It may be defined as a form 
of insanity, in which the individual, with or without the exhibi- 
tion ol previous notable symptoms, and with or without obvious 
exciting cause, suddenly loses the control of his will, during 
which period of non-control he commonly perpetrates a criminal 
act, and then as suddenly recovers, more or less completely, his 
power of volition. 2. Attentive examination will always reveal 
the existence of symptoms precursory to the outbreak which 
constitutes the culminating act, though they may be so slight as 
to escape superficial examination, (a) The hypothesis, there- 
fore, that a person may be perfectly sane one moment, insane the 
next, and then again perfectly sane in a moment, is contrary to 
all the experience of psychological medicine.” 
Page 185 : “ An essential feature of the definition of insanity is 
that it depends directly upon a diseased condition of the brain.” 
“ Medico-Legal papers,” page 221 ; “ Whatever may be said by 
the pure psychological school of philosophers, the world is indebt- 
ed to physicians and physiologists for the only true philosophy of 
mind, namely, that instead of being a simple entity, an indepen- 
dent source of power and self-sufficient cause of causes, it is de- 
pendent on a material organ for all its manifestations.” 
“ Mental power is but an organized result, matured by insen- 
sible degrees in the course of life, and as much dependent on the 
nervous structure as the function of the liver is on the hepatic 
structure.” 
Report of Abner Rogers, Jr., indicted for the murder of Charles 
Lincoln, Jr., tried before the Supreme Court of Massachusetts, 
page 104. 
“ And first as to the point of the State’s attorney, that the 
prisoner’s offense, if not amounting to murder, may yet consti- 40 
tute manslaughter. That as manslaughter is murder upon pro- 
vocation, or under sudden excitement, so murder on insane or 
partially controllable impulse, may be no more than manslaugh- 
ter.” As there can be no such thing as “ partially controllable 
impulse,” no great wisdom is presented in this theory, nor evi- 
dence of careful investigation of mental disease, nor does it en- 
lighten the jury. 
A great statesman of the old country, Mr. Burke, said that 
“the soul of government lies in the jury-box.” But jurors 
should be well-informed, and competent to pass upon and deter- 
mine between questions which relate to facts and those which 
relate to law ; and experts upon questions of insanity should be 
able to make such clear statements before them that there should 
be no difficulty in understanding the true import of their mean- 
ing. But no one can prove to any jury that impulse, or emotion, 
is a disease which only finds a remedy in some criminal act, as 
homicide, and then is instantly and forever cured. 
As a matter of physiological interest connected with this sub- 
ject, and showing some of the functions of the brain, Luys (page 
53) remarks: “Subject, who had been long deprived of an up- 
per limb, in the case of disarticulation of the shoulder, there ex- 
isted in certain long disused regions of the brain, coincident, very 
distinctly localized atrophies. I have, moreover, demonstrated 
that the atrophied regions of the brain are not the same in the 
case of the amputation of the leg' as in that of amputation of the 
upper limbs.” 
Ihe researches of heitsch, Hitzig, Panier, Brown-Sequard, 
Bartholow, and many others, have shown that by applying elec- 
tric excitement in the region of the gray cortex motor, reaction 
in isolated groups of muscles are determined; that at will we 
may cause the eyes, tongue and neck to move. 
The period of incubation of reflex nervous action varies, and the inhibitory force ot nervous activity is the only important fac- 
tor which will or can determine the duration of physical disturb- 
ance as it relates to any specific action dependent upon nervous 
energy. This is often witnessed in cerebral apoplexy, or in- 
juries to the brain from extraneous causes, and shows in the 
simplest manner the correlation between cause and effect. And 
when we apply these truths to the inhibition of mental action, we 
shall be able to prove by physiological facts that spontaneous 
development of disease is impossible, as it relates to growth and 
decay at the same moment. 
In a work entitled "‘Plain Talk about Insanity,” by T. W. 
Fisher, M.D., page 86, we find the following, viz: “Epileptics 
are known to be subject to attacks of frenzy. This knowledge 
makes physicians careful, in cases of unexplained violence, to 
search for some trace of epilepsy, vertigo, or petit mal, in the 
previous history of the suspected person, and it is often found.” 
He states that Dr. Krafft Ebbing “ distinguishes seven different 
groups of conditions, under any of which transitory mania may 
occur,” viz : 
1. The state of dreaming. 
2. Different kinds of intoxications. 
3. Delirium of febrile maladies. 
4. Transformation of neuroses. 
5. Transitory psychoses. 
6. Pathological passion. 
7. Transitory intellectual troubles at child-birth. 
Alas! parturiunt mmtes, nothing having been brought forth 
by his labors but confusion. 
This classification and subdivision of the etiology of transitory 
mania is too vague to secure importance with the careful reader; 
and if it shows anything, it proves the error of the author’s theory 
and the incorrectness of his conclusions, for a manifestation of frenzy or great mental excitement connected with either of these 
physical conditions can only be rationally considered as symp- 
toms of some existing malady. 
II these conditions collectively have any central meaning, 
they refer to epilepsy, not to mania transitoria as an idiopathic 
disease, and the words of the author himself cannot lead one 
astray from this conclusion, for he states : ‘ ‘ All these conditions 
of transitory disorder may prove very difficult to estimate, be- 
cause the direct examination of the accused only affords negative 
results.” 
4 2 
Clouston, on “Mental Diseases,” page 162, remarks: “I 
think cases of mania transitoria result from the following causes : 
Most of them are epileptiform, are, in fact, of the nature of men- 
tal epilepsy. All the symptoms may be seen in the incubation 
of febrile and inflammatory complaints, such as scarlet fever, 
typhus and typhoid, local inflammations, etc.” 
He speaks of visiting a person who was very wakeful, and was 
laboring under some peculiar mental aberration that came on 
suddenly, and says, since then, when he has similar cases, he asks 
himself, “Is it a case of mania transitoria ?’ ’ and then states he 
has seen many similar cases in asylums, especially among epilep- 
tics. 
V 
Edward C. Mann, in his recent work on Psychological Medi- 
cine, page 122, says: “There are certain cases familiar to all 
specialists in insanity, which suffer from impulsive insanity, 
with a homicidal or suicidal monomania. These patients, 
without appreciable disorder of the intellect, are impelled 
by a terrible vis a tergo, a morbid, uncontrollable impulse 
to desperate acts of suicide or homicide.” He also speaks 
of a patient under his care “who would voluntarily enter an asy- 
lum and remain there until the morbid impulse had passed away.” 
While it should be remembered that an isolated case is not sufficient evidence to prove an important fact, the case cited 
shows that the proper exercise of the will was sufficient to con- 
trol what the author says is an uncontrollable impulse, for the 
patient went away of his own accord and escaped the reality of 
his dreadful forebodings. 
43 
Again, on page 126, he says, as a climax to the discussion of 
inebriety: “In these cases also the mental disorder is of a sudden 
and transitory character, not preceded by any symptoms calcu- 
lated to excite suspicion of insanity.’’ “Itis a transitory mania, 
or sudden paroxysm, without antecedent manifestation,” the 
duration of the morbid state being short, and the cessation sud- 
den. Such attacks are transient in proportion to their violence, 
and transition occurs on the completion of the act of violence. ’ ’ 
“ Clearly allied to this state of which I have been speaking is that 
peculiar psychological state, the trance state, which also occurs 
in inebriety.” 
Trance is an exceedingly rare condition—so rare, indeed, that 
ten thousand physicians may enjoy a large practice for many 
years, and not one of them ever witness a typical case. 
Alexander Bain, in his work upon the “Intellect” has many 
valuable thoughts connected with this subject, which are in ac- 
cordance with the views I have expressed. 
When carefully considered, this will be found only to relate to 
some manifestation or symptom of a disease known to exist, and 
has no bearing upon the question of transitory mania as an inde- 
pendent or idiopathic disease. Transitory mania as the result of 
inebriety has nothing in common with trance; trance being un- 
questionably an idiopathic condition in which the patient re- 
mains as if had breathed over the entire organism a feel- 
ing of repose, and left the mind oblivious to its own conscious- 
ness to revel in dreams and ecstacies. Here the author is clearly 
in error, for when he speaks of trance being closely allied to transitory mania in connection with inebriety, he incorrectly 
classes trance with one of the many phases of epilepsy. 
Clouston, in his work on Mental Diseases, discusses the sub- 
ject of “ impulse ” in a very fair tone of argument, and favors the 
theory that it is “ irresistible,” but says nothing of “ transitory 
mania,” and leaves the correctness of his syllogistic reasoning to 
the same criticism of analysis I have given to Mann ; for the lat- 
ter has not proven that transitory mania is an idiopathic disease, 
and the former has not shown that “impulse ” is uncontrollable. 
The theory is easy to accept, but in itself proves nothing. 
The refractory horse is impulsive, but by careful training be- 
comes submissive; by kind treatment the wild animal obeys the 
voice of its keeper. All impulses are the result of cerebral ex- 
citement, which by the control of psychological forces may be 
overcome in man as in the animal, and the person who does not 
attempt to control himself commits a great moral wrong, and the 
“ sin of omission ” rests upon him. 
“’Tis education forms the common mind,” and even where 
impulse is an “inheritance,” the force of moral training and in- 
dividual discipline can and should hold it in abeyance as far as 
it relates to criminal action. The mother’s love controls her sul- 
len and sulky child until his eye is full of laughter and his cheek 
dimpled with smiles. Psychopathy controls the turbulent forces 
of his inhibitory nature, and he is subdued. Man is but a child 
of “larger growth.” 
In this connection we may ask what are the bearings of the 
developmental theory, and the theory of evolution, upon the 
ethics, morals, health, and law of the present age ? A man is 
either amenable to himself or to some established law, with pre- 
cepts his guide, but law his rule, and if healthful laws are not 
administered, crime is either evolved or developed for evolution, 
and the highest interests of society are sacrificed to caprice and 45 
misguided judgment as an unavoidable sequence. It is only 
through the reasoning by induction, inference and comparison 
with concrete things and demonstrative principles, we are in any- 
wise able to judge of the subtle, controlling forces of mentality, 
as witnessed in the agency and effect of electricity, produced by 
induction or chemical reaction, electrolysis, Farradism, magnet- 
ism, etc. By the force of constructive genius applied to mechan- 
ical arts, we are able by a simple touch to illuminate cities or 
sound the alarm of approaching danger. But as this paper is not 
intended to enter into an exhaustive discussion of this subject, 
connected with mind, I will leave this train of reasoning to be 
matured by others. 
Mann (page 43) says : “ In epilepsy the most internal part of 
the ascending parietal convolution of the brain has been found to 
be atrophied and indurated to cartilaginous consistence as far as 
its embrochure in the fissure of Sylvius.” If we state as a path- 
ological fact that it is a disease without a pathology, we shall 
fail to keep in the path of scientific truth and medical learning; 
and the more we investigate this question, the more certain will 
become our conviction that the plea of transitory mania is a 
mere subterfuge to enable the criminal to escape legal responsi- 
bility. 
“ Epileptic vertigo, which a person may have had for years 
without suspicion of its true nature, on the part of himself or his 
friends, is very fruitful of mental disturbances. The irritation, 
we may call it, may at any time seize the higher centres of the 
brain, instead of the lower, producing delirium as transient as 
the vertigo. In this transitory mania—for it is such—an act 
of violence may be done for which the patient is utterly irre- 
sponsible.”—Fisher, page 27. 
This author keeps in the same trodden path of all other writ- 
ers upon this subject, who never fail to associate transitory 46 
mania with epilepsy, where it must for ever rest as a manifesta- 
tion of disease rather than a disease entitled to independent 
nosonomy. Motive and volition cannot be separated in any con- 
scious act performed, for there can be no motive without the 
exercise of the will; and if it can be ascertained that a motive 
existed for the commission of a crime prior to its committal, then 
the act must carry with it the responsibility of the actor. 
All the leading authorities upon medical jurisprudence and 
mental diseases, as Maudsley, Ray, Esquirol, Hamilton, Spitzka, 
Bucknell, Tuke, Beck, Taylor, Browne, Mann, and Buys upon 
the “ Functions of the Brain,” agree upon the legal proposition 
that any party competent to distinguish right from wrong- 
stands in the presence of the law as sane, and is responsible for 
his acts. 
Buys (page 421) says : “The corticle periphery surrounding 
the optic thalami becomes intellectualized in some way to serve 
as exciting material for the activity of the cells of the corticle 
substance. These are the open gates by which all stimuli from 
without destined to serve as pabulum vit<z for these same corticle 
cells pass, and the only means of communication by which the 
regions of psychical activity come into contact with the external 
world.” 
From this view of the author, there appears to be no doubt ol 
a cerebral localization of psychic and intellectual activity, and 
“ that the sensory organs have a receptive organ in some way 
adapted to it in the central regions.” 
I have stated I had no objection to the theory of transitory 
mania as a symptom of some existing form of insanity, or as a 
manifestation of epilepsy; but it would be subject to less objec- 
tion to consider this erratic condition of mind a nomadic spasm 
of localized forces of the brain; and if it cannot be shown that 
some lesion of the brain existed prior to the outburst of criminal 47 
excitement, then the party must be held responsible for any act 
of violence he may have committed; for the act would be volun- 
tary, and all voluntary acts can be resisted. 
When this view of the question of transitory mania shall be- 
come established law, farcical court dramas, where the insane act 
is played, will no longer be brought before the public, with all 
the mockery and satire upon justice and rhapsody of polemic 
pleading in such cases. 
Public morals and common decency demand the restitution of 
common sense of parties interested in court proceedings in all 
insane criminal actions, that juries may be enlightened, and not 
confused by too much technical law and uncertain testi- 
mony. 
If a person commits murder while intoxicated, the law does 
not hold him guiltless, because he voluntarily placed himself in 
that condition which rendered him unconscious of the act he was 
committing. So if one commits murder while laboring under 
any great impulsive excitement, he becomes and should be held 
by the law as responsible; for all such persons can control their 
feelings, and would do so if there was a certainty of punishment 
before them from which they could not escape. And here is 
where we see the psychopathic influence as a restraining force 
in the prevention of crime; for any specific law placed upon the 
statutes affecting crime, which makes its punishment sure, would 
become a psychopathic force to restrain criminal action, and 
more attention should be given to this subject in connection with 
the study of forensic medicine. 
Gen. Grant, in a conversation with Prince Von Otto Bismarck, 
alluding to the attempted assassination of King William, said; 
“ Although at home there is a strong sentiment against the death 
penalty in cases of spasmodic insanity, and it is a sentiment which 
one naturally respects, I am not sure but it should be made more 48 
severe, rather than severe. Something is due to the offend- 
ed as well as the offender.” “That,” replied the Prince, “is 
entirely my view. My convictions are so strong that I resigned 
the government of Alsace because I was required to commute 
sentences of a capital nature.” Let there be a few prompt ex- 
amples of laws faithfully executed, and the psychopathic effect 
will be so great that homicidal lawlessness of cranks will soon 
cease. 
As objects multiply upon which we reason as we advance in 
intellectual development, pan passu, so a series of new forces 
spring up, which become factors in determining processes of 
judgment; hence we find equally well-educated men to differ in 
their opinions upon questions involved in controversies, and 
what seems material and pertinent to one is objective to another 
in its logical sequence and application. 
DEFINITIONS OF INSANITY. 
The legal definition of insanity is, that it is “a condition of 
mind which renders any party incapable of judging between 
right and wrong in any particular act at the time it is committed.” 
A philosophical definition declares, “ Insanity is a mental state 
in which acts of conception, judgment, or reasoning, persistently 
express themselves as different from the states of feeling and 
modes of thought usual to the individual in health ” (Combe). 
Such conditions as these render the patient legally an irres- 
ponsible being, and unfit him eventually for the performance of 
the social and political duties of life, for behind the act remain 
evidences of disordered intellect. This conclusion is in accord- 
ance with the expressed views of Esquirol, Tuke, Winslow and 
Bucknill. 
A pathological definition of insanity is, an aberration and 
erratic condition of mind, dependent upon a morbid state of the 
cerebral nerve centres which control mental activities; and it 49 
varies in form as the location of nerve centres varies that are 
affected, and the changes produced in mental manifestation by 
pressure, over-stimulation, or lack of nourishment of the brain, 
are often analogous to the different forms of paralysis and aphasia, 
according to the localized disturbances. Under such a condition 
molecular forces are interrupted, and mental activity, as the in- 
tellectual factor is left struggling through abnormal media to 
give expression of the disturbance to the outward senses. 
[“ The phenomena of moral responsibility, considered as a 
purely physiological synthesis of all nervous activities, consists 
in a series of regular processes, executed by the organism at its 
own expense, and resulting from the harmonic consensus of all 
its parts. Moral sensibility finds also in the intervention of in- 
tellectual activity a new power which excites it, makes it active, 
and maintains it in a perpetual state of erethism."]—Luys, page 
log. 
While this parenthesis refers to the social conditions of life, the 
truths it contains stand at the gateway that leads up to the fun- 
damental truths of the conditions which impose legal responsi- 
bility. This also accords with the modern researches of those 
who have given much careful attention to neurology and the 
functions of the brain, and is the echo of the voice of science, 
reverberating through all the avenues of thought and the intri- 
cacies of life, arousing the force of mental activity, the vividu vis 
animi, which awaken the consciousness of the errors of judg- 
ment manifested in crime. 
Ray, in his “Jurisprudence of Insanity,” states that “ the pro- 
pensities and sentiments are also integral portions of our mental 
constitution; and enlightened physiologists cannot doubt that 
their manifestations are dependent upon the cerebral organiza- 
tion.” 
As far back as the days of Paracelsus and Democritus, Hypoc- 50 
rates expresses his views of cerebral physiology\nd of the path- 
ology of insanity as follows, viz : “ Men ought to know that from 
nothing else but thence [referring to the brain] come joys, de- 
spondency and lamentations.” 
Says Aitken : “To consider the subjective phenomena which 
collectively, in their various manifestations, constitute mind, an 
immaterial essence, as liable to disease apart from all derange- 
ment of the material organ, the instrument with which it is so 
closely and indissolubly united, is to believe in a most incongru- 
ous, unphilosophical, unphysiological doctrine. The more con- 
sistent theory is that which is known as the cerebral theory, now 
entertained by most of the eminent physicians who have made 
insanity a special study.” 
Dr. Boyd records the singular fact that almost invariably the 
weight of the left cerebral hemisphere exceeds that of the right 
by at least an eighth of an ounce. 
The weight of the brain under different forms of insanity has 
been found as follows, viz : In mania the brain weighs 54 oz. 
11% drams; in monomania, 51 oz. drams; in dementia, 
50 oz. 5 drams; in general paralysis, 49 oz. 12 ® drams. This 
tabular statement shows most conclusively that the true path- 
ology of insanity is found in the encephalon. The specific gravity 
also varies in the white and gray matter. 
Aitken alludes to irresistible impulse, but thinks unresisted a 
better term. 
I introduce these facts to show the difference between insanity 
as a fact and the theory of insanity in mania transitoria, the lat- 
ter having no pathology; and while the logic in any particular 
case may be correct, the premises, a priori, being false upon 
which to base a plea, the conclusions must necessarily be wrong 
and verdicts will be rendered in favor of the criminal. 
Clouston (page 232) says: “ Professor Benedick, of Vienna, showed at the International Medical Congress of 1881, in Lon- 
don, a number of brains of habitual criminals, who, he affirmed, 
had their convolutions arranged in a certain simple form peculiar 
to the criminal classes, so that on seeing such a brain he could 
tell the ethical tendencies of the person to whom it belonged, just 
as one can tell a dog to be a bull-dog by his jaws.” 
When one is suffering from dementia, the listless, incoherent 
condition is interrupted by a sudden loud tone of voice, that 
causes a vibration of certain cerebral nerve centres, which is 
exhausted in a vocal response, while the party is wholly uncon- 
scious of its meaning or of any of the surroundings. 
Bucknill and Tuke, in their work upon “ Physiological Medi- 
cine,’’ page 443, referring to the pathology of insanity to cerebral 
disturbance, state the following facts: “ Greeding, in 216 cases, 
found the skull unusually thick in 167, the dura mater adherent 
to the cranium in 107 cases, the pia mater thickened and opaque 
in 86 out of 100 cases of mania, and beset with hydatids and 
spongy bodies in 92 out of 100 cases. The choroid plexus was 
found healthy in these respects in only 16 cases out of 219. 
Merkel noticed the increased density of the cerebral substance ” 
in insanity. 
Soemmering and Arnold confirm these observations, and Pas- 
cal declares that all mental diseases are the effect of ‘ ‘ morbid 
alterations in the brain and spinal cord.” I will also call atten- 
tion to the views of Virchow, as expressed in his “ Cellular Path- 
ology,” in support of the same conditions. While his views are 
not given in connection with any discussion of this subject 
directly, they have an important bearing upon the theory that all 
insanity is dependent upon cerebral changes, which may be slow 
and progressive in nature, as when melanoid tumors or gliomata 
press upon the corpus striatum, “that have their origin in the 
neuroglia of the interstitial connective tissue,” and many other 
forms of change. 52 
It is not logical to say because the song of the bird is not 
found in its throat, ergo, the anatomical structure of the throat 
has nothing to do with the musical notes ; nor would it be rea- 
sonable to say because specific lesions were not found, ergo, the 
anatomical changes of the encephalon had nothing to do with 
mental diseases. 
Most of the late writers agree to this proposition, and daily 
experience proves its correctness: “ We must be careful not to 
underrate their importance on account of the occasional absence 
of anatomical changes after death, and to conclude that for this 
reason such anatomical lesions, when present, may not be the 
cause of the mental disorder.”—Griesinger, page 291. 
While man does not possess a prescient mind that would en- 
able him to unmask the speculative thought which underlies and 
controls much of human action, a knowledge of the force of 
mental activity must be gained through a comparison of the 
negative with the active life manifested in physical efforts. The 
General upon the battle-field gives the command, and the force 
of the law of obedience brings contending armies together in 
deadly strife, and human life is sacrificed. This is a fair illustra- 
tion of the force of the law of psychopathy, and will enable us to 
judge more fairly of the contingent results of daily action, and 
show how the positive execution of law will tend to lessen 
criminal action. 
The clinical importance of the subject of psychology and biol- 
ogy, as questions of science, seems to have been overlooked by 
our teachers of medicine, and as yet these branches have not 
been assigned a place in the college curriculum; and whatever 
of public attention may have been directed to this department 
of learning, none but the flippant writers upon the stage of ex- 
periments have undertaken the explanation of the curious effects 
mind of upon mind, until quite recently, notwithstanding Baron 53 
Reichenbach's experiments in odic forces and biology nearly 
thirty years ago. 
“ 1 know 
That where the spade is deepest driven, 
The best fruits grow,” 
and make the following quotations from the work of Griesinger 
upon “ Mental Pathology:” 
“ Emotion, when transitory, and occurring in previously healthy 
organisms, is speedily calmed; when, however, bodily disease is 
already present, and when the causes are long-continued, there 
generally arise many complicated disorders of the organic mech- 
anism, which the simple cessation of the emotion cannot as 
quickly terminate.”—Page 40. 
“ Very much depends upon the duration and intensity of the 
phenomena, whether we consider the mental state as morbid.”— 
Page 44. 
“ We frequently see in subjects who, up to that moment, have 
been in the actual or at least apparent enjoyment of perfect health, 
just as in some ot those cases in which there is developed a sui- 
cidal tendency, attacks of most violent anxiety with obscuring of 
consciousness suddenly show themselves, accompanied with 
frightful hallucinations, during which the patient, in the blind- 
ness of his fury, seeks to slay all who come in his way. These 
cases, which, judged by their symptoms, appertain more, it is 
true, to mania, but which in their psychological relations repre- 
sent violent tits of melancholic anxiety, and especially morbid 
negative emotions, possess, in their want of any moral cause, a 
great analogy to those sudden fits of profound anxiety and se- 
vere mental suffering which have sometimes been witnessed as 
precursors of epileptic attacks.”—Page 184. 
Under this head come “ those cases in which those homicidal 
impulses suddenly, and without external motive, arise in persons who have been hitherto of a lively, joyous, and loving disposi- 
tion, and incessantly intrude themselves upon their thoughts.”- 
Page 185. 
Here the author refers to several notable examples of homi- 
cidal impulse ; “ A distinguished chemist, tormented with a homi- 
cidal impulse, would often prostrate himself before the altar and 
implore the Deity to deliver him from the atrocious propensity,” 
etc. Also refers to Catherine Olhaver, to a nurse, and the wife 
ot a shoemaker, who were “seized with an almost irresistible 
impulse.”—Page 187. 
He also speaks of the “habitual perversion of the feelings 
with impulsive fits ol anger, without any derangement of the in- 
tellect, and cites the case ol “an only son, brought up under 
the eyes of a weak and indulgent mother, who early acquired 
the habit of yielding lo all his caprices and to all the impulses 
ol a restless and ardent temperament” (page 190), and on page 
208, example xxxv., refers to “paroxysms of fury,” and as an 
illustration relates the story ot the Swabian peasant, with which 
every student of psychological medicine is familiar ; but in none 
of these cases has he shown that the impulse is irresistible. 
Lpon such cases as these is based the testimony in favor of 
the theory ol ephemeral “transitory mania,” with which our 
coui t calendars are filled ; and these cases even do not prove 
either the conscious or unconscious irresistible nature of the 
malady; nor does this classical writer claim or attempt to prove 
that transitory mania exists as an idiopathic disease, and com- 
mon intelligence forbids such labor, as an effort against justice 
and moral rectitude. 
Ihe fundamental disorder in mania, the irritation upon the 
motory side of the soul-life, exhibits itself, first of all, in this 
sphere, as a high degree of mental excitement, with restlessness, 
impetuous and violent desires and actions.” “The pleasure in 55 
loud speaking, in shedding blood, etc., may show itself in those 
violent and boisterous ways, and these results, fixed or transitory 
conditions which, according to the predominance of this or that 
desire, are known under the name of kleptomania, homicidal 
mania, etc.”—Page 197. 
“ Generally, from the commencement of insanity, or at least 
very soon, the quantitative increase and exaltation of thought are 
so great that there results a restless and constant succession of 
isolated ideas which have no intimate relations with each other, 
and constantly change their combinations, are very transitory, or 
of a very fragmentary nature.’’—Page 199. 
“ Whether, and to what extent, certain directions of the will 
and impulses in the insane, particularly such as lead to criminal 
acts, are irresistible, is a question which can scarcely be answered 
with certainty.”—Page 55. 
“ As to the invasion and course of mania, it is observed some- 
times as a pure and independent form of mental disease, as a 
stage of development in the successive series of mental disor- 
ders ; sometimes transient attacks of mania, or more correctly of 
fury, occur in individuals who are already subjects of profound 
mental disease.” “In epileptics, also, it is not uncommon to ob- 
serve attacks ol mania which are often characterized by a high 
degree of blind jury and ferocity. ■ Sometimes they immediately 
follow the epileptic attacks.”—Pag’e 203. 
The same field of research has been traversed by this learned 
and classical writer that has so repeatedly been investigated by 
others, without any apparent effort to prove how such a condition 
can occur possibly under the laws of psychopathy or psychosis, 
as understood at the present time; and until some more positive 
evidence of its existence shall be presented, the duty I owe to 
society will make it my aim and urge me to oppose the theory 
of transitory mania as an ogre too mythical to be brought be- 56 
fore courts and juries. The baneful effects of this theory upon 
public morals are matters of record and familiar to the judiciary 
of our country. 
In discussing this subject I have endeavored to avoid sacrific- 
ing tacts to either ethics or rhetoric, holding that the cognate 
sciences are the factors to be relied upon to explain by compari- 
son and illustrate the phenomena of cause and effect; and have 
endeavored to show that while the remote causes of insanity 
multiply with daily experience, pathologists have established the 
fact that the disease itself is dependent upon cerebral lesions and 
disturbances of nerve centres of the encephalon, which may be 
either primary or dependent upon reflex action, as in hysteria, 
dyspepsia, disease of the heart, spine, liver, and kidneys. “The 
anatomical changes which indicate insanity—that is, which pro- 
duce psychical anomalies during life—are naturally sought for 
within the cranium, in the brain and its membranes.” Grie- 
singer, page 290. 
Thus, with the preponderance of evidence in our favor, we are 
forced to conclude that it is impossible for transitory mania to 
hold a place in medicine, per se, and that the theory is surround- 
ed by more empiricism of law and medicine than any other hum- 
bug of modern times. 
In conclusion, whatever may be thought of our method of life 
and our efforts in the various walks of a chosen profession, may 
we never forget to cherish a love for justice, reverence for law, 
respect for the rights of others and sympathy for the unfortunate 
in mind; and when our labors shall cease, may we have a con- 
sciousness of having performed our duties faithfully and well, 
without fear or prejudice towards any. 
“ Whatever creed be taught or land be trod, 
Man’s conscience is the oracle of God.”