W't*! ilSSillf:!!--::::::;-,::-. 1 Rt! fell - V B»l!!lM. ;,:-,.,.■: .,:;■ . THE PARISH WILL CASE iffow % ^raxopto of t|o Cftjj of $kfo fork. MEDICAL OPINIONS, UPON THE MENTAL COMPETENCY OF MR. PARISH, JOHN WATSON, M. D. PLINY EARLE, M. D. D. T. BROWN, M. D. LUTHER V. BELL, M.D., LL.D. M. H. RANNEY, M. D. I. RAY, M. D. SIR HENRY HOLLAND, Bart., M.D., F.R.S. NEW m YORK: JOHN F. TROW, PRINTER, 377 & 379 BROADWAY. 1857. w Goo VV336 1657 P f;\^r0, 901, 768, and 769.) For his brother Daniel, with whom, in association with Mr. Kernochan, he had been, during the greater part of his commercial life, a business-partner, he entertained a high regard. (I. f. 768, 769.) And from the time of his relinquishing business in 1838, up to the period of the attack in 1849, the friendship between him and Daniel Parish was of the most intimate character; the two brothers still keeping their accounts undivided, and meeting and consulting together daily at their common office, as in former years. (I. f. 905.) During 16 the period of time now under consideration, though not engaged in commercial pursuits, Mr. Henry Parish was occasionally " in the habit of buying commercial paper; it was rather a favorite occupation with him; he always," says Mr. Kernochan, "had a propensity to operate in notes." (i. f. 835.) But the time for con- sidering him as no longer qualified for active occupa- tion has now arrived. 4th.—The Attach of July 19th, 1849, and its Imme- diate Consequences; Apoplexy, Hemiplegia^ and Loss of Speech. On the morning of July 19th, 1849, about ten or eleven o'clock, Mr. Parish, after entering the office of Mr. Edward Prime, of the firm of Prime, Ward, and King, in Wall Street, became suddenly insensible, con- vulsed, and paralytic, (I. f. 1108.) " In the month of July, 1849, the day he had his attack," says Mr. Isaac H.. Brown, " I met Mr. Parish in the vestibule of the Prime building, 54 Wall Street; after passing the usual time of day, he said, ' Good morning' to me, and then commenced joking me about the diversity of scenes that I met with in my daily pursuits; he ap- peared then to be in very good health ; that conversa- tion lasted from two to three minutes, it might have been longer. I then went into Mr. Prime's office * * while in there Mr. Parish came in; he took a seat to the left of the door, when young Nathaniel Prime said to him, ' Do you wish to see this book ?'—the book of quotations of stock sales for the day—he made him no reply. Young Mr. Prime whispered me, ' He is a little ugly;' I said to him, 'No, he is sick, or something is the matter with him, for I have just been talking to him outside.' I then bawled out at the top of my 17 voice, ' Do you wish to see the stock quotations to- day ?' and I observed a twitching of the shoulders; he made me no reply whatever; he was in the act of fall- ing as I sprang and caught him; took him inside of the railing, turned down one of the office chairs, put a cushion under his head and opened his cravat, suppos- ing he had been overcome by the heat; it was a very hot day; I then told Mr. Prime to go into the Appala- chicola Land Company Office and get Major Delafield to bring him in and send for a doctor; in a few mo- ments in came Major Joseph Delafield and Mr. Rufus Delafield and Dr. Van Rensselaer; the doctor told me it was the heat; I kept fanning Mr. Parish; went down stairs and got him some brandy; he took a little brandy; soon got his consciousness; they raised him up in his chair; he began to look around, and kept sitting, rubbing his right hand with his left hand; I pulled his right leg, raised it up, noticing that it kept slipping out; I then called Dr. Van Rensselaer's atten- tion to the fact, and said, ' I will raise it up again, doctor, and you look and see.' After raising it up it slipped out again; the doctor observed it, and whis- pered to me, ' It is paralysis, Brown.' By this time Dr. Edward Delafield came in, and had heard of it; most of the brothers-in-law were in the office; the first word Dr. Delafield said to me was, ' Brown, who got that doctor here ?' I said to him that I had sent out and got him through Mr. Prime; he said, ' You have saved that man's life;' I think he said any other doctor would have bled him, and he hadn't blood to lose, or some- thing to that effect; at this time Mr. Parish held his spectacles in his left hand, and appeared to have acquired his consciousness; some went to set about to take him home ; we carried him out and put him into a carriage of Dr. Delafield's at the door ; I then asked somebody, I think Dr. Delafield, whether I had not 6 18 better go up with them and help to get him into the house. I rode up in the carriage as far as Fulton street and Broadway; we went very slow ; I then suggested to Dr. Delafield I had better get out of the carriage as it was a light vehicle; I took the car at the Park and went up to the house at Union Square; they had arrived there just before me; had got an easy chair down on the side-walk; we took him out, lifted him out of the carriage, and carried him up stairs ; I took hold of the chair, and I don't know who the man was who took hold of the other; we carried him up stairs; we then undressed him and got him into bed; I don't know but Mrs. Parish was there at the time of my arrival, but she was there after we had got him in bed ; when Mrs. Parish came into the room he appear- ed to nod—nodded; she then said he knows where he is; she made that remark; I remained there I suppose probably ten or fifteen minutes after that; I didn't see Mr. Parish again until some time in February of the next year, 1850."—(II. f. 1705 to 1711.) Dr. Delafield, who had been summoned to the case at Mr. Prime's office in Wall street, after enumerating the persons already in attendance there, and who assisted him in taking Mr. Parish home, says, " I found that Mr. Parish had been attacked with a fit of apoplexy, and was beginning to recover from the first shock ; my first object was to get him home; he was placed in my own carriage, which was a coach, and driven home; this was done mainly with the assistance of Brown, the sexton, who accompanied me to Union Square; he went upon the box; when we arrived at the house he [Mr. Parish] was carried to his bed-room on the third floor; he soon began to exhibit confused consciousness, and we shortly discovered that his right side was para- lyzed ; he recovered somewhat rapidly from this condition, so that about on the first of August I considered him out 19 of immediate danger; I then was out of town for about a fortnight at my country place on Long Island, leaving him in charge of Dr. Francis U. Johnston, whom I had called in consultation immediately after the attack, and of my partner, Dr. Markoe, who had also attended him from the beginning a good deal more than myself; we were one or the other of us constantly with him a greater part of the time till I left town; I may say by night as well as by day, one of us sleeping at the house a good deal. On my return about the middle of August I found Mr. Parish much improved, and he continued to improve regularly up to about the first of October." (I. f. 2041-4.) Nor does Dr. Delafield re- member any recurrence of apoplectic seizures up to that time. (I. f. 2044.) "Mr. Parish," he adds, "first began to sit up about the middle of August, or pro- bably earlier," (I. f. 2048,) and he thinks that before the first of October he had begun to walk with aid, and that he had been brought down stairs; though on this last point he will not be positive. (I. f. 2050-1.) The para- lytic seizure he characterizes as " Hemiplegia," (I. f. 2052,) leading to "defect of motion, not of sensation," (I. f. 2052,) and implicating " the right arm and the right leg, and also the organs of speech." (I. f. 2049.) In reference to the use of the left arm, says Dr. D., " as he recovered strength in his body generally that quickly returned. He had some use of it, so as to show it was not paralyzed, in a day or two," and Dr. D. gives us to understand that his arm was never after- wards affected by paralysis, and so also of the left leg. (I. f. 3232.) Up to the first of October, adds Dr. Delafield, " he necessarily lost flesh a good deal;" (I. f. 2053 ;) but " he had improved to a great extent, and I then entertained hopes of a recovery of speech and a recovery of the use of his right arm to a much greater degree than was ever realized." (1. f. 2055-6.) In the 20 subsequent progress of the case, according to Dr. Markoe, " he gained almost no control over the move- ments of the right arm at any time : he gained very con- siderable control of the movements of the leg; so much so that he was able to walk at one time with a cane for a few steps ; the muscles of the face soon recovered al- most entirely from their paralytic condition." The sphincter of the bladder remained affected "slightly, and only occasionally it gave him trouble," and the catheter was used " at times; I should think not a dozen times in his whole life. He would soon get the relief by the use of the instrument for two or three successive days, and every thing would go on as well as before." (II. f. 1987-8.) 5th.—Tfie Attach in October, 1849. "Shortly after the first of October, 1849," says Dr. Delafield, " he was attacked with new and very alarming symptoms: severe pain in the bowels, fre- quent and unavailing attempts at evacuating the bowels, and a retention of urine took place; he con- tinued suffering severely at intervals until after some days a discharge of exceedingly offensive matter took place from the bowels ; this was repeated from time to time until about the middle of October, he, in the meantime, having become exceedingly exhausted," &c, (I. f. 2056-7,) not, however, to such a degree as to pre- vent him from being again down stairs and riding out in a carriage in the course of the month of November. (I. f. 2069.) The attack above described Dr. Delafield attributes to an intussusceptio, (I. f. 2060,) and slough of a portion of the lower bowel itself. (I. f. 2057-64.) But of this fact he is not absolutely certain ; for when asked if he knew such to have been certainly the fact, he says, " Not with absolute certainty, but as far as 21 could be learned by careful examination with the microscope by7 competent persons." (I. f. 3298.) The attack was accompanied by obstructions requiring the use of the catheter for relieving the bladder (I. f. 2062- 3144) and of enemata for unloading the bowels. (I. f. 2059.) This accumulation of diseases he thinks was " probably in some way dependent upon the condition of paralysis, but the point is a difficult one to deter- mine." (I. f. 2068.) Dr. Markoe, without being able to assign any cause for this ill turn in October, 1849, (II. f. 2104,) says, "He had about this time a very severe attack, the earlier symptoms of which were great distress, particularly at night—distress which he re- ferred, by gestures, to the stomach; connected with this, fever, irregular in its character. The disease lasted many days—several days certainly—before coming to what may be considered its climax, during which time it was necessary to use large anodynes, and by their help only partial relief was obtained. We considered him so ill at that time that one or the other of us—Dr. Delafield or myself—passed the night with him every night. After these symptoms a certain number of days a slough appeared at the anus, coming from the bowels evidently, which, in the course of twenty-four hours after its appearance and first protrusion from the bowels, came away entirely, accompanied with a good deal of bad smelling matter. He was not materially relieved until after the coming away of this slough. From that time he rapidly improved, and, somewhat to our surprise, gained very nearly his natural, his usual condition before the attack* (II. f. iy78-9.) * Drs. Delafield and Markoe both express the belief that this incidental affection had no special connection with Mr. Parish's primary disease, and in this I am disposed to agree with them. I have seen somewhat similar disturbances brought about by the carelessness of nurses in administering enemas. The following instance from Guy's Hospital Report is one of the 0 0 6th.—The Later Ailments. " After recovering: from the immediate effects of this latter ailment," says Dr. Delafield, '' Mr. Parish had a number of attacks distinct from the general disease, but the most frequent dependent upon its cause; or, in other words, dependent upon the condition of the brain, which led to the disease." (I. f. 2070.) " He had one or more severe attacks of cholera morbus; he had more than one, I think, severe attack of inflam- mation of the lungs; at one time an abscess formed under the angle of the jaw, which became so large as to threaten suffocation, and there were various minor attacks from time to time." (I. f. 2071.) Dr. Markoe, in allusion to the attack in July, 1849, considers it "apoplectic," (II. f. 1973,) and that the paralysis, in connection with it, implicated "the whole right side, including the organs of speech," "all the muscles of the back which have connection with the ex- tremities, and the sphincters of the bladder and rectum." " The motion of the head and neck was not affected; there was paralysis of the lips and the movements of some of the facial muscles." As to the circulation and same sort: " The patient in the act of passing an enema-tube experienced great, indeed, excruciating pain; fifteen hours afterwards he had em- physema of the integuments of the abdomen ; a few days subsequently he had offensive purulent discharges; a portion of the sloughing membrane passed per anum; and after death a large ulcer of the mucous membrane of the rectum was discovered, together with a perforation of the muscular coat. It appears probable that a large abscess had formed between the mucous and muscular coats, that the former had sloughed away, leav- ing the latter bare, while the cellular membrane behind it had been com- paratively little affected. I believe," adds the reporter, " that cases of perforation of the rectum from the unskilful introduction of the clyster- pipes are not very rare, and that most [anatomical] museums contain specimens of the accident; but 1 do not recollect myself to have met with an instance in which it was productive of emphysema." (See North Amer. Med. Rev. Vol. I. p. 552, for July, 1857, from Gtiifn Hospital Report Vol. II p. 68, for 1856.) ' 23 the sensibility of the parts involved: " Both were some- what impaired; sensation but slightly, circulation con- siderably, particularly in the lower extremities, the right leg and limb." " It is a form of paralysis which occupies one-half of the body; this case would come under the denomination of hemiplegia." (II. f. 1^83- 4.) Of the incidental terms of illness subsequent to the principal attack, Dr. Markoe speaks as follows: " He suffered great anxiety and apprehension about his eyes, and attention was constantly necessar}T, and insisted on by him in reference to that difficulty; he had, also, several acute attacks of disease at various times, which I cannot now remember, of which, one was an attack of inflammation of the lungs; another was a troublesome abscess under the jaw; another, more chronic and longer continued, was an inflamma- tion of the skin of both legs ; he had, also, at times, a great deal of swelling of the legs, requiring medical attention; his bowels required frequent attention ; he had difficulty about the urinary passages, sometimes incontinence, sometimes obstruction, which required surgical interference; his bladder attacks occurred at intervals through a large portion of his life." (II. f. 1985-6.) " And," elsewhere adds Dr. Markoe, "he was obliged to wear an artificial receptacle to re- ceive the urine which thus came off; this was at times only; this was a more common condition than that of retention of urine." (II. f. 1994.) " His general health, at one time," says Dr. Dela- field, " became perfectly good, to such a degree, that no person would have suspected, from looking at him, that he was not perfectly well; this condition he must have arrived at, well, certainly not later than the 1st of January, 1853, probably earlier; I believe I may say, that he continued to improve until the end even of 1854, and, perhaps, for six months after that till the 24 middle of 1855 ; at all events, till January, 1855, and a few months later; that is, he continued to improve in all general respects; the power of using the paralyzed leg improved, I may say the whole time, but the arm, which gained somewhat during the first six months, afterwards entirely lost its power." After the term of improvement had ceased, " he became more heavy, less inclined to move, more inclined to sleep, but still a fair, good, general health." (I. 2072-3.) " I think," says Mr. Kernochan, " he was as strong within the first two years as he was at any time after his attack, I mean after the first year and during the second." " I think that same degree of strength did not subsequently continue up to the time of his death. I thought he had been failing for at least the last year of his life. I had no means of perceiving much change, and did not, but his failing was visible for the last year. I thought so," (I. f. 963-4.) " For about seven weeks before his death," says Dr. Delafield, " he began to fail in health and strength, without any very definite symptoms, but during the latter part of the time the lungs became the seat of distress, and difficulty of breathing was a prominent symptom. This difficulty increased to within a few hours of his death, and he then quietly sank away, and died without any special suffering," (I. f. 2074.) " As well as I remember," says Dr. Markoe, "the last of Mr. Parish's life, the last six months certainly, he was not as free from these occa- sional attacks, and his health did not seem to be so firm. The last sickness occupied in its invasion and threatenings several weeks; in its serious aspect, pro- bably not more than a fortnight. The illness seemed to be congestion of the lungs, as a main feature; it was a complicated disease, however, depending, I should say, as we supposed, upon the condition of the brain " (II. f. 1990-1.) " During the last few weeks of his 25 life, for some reason difficult to explain," says Dr. Del- afield, " his food was not swallowed as soon as it was masticated." (I. f. 3299.) " I was with him," says the Rev. Dr. Taylor, " at about nine o'clock of the night in which he died; he died at four o'clock the next morning [March 2d, 1856], as I understood; he was then in the agony of death." " I found him breathing very heavily, with all the appearance of approaching dissolution; I spoke to him, expressing the hope that he knew me; he turned his head and gave me a nod of recognition, intimating that he knew who I was; he turned his head at my words very distinctly ; I then remarked that I should be very sorry to disturb him, but if you wish, I will make a short prayer; he again looked at me, and nodded his head in acquiescence; during the prayer his heavy breathing was in a measure suppressed, and at its conclusion I took his hand, when he sensibly pressed mine, and I bade him adieu; I never saw him again." (I. f. 3346.) Immediately after rallying from the first shock of the paralysis, he did not always re- cognize his frieuds at first sight. " Not so promptly," says Mr. Kernochan, " at first; he was very much prostrated; I should say within three months he re- cognized me very promptly, and he continued to recog- nize me quite as much so within one or two years afterwards; he always recognized me afterwards." (I. f. 954.) 7 th.—Disorder of the Right Eye. Some eighteen months or two years after the first stroke of paralysis, although his vision had in the meanwhile been as good as at any time subsequent to the operation for cataract, he began to complain of his 4 26 sight. (I. f. 2075.) " I discovered," says Dr. Delafield, " that apparently the difficulty was not so much injury to the sight of which he complained, as the floating of motes before his eyes." (I. f. 2075-'6.) During the continuance of this new affection, Drs. George Wilkes and Abram Dubois were called on consultation. (I. f. 2077.) " This difficulty, however, of which he com- plained, seemed gradually to subside, and I presume the sight must eventually have become somewhat dim- med from the fact that he laid aside the habit he was previously in, of looking over the newspapers and papers generally, which I would occasionally see him examining." (I. f. 2076-'7.) Dr. Markoe, when questioned concerning this affec- tion, and as to whether it was of a different character from the affection of the eyes prior to July, 1849, says, " I think it was." " It never reached a point of suffi- cient intensity to satisfy me precisely of its nature, and therefore I can hardly give it a single name." He thinks it tended to " amaurosis, a paralysis of the nerve of vision producing blindness." (II f. 1992-3.) Dr. Wilkes ascribes it to " Traumatic Amaurosis, being an affection of the nerve following the operation of cata- ract." (II. f. 222.) And Dr. Dubois says, "I asked Mr. Parish in reference to his principal trouble, which were motes; he answered my question with a simple nod of the head, and a peculiar rapid passage of the hand before his eyes, making at the same time a pecu- liar sound—noise—which I should call a buzzing sound, by which gesture and manner I suppose he wished to convey to me an idea of the annoyance he experienced from these motes." (II. f. 179-'80.) 27 8th.—Natural Evacuations. In the early period of his illness he suffered from bloody urine (I. f. 3214), and afterwards from loss of control over the discharges, both from the bowels and the bladder. Drs. Delafield and Markoe both allude to the natural evacuations ; but for a full description we must turn to the non-professional witnesses. George Simmons, who nursed Mr. Parish from December, 1849, till October, 1850, says, in respect to Mr. Parish's evacuations, " They were sometimes good, sometimes bad. (I. f. 1718.) " Sometimes his water was very bad; he couldn't keep that, and wet himself very fre- quently ; sometimes he would dirt himself too." (I. f. 1718.) Thomas Wingrove, who was his nurse from October, 1850, till September, 1851, says, " Mr. Parish had no way of assisting himself in any way, that is, going from the room to the water-closet, without my assistance; and sometimes it occurred that I have been too late upon that particular business, as Mr. Parish did not have control over his urine to hold it long enough sometimes to get to the water-closet; and in the same manner with other purposes at some times, not so often as his urine; perhaps it occurred three or four times in his besmearing himself in my time." (I. f. 1555-6.) Again, John Clarke, who nursed him from December, 1854, till April, 1855, says, "At mealtimes we would generally keep a watch on him—a very good watch—for sometimes he would make his water before I could get him ready; sometimes he would make his other evacuations in his pantaloons'.' (I. f. 1744.) " He was very feeble and weak, and sometimes I got his clothes off him; he would have his pantaloons dirtied." (I. f. 1744.) " I kept an eye always on him; he would certainly finish his dinner before he would go to the 28 water-closet, and then between the time of dinner, or whatever it would be, he would have himself wet be- fore I would get him to the water-closet, or dirty." (I. f. 1744-5.) " I would see him eating his dinner so fast that I knew he wanted to go." (I. f. 1745.) And while thus hurrying at table, " I would see him with his hand at the front of his pantaloons, as if he wanted to open them." (I. f. 1745.) " He generally would look at me then, that was for me to take him away," (I. f. 1746.) During the four months of this last nurse's term of service, these occurrences at the dinner table, indicating that Mr. Parish was in immediate need of his assistance, " happened many a time, I cannot say how often." " It might be," says he, " ten or fifteen times." (I. f. 1785.) Edward Clark, the coachman, still with Mrs. Parish, and who had been with the family without intermission for many years, even prior to Mr. Parish's illness, says, that on one occasion during the service of Simmons, Mr. Parish, while in the ba- rouche waiting for Mrs. Parish, was taken suddenly. " Yes, sir, he happened to be taken short in regard to his urine, and he wet the cushion ;" " the valet told me of it; it was all over then, and that was before Mrs. Parish came out; lsaw it when the valet told me of it." (II. f. 2225.) Mrs. P. spoke about it on her return to the carriage, in " not to call a loud tone ; not very loud." " It must be to the valet, because she was a little ex- cited herself about the accident occurring; I had nothing to do with it." And as to Mr. Parish at the time, " He made noises and sounds both, but I disre- member what they were; I wasn't looking at him over my shoulder at all, but I heard him hollering and bawl- ing." (II. f. 2227-29.) 29 9 th.—Periodical Convulsions. The occasional attacks of vertigo, fulness of blood in the head, or, as Dr. Delafield calls them, incomplete apoplectic seizures, to which Mr. Parish was subject since about the year 1840, or two years before his visit to Europe, have already been detailed. How far these or any of them may have been associated with spasmodic or convulsive action of the muscles, we have not the means of knowing, since Dr. Delafield had never witnessed these early attacks, or even the commencement of any of the spasms or convulsions to which Mr. Parish was subject. We have seen that the violent and overwhelming attack which, on the 19th of July, 1849, ushered in the paralysis, was accompanied with convulsions; and we ascertain from Dr. Delafield that Mr. Parish was ever after subject, at irregular intervals, to spasms, which made it " im- possible to leave him alone, as a general rule." (I. f. 2091.) "They commenced in the autumn, or early winter, after his attack ; * they recurred at first at intervals of four, perhaps eight days, to three weeks; the intervals gradually increased, and, with occasional exceptions, the convulsions were slighter; in 1850 they were most frequent; in 1851, 1852, and 1853, they gradually diminished in frequency; in 1854 and 1855 they occurred at long intervals, once in six months, and I think once almost a year intervened. (I. f. * According to the testimony of James C. Fisher, who nursed Mr. Parish from the date of the attack in July, 1849, till about the 24th of December following, the convulsions began in September. (II. f. 900.) The credibility of this witness, however, who appears on the part of the proponent, has been on several points so seriously impeached, as to make it questionable how far he can be believed in an}- thing he states. See his evidence invalidated by the testimony of Dr. F. U. JoMnston, T. D. Stewart, William Barber, and E. Faber. (III. from f. 1478 to 1610.) 30 3054.) When asked for the proper medical name, and a scientific description of these spasms, Dr. Dela- field states: " They would be called simply convulsions; whether epileptic, or not, would give rise to difference of opinion." (I. f. 3226, 3227.) He elsewhere states, as indications of their approach, that Mr. Parish " was always much more irritable, and generally uncomfortable, for some preceding days." (I. f. 3221,3222.) And again: "He was evidently not so well, and most strikingly his temper was more irritable, and after the spasm there would be a sudden and marked change in these particulars." (I. f. 3051.) Dr. Delafield never having himself witnessed the com- mencement of any of these convulsions, says, on the authority of the eye-witnesses, " They would commonly come on suddenly, there would be some sudden noise in his throat, sometimes resembling a shriek or scream, his face would redden violently, the whole body would be convulsed, and if not supported, he would sink down." (I. f. 322o.) " The convulsed muscles became alternately rigid and relaxed." (I. f. 3220.) "The convulsion proper would pass in a few minutes; certain convulsive actions, consequent upon it, would last some hours, which I would see." (I. f. 3219, 3220.) Dr. Delafield was probably not summoned to Mr. Parish on every recurrence of these attacks. (I. f. 3218.) But on his arrival after any of them, he states: "I would find him lying on a couch in a state approaching insensibility, sometimes absolutely insensible, with the paralyzed limb most commonly twitching, jerking— both legs did so, more or less, the paralyzed one the most so." (I. f. 3221.) Mr. Parish, during these paroxysms, suffered "injury to the tongue by the teeth, arising from the convulsive action of the jaw, unless provided against by inserting some substance between the teeth, for which," says Dr. Delafield, " I 31 suggested a piece of soft wood to be always at hand to be placed between the teeth." (If. 3222.) When asked from what nervous centre these convulsive movements were supposed to originate, he replies, " The brain." And when asked if the convulsions were connected with the general apoplectic disease of Mr. Parish, he says: " It would be more proper to say they were connected with the condition of the brain left by the apoplectic attack." (I. f. 3223.) Some of these paroxysms, he admits, threatened to result fatally; " one took place in his carriage, in front of Bowen and McNamee's store; he did not come out of it, so that I thought him out of danger, the entire day, and I very much doubted then whether he would re- cover ; upon another occasion, upon being sent for, I found his condition so alarming, and felt his recovery so nearly hopeless, that I immediately despatched a messenger for his brother, Mr. Daniel Parish, and he obeyed the summons." (I. f. 3052, 3053.) The date of the last-mentioned of these two occurrences, Dr. Delafield is unable to state. The other appears to have been during the year 1852 or 1853. (I. f. 3224, 3225.) Dr. Markoe thus speaks in reference to these spasms: " He was subject to epileptic spasms during a large portion of his illness; they were sometimes repeated as often as once in a month, but in the latter years of his life were much less frequent; they were generally of moderate severity, only two or three assuming a dangerous character; they ordinarily were from five to fifteen minutes in duration, except the severe ones, which were much longer; I saw him in a good many of them—four or five certainly; he was generally low-spirited, and more than usually irritable, before the spasm; and after the spasm he usually seemed brighter and better than he had been before; more cheerful and more quiet." In reference to the 32 term " epileptic," " I use it in a very general accepta- tion, so as to include all habitual, sudden, convulsive seizures, whether from disease of the brain or from other causes." " Technically, it is confined to a certain class of cases not referable to disease of the brain, but depending upon general disorder of the nervous sys- tem; cases such as those of Mr. Parish are called epileptic, more from convenience than any thing else; the term that would be precisely proper would be epileptiform." And as to the meaning and character of idiopathic epilepsy, he says: " I have already indicated that character in my first reply; that is, that it embraces cases on which the disease does not depend upon dis- ease of the brain, but upon general disorder, frequently not organic, of the nervous system." (II. f. 2031, 2033.) The attacks which we have now been considering may perhaps be still further elucidated from the de- scriptions furnished by the nurses, before whose eyes they were of frequent occurrence. Geo. S. Simmons (nurse from Dec. 1849 till Oct. '50) says, " There were times during the coming on of those spasms, that he would not care to be dressed at all in time for break- fast ; when these passed off he was generally very cor- rect in his time; these were all the variations before breakfast." (I. f. 1686, 1687.) With regard to the spasms, " They would vary, sometimes two, sometimes three in one month ; they varied in duration from 25 to 30 minutes; they came on with a sudden scream, a contraction of all the muscles and organs of the body; the body would be in complete contraction; the face was very black, and the froth would work out of his mouth ; there was a sudden twitching of the limbs and body altogether, and very frequently he would bite his tongue, which we always had to carry a little stick to prevent, by putting it in his mouth." (I. f. 1700.) Ac- cording to this same witness, Mr. Parish's temper was 33 subject to marked changes for the worse, generally when " these spells, these spasms, were coming on," (I. f. 1701.) Thos. Wingrove, (nurse from 1850 till Sept. 29th, 1851,) speaking of the frequency of these attacks, says, " I should say from once to three times a month, generally speaking; I remember one going about as far as six weeks;" again, " Mr. Parish took them unawares, as he was sitting in his chair, once when I was in the act of shaving him, and the razor upon his face ; he went off with a little twitter of the tongue, and got quite black in the face, and stiff; he had one on me, in my arms, in the dining-room, on the carpet, on the floor; that lasted from fifteen to twenty minutes ; generally speaking that was about the length; he closed his mouth tight sometimes, caught his tongue or lip; he used to cut himself occasionally; I had a small piece of wood which the doctors ordered to be put between his teeth before they closed, if possible; he worked convulsive with his feet up and down, and with his hands and whole body; he was perfectly straight and stiff, and foamed a good deal out of the mouth; that is as near as I can describe it," (I. f. 1533,'4.) Wm. Brown, nurse from Oct. 13th, 1851,till the middle of Nov. 1854, says, "The first spasm Mr. Parish took after I enter- ed the service was about six weeks after, in his carriage; it might have been that he had from eight to a dozen spasms during the first twelve months; there might not have been quite so many; they gradually dimin- ished after that to three, and four, and six months be- tween them, and the last year the interval was six months," (II. f. 1299.) The appearances would show themselves perhaps ten days or a fortnight before- hand ; any little thing then would make him irritable, he would be quick ; want his ideas known immediate- ly ; that is as far as I can describe it," (II. f. 1380.) Again, James Clarke, who nursed him from Dec. 1854, 5 34 till April, 1855, informs us that these spasms or con- vulsions were still continuing, and in speaking of the fit, he says, " It came on with a trembling and chok- ing and frothing and foaming at the mouth; he got black in the face; there was nothing but a constant trembling about his body, I suppose it lasted about three or four hours, I could not exactly say," (I. f. 1750.) "On these occasions," says the same witness elsewhere, " he was put in bed and took a sleep; he worked a little before he went to sleep; he was very much fatigued and weak after; I could not say how long they usually lasted," (I. f. 1786.) Like many persons subject to epilepsy or periodically recurring convulsions, Mr. Parish appears to have been fond of indulging his appetite. "Eating," says Wingrove, "seemed to be his predominant passion," (I. f. 1662.) When Mrs. Parish would, in accordance with the phy- sicians' orders, attempt to restrain him, and the ser- vants "would be ordered to take away the dinner off the table," wishing for more, " he pointed with his finger, saying, yean, yean, yean," pointing at " any thing that was on the table, and very often to be helped with brandy and water." " Mrs. Parish would always pour out so much in a tumbler, and when it was done he would hand the glass back to me ; I would ask Mrs. Parish if he was to have any more, and she would tell that he had enough, it would injure him, that the doc- tor had said so;" then " putting his finger down into the glass, saying, yean, yean, yean;" " He would get very irritable; he would beat on the table with his hand closed, and say, * yean, yean, yean.' During this time when he would be refused he would be more irri- table, and beat longer and stronger, very much excited, and sometimes have to be helped again," (I. f. 1694-6.) The nurse Clarke also says of Mr. Parish, that " he was very ravenous for dinner," (I. f. 1746.) Dr. Dela- 35 field, finding restraint of no avail, at length yielded to this propensity on the part of Mr. Parish. " He him- self gradually insisted upon and did eat more, and this occurring some time before I knew it, and he none the worse for it, I urged him no further on the subject." So that for " about the last eighteen months of his life" he was no longer subjected to restraint, (I. f. 3230.) 10th.—Change of Temper and Disposition. In connection with his protracted illness from the paralysis, periodically recurring convulsions, loss of speech and other ailments, Mr. Parish's temper and disposition appear to have been remarkably perverted from the equanimity and self-control which were among his more striking traits of character while in health. Wre have already alluded to his irritability of temper among the usual precursors of the convulsions. The slightest opposition or disappointment independent of these convulsions would at times excite a similar state of feeling. " Prior to the attack," says Dr. Delafield, his brother-in-law and physician, " he was a pleasant, rather than a joyous man in his disposition; fond of a frolic, I should say ; loved lively and gay conversation —any thing that excited a laugh." (I. f. 2099.) But after his attack, "his nervous temperament became very much impaired, rendering him irritable, more easily excited than before, and to a certain extent changing his disposition. I should have said his ner- vous system became impaired instead of his nervous temperament," shown, " as I have already stated, mainly by altering his disposition, but also by causing emotions of almost any kind to be more easily excited; if, for instance, a former friend would see him for the first time after his illness, it excited him sometimes to a vio- 36 lent paroxysm of weeping: this was the principal effect produced, aside from the effect upon his disposition generally." (I. f. 2098, '9.) Dr. Markoe had not known much of him before his illness, but says of Mr. P.'s condition afterwards, " As far as I know he was much more irascible, easily excited when any thing roused him, and in general of a more irritable temper than I supposed he was before his attack; he was never, how- ever, in the particular of politeness, wanting to me on any single occasion of my having intercourse with him:" and as to tone of feeling, "depressed, uni- formly almost, and low-spirited when I saw him." (II. f. 2020, '21.) Mr. Kernochan, the most intimate friend of his early, as well as of his riper years—his partner in business, and his sympathizing and constant visitor and guest throughout the whole of his protracted illness, says of him, while yet in health, that "he was the most placid and unexcitable man that I almost ever knew." (I. f. 887.) After the attack, adds Mr. Kernochan, " I don't think I ever saw him laugh since, but I have sometimes seen a more agreeable expression on his face than at other times." (I. f. 885.) " I very often saw him shed tears ; for certainly a year, I think, he shed tears almost every time I saw him ; I think it was within the first two years after the attack, and more or less so through the whole course of the period after the attack." (I. f. 886.) " Frequently he was quite irritable, I thought; that occurred generally in the interviews in the carriage, and when there was a difficulty in making out what he wanted, or Mrs. Parish suggested something that he didn't want." (I. f. 886.) This irritability would be manifested " by violent ges- tures with his left hand, and terminating generally with a push at Mrs. Parish." (I. f. 1040.) In the dis- cussion at the counting-room, on January 7th, 1850 between Mr. Folsom and Mrs. Parish, in the presence 37 of Mr. Parish, " I remarked," says Mr. Folsom, " to the effect, that I had no doubt Mr. Parish was satisfied with what I had done, or words of the same effect; she then said exactly these words, I think, ' If Mr. Parish could speak, he would very soon let you know whether he was satisfied or not.' I replied, * If he should ever come to his mind, you may thank your stars if you can render as clear an account as I can,' or words to that effect: these are almost the precise words I used; she then retorted angrily, and Mr. Par- ish turned abruptly towards her, with a menacing ges- ture of the head, and I may say struck her upon the shoulder, and pointed towards the carriage." (I. f. 1151-3.) Mr. Folsom, who had for many years been his confidential clerk, had never before known Mr. Parish to treat any person rudely. "I never did," adds this witness, " and never would believe him capa- ble of so rude an act, unless I had seen him perform it." (I. f. 1183.) To the frequent shedding of tears Mr. Folsom also bears witness, and to all appearance without any real cause for emotion. "Sometimes," says he, " I thought it was pain, weakness of mind, or hysterical; recollecting when I was in a very low con- dition myself, I had frequently shed tears without the power of avoiding it." (I. f. 1201.) Mr. Wm. A. Gas- quet, his former partner in business, when in the city from New Orleans, as he usually was nearly every summer, also witnessed this tendency to weeping. " Oftentimes," says Mr. G., " he was affected, not so much at other times; generally he was affected when I called ; he generally showed it in the same way by weeping; shedding tears." Mr. G. says also of himself on these occasions, " Yes, I could not help being af- fected—seeing an old partner, an old friend; I was al- ways affected more or less ; on the first occasion I was affected to tears; afterwards, I was often affected to 38 tears—not every time; I would get used to it after I first saw him." (III. f. 2019, '20.) Mr. Henry Delafield, speaking of Mr. Parish's deportment at table, after the attack, says: " I saw no difference, with the exception that Mr. Parish could not speak, and that he did not take the head of the table." (III. f. 32.) He admits, however, that Mr. Parish was at times subject to irri- tability ; " on such occasions, when we could not ascer- tain his wishes, he would occasionally, but not often, be irritated ;" showing this " by making sounds and at- tempt to speak—continued sounds." (III. f. 143.) And he would shed tears " on meeting a friend whom he had not seen for some time; this friend speaking to him, and shaking hands, a tear would then come in his eyes." (III. f. 145.) On the subject of irritability, Ma- jor Richard Delafield says, referring to a proposed visit to Greenwood Cemetery in 1852, "Mrs. Parish com- plained of being indisposed, unwell, and did not wish to go; I interceded with Mr. Parish to postpone his visk; he manifested towards me great irritation, ac- companied by gesticulations to me so unpleasant that I determined never to attempt to thwart his wishes again; now his manner, and the irritation thus mani- fested, it is not in my power to explain to you other than this statement of the fact, and my feelings at the time." (II. f. 1767, '8.) Again, as to temper, he was, says the nurse Simmons, " sometimes very mild, some- times very much agitated; if he was going any ways, he would shove you aside if you wanted to stop him." (I. f. 1701.) " As to that," says the nurse Wingrove, "Mr. Parish was very changeable, sometimes very irritable, sometimes very passionate, and sometimes very calm." (I. f. 1505, '6.) Again: "Mr. Par- ish was very changeable in his temper, and very easily ruffled in his temper, and very passionate at times; the slightest occurrence got him into those 39 passions." (I. f. 1518.) The same witness relates that he had repeatedly received blows from him, and that " several times he did the same with Mrs. Parish ; he has made an effort with his crutch sometimes to hit Mrs. Parish ; when they were out of the carriage, com- ing in from riding, he would hit Mrs. Parish on the skirts of her dress; has often done so, but never to hurt; I always remarked that Mrs. Parish kept out of his way whenever he was in any of those little tem- pers." (I. f. 1520.) Again: " At certain times when he was passionate there was no man, or woman either, that appeared to have any control; that might last five, ten, fifteen, or twenty minutes, half an hour, &c.; but when recovered from that, you could lead him about like a child." (I. f. 1609.) Again, in reference to the visit to the cellar, says the same witness: " On this occasion Mr. Parish was very passionate, and very much excited; and I assisted him on going around, as usual, by my arm, and I received myself several punches of his elbow on the stairs, on our returning back from the cellar. Mrs. Parish was standing on the head of the stairs, looking at the occurrence. The stairs are very steep, and they were all laughing at me getting what I did." (I. f. 1654.) So, also, while the market-man Austin, from whom he had long been in the habit of purchasing, was exhibiting to him his choice of poultry, &c, Mr. Parish, sitting in his car- riage, flourished his cane at him. " He flourished his cane," says Austin, " and I went away, sorry to see him behave so." " He acted at me as if he was mad at me; I could not say what for, and so I went away; or didn't know me; he made a motion with his eyes and mouth, and acted to me like a crazy man," (I. f. 1922, '3.) The nurse Simmons, Mr. Davis, and the Rev. Dr. Taylor, also bear witness to his frequent shed- ding of tears. Simmons never saw Mr. Parish laugh or exhibit gaiety, but, says this witness, " I have seen 40 Mr. Parish cry, shed tears at least"—" a number of times," (I. f. 1713, '14.) So also when told by the Rev. Dr. Taylor of Mr. Austin's failure, " he seemed to be affected by it, his tears ran rapidly down his cheeks, and his look was that of sorrow and regret," (I. f. 3380.) And to this adds Dr. Taylor, " When- ever excited, his tears would seem to flow spontaneous- ly, without his control," (I. f. 3442.) " He was," says Mr. Davis, "apt to weep when first meeting an old friend, and on expressions of condolence with him on his condition; I don't recollect any other instances of weeping. On almost all such occasions I would wit- ness that. On friends coming around his carriage when stopping in Wall street or elsewhere, shaking hands with him, and he recognizing them, he expressed emo- tion by weeping; and also at home," (I. f. 642, '3.) Wm. Youngs, the builder, who was frequently at the house on business, says that Mr. Parish often shed tears, " He appeared to be crying, certainly was shed- ding tears; I think half a dozen times I have seen him, it may be oftener, but I can speak of half a dozen." "The incidental remarks of the day were the only topics of conversation in any instances in which I saw him weep; generally his weeping was when I inquired after his health," (II. f. 750, '1.) 11th.—Sounds and Gesticulations used in substitu- tution for Speech. " His power of speech," says Dr. Delafield, " was mainly abrogated on his first attack, and at any time from that moment to his death there never was be- yond the use of a few monosyllables." (I. f. 2081, '2.) " Within a few days after the attack," says Dr. Dela- field, " I was enabled to get intelligent answers, either yes or no. I am not speaking of words. I mean that I understood him; and as the time went on from the 41 one period to the other, the facility of these communica- tions became greater." (I. f. 3058.) Being requested to enumerate the monosyllables, Dr. Delafield replies, " those in most common use were yes and no, when in pain he would not unfrequently exclaim, ' oh dear, oh dear /' that was a common ejaculation." Dr. Delafield alludes to a few other words which cannot be recalled by him, which he appears to have heard of merely, and which were not repeated. (I. f. 2082.) Among the ejaculations he enumerates " oh and ah, or some- thing like that;" and " such a sound as nyeh, making a monosyllable of it." He adds, "there were always some sounds of some kinds testifying assent, over and above" yes, " such as we all use; nodding his head and making a sound such as other persons use who don't intend to speak ; I can't," he concludes, " call to mind any other sounds at this moment." (I. f. 2085,'6.) Dr. Delafield, however, thinks " there were efforts from time to time made to a considerable degree; they evi- dently showed anxiety to speak; he tried to speak. (I. f. 2083.) According to the evidence of the Rev. Dr. Taylor, " Mr. Parish would say ' yes,' nodding his head ; he would say ' no' sometimes, shaking his head violently. He would say ' yah, yah, yah,' generally holding up his hand with the two fingers extended; another one he would say * yea, yea, yea,' when it was yes ; he rarely said ' yes' more than once, and then it would run into ' yea;' I am not certain," continues Dr. T., " whether there was any gesture with that, he used his hand so constantly it is difficult now to say with what words he associated the motion of the hand ; he would say ' nay, nay,' as a continuation of ' no,' and it would run off into an indefinite sound expressive of despondency ; it was accompanied by a shaking of the head ; I don't know of any thing more." (I. f. 3422, '3, '4.) According to the same witness, he never said 5 42 ' yes," and stopped—" he generally repeated the affirma- tive answer," falling " off into yea, yea—yea, yea," and also the negative, as a general thing, he would run on into repeated " nays." Dr. T. when asked if he had ever heard Mr. Parish say " no" or " nay" simply once, and not run on or continue repetitions of sounds, answers " I cannot say positively that I ever did." (I. f. 3424, '5, '6.) Mr. Daniel Lord, in alluding to his first inter- view with Mr. Parish, August 29, 1849, and to ad- dressing him on the subject of the first codicil, says, " I asked him in the same address to him if it was his wish to execute it. I think he made a sound with his mouth, and nodded assent. His articulation was diffi- cult and uncertain." (I. f. 98.) At the period of exe- cuting this same codicil on the 17th of December, 1849, " he answered the word ' yes' much more articulately than he did or could do when I had seen him before, and accompanied it with some inclination of the head." " He uttered ' yes,' unmistakably; but not so distinctly but that his speech seemed to be obstructed." (I. f. 147, '8.) At this interview Mr. Parish also made that mode of expression which was interpreted as a want to communicate something, and sometimes as a sign of inquiry. "I can't," says Mr. Lord, "well imitate or describe it. It was a continued repeating articulation of the same sound." (I. f. 166.) In the interviews for preparing the second codicil, particularly that of September 13th, 1853, Mr. Lord recollects no other word, sound, sign or gesture than those above enume- rated, to which he could attach any particular sense or meaning." (I. f. 381, '2.) But he adds, "The sounds indicating 'no' or 'yes,' or interrogation, were used by him with considerable variety of modulation ; he accom- panied them all occasionally with moving of his head and the use of his hand in connection with interroga- tion ; his countenance also had expression which I at- 43 tended to and regarded." (I. f. 382.) In the inter- view for preparing the last codicil of June 15th, 1854, Mr. Lord found nothing to add to the former list of sounds or audible expressions, except some sign or sound, which according to Mr. Lord's opinion, "indi- cated a hesitating acquiescence." He says, " I cannot imitate the sound, because it was not a well articulated sound; the mode of his intonation indicated hesitation," etc. (I. f. 447.) On the other hand Mr. Kernochan (who more than any other individual witness was inti- mately acquainted with Mr. Parish), says when asked if the latter had uttered a word since his-attack in 1849, " I have heard him make a sound, accompanied with a nod or shake of the head, as affirmative or nega- tive ; with my hearing (and he elsewhere admits that his hearing was not so perfect as in his younger days, I. fol. 967,) there never was any distinct articulation in any case, not even a single word; the sound was always very much alike, though sometimes louder than at others." (I. f. 847.) Besides the nod and shake of the head, says Mr. Kernochan, " he had a motion of his left hand which he used in connection with a sound, a continuous sound; and sometimes when more vehement than at others, he would put his two forefingers in his mouth, his mouth being open, and the sound being continued until sometimes it was stopped by the intervention of the fingers; that was the universal motion, waving the left hand with the two forefingers extended ; the other two closed in the palm, back and forth across in front, terminated generally by putting them in his mouth; the continued sound was like ' nin, nin, nin;' the sound was always the same, but sometimes more rapid and louder than at others; if it could be spelled at all, it must always be spelled by the same letters." (I. f. 848, '9.) " As to the sound and the motions with the hand," adds the same witness, " I certainly never un- 44 derstood them; I was told that he wanted to be informed of something; I attached no definite meaning to them of my own observation." (I. f. 849.) " I was told that was his object, but I never could make it out with any certainty myself; I frequently acted on the suggestion that he wanted to make some inquiries, and would go on to communicate whatever I thought would be in- teresting, but was never perfectly satisfied that I had hit the object." (I. f. 850.) In the carriage visits of Mr. and Mrs. Parish to the counting room, says his clerk, Mr. Folsom, " We always made great efforts to find out what Mr. Parish wanted, but never, to the best of my memory, has Mr. Parish ever been able to convey his wishes to me to my satisfaction." " On coming before him he wrould always put up his hand, raising it with the two forefingers extended, and the remaining three partly closed, or sometimes two, shak- ing it as he raised it, and then turning it over, putting the tops of the fingers downwards, with the same shak- ing motion accompanying it with a sound from his mouth, which the letters a s e would express more nearly than any others; these motions of his would become more violent as Mrs. Parish, in trying to ex- press what he meant, failed to do so; the voice might cease or might be continued in the same manner; as he became more excited the a s e would become more emphatic and loud; I do not mean to say that the shaking motion was involuntary, nor do I say it was voluntary; I know not; the motion was such as I might make if I should say, ' you do not understand me.'" V(L f. 1181' 2' 3.) These motions terminating, "he would eventually fall back, or lay back, apparently giving it up, apparently perfectly placid, and seeming to have no further effort to make." (Lf. 1183.) The waiter, Michael Quin, who was in Mr. Parish's family as a servant from November, 1848, till December, 45 1849, says of Mr. Parish after that attack—" If he wanted any thing when he was that way, all I heard him say was a noise in his throat, accompanied with a nod or shake of the head." And when asked if Mr. Parish, in his hearing, had made any other sound with the voice, throat or mouth, he answers " no." (I. f. 1810.) The butcher, WThitfield Case, with whom, during his dependent condition, Mr. Parish was in the habit of marketing, says of his articulation that it was "nothing but that sound you heard come from his throat." (The witness here making a sound in his throat which the Surrogate cannot describe.) (I. f. 1895.) The nurse Simmons speaks of Mr. Parish using the sounds "nan, or yan," accompanied with ges- ticulations as already mentioned. (I. f. 1685.) In ref- erence to a colloquy at the counting-room, the same witness states—"Mrs. Parish then replied that Mr. Parish wished to look over the books himself; he made a gesture with his hand, raising and shaking it, saying ' yean, yean, yean,' very much excited." (I. f. 1691.) This same sound is also mentioned by the waiter Wingrove. " He waved with his hand," says the witness, " and with his four fingers, and made different sounds such as ' yanne, yanne, yanne,' rapidly repeated; he always, when he appeared to want any thing or to hold a conversation, made that motion and sound ; that was his first effort, and it was his only one." Again, says the same witness: " When I went here, to Mrs. Parish's, to live, she told me that Mr. Parish could say yes and no. I said, if so, it won't be very difficult to get along with Mr. Parish; this sound has been often used imitating yes ; that Mrs. Parish told me that Mr. Parish meant yes; as a general thing, by being told by Mrs. Parish, I attended to as yes, whatever it was at that time, but it was through her orders; in a very short time after, my own experience led me to believe to 46 the contrary, as I often had been deceived by the word yes; for instance, if I asked Mr. Parish to come and have a little walk, and he say ' yes,1 I could then know exact what to do; but Mr. Parish,;when I asked him to come and take a little walk, he shook his head and made a kind of sound which you could not tell what it was; he did not seem satisfied for my asking him; on this occasion I told Mrs. Parish that Mr. Parish did not seem anxious to go out for a walk; she told me, ' Thomas, you had better go, insist upon him.' I went back secondly to insist upon Mr. Parish to come out for a walk, if possible; it was then, when I pressed upon him, that he used this—this word that I understood to be yes; according to that, I went and got his coat and hat, but when I brought the coat and hat for him to put on, he shook his head, ' yanne, yanne, yanne,' and seemed quite angry and dissatisfied that I should insist upon him; from that time afterwards I never placed any confidence in yes, either told by Mrs. Parish or expressed by Mr. Parish, because it was of no use to me," (I. f. 1544,1545,1546.) As to those sounds, called by Mrs. Parish " yes and no," says this witness at an- other place, " I have never made any use of them; they have never been of any benefit to me in my at- tendance on Mr. Parish; not once to my knowledge," (I. f. 1552.) "This sound resembling yes, if I were asked to write it," adds the same witness, " I should say it would be kas, (I. f. 1549,) that is my opinion of it." As to other sounds, " There was one which was supposed, and was remarked to me by Mrs. Parish, that it meant ' no;' sometimes he got'in a passion, and when he got in a passion the sound came through his nose in a manner which you would think resembled ' no,' sometimes plainer and sometimes worse, but without any meaning, to the best of my knowledge." And if asked to write this sound, he replies; " To the best of 47 my opinion, ' oh' would be the nearest, if any thing could be, to spell the sound," (I. f. 1550). The nurse, James Clarke, says of Mr. Parish, " He didn't use only these two sounds, ' neay, ne y, neay, and yaune, yaune, yaune.'" But the same witness elsewhere adds, " When he opened his mouth, and I could not find out what he wanted, he would put his hand to his tooth, take hold of it as if he would tear it out sometimes, and would make a sound," which neither the witness nor the sur- rogate can express by letters, (I. f. 1765.) Clarke elsewhere remarks again, that he could, discover no meaning in the sounds, " nothing but by his motions," and "by the signs with his hands pointing," (I. f.1715,'6.) William Brown (nurse from Oct. '51 till Nov. '54,) enumerates the several sounds and gestures; viz., a sound which he spells " ne, ne, ne," (II. f. 1310;) another, which he and the surrogate spell "hoh," (II. f. 1311;) another, which he spells nes (II. f. 1312,) "neah," "nyeh," (II. f. 1341;) " neow," (II. f. 1464;) the word, " no," dis- tinctly on one or two occasions, (II. f. 1465.) After enu- merating these, he further adds, that Mr. Parish very frequently uttered the exclamation " Oh, thear, thear! " (II. f. 1470;) on several occasions, the words " why, yes," or as near that as possible, with a smile, (II. f. 1471,) and the exclamation, " Oh, Got, Got, Got!" " I should say that was about it, as near as possible," (II. f. 1472.) Of the habitual gestures, the same witness says, " One was raising the finger and shaking it thus: [The witness here raises his hand with the forefinger extended,] ac- companying the same with the sound, ' ne, ne, ne;' an- other, was bowing his head without a sound, as of yes; another, shaking his head, as of no, from side to side; another, the expression of yes, with a motion of the head downwards, and with the left hand downwards with an open palm; if excited, he would put his head down in the same way, with the sound ' neow,' 4S that's all, I think, that constitutes the general rou- tine of sounds and actions accompanying each other; he also, when he said, 'Oh Got, oh Got,' raised his head, looking upwards, and also his hand open and raised upwards; I have named all his habitual gestures," (II. f. 1474-5.) The coachman, Edward Clarke, (al- ways in the family,) says, " It was a regular thing for the valet to come out every morning betwixt nine and ten o'clock, and say, ' Edward, Mr. Parish wants to see you this morning.'" " On entering and finding Mr. Parish seated, Mr. Parish would say ' neay, neay,' with a nod of the head and a smile on his countenance." " He would look me straight in the face and hold up his finger and say, ' neay, neay, neay.' I would say, Mr. Parish, you want to know how the horse is ? he would assent by a nod of the head; then he would hold up his fingers again, and say, ' neay, neay, neay, neay;' then I would say, Mr. Parish, you want to know if I have plenty of feed ? and he would answer with a nod of the head, ' neay, neay,' and then I would say, I have plenty of feed; then he would hold up his fingers again, just in the same way, and say, ' neay, neay, neay,' or, ' aney, aney;' then I would ask him if he wanted to know if the carriages and harnesses were all in good order, and then he would nod his head and smile on his countenance and say, ' neay, neay;' then I would say, good morning, Mr. Parish, and he would nod his head and say, ' neay, neay, neay;' well, that was the regular conversation every morning that he was not sick, that is, when I could see him when he was not in bed." The same witness, when asked if Mr. Parish, at these inter- views, made any other motions with his left hand besides the putting up with the fingers, says, " No, never to my memory; it was just the one thing every day for the general rule; I had no trouble at all after the first two or three days; I always let him put the question himself, and I answered it," (II f. 2195-9.) 49 When asked whether he had seen and when he had seen Mr. Parish put his hand or fingers into his mouth, this witness says, " Yes, sir." " It was in town and out of town, both,T think. I couldn't say when,' I kept no memorandum of these things; I never thought I would be called on this way." When asked if he had witnessed this motion fifty times, he says, " Well, I told you I couldn't say, because I was very little in his company." Was it accompanied with a noise ? " Well, yes, sir, a kind of sound about the throat. When he would get hold of his teeth—a kind of sound—the same as if he was strangling." In describing it, (the witness here raises his hand and places the first two fingers, somewhat bent, upon the top of the lower teeth, and keeping them there, slightly shaking his head and making a guttural noise.) This would be in the presence of others ? " I don't recollect any one without the valet; there might be, but I don't recollect." As to the meaning of it ? " Well, I know he wanted something; it was some sign for something he wanted, I should think, but I don't know," (II. f. 2203-6.) Mr. Leroy M. Wiley, formerly a business partner of Mr. Parish, and who was in the frequent habit of visiting him after his illness, says of his vocal sounds, " I don't think I have ever heard him utter a word of any kind that was distinct." None which, without seeing him, could be supposed to mean yes or no. (II. f. 92, 93.) And as to his gestures, " There was one motion of his hand, holding the arm out, bending the elbow, and placing the hand with the fingers ex- tended, pointing downwards, holding it steadily so. Another motion was, raising the same hand and put- ting two or three fingers in his mouth—opening his mouth wide—and putting them in as far as the first joint. I believe these were the only motions he had." (II. f. 95.) He " always looked attentively to the per- 7 50 son who was sitting by him, and whom he was address- ing at the time, when he put his hand in his mouth, or when he put his fingers down." (II. f. 98.) Dr. W. V. Wheaton, surgeon U. S. A., an aged gen- tleman and friend of the family, in his frequent calls never heard Mr. Parish utter any distinct sound but the word "yes." It was repeated " yes, yes,"—"yes, yes." (II. f. 655, 656.) But says he, " I heard him make mumbling sounds, which could hardly be de- scribed, when he wished to assent to, or dissent from, any thing others had said." (II. f. 655.) "I think they could be distinguished when he meant no or yes, but perhaps more from the shakes of the head in say- ing no or yes, than by a difference, or very great dif- ference in sound." (II. f. 659.) His yes was "always a nod of the head, and sometimes with a pressure of the hand upon the person that he was addressing." (II. f. 658.) "I have observed him shake his head when dissenting from any thing that was said; and I have sometimes seen him put out his hand as repelling whatever he didn't wish to have done. [This was a push with the open palm and extended fingers, re- peated several times, the arm being raised horizontally, and the hand being passed to and from the body, the motion being from the elbow away from the left side.] With this motion Mr. Parish would shake his head " very emphatically; that was when he was irritated;" and, adds this witness, " I would say I have seen him strike his him [hand] upon his thigh at times; [the witness here strikes his hand upon his thigh several times in repetition;] I don't recollect any thing else." (II. p. 228, f. 660, 661.) Major Richard Delafield, his brother-in-law, when asked " How distinctly did Mr. Parish say ' yes' and ' no ?' " replies, " As distinctly, to my understanding, as that gentleman who asked me the question. The sound of his voice, and the articulation, I can better 51 explain, by saying that the sound came from him as a person who lisped, or the tongue was tied; but it could not be mistaken; in all my business with him, I could not be mistaken, as to his ' yes' and ' no,' any more than from other persons." (II. f. 1795,1796.) Among the other sounds to be spelled, " Not so satisfactorily to myself; but I would say an exclamation of 'ah,' and the sound of ' nan,' possibly would give an idea." (II. f. 1827, 1828.) And as to gestures, when other persons were conversing around him, there would be " strict attention on the part of Mr. Parish." " At the conclusion of a sentence on the part of one of these gentlemen, for example, Mr. Parish would look most inquiringly in the eye of the party, at the same time raising his left hand, with the forefinger of that hand motioned towards the person who had been so address- ing, and making a sound of the voice, which would be followed by prolonged conversation, in explanation of the subject talked about." (II. f. 1794, 1795.) Mr. Henry Delafield says, " I have heard him say, 'yes,' 'no,' 'oh dear,' 'ah,' that is all I recollect at the present moment," (III. f. 132.) But this witness differs in his evidence in one respect from nearly all the others. When asked if Mr. Parish, in saying " yes," uttered it repetitiously, he replies, " I can't call to mind that he did; I recollect no repetitious sound," (III. f. 316,) and the uttering of " no " was also, he says, " singly." " I do not recollect," he adds, to have heard it repetitiously, (III. f. 316.) But in the manner of utterances, "They may have been more distinct at one time than at oth- ers," (III. f. 317.) As to "yes" and "no," the witness however elsewhere admits the utterance would be, " generally, singly, ' yes' and ' no;' occasionally it would be repetitiously," (III. £ 420.) He speaks of the following gestures: " Raising his hand and pointing to the bell was one gesture; raising his hand and 52 pointing to the window, pointing to a person ; raising his hand also in this way—[the witness here makes the following motions: one, raising the hand with the arm bent at the elbow, and the palm facing outwards, the hand being open, and pointing upwards; another with the hand in the same position, with two fingers bent inwards, and two extending upwards, the latter two being the index finger and the next, the palm be- ing towards the body.] When suffering pain he would raise his open hand and let it fall on his thigh, his countenance expressing anguish or sorrow, or some feeling of that kind; another sign, when it was wished to know how much money he wanted, he would raise his hand with the palm upwards, and the hand bent so as to form a hollow, holding the same near his breast, moving it slightly, and making a sound, when Mrs. Parish would ask him how much money he wanted; I have also seen him take his left hand, and with it raise his paralyzed arm and hand, and holding the right hand in the hollow of the left, and evidently try- ing to arrange and move it, so as to make a larger hol- low by means of both hands; that would take place when Mrs. Parish had not succeeded in ascertaining the amount of money Mr. Parish desired; she would then put more questions as to the amount, until she arrived at it; another motion was, when Mrs. Parish and my- self failed in ascertaining his wishes, he would let his open hand fall on his thigh, and throw his head back, giving it up in despair; these are all the motions I can call to my recollection at present; I may add to the above, he would shrug up his shoulders at the same moment," (III. £ 132-5.) When asked if Mr. Parish ever put his finger to a particular figure on the face of his watch, he replies " no," and when asked if he ever performed the process of comparing his watch with that of witness, he says " I have." " He would take 53 his watch out of his pocket, he would look at it, then at me, make an attempt to speak; that is the manner I believe," (III. f. 321, '2.) This was not of frequent occurrence, It was subsequent to the attack of July, 1849, "probably about a year," (III. £ 325.) When asked to describe Mr. Parish's manner of putting his fingers in his mouth, the witness puts the first two fin- gers of his hand between his lips, resting the ends on his teeth and lower lip, and states that this motion "was not habitual," and was accompanied with "a sound of inquiry, Mr. Parish looking attentively at the person who was speaking to him," the sound being " continuous for three, four, or five seconds," (III. £ 326.) Again, " he would look at his servant, point, put his finger up to his teeth, attract his attention to his teeth, and the servant would pick his teeth, clear his teeth," (III. £ 327.) And " money being on the table, having been handed to him, he would count it in this manner, [taking up a single coin and placing it apart, and then another in the same way, putting it with the piece already placed apart, and so on through the whole pile,] and then take it all up and put it in his pocket," (III. £ 327, '8.) He also counted coupons. " The coupons having been cut off by Mrs. Parish, they were placed before him, and he went through a motion the same as in respect to the money, picking up the coupons one by one and placing them together," (III. £ 328, '9.) The motion with the hollow of the hand indicating the want of money, the witness may have seen, " half a dozen times or more; it might have been less." In drawing a check for house expenses, if Mrs. Parish chanced to ask whether it should be for a hundred dollars, " he would hold up his hand, make a hollow, as has been described in my direct examina- tion, and upon asking him as to the amount required, the amount he wanted, when we could not arrive at 54 his wishes immediately, he would take his left hand, raise up his right hand, and make the hollow of the two hands deeper," (III. £ 330, '1.) "Mr. Parish," says the witness, " would point to the drawer, his books would be handed to him, open the check-book ; point at his wife, when she would ask him if he wanted a check drawn, if it was for Dr. Taylor, he would nod his head and say, yes; a check was drawn by Mrs. Parish; the check was handed to me sometimes by Mr. Parish himself; I would ask him if I should draw it in gold, he would nod his head and say, yes. In the evening when I came home he would look at me, make an inquisitive sound, when I told him I had brought the money and handed it to him; sometimes he would put it in his pocket, having previously counted it in my presence," (III. £ 120, '1.) With regard to money, the servant Wm. Brown (the nurse from Oct. 13th, 1851, till Nov. 12th, 1854) says of Mr. Parish, " I have never seen him with money in his pocket." " The first of January, 1854, from his own hands he gave me $100 as a present; I never saw him actually give or pay any other money, not with his own hand." " It was in gold." " It was given me in the dining-room; Mrs. Parish was present." " Mrs. Parish brought in the money, rolled up in paper, placed it in Mr. Parish's hand, and then said, as far as I can remember, ' Wil- liam, Mr. Parish is going to make you a new-year's present.' Mr. Parish handed it to me." (II. £ 1422-4.) Dr. Markoe, when asked if Mr. P. could at any time and for what length of time utter "yes," dis- tinctly, says, " He did so for many weeks in the early part of his illness utter it distinctly, to my perfect re- collection." " I do not know whether he lost the power; he ceased to do it, to my knowledge, during the first six months I should say; I do not remember how early after his attack I first heard it." As to 55 having heard it after the lapse of six months, " I can- not be sure; I think not." As an equivalent for it after that time, " I think he sometimes used the articu- late sound ' niah, niah,' which has been described as ' yes,' but more commonly his sound of assent was like ' humph,' as it is usually spelled, with a falling inflec- tion of the voice, (II. £ 2076, '7.) The word " no," " He never uttered as distinctly as he did the word ' yes'; it was more like ' nan, nan,' and continued, I think, about the same time as the use of the word ' yes' continued, as near as I can recollect; I mean about six months." The substitute afterwards employ- ed for it was, " A sound somewhat similar, but more approaching the 'niah, niah,'" (II. £ 2078.) The words " oh dear," were heard " Only on one occasion, and I think it was in the October illness," (II. £ 2078.) The only variation in the sound " niah," " was the substi- tution of' nin, nin, nin,' a more sharp short sound." As to " nin," and " niah," " I think he used them somewhat interchangeably, but I don't remember distinctly." They were used " always repetitiously, I think." " My impression is, that he used the ' yes' and the ' nan' singly at times; but my recollection is not distinct enough to say positively." He commonly spoke each of them repetitiously, (II. £ 2078-80.) As to other articulate sounds, " I do not remember any," (II. £ 2081.) " He used the ordinary inarticulate sounds, groans, and guttural noises which patients use that are suffering much." " I remember his interroga- tive sound; the rising inflection of the voice was very distinct on all occasions," (II. £ 2000.) " A sound something like this frequently repeated with a rising inflection of voice."—[The Surrogate here describes the sound made by the witness, as emh, as nearly as he can approximate it.] (II. £ 2083.) Speaking of gestures and motions of the limbs, Dr. 56 Markoe says, " I observed all the motions of the head performed with great ease; all the motions of the lower extremities performed, however imperfectly; walking, rising, sitting, and all the motions of the sound side were normal." " There was the shake of the head and nod of the head." " The left hand and arm were constantly used in connection in making gestures, one very common was a raising of the hand and arm, with the fingers elevated, turned up—this was either shaken when the attention was to be emphatic, or it was held out towards the person addressed apparently with the intention of drawing attention, as the fingers were was held out separately, one, two, or three together, and the arm moved up and down; I don't think of any other gestures now, except one, which was, striking his own thigh forcibly, with his hand flat, when he was disappointed, or when he could not make himself un- derstood, or when we could not understand him, more properly, (II. £ 2001, '2.) The principal gesture he made was holding up his left hand with the fingers in the air; it was used, apparently, for calling attention, to give emphasis, and in various other ways; he would also point with his finger and his hand. I have seen him point to the window, to the mantelpiece, and more particularly to those organs of the body in which he might be suffering pain at the time." " This motion of holding up his hand was usually accompanied with the articulate sounds, and the interrogative and negative sounds which were inarticulate. I think it was more particularly associated with the interrogative sounds." (II. £ 2086, '7.) Mr. P. M. Bryson, cashier of the Phoenix Bank, states, that on the 22d of August, 1853, "In reply to my question as to whether he wished Mrs. Parish to sign the articles and receive the new stock, he nodded his assent, aud I think, replied ' yes.'" It was distinctly uttered, though perhaps not so 57 plainly spoken as I would speak it here." It was with " An immediate repetition, ' yes, yes,' deliberately." And " As to the question of signing the articles of association and the issuing of the new stock, my im- pression is, he said * her,' pointing to his wife." " As to the frequency of saying ' her,' I don't remember how often; once, certainly." " I think it was not repeated, but accompanied by a motion of his hand towards his wife, [the witness here in describing his motiou, ex- tends the arm and hand horizontally with the hand open, waving it laterally and then vertically several times as extended,] (II. £ 342 to 346.) Mr. J. S. Dun- ning, note-teller in the Phoenix Bank, witnessed the transactions referred to by Bryson, the witness last re- ferred to, and states that he heard Mr. Parish utter the two words " yes and her." The one of these words this witness would write " Herrh," and he says, " there was a kind of aspiration after the word seemed to be finished." As to the word yes, " It was uttered as dis- tinctly as I could utter it. There was rather a harsh sound given to it, as if he made the word up with an a and an e together," (II. £ 432 and 437, '8.) William Youngs, builder, working frequently for Mr. Parish since 1847, and having had frequent interviews with him after the attacks, and borrowing money on bond and mortgage, both for himself and his friends, says of the sounds or words uttered, " Well, for yes, it would be ' eh, eh, eh,' as well as I could describe it, with two or three nods of the head, sometimes more earnest than at others; and for no, it would be a shake of the head, and the sound ' nah, nah, nah, nah.'" " When it was a matter of inquiry it was a different sound and a different shake of the head; the sound was ' esh, esh, esh, and an eh,' and a different shake of the head; I don't know how I can give it any nearer." " I don't recollect any other sounds but these three I have spe- 8 58 cified," (II. £ 710,' 11.) Thes ound " eh, eh, eh," as un- derstood by the Surrogate, this witness says, " I would spell uh, uh." The sound accompanying the shake of the head, he would spell, " nan, nan, nan," and as to the sound and gesture of inquiry, the witness says, " He often put up his hand and fingers in that way in saying yes and no both; but when a matter of inquiry with him, the sound was ' nin, nin, nin,' as near as I can pro- nounce it and spell it," (II. £ 742, '3.) Of this peculiar gesture the witness also says, " At times, there was a movement of, I believe, the left hand, and one—two forefingers elevated, with the palm of the hand towards the fall, the fingers pointing upwards, diverging, and the other fingers closed, and he looking at the fingers and then at me earnestly, at times." (II. £ 712.) As to the number of fingers usually elevated, " To the best of my recollection, it was two generally; some- times one—it may have been three; but I have no re- collection of it, (II. £ 741.) 12 th. Senses of Feeling, Hearing and Smell. With regard to the external organs of sense— feeling, hearing, smelling—they do not appear to have been seriously implicated further than has been already stated. " The only one of the senses that seemed to be impaired," says Dr. Markoe, " was that of vision, and that only at a certain time or period, but not constantly or essentially injured." (II. £ 1992.) As already shown, however, he admits in another place that sensation of feeling was slightly impaired in the paralyzed mem- bers (II. £ 1984) of the hearing, Mr. Kernochan says, " I think it was very good—much better than mine." (I. £ 970.) " I considered his hearing very acute," says Wingrove. (I. £ 1583.) "The hearing," says Clarke, " was pretty good ; sometimes, if you did 59 not speak to him pretty loud, you would have to speak again." (I. £ 1782,'3.) The sense of feeling was not lost, according to Dr. Delafield, in the paralyzed limb. But we have seen it was less acute then than natural. The servant Clarke, on duty from December, 1854, till April, 1855, was in the habit of trimming Mr. Parish's nails; and, says this witness, " he would make me cut and cut until almost I had drawn the blood; some- times I would; he would not feel me; Mrs. Parish would come and say, ' Mr. Parish, don't have them cut so close,' and he would give her a push, saying ' neay, neay.'" This occupation of trimming the nails was of frequent occurrence; and on two occasions the same witness drew blood from what he calls the " dead," or right hand, and on these occasions Mr. Parish would not feel the cut." (I. £ 1772.) As to the sense of smell, there is an allusion to it by Wingrove, who says that Mr. Parish, in examining his pantaloons, " would take them separately, take one at a time in his hand and put it to his mouth ; he always put it to his mouth; I thought it was to smell; and he would say quickly, " yanne, yanne." (I. £ 1510.) This witness was led to think such to have been Mr. Parish's intention " from the fact of putting it so near his nose; it's what any person would have thought at the time as well as I did." (I. £ 1605.) In visiting the butcher's shop, says Wm. Brown, "If there was grouse, or woodcock, or quail, or those kind of things that he selected, he would take them in his hand, poise them, and show them to the person who presented them, or was by—that would be either Mr. Case, Mr. Vande- water, or myself—and inquire if they were good, and what was their cost; and also make a sort of inspec- tion himself by smelling them." (II. £ 1309, '10.) 60 13th.—Capacity to Read and Write. The condition of Mr. Parish's sight both before and after the paralytic seizure has already been the subject of remark. We have seen that his left eye had pro- bably never been of any use to him, and that the operation upon this organ was rather injurious than beneficial. The operation upon the right eye, in which the cataract had been only of recent formation, proved much more successful, and restored to him a fair amount of vision; which, according to Mr. Kernochan, was even better for some time after than before the occurrence of the paralysis. (I. £ 956, '7.) But from the fact that Mr. Parish ceased to look at the news- paper and other papers, Dr. Delafield is disposed to think there must have been some falling off in vision perhaps for the last four years of Mr. Parish's life. (I. £ 2077 and 3239.) This impairment, if real, must have commenced after the patient had been complaining of his vision, and of what was presumed to be floating motes before the eyes, and which occurrence was some eighteen months or two years subsequent to the attack of paralysis. (I. £ 2075,'6,'7.) Dr. Delafield is not aware that he ever saw Mr. Parish reading the news- paper after the attack earlier than 1850. He has seen him with his tin box before him picking out papers and looking at them, " say six times, probably much oftener." This reading Dr. Delafield thinks was within eighteen months after the attack of paralysis, and was not wit- nessed within the last four years of Mr. Parish's life. (I. £ 3243-6.) Mr. Lord states that on the 29th of August, 1849, on the occasion of executing the first codicil, " his vision did not appear to be unimpaired; one of his eyes, I think, exhibited difficulty, and the other did not seem perfect; but I have no doubt that 61 he saw and recognized the persons whom he knew, and who were present. It so appeared to me." (I. £ 125.) " I understood he could distinguish dates and figures to some extent; but I have had no communication on the subject of his reading that I can recollect." That Mr. P. could distinguish dates and figures, Mr. Lord ascertained from one of the Messrs. Delafield, perhaps both at different times." (I. £ 496.) "In passing the City Hall," says the nurse Wm. Brown, " he took out his watch and compared it with the City Hall clock; on going home he would compare his watch with the clocks at home." (II. £ 1383.) " When he was going out in the carriage he would put his finger and thumb in his pocket and pull out his watch and indicate the time with a motion of his thumb or finger on the watch, having the watch in his hand." (II. £ 1382.) After the attack and after Mr. Parish was up, Mr. Kernochan had conversed with Mrs. Parish on the subject of Mr. Parish's ability to read and write, " and understood from her that he could neither read nor write ; I don't mean," says Mr. K,, " to say that he could not know the letters—some of them—but that he was not in the habit of reading; I suggested to her that it would be a kind of pastime'to him if he could read; I also remarked that it would be very easy, he then having the use of his left hand, to learn to write with his left hand; I also suggested taking a diction- ary and referring to the words, his looking up the words and pointing to them to construct phrases and sentences, by which it would be known certainly what he wanted to communicate; I made these suggestions several times, but I do not know that they were ever attempted, either of them." (I. £ 874, '5.) " I don't know that I ever saw him attempt to read any thing." (I. f. 875.) " It does occur to me that I have seen him with a newspaper in his hanoV, but he did not appear to 62 look at it as if he were reading." (I. £ 876.) As to Mrs. Parish's reply to the proposition about writing, " I don't distinctly remember the words she used, but the amount of it was that he would not take the trouble;" (I. £ 876;) and in reference to the diction- ary, " the answer was very much to the same effect;" (I. £ 877 ;) and as to using block-letters for the same pur- pose, " I am not quite certain whether I ever suggested that, but she told me they had been placed before him, and that he brushed them off with his hand or arm." (I. £ 877.) Again, in reference to recommending the use of the dictionary, " It was certainly in a belief that he could see, and if he had mind enough that he could find the words." (I. £ 968,'9.) As to writing, "I never saw him try, and I never saw any specimen of his performance in that way, that I know of." (I. £ 970.) " I have an indistinct recollection to have seen a paper, and I don't know what paper it was, that purported to be signed by him; I could never have made it out to be his name, and I don't know what instrument could have been used in making it." (I. £ 970,'1.) "His sight," says Wingrove, "was a good deal impaired, but he could see to a very great extent; that is, for instance, if we were walking around the room, I often saw Mr. Parish in the presence of Mrs. Parish, point to the carpet to a small little piece of paper, or a little bit of dust, dirt, or any thing that you might think that he would not discern." (I. £ 1648, '9.) As to read, however, "I have every reason to believe that he could not. He never made the slightest attempt at any letter or word that I could understand as reading." (I. £ 1649.) The cards of visitors, however, when placed in his hand, according to this witness, he often looked at a considerable while." (I. £ 1587.) "JEis eye-sight," says Clarke, " was not, I think, very good." " I have seen him take straws, 63 point to straws with his hand, saying ' neay, neay, neay.'" (I. f. 1775.) There appears to have been an attempt to teach Mr. Parish the use of block letters for communicating by words with those about him. The waiter, Michael Quin, who remained in service in the famity till December, 1849, says, " I saw them in his room on a small table; I did not see exactly what they were. I asked the nurse what they were. He told me that they were block letters ; that Mr. Richard Delafield brought them to Mr. Parish." " I saw him after Mr. Delafield leaving them before him, put his hand on the table and throw them off." " They looked to me as if they were a lot of dice." (I. £ 1810, '11.) In reference to Mr. Parish's attempts at writing, Dr. Delafield says, " There were frequent attempts; the first that he made was under my own direction ; he seemed shortly after recovoring his senses after the first attack to be anxious to communicate something, and this was repeated from day to day ; not being able to understand it, not having become so familiar with his modes of communication, I tried the experiment whether he could write; I presented to him, I am not quite sure as to the real object, but my impression is it was a book to write on the fly-leaf; and as I or some other person held the book, I am not certain; at all events the book was held before him under my direction ; he began to write with his left hand with a pencil, and he made characters; this experiment was tried several times; certainly on paper more than once, and my strong impression is, on a slate several times; the characters were always the same, and were construed to mean the word ' wills,' sometimes commenced and the word partly finished, and then beginning again; that is all as to that period." (I. £ 3044, '5.) As to the time of the occurrence, he adds, " I presume it must have occurred after I returned from the country, about 64 the 15th of August, [1849;] I am not absolutely sure that it did not take place prior to my going into the country on the first of August, but the latter is very improbable." (I. £ 3049, '50.) Again, " Some time I think in the course of the winter after his attack," says Dr. Delafield, " I took and caused to be taken a great deal of pains* to induce him to write with his left hand; the first attempts were limited to his writing his name, and in this to a certain degree he succeeded; he wrote his name so that it could not be mistaken as being his more than once; but in most of the after attempts his hand would seem to tire before finishing the entire name ; the process was a very difficult one to him, and as I would urge it upon him from day to day, he would become more and more disinclined to try, and event- ually declined further attempts; these trials were made also at other times in consequence of my directions." (I. £ 3051, '52.) Some of them with pencil and paper; some of them with slate and slate-pencil. (I. £ 3250, '52.) With the first, two, three or four trials were made; (I. £ 3250;) with the second, probably not more than two ; (I. £ 3253 ;) on the same or on some other following days. (I. £ 3254.) The characters on the paper were large, " from three-fourths of an inch to an inch long, as far as I can call to mind;" (I. f. 3252 ;) each word with the pencil and paper taking " possibly one or two minutes." (I. £ 3251.) " Such characters as these made with the pencil," says Dr. Delafield, " have been shown to me since Mr. Parish's death, by Mrs. Parish, but I cannot identify them." (I. £ 3256.) "At another time," says Dr. Delafield, "a black board was brought to the house, but whether I tried that I am uncertain." (I. £ 3262.) " He would write as far as H Par, or thereabouts, and then the hand would be unsteady and the word not be finished." (I. £ 3262, '3.) He wrote his name H. Parish, cer- 65 tainly twice. (I. f. 3263.) Copies of his own name were made for him to imitate on some of these occa- sions, " but not at the first trial when he wrote his name," (I. £ 3265,) that is to say, the first day of trial. For when questioned, Dr. Delafield cannot say whether Mr. Parish failed or not; several times before he wrote II. Parish. (I. £ 3266.) The Rev. Dr. Taylor, also, at an early state of Mr. Parish's illness recommended the use of the black-board. " At first he said ' yea, yea,' nodding his head that he would ; afterwards upon renewing the subject, he said ' no, nay,' very des>pond- ingly, as being past hope." (I. £ 3434, '5, '6.) Sim- mons, who nursed Mr. Parish from Dec, '49 till Oct., '50, also bears witness to the attempts at writing: " Mrs. Parish wrote his name with a slate-pencil, and told Mr. Parish to try and write; after being per- suaded a little while he tried to do it, but I don't think he ever wrote any thing distinct, I never see it." " This slate attempt, I suppose," says he, " was followed up for about two or three weeks." (I. £ 1712.) The Rev. Dr. Taylor thinks he saw Mr. Parish reading the newspaper " within the first year of his illness ;" (I. £ 3411;) and again, " about eighteen months or two years preceding his decease." (I. £ 3411.) In all " two or three times," (I. £ 3413,) and at the utmost at any given time, " from five to seven minutes." (I. £"* 3414.) He also thinks that Mr. Parish could at times follow the communion service in the prayer books. " Places were found for him, and as soon as they were pointed out, he would nod his head to show that he understood ; I," says Dr. Taylor, " would, on such occa*. sions, wait until I saw that Mr. Parish was prepared to go on with the service; Mrs. Parish standing or sitting by his side, would point out the places and turn the leaves." (I. £ 3403, '4.) "In the latter part of his illness I should say he discontinued the use of the prayer-book, 9 66 before that he did read it always." (L £ 3403.) Mr. Charles A. Davis, a familiar friend of the Parish family, and often with him, and who acted as witness to the codicils of September 15th, 1853, when questioned as to Mr. Parish's ability to read, gives hearsay state- ments of others to that effect, implying even that Mr. Parish could detect errors in his account-books, (I. £ 610, '11,) and that he was in the habit of reading the newspapers. (I. £ 612.) But he acknowledges he had himself never seen Mr. Parish reading any thing, or make any attempt to write any thing except on the occasion of signing the codicil. (I. £ 603, '4.) It does not appear anywhere in the evidence that any one ever knew him to detect an error in any account. William Youngs, the builder, was in the habit of rendering his accounts semi-annually. When asked if he had ever seen Mr. Parish reading, says, " He took my bills, and held them up before him; I don't know whether he read them or not; he seemed to me to be looking at the amount of the bills at the foot—the gross." He did this "twice or three times, I think, twice, certain; I believe three times." " Sometimes he would stop me in the reading of the bills by an earnest look, and an ' eh, eh, eh,' as near as I can de- scribe it; I would then ask him if he wanted the bill explained; he would say ' yes'—nod his head ' yes.'" This occurred " three times, to the best of my recollec- tion ; on three separate occasions;" (II. £ 699 ;) " I can state two, and I believe three." (II. £ 772. On one of these occasions in which the witness was thus inter- rupted, and, as he supposed, for giving an explanation, it turned out that Mr. Parish could hardly have inter- rupted him for that purpose. "The time that Mr. Parish had a fit or spasm, when I was reading a bill, was when I called for the money after the bill had been left there some two weeks; the other instances 67 of my reading, I believe, were when I presented the bills, to the best of my recollection." Before the fit occurred, when stopped, he is asked whether he at- tempted to make explanations to Mr. Parish; and he answers, " I did." And at this time in the reading of the bill: " To the best of my recollection, it was nearly completed." (II. £ 772, 774.) When asked, " Besides that looking at the bills, did you ever see him read, or attempt to read ?" he answers, "No, sir." (II. £ 750.) He states "it was difficult to make him understand, because he couldn't talk." (II. £ 775.) In making suggestions to him, " sometimes it was a no we got; it didn't follow it was a yes; the longest time I recollect might have been from half an hour to an hour that I was trying, or we (Mrs. Parish and himself) were try- ing to find out what he wanted; it was not usually as long as that; that was the longest time; ten minutes would probably be nearer the usual time I was so en- gaged." He is asked, " Can you now remember how often you came away from an interview with Mr. Parish, supposing that you had not arrived at his meaning or ascertained his wishes ?" and he answers, " I cannot tell how often." " Did he on any of these occasions, when thus repeatedly questioned or suggested to, fall into tears or weep ?" and the answer is, " He did several times." When asked, " Did you ever see any thing written on a-paper or a slate, and handed to him, or put before his eyes, as if to be read by him?" he says, in answer, "I never did." (II. £ 779 to 781.) William Brown (nurse from October 15th, 1851, till November 12th or 15th, 1854, and since about April, 1856, the keeper of the New York Eye In- firmary) says Mr. Parish's right eye was good. (II. £ 1374.) When cards or notes were brought in from the door, " he would sometimes open the notes, and 68 place them on the table again." (II. £ 1374.) While this witness was reading the news to him, " If there was any thing in the paper that Mr. Parish wished Mrs. Parish to see, the paper was laid aside by his own side; on her making her appearance, Mr. Parish would show the paragraph or part he had been inter- ested in ; show the paper to Mrs. Parish, and point out the part that had interested him; Mrs. Parish would read it; if it was a death, he would make inquiry, and Mrs. Parish would go into a description, or give an ac- count of the person, his or her family." (II. £ 1316.) The witness has seen Mr. Parish looking at the news- paper, " as long as it would take a man to look at the date, or to pick out a certain paragraph for rne to read." " I should say from one to two minutes." " I have seen him look in the Bible, visiting cards, circu- lars, invitation notices, and all such matters as that." The longest at any one time, " I should say five min- utes." (II. £ 1500, 1502.) And as to the plans or drawings of the tomb, " I saw Mr. Parish looking at them on several occasions." (II. £ 1366.) This wit- ness speaks of Mr. Parish's perseverance in following up an object when persons were questioning him and making suggestions; and when asked, " How long have you known the attempt to ascertain his wishes in this way continued before you reached an object to which he assented?" replies, "Three days." (II. £ 1510.) When asked, " Did you ever see Mr. Parish write with any thing—chalk, pencil, pen, or any thing else ?" he says, in reply, " No, sir." Or see him make any at- tempt of the sort? "I don't think I ever did." (II. £ 1513.) "I never saw him write with his left hand, and I suppose, from that fact, he never could; that he could not." (II. £ 1526.) When asked, "Did you ever see any one write upon a slate, and show the writing to Mr. Parish V he answers, " Yes, sir." About 69 twice—may be three times. " Both times it was in the library, and Mrs. Parish was present, and the pres- ident of the Bible House was present on one occasion ; Mrs. Parish, on both occasions, showed the slate to Mr. Parish; I have no remembrance as to dates; I should say there was a third person present on each and sev- eral of the occasions, but I do not recollect whom it was." As to the name of the president of the Bible House, " I think it was Mr. Burrows, or a name similar to that." (II. f. 1527, 1528.) This witness officiated after the death of Mr. Parish, in laying out his corpse. " I dressed it, and prepared it for the coffin." (II. £ 1409.) Major Richard Delafield, his brother-in-law, who had the supervision of the plans and drawings of the family vault at Greenwood, in which he was much en- gaged during 1851 and 1852, when asked, "Did you ever see Mr. Parish reading after his attack ? " replies: " I have seen him with a newspaper in his hand—the newspaper of the day—apparently reading." This was rare, "very seldom, being in the morning—a time when I seldom or ever visited the family : perhaps not more than once." (II. £ 1807, '8.) Mr. Henry Delafield, when asked, " Did Mr. Par- ish, after his attack, when up, generally wear specta- cles ?" replies : " He did." " He generally kept them on." " I was told they were cataract glasses," [glasses of very high magnifying power to supply the place of the natural lens of the eye, which is always destroyed in the operation for cataract.] " I should say they were colorless, and without side-glasses; none that I saw; they have no siding." As to spectacles, with siding used when riding out, "I never have seen such." (III. £ 251-3.) As to reading the evening paper, " Having taken our tea, and the paper not being re- ceived, Mr. Parish would point to the street-door, when 70 he was asked if it was the newspaper he wanted; he would say, ' Yes;' he then pointed to the bell, it would be rung, and then the servant was told to look for the newspaper, to see if it had come ; occasionally it was not received; a little time after he would again go through the same course, and if the paper was there it would be brought in, and if not, he rested, and that was the end of it. He was told it was not there, and he rested from making further inquiries." (III. £ 113- 16.) The paper was usually read by those around him ; but, says this witness, " I have seen it frequently in his hand, looking at it as if reading it." (III. £ 115.) And this apparent reading would last " half a minute, or a minute." As to its being at any time longer than this, "I am not certain." (III. £ 344.) As to seeing him looking at other printed matter, " I have; the London Illustrated News; the printed part of bonds and mortgages, and the writing also; I can't call to mind any thing else at present." As to his looking at the London Illustrated News, "I don't know the num- ber of times—a dozen or more; they were always within his reach when he was seated by the library table." As to his actual reading, "I think he did ; I am not positive." As to the length of time at once, " Probably not more than a minute." " I think he was looking at the large print on the paper, and at the woodcuts." "I think he could not read the small type ; his sight was not good enough, I think." As to the frequency of looking at bonds and mortgages, " several times," " I don't recollect the lenorth of time; he might have been looking at it ten or fifteen minutes." When asked if it could have been as much as ten minutes, he replies, " It might have been less." (III. f. 344-47.) Again, " Letters, accounts, bills, check-book, tickler; I have seen him look at all these." The apparent reading of letters would last " two or 71 three, or more minutes." " I should say from a quarter of an hour to half an hour at his tickler and check- book ; as to accounts, it would depend upon the length of them ; some of the accounts not more than a quarter of a minute or a minute, more or less, the same as any other gentleman would look at them." When asked, " Did he continue the practice of thus looking for a considerable time at his check-book and tickler, appa- rently reading them, down to near the time of his death ? " the witness answers, " Yes." (III. £ 349-52.) He is asked, " Did you ever see Mr. Parish write, or attempt to write with chalk upon a blackboard, with pen, or with a pencil on paper, or slate, or in any other way?" and he answers, "No." "As to the black- board, I never saw it in his room with him; I saw such a board in the outer passage: probably I saw it twice." (III. £ 352, '3.) Besides the three exhibits numbered 11, 89, and 90, he is asked if he had seen any writing purporting to be a signature of Mr. Parish made after his attack, and answers, " I think I have seen one or two." "I am inclined to think I may have seen five in all, including the three exhibits." " All that I recollect of were powers of attorney, and satisfaction pieces, as far as I can recollect; I mean that all I remember were, or purported to be, signa- tures." (III. £ 354.) He was asked if he had seen Mr. P. use a slate, and replies, " I have ; he tried to write on it." " Two or three times;" and he is asked whether at one or different interviews? "At different." The periods not remembered. " It was some time previous to his death." The witness thinks Mr. Parish wrote his name on the slate in his presence, " I think he did;" " I think it was H. Parish." He was asked, " Did you see his hand, unaided by any other person, write H. Parish on the slate ?" and answers, " No." Or, " any other word or letter on the slate ?" and again answers, 72 " No," (III. £ 357-62.) At another occasion, he is asked " About how Ions: was it after the attack that you saw this attempt to write on the slate ?" and an- swers, " To the best of my recollection, about a year or eighteen months, (III. £ 452.) He was asked, "Did you ever see Mr. Parish make any attempt to write with pen and ink or pencil on paper ?" and answers, " No ; I don't recollect any." (III. £ 362.) " He was asked, " Did you ever see a slate with writing on it presented to him, as if to have him read the writing ?" and replies, " I think I have some recollection of such a circumstance." " I believe it was at the time Mr. Tileston was there; I don't recollect what wTas written on the slate." He was asked, " Did you ever see writ- ing on a slate exhibited to him on any other occasion ?" and answers, " I don't recollect," (III. £ 382 '3.) With regard to " the alphabet, in separate letters," the witness says, "It was supposed, it was conjectured that Mr. Parish might be made to explain himself by means of them." " I suggested these cards; cards like these should be used, and went out and bought them myself, late in the evening, brought them home; showed them to Mrs. Parish, and laid them on the table, when, probably, I have no doubt some conver- sation did take place about them between Mrs. Parish and myself in relation to their use; I saw them used;" but he states he saw them " Only once afterwards," viz., " within thirty days from the present time," (III. £ 362-8.) He was asked if an attempt had been made to induce Mr. Parish to use those letters, and replies, " I think I have been told so, heard so." By whom ? " I suppose it must have been Mrs. Parish." " I don't recollect the words." " The substance probably was his willingness to make the attempt." (III. f. 371, '2.) At the request of Mr. O'Conor these printed letters were by Mr. Evarts presented in court. They consist 73 of twenty-seven separate pasteboard cards, about 2£ inches square, twenty-six being the letters of the alpha- bet in capitals, and the twenty-seventh being, on one side the same letters in Roman, and on the other side the cardinal numbers and the cipher 0, and the diph- thongs J& (E, the whole contained in a box labelled " Picture Alphabet," (see exhibit No. 9, III. p. 140.) The witness was asked, " Did you ever, at any time in the life of Mr. Parish, advise Mrs. Parish, or any body else, to try any other means than those letters to get at Mr. Parish's meaning or wishes ? " and answered, " I don't recollect—I don't know." Again he was asked, " Do you know of any other person having spoken to or in the hearing of Mrs. Parish, in giving any advice on that subject ?" and he answered, " I don't recol- lect." (III. £ 375, '7.) He was asked, " When, after that period, [in which the attempts to write on the slate were made,] you attended to his executing satis- faction pieces, and witnessed them yourself, why did you write his name and take his mark, instead of get- ting his signature ?" and he replied, " It must have been because he declined doing it himself; I can im- agine no other reason, and don't recollect any; it is conjecture on my part." " I don't recollect." (III. £ 452.) At this point it is proper to scrutinize, first, the fac- similes of the signatures known to have been Mr. Parish's, before his attack; 2dly, those purporting to be his after the attack ; 3dly, the several crosses alleg- ed to have been made by him, in lieu of signatures, at different periods after his attack [No. 89, 90, 92, 93, 94, 137, 11 repealed (at III. £ 1391), No. 232,236, 248, 250, 262, 263 ;] and, above all, the fac-simile of what is called writing of Mr. Parish's (No. 264,) which Dr. Delafield says (If. 3044 '5) (I.f. 3255) was interpreted to mean "wills" Thesefac-similes should be also exam- 10 74 ined in connection with the evidence of the experts, Richd. W. Bleecker, Jacob C. Parsons, and Charles T. Leake, which has been offered in reference to the genu- ineness or spuriousness of the signatures alleged to have been written after the attack, and in reference to the manner in which these may have been executed. Dr. Markoe, speaking of Mr. Parish's capacity to read, says, " I have seen him reading the newspaper, and have seen him looking over a store-book or pass-book always, as well as I now remember, sitting in the library, near the window. I don't know that I can specify any other circumstances." " It could not have been more than three or four times; the period of the illness I can- not specify; I think it was at long intervals." (II. £ 2014 '15.) He was asked, " How long after Mr. Parish's attack did you first see him apparently reading some- thing ? " and answered, " I can't fix the time better than by saying, ' within the first six months;'" and, as to length of time on any one occasion, " only a few mo- ments ; the print or writing was generally laid aside on my entrance into the room; I mean one or two minutes probably." He was asked," Did you never set Mr. Parish a-reading, or try to ?" and he answers, " I never did." (II. £ 2089 '90.) Again, he says of Mr. Parish, " I have seen him write; it was at our suggestion, Dr. Delafield and myself; it was in my presence; I have seen him write^ both with pencil on paper, and on a slate, which we presented to him, for the purpose of inducing him to make the attempt; at first he did so with alacrity, and succeeded, particularly on the slate, in writing his name, so that it was readable; he would never try more than a few times at each sitting; he would then be discour- aged, and give up the attempt, and it became more and more difficult at future sittings to induce him to make the attempt; he seemed to feel an absolute de- spair of any available success, and finally refused alto- 75 gether to try." He was asked, " How many times were these efforts repeated, and through what period did they continue ? " and he answered, " Not more than three or four times, occupying a period of perhaps as many days; he became very soon discouraged. (II. £ 2015-17.) He was asked, " How long after the attack was the first of these experiments ? " and answered, " I cannot fix dates ; they were all within six months from the time of his attack, and, I think, after the October illness ; I don't remember at whose instance or sugges- tion these experiments were instituted." Each attempt occupied " about half an hour, I suppose." Pen and ink were not used—" I think not." The witness was asked, " What did he write with the pencil on the slate ?" and answered, " Henry Parish." As to the number of times " I cannot say; he wrote the full words, or nearly the full woi'ds, the whole name, several times; afterwards he would give up the attempt before he got through the whole, leaving it imperfect, and finally would not try any more." " I don't think he ever finished com- pletely the last word at any time; but he wrote several times both words, so that they were unmistakable." " He never wrote the full word ' Parish,' that I remem- ber," but, " as well as I remember, the first three or four letters; the two last were scrawls." At any one visit he wrote some part of the two words, " three or four times perhaps." This applies to the attempts also with pencil and paper. He was asked, " Did any one tell Mr. Parish what to write when these experiments were made ? " and he answered, " I don't remember—I suppose so ; " and again, " That any attempt made to make him write any other word than these two ? " the witness answered, " I believe not." The word " Henry " was written in full ?—" Yes, sir." He was asked, " Did you ever see an experiment made with the shorter de- signation^ ' H. Parish ?' " and he replied, " I may have 76 done so, but my recollection is indistinct about it." He was asked, " Can you swear that these experiments were made by you, or in your presence, at as many as four visits ?" and he replies, " No, sir, I cannot swear that, because I do not recollect distinctly enough; I should say at more, as far as my recollection goes; I can't spe- cify any nearer to the number than by saying ' several times,' as I have done." As to the manner, " the pencil was put into his hand, and the slate or book was held before him, or fixed upon the table before him, as the case might be ; that is all the aid, I believe—all I now remember; the hand was never guided in any experi- ments in the slightest degree." As to copies set to him for guidance, " I do not remember." The witness was asked, " Will you say that you did not yourself person- ally write such a copy, and place it before Mr. Parish ?'' and he replied, "I will not, sir." (II. £ 2092-97.) He was asked, " Do you remember any use of the black- board in connection with writing ? " and he replied, " I have an indistinct recollection of the blackboard, but I have no remembrance of any precise writing upon it, no particular writing upon it, I should say;" and as to the trial with the alphabet, " not of my own knowledge —I never saw it tried in any shape or way." (II. £ 2017 '18.) He was asked, " Did you witness any at- tempt to make Mr. Parish write on a blackboard ?" and he answered, " I don't remember." He was asked, " Whilst you were attending him, were you informed of any other attempt to make him write ? " and he an- swered, " I was ; I heard that he had written the word ; wills' on a piece of paper, that is all." Again, as to the block letters, or separate letters of the alphabet, " the substance of what I was told was, that they were presented to Mr. Parish, and he would not try them— would not have any thing to do with them." " I only remember that I was told letters had been presented 77 to him, but in what particular form I do not now recol- lect." Again he was asked, " Did you ever know any communication to be made to Mr. Parish by writing, as, for instance, writing on a slate and presenting it to him to read ?" to which he replied, " I never did." (II. £ 2100.) 14th.—-ThePower of Attending to and Understanding what was Read to him by other Persons. The reading of the newspaper to Mr. Parish was a daily ceremony. These readings, says Simmons, (serv- ing from December, 1849, till October, 1850) were " seldom with me more than half an hour, but with Mrs. Parish about one hour or more." I don't think he paid much attention during the reading." As to sign or gesture during the reading, he made " To me none, and I never saw or heard any to Mrs. Parish." " He was generally in the habit of sleeping after breakfast during the time of reading the paper." (I. £ 1697, '8.) "After breakfast," says Wingrove, (serving from 1850 till September, 1851) " the next thing was to go to mar- ket ; he went to market with me; the market was at the corner of Nineteenth Street, and Broadway, Case and Vandewater's; he walked there with my assist- ance, and with a crutch sometimes ; he returned home, and I commenced to read the newspaper for him for about one hour and a half, or two, more or less, when Mrs. Parish came down stairs to relieve me." (I. £ 1496.) Again, after dinner, "perhaps he might take a little walk around the room, and perhaps not. I would read the evening paper sometimes to him." (I. £ 1503.) " Mrs. Parish told me that Mr. Parish wished to have the stocks, and the deaths and marriages read to him, and nothing more. I made no selection ; I commenced my beginning anywhere, the editorial generally; that was before Mrs. Parish gave me instructions." (I. £ 78 1590.) Once while Wingrove was thus reading, Mr. Parish made some sound, and, says the witness, " It appeared to me as if he wanted to look for something all over the paper, and I read the headings of each article; we could not find out. (I. £ 1591.) This the witness inferred from Mr. Parish's " throwing himself back in th chair, and paying, ' yaune, yaune, yaune.'" (I. £ 1 "»95.) " I had the paper in my hands at the time ; he put one hand upon it, and he went down the paper with his hand - otty close to mine, all the way so, I reading the headings, as I stated at the time." He followed t: I snould say, perhaps two pages, not the column, for he did not; but I should say the paper; ( is hand was flat upon the centre about." (I. £ 1596.) On one occasion Wingrove called his attention to an article in the paper concerning the Phoenix Bank, in which Mr. Parish had for many years been a director, and read the article to him four times in succession, thinking, from hearing the expression " yaune, yaune," that Mr. Parish desired him so to do. (I. £ 1598- 1600.) It was the duty of Clarke also, under the directions of Mrs. Parish, to read the newspaper to Mr. Parish, and during this ceremony, says Clarke, " He was generally asleep or looking out of the win- dow, never minding it." (I. £ 1738.) " Having got settled in his library," says the nurse Wm. Brown (serving from October, 1851, till Novem- ber, 1854,) " I would take the newspaper, the Courier and Enquirer, commence reading aloud to him ; begin with the marriages, deaths, stocks, and other news in the paper, and continue reading perhaps an hour, two hours, sometimes more, sometimes less; advertisements and different matters in the newspaper; he would call my attention to parts in it that he wished to know something about." " He would point to the paper and to me, he sitting in his chair, saying at the same 79 time that he pointed, ( ne, ne, ne;' I would say, do you wish me to read some particular part or paragraph ; he would nod with his head, making the sound I have said before, as if yes; I would then look over the lead- ing articles and name them, and so on until I found out what he wanted me to read." " Having named the subject, I would say, is that what you want me to read • he would shake his head sometimes, take the paper in his own hands, place it on his knee, and turn it over, and at last point to the subject he wished; that would perhaps be an obituary of some person, or to some per- son who he heard had died ; or a marriage, or an acci- dent, or some advertisement of stock, extra stock, or some business down town." (II. £ 1313-15.) Mr. Henry Delafield remembers the reading of prayers to Mr. Parish, " more particularly at Hellgate on a Sunday morning, when Mrs. Parish would ask Mr. Parish if she should read the prayers to him, he nodded assent; we would assemble in the hall, all being seated, Mrs. Parish would commence the morn- ing prayers of the Protestant Episcopal Church in the Common Prayer Book; when she came to the Lerd's Prayer and read it, Mr. Parish would say it also by making a sound as if following her as she read, and so when reading the Creed in the like manner, he on both occasions moving his lips, and making a slight sound; and so when reading the Litany, he would make the same sonnd for the responses, and all in proper time." " It was generally of a stormy or rainy Sunday." Again in the evening, " Mrs. Parish would ask him if he wished the Bible read to him, he would nod his head in assent, when Mrs. Parish would read some chapters in the Bible; I would then ask him if he would like to hear a sermon read, to which he nodded assent, and I would read a sermon." (III. £ 145-8.) Besides the Bible the witness recollected reading to him out of 80 some other book. " I don't recollect the name of the book; I don't recollect the number of times; I can call to mind twice; I am under the impression it was several times." When asked, " Do you recollect any other person reading any other printed matter to him ?" He replied, " I don't recollect at present." But " letters, documentary papers, and other written papers, whatever they may have been at the time; his balance sheets. These were read to him sometimes by Mrs. Parish, sometimes by myself, and sometimes by my brother William." He was asked, " Was the practice of reading the newspaper to him kept up steadily until his death ? " and answered, " It was, with the exception when he was too ill." (III. £ 332-4.) 15th.—Helplessness, and constant Need of Supervision. Subsequent to the attack of July, 1849, Mr. Parish was never able to supply his own wants. During the whole period of his illness after that event, he was en- tirely dependent for the comforts and necessities of life upon those who were immediately about him; and he was never permitted to be alone. Mr. Ker- nochan, who " was in the constant habit of visiting the house," (I. £ 841,) says that he was never alone with Mr. Parish : " No, sir ; never to any length of time; perhaps never to the extent of half a minute; I say that up to within a year or so of his death; within the last year or fifteen months of his life I have been with him alone, perhaps from one to three minutes; when at these visits we were not alone, Mrs. Parish was generally present, and in her absence, one of the Messrs. Delafield, Henry or William; it sometimes happened that I called there before Mrs. Parish had returned from Grace Church, on Sundays, and then I 81 found one of the Messrs. Delafield there, as I stated before." (I. £ 846, '7.) Dr. Delafield also says: " He was rarely left alone; occasionally he would be so; it was impossible to leave him alone as a general rule, from his liability to those spasms, y Mr. Lord, under the instructions of one of the Messrs. Del- afield, and after a conference with him and Mrs. Parish, at the house in Union Square, (I. £ 6,) assigns to Mrs. Parish the Union Square property and the property in Wall street, which have been already mentioned, val- ued, according to the estimate of Mr. Kernochan, the one at from $100,000 to $120,000, and the other at $90,000. (See the document in the case.) Mr. Lord's first inter- view with Mr. Parish, was after the preparation of this document for the signature of Mr. Parish, Aug. 29th, 1849. (I. £ 90, 91.) It was held in the presence of Mrs. Parish, and of two gentlemen who were invited to of- ficiate as witnesses to the signature of Mr. Parish, viz., Mr. E. Holbrook and Mr. Daniel D. Lord, son of Mr. Daniel Lord. (See codicil in the minutes.) As to Mrs. Parish's mode of introducing them into Mr. Parish's chamber, " I think," says Mr. Lord, " she went up be- fore us; she may have been up before us to prepare Mr. Parish for our coming, and then returned and led us up." (I. £ 94.) The physical condition of Mr. Parish at this period need not be again described. " On coming into the room," says Mr. Lord, "Mr. Parish was sitting in his chair; I think we spoke to him with the usual civilities, and he recognized us; he did not otherwise express himself, as I recollect." (I. £ 96, 7.) The subject of the visit having been introduced, and the codicil produced, "I read it," says Mr.Lord, "slow- ly and distinctly, and I think by sections, but I am not positive." (I. £ ,102.) " Before he was asked if he would sign it, he was asked independently and sepa- rately if he wished to give that house and property to Mrs. Parish, and if he wished to give her the lot in 187 Wall street." (I. £ 103.) " He expressed his assent by a sound or gesture; I think by both. The sound was a single sound, an attempt to say yes, and the gesture was a nod or nodding." (I. £ 105.) "A cush- ion was brought and laid before him, and I think a table was placed before him to write on. Whether the table was there already and a cushion placed on it, did not impress me, and I can't say. Mrs. Parish said sometimes he uses this cushion. Mr. Parish expressed that he did not want it, made some movement that he did not want it, by shaking his head. When the prep- arations were ready for his signing, and he could not lift his arm, he made some expression as of sadness at his condition, as I understood it. It was a sound and a sort of expression in his face. I then assisted his arm to the spot where the signature was to be made, and assisted him to make his mark, and asked him if I should write his name. He expressed his assent to that in the manner in which he had done before. I asked him if he signed it as a codicil to his will, and he expressed he did." (I. £ 106, '7.) " I asked if I should write his name for him ; I think this followed his making his mark, but it may have been before, as to which my recollection is indistinct." (I. £ 113.) The process of witnessing was after the same manner. " When we came in, he was sitting; he remained sitting while we were in the room, and we left him in the same place sitting when we came out." (I. £ 129.) The interview occupied " I should think about half an hour." (I. £ 126.) Mr. Parish it will be remem- bered had not as yet been able to wTalk about, be- yond his bed-room. (I. £ 1798.) "He appeared by looking at him," to use the expressive words of the waiter, Quin, "to be very low, just like a man who would be between dead and alive, and to have no com- mand of his mind, perhaps I might say, half dead and 188 alive." (I. £ 1804.) Mr. Lord himself, in view of Mr. Parish's condition at the time, deemed it proper to ask for a re-enactment of the same codicil. The exact cir- cumstances leading him to ask for this are not specified, but from the fact that Mr. Lord found while guiding Mr. Parish's hand, that he could do no more than make his mark, and that the name was afterwards left to be subscribed by another hand, is presumptive evidence at least that up to this period Mr. Lord must have placed too high an estimate of Mr. Parish's ability to execute business understandingly. 25th.—The re-execution of the First Codicil. As to the re-execution of this codicil, " The actual date of my suggesting it," says Mr. Lord, " I am una- ble to state, but from the peculiar circumstances under which the codicil was drawn, it had always been my intention, if possible, to have it again submitted to Mr. Parish; for although I was satisfied myself that it was all understood and well executed, yet it seemed to me proper and prudent that it might appear to others whether this was so or not, by a re-publication or re- execution under more auspicious circumstances." (I. £ 131.) " The suggestion had been made by me to one of the Messrs. Delafield to be communicated to Mr. Parish;" (I. £ 134;) and the time of meeting for the re-execution, December 17th, 1849, was fixed upon by " either Mrs. Parish, or one • of the Messrs. Delafield." (I. £ 135.) On this second occasion Mr. Lord found Mr. Parish "in his library, in the basement story fronting the south." (I. £ 141,) " He was dressed in his usual dress, as a gentleman, and appeared quite a different man from what he had when this codicil was first exe- cuted." (I. £ 142.) "He was sitting between the 189 window and the fire-place," " in a chair." " He was aided to move from where he sat to a place near the window, where he sat when he finally re-executed the codicil." (I. £ 143.) He was aided by, "I think Mr. Holbrook and Mrs. Parish, but I am not distinct in the recollection of that." (I. £ 143.) "They, or one of them, stood by his side, and took his arm, and assisting to bear the weight of his body, aided him to a seat near the window." (I. £ 144.) As to walking with aid, " I think he did, but imperfectly ; I rather think shuffling his feet, progressing in that way; but this is a circumstance of which I speak, with others of that character, with no great certainty." (I. £ 144.) On entering the room and addressing Mr. Parish, " I re- collect no sound nor gesture, but a cordial expression of countenance." (I. £ 146.) When asked, as before, to re-execute the codicil, " he uttered ' yes,' unmistaka bly, but not so distinctly but that his speech seemed to be obstructed." (I. £ 147, '8.) "I think he accom- panied it with a gesture, by inclining his head." (I. £ 149.) " After the table was prepared and the pen and ink brought, Mr. Parish put his hand upon the table, and, with my assistance, made his mark as it is upon the codicil." " I think it was his right hand. I do not now recollect any thing to indicate that it was not his right hand." (I. £ 155.) "I think he took the pen." (I. £ 156.) " As to that matter I am not sure." (I. £ 156.) I assisted him, replied Mr. Lord, "by placing the pen, the point of the pen, where the mark was made, and assisting and directing his hand in making both the marks of the cross." (I. £ 157.) On asking to assist him to write, " I think he smiled upon that question." (I. £ 157.) "I asked Mr. Parish if he ex- ecuted that as a codicil, and if he wished us to attest it as witnesses. He answered ' yes,' or nodded, and pointed to the subscription clause on the paper. I mean the 190 original subscription clause." (I. £ 160.) After the document had been witnessed, as before, by Mr. Hol- brook and Mr. Lord, " Mr. Parish," says the latter, " then made that mode of expression, indicating that he wanted to communicate something. I can't well imitate or describe it. It was a continued repeating articulation of the same sound. Mrs. Parish suggested that he had a wish to vary the residuary clause mak- ing gifts to various persons, among others, the children of his brothers, (i. e. the 12th clause.) Mr. Parish, in the usual mode of expressing himself by a nodding, or saying 'yes,' assented to that." (I. £ 166,7.) Mr. Lord, however, was not yet prepared to accede to the sug- gestion. " I was at that time," says he, " aware that some difficulty had come to pass between Mr. Daniel Parish, and, I think, a Mr. Sherman, and Mrs. Parish, and, I understood, Mr. Henry Parish. I was aware of it from the statements of Mrs. Parish or Mr. Delafield, and I think, of both. I expressed that I wished that it might not then be done ; that it would fatigue and disturb Mr. Henry Parish; that it would require a good deal of deliberation, and that I could come and do it at some other time. In this he acquiesced, with an expression rather of pain or regret, not expressed by a sound, but by the expression of his countenance." (I. 167, '8.) 26th.—Mr. Parish's Condition at the time of the Re- execution of the First Codicil. This transaction, it is proper to recollect, was on the 17th of December, 1849 ; and in relation to Mr. Parish's power of giving expression to any thought, by his countenance, at this period, we have the evi- dence from several witnesses that his eyes were both 191 affected, from cataract and other ailments, and that he wore glasses; we have, in reference to the movement of his features, also the evidence of the Rev. Dr. Taylor, who says that, " On the 3d of November, 1S49, I was called to baptize Mr. Parish ; I found him in his cham- ber, at his residence in Union Square, I think upon the third story. He appeared a very feeble man." " The general expression of his face would have indi- cated a lack of intelligence, the muscles were rigid, apparently, and failed to give expression to his counte- nance." (I. £ 3330, 3331.) So also Dr. Delafield, even after the period above indicated by Mr. Lord, " after the fall of 1849," admits at least some loss of power in the muscles giving expression to the counte- nance ; for, says he, " at some period, I can't say when, there was occasionally a slight flow of saliva from one side of the mouth—very slight, not perceptible by common observers—which showed that the muscles of that side of the face, although not altered in appear- ance, were really not so strong as those on the other side." (I. £ 3043.) Again, Quin, who served in the family up to December, 1849, and who speaks of Mr. Parish, about the period of first executing this codicil, as "half dead and alive," afterwards adds that Mr. Parish was "pretty much the same—all through he was pretty much the same." (I. £ 1805.) But how- ever much regret Mr. Parish may have evinced to Mr. Lord in not being allowed to alter the residuary clause of his will at this time, (i. e. the twelfth clause,) he does not appear to have been soon anxious for a renewal of the proposition. The second codicil was not executed until nearly two years from the time now spoken of by Mr. Lord; and the third codicil, in which the ultimate residuary clause of the will (i. e. the thir- teenth clause) was really altered, and the general resi- due of the estate diverted from Mr. Parish's brothers L92 and their children, to Mrs. Henry Parish, was not effected until the 15th of June, 1854; and not even then was the disherison of his brothers' children effected as fully as had been proposed, owing, as in the present instance, to Mr. Lord's interposing an objection. Speaking of Mr. Parish's capacity for the execution of the first codicil, and its subsequent re-execution, Mr. Lord says, " On each occasion he perfectly understood what was proposed to be done, and what was done. On the first occasion I had little communication with him, further than to ascertain if it was his wish to give the property expressed in this codicil to Mrs. Parish; on the second occasion, I think my communication with him was somewhat more extensive; I had no doubt of his capacity, in regard to mind, memory, and understanding, to execute a testamentary paper." (I. £ 14, 15.) But the modification of the will, effected by this first codicil, appears to have made but little, if any, impression upon the mind of Mr. Parish. Indeed, the evidences are all in favor of his having entirely forgotten it. Mr. Folsom and Mr. Kernochan both state that, at the interview when the duplicate copy of the will was surrendered to him in January, 1850, when questioned as to whether he had ever altered his wiU—and where the question was fairly put by Mr. Folsom—Mr. Parish gave a negative answer. " I then put the same question to Mr. Parish, the same as I had before, asking him if he had made any alteration in his will; he made a very decided negative movement of the head, or shake, and, I think, made a sound with his voice, sounding much more like ' no' than ' yes,'" &c. (I. £ 1161, 1162.) "Mr. Folsom, on surrender- ing the will," says Mr. Kernochan, " asked Mr. Parish whether he had made any alterations in the will since he had made that will, to which Mr. Parish shook his head." (I. £ 865.) If capable of understanding so 193 simple a question, he not only appears to have forgot- ten the fact of altering the will, but he also appears to have forgotten that the duplicate of the document had been placed in his possession. For afterwards, in front of the office, says Mr. Folsom, " on one occasion, when Mr. Parish continued those gestures with his hand, I asked if he wanted his will; he made an affirmative nod of the head ; I said in effect, you have it already; and Mrs. Parish said, as near as I can remember, ' Why, Henry, you know it is home.'" (I. £ 1265.) We need not again refer to a similar indication of want of memory in regard to the trunk in which the copy of the will had commonly been kept. (I. £ 1266.) 27 th.—Mr. Parish refuses to cancel the Original Will. But if Mr. Parish had forgotten the alterations effected in his will by the execution of the first codicil, Mr. Lord gives us to understand he had not forgotten that he had made a will. For in September, 1853, during the conferences preparatory to the execution of the second codicil, " I remarked," says Mr. Lord, " that the taking of the stocks in the name of Mrs. Parish was not, in my judgment, a valid disposal of them in her favor; I suggested whether, inasmuch as gifts to so large an extent were about being made to Mrs. Parish, and it was understood to be likely that they would be controverted, whether he would not prefer the cancellation of his will, and the leaving of his prop- erty to go by disposition of law, by which she would have a large provision. I was not then aware of the amount of Mr. Parish's property. Mr- Parish did not favor that suggestion of cancelling his will." (I. £ 207, 208.) " He said 'no;'" and as to accompanying ges- tures, says Mr. Lord, " I have no recollection at this 25 194 time, except that he gave me the answer so distinctly and clearly, that I saw that he understood it, and it did not suit him; but the tone of his voice, and the character of his gestures, I do not now recollect." (I. £ 210, 211.) As to the proposition of cancelling the will, Mr. Lord says, "It was entirely my own thought." (I. £ 492.) " I had never spoken of it to any of the Messrs. Delafield; I think I had not spoken of it to Mrs. Parish, but I am not sure that I did not before I mentioned it to Mr. Parish." (I. £ 493.) Again, Mr. Lord, when questioned whether he had not at all times, subsequently to the execution of the first codicil, a belief that the capacity of Mr. Parish to make that, or any other codicil, would be contested, and form a subject of litigation, replied, " I had a belief that it might be attempted to contest his capacity; I cannot say that I expected that it would be; but I always had a belief that it would be the subject of litigation; and when I consented to become a witness, I mentioned that it would preclude my acting as counsel upon the trial of the will, if such liti- gation should accrue." (I. £ 494, '5.) The alterations of the will, however, were repeated; and what Mr. Lord tells us Mr. Parish was unwilling to do by the single act of cancelling his will, was substantially ef- fected in detail, by a series of transactions requiring a considerable amount of intellectual acumen to devise or to unravel. 28th.—The Making of the Second Codicil. The subject of the second codicil, or that of Sep- tember, 1853, occupied a series of conferences running on from one, two or three days before the sixth of September, 1853, up to the fifteenth of that same month. (I. £191,'2.) "Before my family had re- 195 turned to town," says Mr. Lord, " Mrs. Parish called at my house to learn if I had returned, and requested me to call and see Mr. Parish; she called personally, and I received her." (I. £ 194.) "She expressed to me that Mr. Parish wished to make a further disposi- tion of property. She brought a paper containing a list of stocks and securities, some part of which stood in her name, others not. She expressed that Mr. Parish had put the stocks in her name, with a view of her having them; that he wished to give her the rest of the securities contained in the paper. Mr. Lord informs Mrs. Parish of her defective claims upon certain alleged gifts, and Mrs. Parish's Li- vestments in her own name. " I expressed then that the securities being made in her name, was not, in my judgment, a secure or effectual gift. She expressed a wish that I should call and see Mr. Parish ; that he was much better than he had been, and she wished me to see him and take di- rections from himself." (I. £ 195, '6.) It is proper here to explain that at the time of his attack in 1849, much of Mr. Parish's property consisted in public stocks, bonds, notes, and other similar securi- ties, falling due from time to time; and that in the re. investment of the funds as they were received on the maturity of such bonds or other business paper, it was customary for Mrs. Parish to make the new invest- ments in her own name. Mr. Lord's remark, that securities being in her name was not a secure or effect- ive gift, had reference to these new investments. Mr, Kernochan admits that Mrs. Parish very often con- sulted him about the investments she was making or holding in contemplation. But when asked " Did Mrs. Parish inform you that she was placing stocks or secu- rities, or making investments in her own name ?" he 196 replied, " I don't think she ever did ; not to my recol- lection." (I. £ 872.) Nor had Mr. Lord been pre- viously informed of it by Mrs. Parish. " Not by her. It is probable—and I think it was so, that some bonds and mortgages were taken in her name through the office of my partners as conveyancers, and I may have known it from them." (I. £ 199, 200.) Numerous Conferences and Complicated Transactions And now to return to the subject of the second codicil, Mr. Lord says, " I find, by referring to the diary, that I saw Mr. Parish on the 6th and 7th, 9th, 12th, and 13th of September. The codicil was executed on the 15th, as appears by its own date, and I have no entry on my diary of that date." (I. £ 192.) " The entry of the 12th designates Mr. Parish's house, meaning his house in Union Square; the entry of the 13th indicates at Mr. Parish's at Hell-Gate; none of the others indicate where they were, but my memory is perfectly distinct that they were at his house in Union Square, except the one near Hell Gate." (I. £ 192, '3.) After Mrs. Parish's call upon him, before seeing Mr. Parish, Mr. Lord prepared from the paper which had been submit- ted to him the draft of a codicil. " A very rough draft of a codicil," says he, " my recollection of which is, that with a formal commencement, it contained two sections, one embracing the stocks and securities which stood in her name; the second embracing the other securities." (I. £ 197, '8.) " As to the securities which stood in Mrs. Parish's name, I think those which stood in the first section of that draft were the same as those described in the second codicil as standing in her name. As to the stocks on the second section of my draft, whether they are all the same as those expressed in the second section of the second codicil, I cannot 197 say. My draft underwent a great many alterations and changes, and was finally superseded by a draft made at Hell Gate, and it was destroyed; but I do not re- collect whether it was destroyed before the codicil was executed, or shortly afterwards; I think it was de- stroyed." (I. £ 198, '9.) The first interview with Mr. Parish on the subject of this codicil, on the 6th of Sep- tember, lasted not over half an hour. (I. £ 204.) The draft of the codicil was now under consideration. The substance of the remarks previously made to Mrs. Parish respecting the ineffectiveness of placing the securities in her own name, and the proposition to cancel the original will formally made to Mr. Parish. Mr. Lord then informed Mr. and Mrs. Parish that the codicil was for their consideration, and left them, with the remark, that "we would meet again about it." (I. £ 207, '8.) The interview of the 7th of September was by appointment, but has left no clear impressions on Mr. Lord's memory, who says: "I do not think any thing was done on that day, but I know that he had the draft codicil which I had left; and he was not ready, or they were not ready to proceed to conclude it; I am unable to state the hour I was in the house, nor the length of the interview, except that it was not long." (I. £ 216.) Mr. Lord is not even certain at this call he saw Mr. Parish at all. (I. £ 220.) "In the call on the 9th of September," says he, " I came by prior appointment; whether the time was fixed at the meeting before, or whether Mr. and Mrs. Parish stopped at my house and gave me an appointment, I am unable to say." (I. £ 224.) The meeting was in the library, in the presence of Mr. and Mrs. Parish, and Mr. Wm. Delafield. As to Mr. Parish, " his articulation was much better than when I had seen him in 1849, and his condition—his general condition was much improved ; my general re- 198 collection of the articulation of Mr. Parish, when he expressed assent by the word ' yes,' or dissent by the word ' no,' is, that it was accompanied with a move- ment of the head or gesture ; I would also add, that he had a very intelligible mode of expressing by an in- articulate sound, inquiry, or a wanting communication, and his assent or dissent by ' yes' or ' no,' was made with a variation indicating more or less firmness in his determination." (I. £ 228, '9.) At this interview: " The items of the property to be disposed of by the codicil, as expressed in the draft, were taken up, and he was asked if they should be included. The draft of the codicil had pencil marks drawn over several of the items originally written down. The course of the interview was to ask concerning the items, or other items of property, to take the place of these which had pencil marks through them. The business was pro- ceeded in, until the items were gone through with, and adopted as gifts intended to be made by him." (I. £ 231, '2.) As to taking up the items that had been erased with pencil marks, and those that were not: " I have no recollection of any difference, but I confess that I have no recollection distinctly on that subject: I acted under the conviction that the draft had been read to him." (I. £ 234.) When asked as to whether any of the items in the first section had been erased by pencil marks, Mr. Lord answered, " They had not." (I. £ 236.) And when asked, if before reading off the items in the second section, he there, in the presence of Mr. Parish, made any inquiry about the pencil erasures, he replies, " Not to my recollection." (I. £ 243.) And again he says : " I cannot say that I was told so, and yet I have an impression I understood them to be items he had not determined upon. That was the un- derstanding upon which I acted." (I. £ 244.) Again, Mr. Lord being asked whether, in reading off the items 199 to Mr. Parish, he had read the pencil-erased items in like manner as the others, following each with an in- quiry whether that should go in, he answered: " My impression is there was a difference, but I cannot now state what it was." (I. £ 244.) " I cannot recollect any of the items erased, nor any of the items which, according to my impression, were substituted, but I recollect there were only two or three items in the second section which had not a pencil line drawn through them. My recollection is distinct that the number of unpencilled items was very small. It struck me." (I. £ 245, '6.) In regard to the adoption of the whole of the items of the first section, Mr. Lord says: " From the fact that he could express his assent or dis- sent intelligently, and the fact that the items were left to stand, I have no doubt in my memory that he ex- pressed assent by saying yes; he was equally able to express dissent, and I am very positive he expressed no dissent." (I. £ 237.) Like those in the first: " The items in the second section, consisting of securi- ties in Mr. Parish's name, were taken up separately, one by one." (I. £ 240.) " The item would be named, and he would be asked if that should be included or put down." (I. £ 240.) As to interpellations by Mrs. Parish and Mr. Delafield in reference to the items of this section: " It is my best recollection that they ad- dressed questions, both of them, in relation to some of the items that were included in that second section, as it was eventually settled." (I. £ 241.) "No item was put in without a distinct assent by word from Mr. Parish, given after different spaces of time—sometimes more promptly—sometimes after some delay. He did in every instance give me an unmistakable answer of yes or no, as the case required." (I. f. 242.) " Some items, according to my best recollection—and I feel positive as to the result—were left out, and I think 200 some substitutions were made." (I. £ 242.) The idea of these substitutions was not from Mr. Lord ? " No—but by Mrs. Parish," (I. £ 24!);) "and my best recollection is that, in substance, it was a naming of some other piece of property, and an inquiry if that should be put in ; but as to this answer I will not be positive or certain." (I. £ 249.) " By substitution I do not mean a simple putting of one thing in the place of another, but an adding of items to make up some supposed or expected amount, that was my idea in the use of the term." (I. £ 251.) When Mr. Parish ap- peared to hesitate about the disposal of any item, " It was left out of consideration." (I. £ 254.) But as to resorting to the same item more than once : " I am un- able to say; my impression is not, but I confess my in- ability to say; an item may have been dropped and resumed again, but I am not positive it was ever done." After the items had been all arranged: " I think the clause as to the stocks being replaced if sold, was read to him, but I am not sure, for I supposed that it had been read to him, and I acted under that impression ; still, I think I read that clause to him." (I.f. 259,'60.) " The amount of property [see the second codicil] having been so far arranged, which the codicil was to embrace, I opened the subject to Mr. Henry Parish of revoking the appointment of Mr. Daniel Parish as ex- ecutor ; I had previously mentioned that subject to Mrs. Parish, either when she first called upon me in September [1853] or in some intervening meeting with her, and told her the ground of my suggestion; she expressed a wish that I would speak of it to her hus- band." On this occasion of the 9th of September, [1853J I did speak to Mr. Henry Parish on the sub- ject, and asked him to consider it, and it was left for his consideration; I think no answer either way was then given upon the subject; the afternoon had got quite 201 advanced, and we separated." (I. £ 262, '3.) Alluding to Daniel Parish, and the misunderstanding between the two, Mr. Lord goes on to say, " she expected that the codicil would be disputed by him, if it could be; when I saw the large amount of property to be given to her, I thought it right to suggest the difficulty or incongruousuess of having an executor act, who would probably act in opposition to the codicil." (I. £ 264, '5.) As to the exact mode of introducing the subject of the revocation, " I cannot give the words, but in substance I wished him to consider the subject of this revocation, giving the reason, that if these large amounts were given to Mrs. Parish, and alluding to the variance between them, it seemed to me to be a false position for Mr. Daniel Parish to stand in in reference to the gifts to Mrs. Parish; these ideas were given in substance." (I. £ 274.) As to the expected opposition from Mr. Daniel Parish, " I never spoke of it previously; on this occasion I did allude to the supposition that he might probably dispute the codicil." (I. £ 276.) " I recollect no reply by sign or sound; no reply was ex- pected ; the object was to communicate to him, that he might consider it." (I. £ 276.) Mr. Lord was at this time still uninformed as to the exact amount of Mr. Parish's personal property; and as to those gifts to Mrs. Parish, he says, " I did not understand these gifts to trench upon the gifts of particular legacies in the will; I had not any estimate of the supposed aggregate of Mr. Parish's personal es- tate." (I. £ 284, '5.) But as to the residuary bequest to his brothers, " I do not think that was distinctly adverted to; but it was my understanding that the gifts contemplated would nearly absorb, if not quite, the residue of the estate over the gifts in his will and the previous codicil." (I. £ 285.) This interview began 26 202 between four and five o'clock in the afternoon until somewhat before dark. (I. £ 286.) The next conference was on Monday, September 12, 1853, in the afternoon, place and persons as before; " But what particularly was done, I cannot say," ob- serves Mr. Lord, " until Mr. Parish made the sign used by him for an inquiry for something; it was asked if he wanted those papers, which he expressed to be his wish; there were then produced two papers, one in the handwriting, I think, of Mrs. Parish, the other in the handwriting of Mr. Delafield; the first was a state- ment of all the property of Mr. Parish ; the second, in the handwriting of Mr. Delafield, was a statement of all the gifts, real and personal, in his will and in the first codicil, with valuations assigned to it. There was in that paper also a statement, apparently the amount of the gifts in the draft codicil." (I. £ 287, '8.) [For these lists, see Exhibit, in Vol. I., at page 100 et seq. the first, marked No. 1.; the second, marked No. 2. ] Mrs. Parish's mode of eliciting his wishes on this occa- sion was after the usual manner ; " His wife would say, ' Mr. Parish, do you want this, or do you mean that,' naming what she suggested, and continued so to do, until she had hit his meaning or intention." (I. f. 297.) Detection (not by Mr. Parish) of the $95,510 Dis- crepancy.—Mr. Lord proceeds to say, " Whether the codicil had been entirely read through or not, I am not positive ; when these two papers were produced, it was observed by some one that the gifts on the will and the first codicil and this codicil, would exceed the amount of property; whether that was Mr. Delafield or myself who observed it, I am unable now to say; it was one of us two." (I. £ 300.) The estimate of gifts, as per statement marked No. 2, pages 102 and 103, beino- $1,186,960, and the valuation of the whole estate 203 $1,091,450, shows that this excess of the gifts over the property was no less than $95,510. (I. £ 302.) "The discrepancy between his gifts and the amount of his property, was then stated to Mr. Parish, and I asked him," says Mr. Lord, " whether that should stand, that the gifts should exceed the property ; he ex- pressed unwillingness at that; he disapproved of it." (I. £ 301.) The matter of the amounts and of the codicils was passed over for future corrections," and Mr. Parish then fixed his finger upon the $52,000 Alabama stock, and I think the $60,000 stock close by it in Ex- hibit No. 1. (I. £ 364.) I noticed that from his see- ing it, laying his hand on it, and pointing to the item." (I. £ 30 J, '5.) " He placed his fingers on the item." (I. £ 305.) " The thumb and two fingers of his hand were bent together, and he put the ends of them upon it." (I. £ 306.) " If it had not been for what took place the next day, I should be unwilling to say up- on which of these items he fixed his attention; it was to one, and I am not sure but it was to both ; but the Alabama stock of $52,000 was the subject of so much consideration the day after, that I will not be positive that he noticed the other sum; my impression at the time was that he noticed both, and I still think so from the addition by me of the $112,000." (I. 307, '8.) After this indication of the fingers, " I think some in- quiry was made as to the meaning, but I am not sure that it was pursued." (I. £ 309.) Among the suggestions elicited by this indication of the fingers, the one which was eventually adopted was that the amount pointed at should be appropriated to charities. " I am not very positive whether it was expressed, that that was his wish, on that afternoon or not; my impression is that it was." (I. £ 313.) " In connection with this act of placing the fingers on an item or items in Exhibit No. 1, and his pointing at another time to a subscrip- 204 tion clause, Mr. Lord at another place says, " I don't recollect intending to convey the particular idea of his reading ; the subject was his discriminating the partic- ular place and the particular article." (I. £ 506.) And again, " I did mean to convey the idea that he could distinguish those parts of the papers by his sight of the figures in one case, and the place in the other." (I. £ 505.) Next as to the revocation of Mr. Daniel Parish's executorship: "I asked him if he had de- termined about it, in substance, not giving words; and whether that appointment should be revoked." (I. £ 309,'10.) He replied, by "the word 'yes.'" (I. £ 310.) " I drew up the form of revocation to be added to the codicil, excepting that which relates to the lega- cy of $10,000 to the executor, and read it to Mr. Par- ish, and asked him if he approved of it; he answered? 'yes.' I wish to state here that the will was not then present." (I. £ 310.) The time and place of the next meeting were now fixed upon by Mrs. Parish or Mr. Delafield, namely next morning at Hell Gate. At the Hell Gate meeting the persons engaged were the same as at the previous conferences (I. £ 320), and the business of the codicil was continued. (I. £ 324.) " The papers," says Mr. Lord, " which had been before us the day before, were produced. One of the dupli- cates of the will was there. The first thing done was the production of this paper I now have in my hand, by Mr. Wm. Delafield. It is marked No. 3. [See I. p. 104, f. 401.] That was read or stated aloud, I am not certain which. Some items of property Mr. Dela- field stated, in the hearing and presence of Mr. Parish, were included in this Exhibit No. 3, which had not been in the former list. By this paper it appeared that the difficulty about the property answering to the gifts disappeared. And this removed the obstacle of proceeding with the codicil as it stood." (I. £ 326-8.) 205 Revocation of Executorship of Danl. Parish, by Mr. Lord.—But in commenting on this remark at an- other place, Mr. Lord stated, that the additional items did not equal the difference of $95,510. " The papers show that they do not; the paper No. 3, took up the estimated value of the property, and added the new items ; it took up the gifts by the will, and the footing was carried out, which left a surplus of $382,450 ; the gifts by the intended codicil were found not to equal that amount. In looking for the discrepancy, there appears an error in the addition upon Exhibit No. 2 of the amount of gifts, which error is in the figure one, being one hundred thousand dollars; it should have been $1,086,960, instead of $1,186,980." (I.f. 543, '4.) Then again in regard to the value of property at 162 Pearl street, as stated in Exhibit No. 2. "From the in- spection of the paper," says Mr. Lord, " the sum original- ly written appears to have been $12,250; the alteration confuses it so that it may be read $12,500 or $16,500, but the addition shows that it should be read $12,500." (I. £ 544.) Mr. Lord proceeds: " I have the impression that the draft codicil was then read to Mr. Parish. At the same time another statement, which is now in my hand, ending with a balance of $33.50, was produced by Mr. Delafield, showing the disposition of property by the intended codicil, (this is marked No. 4),* and I think that paper was also read aloud in the presence of Mr. Parish." (I. £ 328.) As to the reading of Ex- hibit No. 3, " I think it was addressed to me, but in the hearing of Mr. Parish, who sat close to me." (I. £ 332.) And as to the reading of No. 4, "It was imme- diately after, and as a part of the same communication, but without being, so to say, a part of the same sen- tence, or sequence of speech. There was some conver- * The Exhibit No. 4, (I. pp. 104,105, f. 402, '3,) has no such ending as Is spoken of by Mr. Lord. There are also misprints or errors in the foot- ing tip of the figures. 206 sation or explanation along with it, and I am not able to say what it was." (I. £ 333.) Revocation of the Legacy of $10,000 to Danl. Parish at the suggestion of Mr. Lord.—Mr. Lord now infers from certain marks on Exhibit No. 4, " that the next thing said or done was in reference to the revoca- tion of Mr. Danl. Parish's appointment as executor." (I. £334, '5.) "The will was present; the clause appointing the executors was read by me ; I stated that it would n ot be clear from the mode in which the legacies to the executors were given, whether the revocation of the appointment would revoke the legacy to Daniel Parish or not, and I asked Mr. Parish whether he meant to revoke that legacy—that that ought not to be left un- certain." (I. £ 335.) " He made reply by saying ' Yes ;' I then added to the clause a revocation in the draft codicil; that which speaks of revoking the lega- cy." (I. £ 336.) "I next read the clause as complete to Mr. Henry Parish, I think, as it now stands in the codicil." (I. £ 337.) " Having read it for his informa- tion and approval, and having acted upon it as ap- proved by him at the time, I infer and have no doubt he answered ' Yes.' But my recollection is founded upon these facts that I state. I ought to add also that Mr. Parish, in this interview, was very able to express by sounds his assent or dissent." (I. £ 337,'8.) "I have a recollection of asking whether he approved of it, and of his saying ' Yes;' but it is less positive than if it were not corroborated by the circumstances I have stated."* (I. £ 339.) Mr. Lord, when here asked, " Was not the revocation of the appointment of his brother Daniel as executor, with the revocation of the * Mr. Lord hero expresses himself evidently wrong, and in a way not to convey his meaning. 207 legacy to him, the act of all others to which you sup- posed Mr. Parish assented, that which seemed to you, during the transaction, as the most impressive ?" says, " It was not. It did not strike me in the sense sup- posed in the question. If these legacies were given to Mrs. Parish, I did not suppose Mr. Daniel Parish would have cared to be continued executor. It did not impress me as being any thing very remarkable." (I. £ 340.) The Alabama stocks devoted to charities, and not all thus used.—After the revocation was disposed of, " Mr. Henry Parish then made the expression that he wanted to communicate with us, either by again touch- ing the paper Ex. No. 1, or by answering to the sug- gestion whether he wanted to take up the Alabama stock, he indicated his wish to take up that subject. I have the impression that it was by touching the paper, but I am not positive in which of the two modes this matter was expressed." (I. £ 341.) " During the inter- view before this time," " Mr. Parish, in the course of our interview, made several times the expression of wanting to communicate, but I am unable to say upon what sub- jects that was done ; the general fact I recollect." (L £ 343, '4.) At this point, when asked, " who first spoke about the charities or gifts to institutions on that occa- sion ? " Mr. Lord replies, " His wife, Mrs. Parish," (I. £ 344), and says further on, " I made no suggestion at all of any charity; I have an impression, but faint, that Mr. Delafield did make some suggestion of a charitable object or association ; Mrs. Parish made all the other suggestions ; I have forgotten every one suggested that was not adopted; the order of suggestion I am unable to state, other than in this manner—I have an impres- sion that she first suggested the making of a very large donation to the Eye and Ear Infirmary, or the charity 208 of that kind mentioned; and I think she mentioned that he had given Dr. Delafield, who had charge of it, reason to expect something very handsome. My im- pression is, that the sum she named would have ab- sorbed nearly the whole amount; he expressed the sound ' No.' Then various suggestions of names of char- itable institutions were named, but in what order I can- not state, except that the Bible Society was the one which he first adopted. The Orphan Asylum Society was the one which he next adopted ; St. Luke's Hospi- tal was the next, and a receipt for some contribution to that object was produced to me by Mrs. Parish during the interview. He next adopted the suggestion of the Eye and Ear Infirmary. When these were adopted, sums were suggested. He first adopted the suggestion of $5,000 for the Bible Society. [From the memoran- dum Ex. 4,1 am mistaken as to the order. I think the Eye Infirmary was the second, and the Orphan Asylum and St. Luke's Hospital next after.] The sum adopted for the Orphan Asylum, I think, was also $5,000 in/the first instance. My recollection is then imperfect as to the suggestions for the others; but the amount to be disposed of left larger sums to the other societies than he inclined to give, expressing, when the suggestion was made of the sums, ' Yes,' or ' No,' according to his purpose. The sums were then again suggested to him, in consequence of his intimating an inquiry, by the sound and gesture he used for that j)urpose. Upon these sec- ond suggestions, he adopted the sum of $10,000 for the Bible Society, $10,000 for the Orphan Asylum Society, $10,000 for St. Luke's Hospital, and $20,000 for the Eye Infirmary. The suggestions as to sums were made to him by Mrs. Parish, and his answers were by the sound ' Yes,' when he adopted the sums." (I. £ 346, '50.) " The institutions were settled upon before the amounts of the legacies to them were taken up." (I. f. 352.) 209 As to the other institutions suggested, there were, " Yes, several others, quite a number." (I. £ 353.) " I should not hesitate to say more than five others, according to my best recollection." (I. £ 353.) " On reflection, I think some of the dispensaries were named, and I do not recollect whether that was not by Mr. Delafield." (I. £ 354.) The Eye and Ear Infirmary being Mrs. Parish's first suggestion, " I think she suggested to him to give the whole to that, at the time she suggested it as an object." (I. £ 354.) " Various institutions were suggested before all the four were adopted. I am unable to say whether any institutions or charities were sug- gested after the four were adopted or not." (I. £ 355.) But the whole amount of the Alabama stock, i. e. of $52,000, which had been appropriated to charities, had not yet been exhausted; and as to the mode of dispos- ing of the balance of this fund, says Mr. Lord, " I recol- lect nothing, except that his attention was drawn to it, and of that I am not positive." (I. £ 361.) As to the $60,000 item, which Mr. Lord had supposed was also to be appropriated to charities, " nothing was said about it; no inquiry was made about it" at the meeting of Sep- tember 13th. (I. £ 381.) Mr. Lord goes on to speak of Mr. Parish: " He next either took up the will which was on the table, or made a sound of inquiry, which led to its being brought to him, and also made a sound of inquiry for another paper. That suggestion proved to be an inquiry for the first codicil, the original of which was not there, but a copy was, and at his instance it was read to him. He then drew attention to the blank leaves or sheets attached to the will, and it was surest- ' Do ed whether he wanted to have the codicil and the new codicil copied there. Upon that I made the suggestion that I would embody them in one, and send a new draft for them to read." (I. £ 366, '7.) Mr. Lord, when his recollection was refreshed, says, " It is that he called 27 210 for a suggestion for something, which turned out to be wanting the will." (I. £ 372.) And the object of the next sign of inquiry Mr. Lord infers, " from the fact that when the codicil was produced, and he was asked if it should be read to him, he said ' Yes.' " (I. £ 376.) The next subject introduced had relation to witnesses for attesting the execution of the new document, (I. f. 377); and the names of Messrs. Fearing and Ward were suggested by " either Mr. Delafield or Mrs. Parish, and I can't recollect which." (I. £ 379.) Here the interview closed. " I should think we were together from about half-past nine till twelve o'clock." (I. £ 380.) In connection with these transactions, Mr. Lord was asked, " Was the fact present to your mind on the 12th and 13th, when the subject of charities was up before you, that Mr. Parish, in his will, had given nothing in that way ?" and he replied, " It was not; neither had I any idea or thought at all on the subject of a gift to charities, until he himself opened the matter, as I have stated." (I. £ 388.) The mode of opening it has al- ready been related. Mr. Lord further states: uCi-. the same day that I returned from Hell Gate, I draited the codicil anew, embodying the codicil which had been executed in 1849, with the dispositions contained in the draft, which had been before the parties at Hell Gate. I enclosed it in an envelope on the same afternoon, and left it at Mr. Parish's house, Union Square. I received that draft back the next morning, by Mr. Delafield, with a single alteration in the draft, which was to make the charitable legacies payable in two years, instead of one. It was interlined over an obliteration, and I think in the handwriting of Mr. Delafield. Mr. Wm. Dela- field was to get me the other duplicate of the will from the bank. We then arranged for the execution. I was mistaken in saying that the witnesses were selected at Hell Gate. Those witnesses were arranged between Mr. 211 Delafield and myself, on the 14th, at an interview, which was, I think, at my office. The codicil was then engrossed on the blank sheets of each of the duplicate wills. The time for execution had been appointed to be on the 15th, in the afternoon. I think that was done between me and Mr. Delafield, on the 14th." (I. £ 408, '10.) On the 15th, " It was between four and five P. M., in the library of the house in Union square; Mr. Henry Parish and Mrs. Parish were there when I went in; whether Mr. Davis was there at the time, or came in shortly afterwards, I don't recollect, but he was there before any thing was done; I have no recollection whether Mr. Delafield was there or not." (I. £ 411, '12.) " I gave one of the codicils to Mr. Davis to compare." " I then proceeded to read the duplicate in my hands slowly, and stopping at every clause;" (I. £413;) " not meaning that I stopped at every item of stocks in the second section, but stopping at the end of the stocks in Mrs. Parish's name, and then again at the end of the stocks which afterwards followed in the second section." (I. £ 413,'14.) "Whether he made any sound or gesture at each or any stop, I confess I do not now recollect; he made no expression of dissent; of that I am positive." (I. £ 414.) "I asked him who should write his name, Mr. Davis or myself, to which he made a sign by bowing or nodding to me, indicating I should do it." (I. £ 416.) " I wrote his name as it appears upon the paper which I held in my hand, and laid it before him to make his mark, which he did." (I. £ 416.) " I steadied his hand, but I happen to re- collect a little incident, that one of the strokes of the cross had been made somewhat imperfectly, and he with the pen pressed it, as appears upon the mark itself." (I. £ 416, '17.) " I had indicated the precise spot by writing his name there; whether I put my 212 finger to the spot I cannot be positive, but 1 think that I did." (I. £ 419.) " He pointed or repeated the stroke; it struck my attention ; whether he had lifted his pen from the paper before he did it I cannot say." (I. f. 420.) As to the length of this interview, " I came not far from half-past four, and I think I left at my dinner hour, which was half-past five, my house being near." (I. £ 426.) 29th.—A Comment upon these Transactions, and Mr. Parish's Condition at the Making of the Second Codicil. Thus closes the execution of the second codicil; a protracted and somewhat complicated procedure, for the analysis of which no small amount of discernment and grasp of thought would seem to be requisite. " I had no doubt," says Mr. Lord, " and I have not any, of his entire capacity to understand what he was doing, and the effect of it. I will add, I was quite gratified at the better condition of his bodily health, and the intel- ligence with which he acted." (I. £ 34.) But to judge correctly how far Mr. Parish, under the circumstances in which he was then placed, was competent to see through the whole business brought before him, or judge of its bearings upon the absent as well as present individuals, who were likely to be affected by it, would require us carefully to collate the narrative of the whole proceeding, with the statements furnished by other witnesses in reference to Mr. Parish's general conduct, and to the consideration paid to his judgment by those who were usually surrounding him, both before and afterwards. It must not be overlooked, however, that in the conference connected with the making of this codicil, Mr. Parish, though possibly possessing some no- 213 tion of their object, was incapable of spontaneous action. We are sure that we see him during the whole affair devising nothing, originating nothing, modifying no- thing unequivocally by himself; and acting (if he can be said to have acted at all) only as he was acted upon by those who were about him. And if at the incipient stages of the proceeding he did understandingly refuse to cancel his will, yet he allowed some of its most essen- tial features afterwards to be obliterated in detail. Mistakes to the extent of over $90,000 could be made in the estimation of his property, and bequests to that amount over its apparent value could be made in his presence, and ostensibly under his authority, and other errors introduced among the estimates and calculations without his discovering error or discrepancy; funds which he is supposed to have assigned to charities, could be rendered more or less, or partially set aside, at the suggestion or disposition of other persons ; the name of his brother Daniel, even without a substitu- tion, could be stricken from the list of executors, and a legacy of $10,000 assigned to that brother in the will, could be erased from the list of legacies, simply at the suggestion of a lawyer whom Mr. Parish while in health had never employed; and that brother, be it remembered, the one with whom Mr. Henry Parish, while he had yet the power, had ever been on terms of the closest intimacy; and of whom, in the making of the original will, and while yet in the full possession of his faculties, he said, "had been his partner a long time, that they had made his money together." (I. £ 768, '9.) Mr. Parish's bodily health, as shown by the evidence of Dr. Delafield and others, may have at this time been as good as at any period subsequent to the paralytic seizure, but he was still under the constant charge of a sick nurse. The marketing scenes described by Case and others, were going on apparently up to July, 1855, 214 (I. £ 1889,) and the bedroom exposures on the ground- floor, described by James Clarke, not to speak of the repeated efforts to ignore the name of Daniel Parish in front of his office-door, and the efforts to exclude friends and visitors from the presence of Mr. Henry Parish, except under the supervision of Mrs. Parish or those immediately connected with her, or serving under her directions ; all transpired not merely after the making of the codicil in question, but even after the making of the third and last codicil, that of June 15th, 1854. To the documents of this latter date we must next direct our attention. 30th.—-The Making of the Third Codicil. " Prior to this, Mr. Henry Delafield had called on me to inquire what should be done with some accept- ances of the Buffalo and New York City Railroad Company belonging to Mr. Parish, which had been dishonored. That led to a call of Mr. and Mrs. Parish, in their carriage, at my office. I saw them in their carriage at the door, in the street; this led to my call- ing upon Mr. Parish, at his house in Union Square, on the morning of the 13th of June." (I. £ 428, '9.) " Mrs. Parish spoke to me something about the accept- ances, and some very short conversation on the subject took place; she then mentioned that Mr. Parish wished to make an alteration in his will, in relation to the last residuary clause, (i. e., the 13th clause;) I was en- gaged that day in a trial, and left without going into the subject further than making an appointment to call again that afternoon." (I. £ 429,'30.) "I met him in the afternoon of that day, after 4 P. M., at the library of the house in Union Square; Mr. and Mrs. Parish and myself were the only persons present, so far as my memory serves; as to the order of things, upon his attempting to communicate, it was suggested that 215 he wanted to change the residuary gift, and also wish- ed to make an alteration in the gifts to the children of his brothers, in the other (i. e. the 13th) residuary clause." (I. £ 434.) " I asked him if I should read the residuary clause, to which he answered' yes;' I read it and explained it, in relation to the effect of that clause upon lapsed legacies; my impression is that Mrs. Parish then suggested to him, or to me, I don't recollect which, that he wished to make her the residuary leg- atee, and he was asked if it was so, and he answered 'yes.' Then he expressed the wish to communicate by sound of inquiry, and it was through that the sug- gestions came from Mrs. Parish of his disposition to disturb these gifts to his brother's children, (i. e. the 12th clause ;) whether it was the first suggestion or not, I cannot say, but it was acquiesced in by him when it was made, by expressing ' yes.'" (I. £ 438, '9.) " The par- ticular alteration, if any was specified in language, I only remember inferentially,from my remarks which followed it. I remember that I dissuaded from it,and am therefore confident that it was expressed to be an alteration un- favorable to those children's gifts." (I. f. 442.) In regard to cutting off the children's gifts, " My advice, I think, was acquiesced in, and the matter did not pro- ceed to particulars." (I. £ 443.) "I said to him that that would be harsh, and making the difference be- tween them to bear upon the children." (I. £ 444.) " I do not remember the precise occurrence on his part in reply to me; he forbore to make the sign of in- quiry, and indicated a hesitating acquiescence by some sign or sound which I cannot now remember." (I. f. 445.) In the next place, " I said I would draw up the form of a codicil and submit it, and I think I promised to do so the next day." (I. £ 456.) "I drafted the codicil which was executed on the 15th of June, and enclosed it in an envelope, and left it at Mr. 216 Parish's house, in Union Square, or gave it to Mr. Delafield, I don't recollect which, and I proposed to meet them th-*. next morning. I proposed it on the 14th." (I. £ 457.) " I met him on the morning of the 15th at Ins house in Union Square, in the library-room, with his wife. 1 do not recollect the presence of any other person." (I. £ 457,'8.) "Upon the first opening of the matter of business, I asked, I think, if I should read the draft codicil, to which he answered 'yes.' I read it. I perceived it was an absolute revocation, by virtue of a direct gift to Mrs. Parish. The deaths of two of her brothers, before Mr. Parish, whose life had been con- sidered more precarious than that of either, had caused me to reflect upon the possibility of Mrs. Parish's death before her husband. I then suggested the introduction of this clause, 'in case she shall survive me, I revoke the thirteenth article of my above-written will,' which I then wrote in the draft and read to him. I have the impression, also, that I explained to him the purpose of it. Having then completed the reading of the draft to him, I asked if he approved of it. He an- swered, ' yes.' Then the subject of attesting it was ta- ken up, and a time appointed to execute it in the after- noon. This was in the presence and hearing of Mr. Parish, but whether he made any sound or sign about it I do not remember. Something was said about the witnesses, and Mr. John Ward was the person whom we agreed to invite. I was to have the codicil en- grossed in duplicate upon the blank sheets of the will, and then I came away." (I. £ 457, '61.) As to the length of this interview, " it could not have been an hour." (I. £ 461.) As to the next interview, "it was about six o'clock in the afternoon." (I. £ 463.) " On that occasion I met Mr. Ward and Mr. Henry Parish at his house in Union Square. Mrs. Parish was pres- 217 ent; this was in the library; nobody else was present that I recollect." (I. £ 465.) "The opening of the matter of business was that I said, I have got the two codicils, and I asked Mr. Parish if I should read them to him and proceed to have the same executed, to which he answered ' yes.' I then gave one to Mr. Ward for him to examine, as I read the other aloud to Mr. Parish. I did read it aloud and slowly for the pur- pose of his understanding it, and asked him if he ap- proved it, or whether that was his mind or wish in some form of expression; he answered ' yes.' I then asked him if I should sign it for him, to which he answered ' yes.' I then wrote his name where it appears upon the codicil, and asked him if he would sign it, which he proceeded to do; I have no recollection at this time whether I assisted him in making his mark or not; he then did sign his mark to the name I had written." (I. £ 463-'6.) The process of witnessing was next ac- complished, the interview lasting "probably not over half an hour." (I. £468.) 30th.—Mr. Parish's Condition at the Making of the third Codicil. Before closing this subject of the codicils, it is proper to remark that Mr. Lord, from first to last, re- sorted to no criterion to test Mr. Parish's competency to think for himself, independently of the prompting and suggestions of other persons. And when asked, " Did you ever, at any time during the life of Mr. Parish, advise any step or measure to get from him by any means or device, any writing of his own to indicate his assent to any thing, or his knowledge in relation to any subject?" Mr. Lord replies, "I never did." (I. £ 510.) 28 218 As to the bodily health of Mr. Parish, at the period of executing the third codicil, we have Dr. Delafield's opinion that Mr. Parish's health continued to improve up to the close of the year 1854, if not later, (I. £ 2072,) and that after this period he became more heavy, less inclined to move, more inclined to sleep, but still in fair, good general health." (I. £ 2073.) The Rev. Dr. Taylor speaks of his growing heavy and weaker than he had been; of his no longer looking at his Prayer Book, and of his finding it incon- venient to stand during the communion service, at an earlier period than this; " I should say it was eighteen months or two years before his death." (I. £ 3406.) And Mr. Kernochan, " thought he had been failing for at least the last year of his life." But as early as De- cember, 1854, according to the testimony of Clarke, then the nurse of Mr. Parish, he had already ceased to walk out of doors at all, even by the support of his attendant, except on stepping to and from his carriage." (I. £ 738, '9.) And according to the evidence of Sam- mis, Mr. Parish's feet and ankles began to swell, show- ing a dropsical tendency and a failing of bodily health about a year before taking his measure for the first pair of shoes, (III. £ 1628;) and this pair of shoes was made about a year before Mr. Parish's death, (III. £ 1623,) showing that the tendency to dropsical effu- sions had existed for about two years. Dr. Markoe also alludes to the disease of the lower extremities, but without fixing any exact period. The last codicil, as already shown, was executed June 15th, 1854, and Mr. Parish survived the transaction somewhat over a year and eight months, dying on the 2d of March, 1856. 219 PART III. 31st.—The Question as toMr. Parish's Competency for Executing the Codicils. After the general review of the evidence which we have now taken, and which would seem to be essential to a just appreciation of Mrs. Parish's mental as well as physical condition ; and after having in the progress of this review noticed as carefully and as impartially as possible the circumstances under which he was placed, and the influences surrounding him, from the commencement of his attack to the close of his life, and having also stated every fact of importance brought to light in connection with the making of the three codi- cils to his will; the question presents itself to us; Was Mr. Parish at any time subsequent to July, 1849, com- petent to devise and execute a will or a codicil to his will ? This question we must now proceed to consider. 32d.—The Question of Competency Propounded. Let us observe, then, in the first place, that the complications of disease with which Mr. Parish was overpowered from the moment of the attack in July, 1849, had their origin in the brain. The primary disease of this organ must have been long in progress, probably for years, before the open manifestation of its existence as an organic affection. It may not have 220 reached its utmost development even at the time of the paralytic seizure; but, as afterwards evinced by the persistent recurrences of convulsions, it probably continued its ravages within the brain, not always, however, with equal or uniform progress, up to the period of approaching dissolution. a. Authoritiesin Support of this.—The intimate re- lation and common dependence of vertigo, apoplexy, hemiplegia, and convulsions, as they existed in Mr. Parish's case, is a fact in pathology not now to be pointed out for the first time. It has always been un- derstood, as may be shown from the records of the medical profession in ancient as well as in modern times. " Vertigoes," says Galen, " approach very near in their nature to the falling sickness, and that which we call apoplexy, so as to precede both the one and the other."* The connection is ably traced in the writings of Bonetus f and Morgagni J, and is too well understood at the present day to require any formal comment for its support. § b. Anatomical Features of the Case deducible from the Symptoms.—That changes in the organic structure of the brain lay at the foundation of all Mr. Parish's ailments and disabilities, might have been anticipated * Opera Oaleni, (Kuhn's edition,) vol. xvii. part II. p. 611. Where, in Aphorism, Comment. 3-17, we read as follows: "Quid autem de vertiginibus quoque dicendum? Usee namque turn epilepsias turn apoplexiae proximo sunt. Uingus enim est tenebricosa ver- tigo qua? fit quum humor in capite movetur, ideoque epilepsiarn et a o- plexiarn precedit." t Sepulchretum, lib. 1., passim. I De Sedibm et Cavsis Morborum, vol. I., lib. 1., passim. § See Romberg on Diseases of the Nervous System, vol. II., chap, xxxii. • Sir Henry Ealford, Bart., M.D., on the influence of some of the dis- eases of the body on the mind, in his Essays and Orations, Essay V. Cook on Nervous Diseases, Appendix to Vol. II. p. 77. Copeland on Palsy and Apoplexy, (Philadelphia; reprint, 1850,) pp. 163, 175. 221 from his family predisposition to apoplexy, and also in some measure from their tendency to loss of vision ; and that such changes really existed, is sufficiently ap- parent from the history and progress of the case itself, as well as from the admissions of the medical attend- ants. The early attacks of vertigo, or determinations of blood to the head ; the recurring turns of unconscious- ness or partial apoplexy, commencing as far back as 1850, two years before the European tour; the more alarming seizure while abroad ; the similar seizure re- called to Dr. Delafield's recollection, at a later date; the overwhelming attack of July, 1849, by which Mr. Parish was permanently disabled from all the active occupations of life, and isolated from society at large; the paralytic and other symptoms that followed in the train of this; the epileptic seizures; the periodical paroxysms of excitement and ill temper, followed by periods of passive indifference, showing a total change from his former equable temper and disposition; the loss of voluntary power throughout the right half of the body and limbs ; the loss of control over the natural evacuations ; the inability to converse, while still retain- ing to some extent the power of enunciation; the inabil- ity to write while still able to see, and to use the left hand freely for supplying his physical wants; the fail- ure to employ artificial signs for the expression of dis- tinct thought,—not to speak of numerous other minor features of the case,—all readily and naturally resolve themselves into the mere manifestations of one contin- uous disease within the brain; which, however it may have begun, must, as early as the seizure of 1849, have already assumed an organic character. By this view of the case, the numerous ailments and disabilities of Mr. Parish, not already otherwise accounted for, are easily understood; and they are not to be explained either 222 rationally, or in accordance with the established prin- ciples of medical science, on any other hypothesis. c. Organic Disease of the Brain, as Affecting the Intellect.—There are instances in which very limited or- ganic changes in the brain lead only to partial loss of function. This loss, commensurate with the internal dis- turbance, commencing imperceptibly, and progressing slowly, may for a season be compatible with mental ca- pacity for many of the ordinary duties and responsi- bilities of life. The progress of disease in this respect, is like the progress of age, often so insidious as to escape our notice, until it at length declares itself clearly, and unmistakably to the most casual observer.* But an organic disease of the brain sufficient to produce the disabilities under which Mr. Parish labored, in and subsequent to July, 1849, must have been wide-spread within the skull, and not limited to a small portion of the cerebral mass. Its effect must have been exercised upon the mind, as well as upon the body. For the brain is the organ of thought and intellectual percep- tion ; and its integrity is as essential to a thorough and unembarrassed exercise of the intellectual functions as of the mere animal or physical powers of the body.f 34th.—Summary View of the Organization and Functions of the Nervous System. The view of Mr. Parish's case now stated, I am aware, is not in strict accordance with opinions ex- pressed by some of the medical witnesses. It becomes, therefore, necessary to examine these, so far, at least, as they have a bearing upon the facts and principles of * Sir Ilenry Holland's Mental Physiology. Chapter VIII. ; On the Memory, as affected by Age and Disease. ,_~ t Carpenter's Human Physiology. § 228 et seq. 223 medical science. But before doing so, it may not be amiss to give some brief general description of the or- ganization, distribution, and functions of the nervous system in man, so as to render the terms which we may have to employ intelligible, and the subject itself com- prehensible to all. The various actions proper to the living body in its internal as well as its external relations, are under the direct control of the nervous system. This consists of the brain, the spinal cord, and the nerves proper, which are connected with these, or which proceed from them to every other part of the body. The nervous system, which is the great source of living action throughout the whole frame, is itself, in turn, kept in healthful op- eration, through the support which it derives from its due and equable supply of arterial blood. The nerves proper are small white cords or fila- ments, serving, like electrical wires, for conducting the nervous influence of the brain and spinal cord to every organ, and every set of organs, in the body; and for bringing back impressions, healthy or unhealthy, from the various organs of the body to the common centres of the nervous power. The brain and spinal cord are protected from ex- ternal injury by bones and other coverings. The brain occupies the cavity of the skull; and the spinal cord, which is but a prolongation from the brain, passes downward through the centre cf the bones of the back, from the great opening in the base of the skull, to the bottom of the spinal column. The configuration of the cavity of the skull is ovoidal; except at its base, where the general ovoidal shape is interrupted, anteriorly, by the inner projections which correspond to the upper part of the sockets of the eye-balls ; and again, by two lateral projections which correspond with the bones of the ears. These irregularities at the base of the skull 224 are further increased by a central projection in front of the great opening at the base of the skull through which the spinal cord descends, and by other much smaller openings for the passage of nerves and blood- vessels, mostly in front of this. These irregularities at the base of the skull give it the appearance of three distinct compartments, which leave their corresponding inpressions on the base of the brain itself, and justify the divisions of the cerebrum into the anterior, middle, and posterior lobes. Within this bony covering, the brain and spinal cord have three other envelopes, called meninges. The outermost of these is the dura mater, which is an un- yielding membrane, as thick and firm as parchment. The next is the*arachnoid, a thin, transparent mem- brane, thinner and smoother than the finest tissue pa- per, and taking its name from its resemblance to a spider's web. The innermost is the pia mater, a thin cellular mesh, as delicate as the preceding, embracing the substance of the brain and spinal cord very closely, dipping down into all their depressions, and extending into all the cavities of the brain. Upon the pia mater the bloodvessels of the brain ramify before passing into its proper substance for supplying it with nutriment. Within the skull there are three projections from the dura mater, which serve as partitions between dif- ferent parts of the brain. The first of these is the falx cerebri, extending from the roof of the skull along its whole middle line from before backwards, projecting downwards like a curtain, in a perpendicular direction, and dividing the upper portions of the cerebrum, but not through their whole extent, into two lateral halves or hemispheres. The falx cerebri terminates posterior- ly on the upper surface of another projection, called the tentorium, which is horizontal, extending from side to side, and from about the upper level of the bones of 225 the ears, backwards to the occiput. This tentorium overlies that part of the brain which is called the cere- bellum, and over it rest the posterior lobes of the cere- brum. Projecting downwards from the lower surface of the tentorium,'^, the falx cerebelli, which seems to be the continuation of the falx cerebri, and serves partial- ly to divide the cerebellum into two lateral halves. The large veins or sinuses of the brain, are protected by running within the folds of these fibrous envelopes. The encephalon, or brain proper, of an adult man, weighs about fifty ounces avoirdupois, or a little over three pounds. A large man has not a brain large, in proportion to the greater size of his body. But men of great intellectual power usually exceed others in the size of their brain, mainly by the greater development of the upper portions. Cuvier's brain is said to have weighed but little short of five pounds troy, and that of Dupuytren hardly an ounce and a half less than this. On the other hand, natural idiots have brains below the average weight. Tiedemann found the brain of an idiot forty years old weighing only one pound eight and a half ounces troy; and another, in an idiot forty years old, weighing one pound eleven and a half ounces. In advanced life, when the intellectual facul- ties fail, the brain undergoes a corresponding diminu- tion, and the space left by the wasting is filled up with watery fluid. The great weight of the brain in man depends mainly on the great development of the upper and lateral portions, which constitute what are called the cerebral hemispheres. These do not exist at all in many of the lower animals. They are rudimentary in birds and quadrupeds, and increase in size among these only as their instinctive faculties increase in number, and approximate in character to the intellectual pow- ers, which are proper to man himself. These hemis- pheres occupy nearly eight-tenths of the whole weight. 29 22G The cerebellum is common to man, and all the animals possessing a spinal column. It lies in the lower and posterior part of the skull, in a compartment by itself. Its function appears to be the co-ordination of muscular action, by bringing into harmonious operation all the nerves that influence muscular movements. The cer- ebellum weighs from an eighth to a tenth of the whole. The me Julia oblongata, and the sensory gan- glions, which make up the remainder, lie at the central portion of the base of the brain, and bring it more immediately into relation with the spinal cord. The medulla oblongata, with the several sentient ganglia associated with it, is the special portion of the brain connected with the organs of external sense; the nerves of smell, of vision, of hearing,. of taste, have their origin from these parts; as also certain nerves of motion, and particularly those of touch and of common sensation, which supply the sense of feeling to every portion of the body. These sensory ganglia, with the medulla oblongata and the spinal cord, constitute the cerebrospinal axis, which is common to almost every living animal. And even in those where the spinal cord is only rudimentary, the ganglia exist, and, inde- pendent of any mental influence, enable these animals to execute all their instinctive actions. From these facts it is clearly ascertained that, in man, these several portions of the brain are subservient to the intellect only so far as they minister to the actions of the cere- bral hemispheres, which are superimposed upon them, and which are the special organs of intellectual action. The proper substance of the brain and spinal cord is a pulpy mass, in some places of an opaque white, and in others of an ashy-gray color. The white is called the medullary, and sometimes the fibrous and the tubular portion ; the gray, from its color, is called the cineritious, and sometimes the granular, or vesicu- 227 lar portion; and where it lies external to the white, or more superficially, as it does over the hemispheres of the cerebrum and cerebellum, it is called the corti- cal substance. This is the part in which the special power of the several nervous or ganglionic centres is generated, or within which that special power resides. The white or fibrous portion is subservient to the other, and appears to act as the conducting medium from one nervous centre to another, or between the nerves and their several centres of nervous influence. The proper apparatus, then, of every nervous centre, consists first, and most essentially, of its cineritious substance ; secondly, of its white or fibrous substance; and lastly, of its nerve trunks, or nerves properly so called; which, as they proceed to the ganglia, are called the afferent, or concentric; and as they issue from the ganglia, are called the efferent, or divergent. Now, as the nervous centres in the spinal cord are, when unassociated in action with the sentient ganglia, merely automatic, their actions are called excito-motory, or simply reflex actions; and may take place indepen- dent of sensation or consciousness, though they are in some respects under the control of the sentient ganglia; and, through them, under the influence of the will. The actions that take place exclusively among the sentient ganglia, where the cerebral hemispheres are not in operation, are called excito-sensory, and these too may take place under circumstances where the intellect is, for the time, completely in abeyance. The cerebellum being superimposed upon the me- dulla oblongata, holds a direct communication with the spinal cord, and has but a very slight connection with the higher portions of the encephalon, and we are justified in believing, from these and other circum- stances, that its functions are mainly associated with muscular movements, and that it is in no way very 228 active in the operations of the intellect. The proper centre of intellectual power is admitted, by the physi- ologists of the present clay, to be the cortical or super- ficial portion of the cerebral hemispheres. But as these are superimposed upon the sensory ganglia, they can operate only indirectly through these in influencing the actions of the body in its relations to the world around it. " We find," says Carpenter, "strong physi- ological, as well as anatomical, ground for the belief that the cerebrum has no communication with the external world, otherwise than by its connection with the sensori-motor apparatus ; and that even the move- ments, which are usually designated as ' voluntary,' are only so as regards their source, the stimulus which calls the muscles into contraction being, even then, issued from the cranio-spinal [cerebro-spinal] axis, as it is in the movements prompted by the reflex stimulation of an external impression." * Again, superimposed upon the terminal nerves of the cerebro-spinal axis, or associated with these, there is another system of ganglionic centres, with which the cerebral hemispheres have no direct relation, and over which the will, or consciousness, has no cogni- zance—these are the sympathetic ganglia • and the nerves proceeding from them are ranged in front of the spinal column immediately behind the larger viscera of the abdomen and the chest; their functions are to reinforce the power of the cerebro-spinal nerves, and to preside over the processes of vegetative life. They may be in healthful operation though the functions of the cerebrum are permanently arrested. These differ from the other nervous centres in not hav- ing a symmetrical arrangement; that is to say, in not having the portions on the one side to correspond with those on the other. * Carpenter's Principles of Human Physiology, § 466, p. 438. 229 But though each of the great centres of nervous force has its own special functions, yet the action of the whole is somewhat regulated by the general amount of nervous power, throughout the body, and an ex- haustion of, or over-draught upon, that power at any point when very great, will lead to a depression of nervous energy at every other point. Great bodily fatigue, by exhausting for a time the nervous force from the excito-motory apparatus, will interfere with the activity of thought. Excessive pain, by exhaust- ing the excito-sensory apparatus, may operate in the same way, and any disease of sufficient gravity per- manently to diminish the normal amount of nervous powTer generated in the S37stem, will permanently crip- ple or enfeeble the functions of both mind and body. An excessive exhaustion of nervous power, how- ever, in any of the organs of sense, may arrest the functions of that organ before the supply is very mate- rially influenced in other parts. The eye may become amaurotic, or the ear permanently deaf, from over- action or abuse, without impairing the general amount of nervous force ; but an extensive scald, or the crush- in <* injury of a limb, may leave the patient utterly un- conscious of pain ; and while he is yet able to speak, to see to hear, and to describe every circumstance con- nected with the accident, he may be totally indifferent to the wounds inflicted upon his injured member by the surgeon's knife. Moderate, regular, and long- continued use of an organ, may quicken and improve its functions; and by such exercise the force at the nervous centre supplying it, may be correspondingly augmented; but on the other hand, the loss of function in any organ will sooner or later lead to a correspond- in^ loss of force, and sometimes to complete wasting, in 230 the ganglionic centres, as well as in the nerves, through which it is supplied. The Spinal Cord is to the brain as 1 to 40 ; it is in shape somewhat cylindrical, and has along its whole course an anterior and a posterior fissure, which divides it into two symmetrical lateral halves; and these again are subdivided, in function rather than to the eye, into the anterior and posterior columns. The cineritous portion of the cord is central. In its passage clown- wards the cord sends off at every interspace between the vertebral bones, anterior or motory, and posterior or sensory nervous roots on either side; and these roots immediately afterwards coalesce into right and left nervous trunks, to be distributed to their respec- tive sides of the body and limbs. There are twenty- four pairs of these spinal nerves passing from between the vertebral bones, besides a few others lower down, which pass through the terminal openings in the sacrum, or thick bone behind the hips. But though the posterior roots of the spinal nerves are sentient, they are so only in virtue of their commu- nication (indirectly through the central portion, or through the anterior columns in the cord) with the sentient ganglia within the brain. When the spinal nerves act only through the influence of their own proper central gray substance in the cord, their action is simply excito-motory, and unattended with conscious sensation. A common fowl, with its head severed by a sudden wound from its body, will flutter and jerk about as if convulsed, and continue to do so for some minutes before it dies. A frog, lizard, or other cold- blooded animal, treated in the same way, may live for hours and days; and as long as life is retained, if touched or impressed in any manner, it will retract the muscles and move the limbs that happen to be irritated although the seat of sensation has been annihilated. 231 Excito-motory actions of this sort are indicative of life, but they have nothing more to do with sen-ation or volition than the closure of the leaves of the mimosa or sensitive plant, which follows the touch of the finger or the weight of an insect upon them. It is in this way that irritation, whether healthy or diseased in any organ or set of organs, excites corresponding action, in- dependently of real sensation, in other organs or sets of orsrans more or less remote from them through their common centre of reflex influence in the spiual cord- An overloaded stomach may thus excite irritation in the diaphragm, and give rise to hiccough ; or may bring into play other muscles and excite vomiting: or, where the irritation is still more diffused, may give rise to convulsions; and so of other organs, and actions, over which the will has no control. The medulla oblongata is a prolongation from the spinal cord upward. It is scarcely two inches in length, and is thickest at its upper part. It rests on an inclin- ed plane or shelf of bone ascending obliquely forward and upward, in front of the great opening at the base of the skull. It has, like the cord, its anterior and its posterior fissure [partially dividing it into two sym- metrical halves, lying side by side; and each of these is again marked by slighter depressions, dividing it into three parts. Of these, the posterior is called, from its fancied resemblance to a rope, the rest form body, (corpus rest if or me,) the ascending fibres of which are continuous with those from the posterior column of the spinal cord The anterior, from its fancied resemblance to an inverted pyramid, is called the pyramidal body, (corpus pyramidal.) and the fibres of this part are continuous with those from the anterior column of the spinal cord. The middle portion, rather smaller than the other two, and occupying only the upper portion of the medulla oblongata, has the oval shape of an 232 olive, and is hence called the olivary body, (corpus olivare.) The fibres of this portion of the medulla ob- longata are continuous with those of the anterior col- umns of the spinal cord. These several bundles of fibres constituting the medulla oblongata, proceed from it, at its upper ter- mination, to distinct portions of the cerebral mass above them. But before their ultimate separation, the medulla oblongata seems to lose itself in, or to be em- braced by, a thick nodule of transverse nervous fibres, which constitute the nodus cerebri, tuber annulare, or pons varolii. This body after partly embracing the several bundles of the medulla oblongata, and send- ing its fibres in between them, ultimately spreads out backwards to form the crura cerebelli, and lose itself in the cerebellum, serving as a bridge of connection be- tween the right and left halves of the cerebellum with the anterior columns of the medulla oblongata. To the cerebellum are also sent the fibres of the two resti- form bodies, so that the cerebellum has two distinct connections with the medulla oblongata on either side. But deep at the bottom of the posterior cleft of the medulla oblongata, portions of each restiform body constitute what are called the posterior pyramids, which send their fibres upward and forward through the pons varolii, decussating, or crossing each other, as they ascend. The olivary bodies send most of their fibres directly upward, to terminate immediately over the top of the medulla oblongata in four little eminences, not much larger than four small peas, one above the other on each side, and known as the tubercula quadrigemina. A few fibres, however, from the olivary bodies extend still further forward, and can be traced into the other sentient ganglia in front of them. The pyramidal bodies, corresponding both to the 233 motor and to the sentient portions of the spinal cord, stand in the relation of roots to the cerebral hemis- pheres ; but only indirectly so, through their inter- mediate connection with the censory ganglia in front of and above them. But they also send a few fibres backwards to mingle writh those of the restiform bodies as these proceed towards the cerebellum, and thus the corpora pyramidalia serve as the general point of union for almost every other portion of the cerebral masses. Again, at the bottom of the fissure between these two pyramids there are bundles of fibres—four or five bun- dles from either side—crossing over obliquely to the side opposite. These decussations partly fill up the fissure here, and mark the point at which the medulla oblongata loses itself in the spinal cord. The decussation of these motory fibres of the an- terior pyramids with that of the sentient fibres of the posterior pyramids already mentioned, has an impor- tant bearing; and by it we are able to understand how disease or injury in one side of the brain gives rise to disturbance, or to arrest of function, in the opposite side of the body. The ascending fibres of the anterior pyramids, after emerging over the top of the nodus cerebri, proceed upwards and forwards for about three-fourths of an inch, where, incorporating with new deposits of cineri- tious matter, and with some fibres from the posterior pyramids, they constitute the crura cerebri. These are two cylindrical-shaped bodies at the base of the brain, lying nearly side by side posteriorly, but slight- ly diverging from each other anteriorly, and contain- ing a track of sentient as well as of motor fibres. Proceeding still further upward and forward, with an outward divergence, the fibres from the pyramids next expand out, combining with the proper substance of two other ganglionic centres, and forming what are 30 234 called the thalami optici. These two bodies, of an oblong ovoidal shape, also lie side by side, but hardly so as to touch each other at their bulging internal edges. They have, however, stretching across from one to the other, twro small cross-bands, or commissures, by which they are brought into direct relation with each other. Diverging still further forward and outward, the fibres from the pyramids ultimately terminate in two ganglionic bodies, which, from the striated appearance of their white and gray substance, are called the cor- pora striata. These are somewhat pear-shaped, their broadest part projecting forward and inward, where a transverse band or commissure extends from the one to the other; and their apex or narrowest portion ranging backward and outward along the outer bor- der of the thalamus. The nervous trunks proceeding from these gan- glionic centres, and finding exit through openings along the base of the skull, between the root of the nose and the great posterior opening of the spinal cord, are arranged into nine pairs. The first pair are the olfactory, or nerves of smell. These originate in front of all the others in a small ganglionic centre of their own at the point of junction between the anterior and middle lobes of the brain ; but they have an indi- rect communion further back with the inner surfaces of the thalami. The second pair are the optic, or nerves of vision, which pass to the eye through the bottom of the orbits or sockets of the eye-balls. These, poste- riorly, are lost in the tubercula quadrigemina, though their nervous centre through these bodies, is in the gray matter of the olivary bodies in the central portion of the medulla oblongata. The third, fourth, and sixth pairs, are all distributed to the muscles of the eye, and leave the skull through a cleft or opening at the bot- 235 torn of the orbit. They are minute nervous trunks, originating from the motor track at and above the up- per limits of the medulla oblongata; but quitting the substance of the brain at different points. The fifth pair belongs to the general system of spinal, rather than cerebral nerves, having each a motor, and a sen- sitive root, from the motor and sensitive tracks of the medulla oblongata; and quitting the skull, by three separate openings, to be distributed to the face, fore- head, and teeth, to parts within the orbit and nostrils ; and one branch, the gestatory, is the proper nerve of taste in the tongue. The trunk of the seventh pair in- cludes two distinct nerves,—one the auditory, or nerve of hearing, originates in a ganglionic centre behind the medulla oblongata near the posterior pyramids; the other, the facial, comes from between the restiform and olivary bodies just below the pons varolii, and quits the skull through a small opening behind each ear, to be distributed to the muscles of the cheeks. The eighth pair includes three distinct nerves, which all quit the skull together. The lowest of these, properly speak- ing, is a spinal nerve, and is sent to the muscles at the root of the neck; this is the spinal accessory. The uppermost, or glosso pharyngeal, comes off from the medulla oblongata just below the facial, and is destined to parts about the throat and posterior portion of the tongue. The middle of the three is the vagus or pneumo-gastric, an important nerve, which distributes its branches to the larynx, or apparatus at the top of the wind-pipe in which the voice is formed, and to the viscera of the chest and abdomen. The last, or ninth pair, are the hypoglossal, which leave the medulla ob- longata immediately below the roots of the pneumo- gastric, and are destined to the muscles of the tongue and other parts lowr down on the neck. But the points of emergence of these several nerves from the medulla 236 oblongata and parts contiguous, do not always indi- cate their nervous centres: those for sensation being traceable to different points within the sentient, and those for motion to different points within the motor tracks; and these tracts, as already indicated, extend far forward; the sentient terminating anteriorly in the thalami; and the motor, in the corpora striata; and in these two sets of ganglia we have, in all proba- bility, the focal influence regulating voluntary motion, and common sensation, throughout every organ of the body- The functions of the several ganglionic centres above described, are in some measure ascertained from our knowledge of the uses of the nerves derived from them. These nerves have no immediate connection with the cerebral hemispheres, except through the medium of these ganglia, which stand, as it were, internunciary between the proper organ of the intellect and its out- posts—the proper organs of external sensation, special and general. Through the agency of these ganglia, are executed all the excito-sensory actions, which are strictly instinctive, and which are performed with or without the cognizance of the mind; and even more accurately and certainly among the lower animals, where there as yet exists no cerebrum, or only the traces of a cerel irum, than in man himself. And that many of what appear to be volitional acts in man, are merely excito-sensory, and of an instinctive character, we have the most sufficient evidence. The fly lighting on the hand or foot of the sleeping child, causes an in- voluntary contraction of the limbs without exciting consciousness. A ray of light falling upon the shut eyelids excites a wrinkle of the eyebrows; the impres- sion of the nipple on the lips of the new-born infant, throws the whole muscular apparatus of the mouth and fauces into active operation. We shrink from danger, 237 or from an offending object; we cry out to warn others to avoid it, or wre grasp hurriedly at the nearest ob- ject offering protection or relief, before we have time to give expression to articulate speech, and before we have time for either reason or reflection. In these and a thousand other similar actions, ,our impulses and movements, even to the expression of our countenance, are strictly excito-sensory and instinctive. So also are at times the actions of the somnambulist; though in his movements the stimulus to action, while it is always involuntary, may be as readily excited in the ganglia of the sensori-motor apparatus through impressions reach- ing these from the cerebrum, as through those which are communicated from without. The Cerebral Hemispheres, as already remarked, are implanted directly upon the sensory ganglia. The di- vergent fibres from which they take their origin, spring from the outer and lower borders of the thalami and corpora striata, and extend thence downward, forward, backward, laterally outward, and then upward, to the arch of the skull, spreading out over the upper surfaces of the ganglia already named, and filling the whole re- maining portion of the cavity of the skull. The various portions of the hemispheres, with their white or medul- lary substance innermost, and their granular substance the most superficial, are thrown into innumerable folds, or as they are called, convolutions, with intervening deep depressions, for giving greater surface to the lay- ers of cortical substance. As the hemispheres approxi- mate each other along the upper line of the skull, their fibres dip downwards along the sides of the falx cere- bri, and on reaching its lower edge, they unite together by a transverse horizontal band of white substance called the corpus callosum. This is the great middle commissure of the hemispheres; narrow transversely, but about three inches long; uniting the hemispheres 238 throughout more than half their length, but leaving the cleft between them perfect for a space both anteri- orly and posteriorly. The anterior edge of the cor- pus callosum, which is the thickest, loses itself inferi- orly by prolongations which reach the base of the hemispheres in front of and under the corpora striata. Its posterior edge turns down to become the Fornix, which is a thin plate doubling forwards under the cor- pus callosum, and of a triangular arching shape; broadest posteriorly, where it partly covers the inner surface of each of the thalami optici; and terminating anteriorly in two delicate pedicles, which pass through a narrow space downwards to the base of the brain. Where the cerebral hemispheres double over the upper surface of the corpora striata and thalami, they leave an interspace constituting an irregular-shaped longitudinal cavity on either side. These cavities are the Lateral Ventricles. They extend through the whole length of the middle lobes, and through a por- tion of the anterior and posterior lobes of both hemis- pheres. They approximate towards each other anteri- orly, where they are separated only by a thin double perpendicular layer, which projects from the anterior border of the corpus callosum, and which is called the septum lucidum. Posteriorly the floors of the Lateral Ventricles are partly covered in by the thin expansion of the fornix, under which, between the two thalami, lies a narrow cleft or cavity running perpendicularly from behind forwards, which is the Third Ventricle. This, by means of a minute opening, communicates with the lateral ventricles above on either side of it; and again, posteriorly by a narrow opening which runs be- neath the corpora quadrigemina,—it communicates with another cavity, called the Fourth Ventricle, which lies between the cerebellum and the posterior or upper ace of the medulla oblongata. 239 The Commissures or bands of union between the different portions of the brain, the most of which have already been noticed, are either transverse, uniting the halves of the brain on the right and left, or they are longitudinal, and uniting the several portions of the same side, antero-posteriorly. Thus, without again referring to the decussating fibres of the pyramids, as transverse ; or to the whole of the three great bands of the medulla oblongata, as longitudinal fibres, we have the nodus cerebri or transverse commissure of the cere- bellum. We have crossing at the base of the brain thin lamellae, which spread out between the ganglia of either side, closing in the cavity of the third ventricle; then the small commissures that cross this ventricle, from one thalamus and one corpus striatum, to the other ; and over all these the great commissure of the hemispheres, the corpus callosum. These constitute the series of transverse commissures. Among the longitudinal we have a band of fibres extending lengthwise over the outer edges of the corpus callosum, uniting the anteri- or, middle, and posterior portions of either hemisphere. We have below the corpus callosum, the thin expansions of the fornix, which may be said to unite the functions of both a transverse and a longitudinal commissure; and, behind this, we have the minute projections from the tubercula quadrigemina, which proceed forward to the thalami; and again the valve of Vieussens, which serves as the roof the fourth ventricle, and connects the cerebellum with the tubercula quadrigemina. These several commissures bind together the different divi- sions of the cerebral mass ; uniting its various fibres and ganglionic centres so intimately that, in the perform- ance of their respective functions, none of these parts can be very seriously affected without implicating to a greater or less extent, every other part. The difficulty of analyzing the symptoms of disease in any one part 240 of the brain, it may now be seen, is no less the result of our imperfect knowledge of all the functions of the part, than of the disturbances which may be excited by it in other portions of the encephalon. But by the careful study of development in the ascending orders of the animal kingdom, and by tracing the general dis- tribution of the white fibres from and to the several centres of nervous force, we can arrive at something like a clear perception of the general course of nervous influence, from the centre to the periphery of the whole nervous system. We have no anatomical reason for classifying the intellectual powers ; but the source of in- tellectual action is in the convolutions of the cerebral hemispheres. From these the nervous power is propa- gated to the corpora striata, and thalami optici, to the crura cerebri, and thence to the pyramids of the medulla oblongata; from which, by the crossing of the fibres, it will be conveyed to the opposite halves of the spinal cord, and through the nerves springing from these to the terminal extremities of these throughout the body. This being the route along which volition is propagated to the muscles, and common sensibility to every sentient organ, it is easy to understand how an apo- plectic clot or morbid deposit in any part of this track within the skull, by rupturing, compressing, or other- wise disturbing the fibres among which it lies, or the ganglia within which it is deposited, may be followed by paralysis; and how the same result may follow where a state of softening among the fibres or their ganglia, has interrupted their continuity, or destroyed their vital powers. The cerebellum being the source of power for its own special uses, that force will be propagated from the gray matter of its numerous lamel- lae, along the fibres of the restiform bodies and of the crura cerebelli to the posterior columns of the spinal cord. And here, as in the fibres converging from the 241 cerebrum, if the seat of disease be in the white matter, the channels along which the nervous power descends will be interrupted; if it be in the gray matter, the sources of nervous power will be impaired or annihi- lated. "In all cases the extent of the paralysis will be proportioned to that of the lesion, and for the most ob- vious reasons. The course of upward influence to the cerebrum from without, through the ganglionic centres of the special organs of the senses, may vary somewhat in ac- cordance with the particular organ of sense that hap- pens to be in action, but in the general direction of these impressions from the ganglionic centres upwards the course will be the reverse of that which communi- cates the motive power to the muscles. In apoplec- tic and other diseases within the brain, though sensa- tion as well as motion may be paralyzed in the limbs and other parts of the body, yet the loss of motive power is much more frequent, and usually much more marked, than that of sensation. An injury or disease within the brain, producing total loss of both sensation and motive power, is usually of the gravest character. And the loss of motion may be complete whilst impair- ment of sensibility in the paralyzed member is but little, if at all observable. But such facts only serve to show that " the channels of sensation are more numer- ous than those of motion ; and that if one route be in- terrupted, another is easily opened. It may be that the commissures are valuable instruments for this purpose; and it is highly worthy of notice that no segment of the cerebrum has so many commissures either with the oppo- site or its own side as the optic thalamus."f It is here, too, worthy of notice, that in the double arrangement * Todd & Burns1 Physiology. Philadelphia reprint, p. 263. t Ibid, p. 263. 31 242 of organs throughout the body, nature has provided for the execution of the functions by a single organ when its fellow of the opposite side is for the time in- capable of action. For even those organs which occu- py the middle range of the body have a symmetrical and double distribution of their parts, and offer no ex- ception to this general law. The one eye sees, and the one ear hears, and the one side of the tongue moves and tastes, wrhile the other, from paralysis of its nervous power, is incapable of executing any function; showing that the sentient ganglia on one side of the brain con- tinues to act, while those of the other side, from accident or disease, are no longer in possession of their vital force. What happens to the sentient ganglia, also, from the same causes, may happen to the hemispheres above them; so that while intellectual action is arrest- ed in one hemisphere, the other may still be capable of manifesting a fair amount of intelligence; never, however, to the full and equal measure of which the brain is capable in its healthy state. And even though one hemisphere is occasionally thus capable of execut- ing all the natural functions proper to it, the force of its operations is, at best, feeble; and from the ready and easy propagation of irritation from one portion of the brain to the other, the disease of one hemisphere almost invariably entails disturbance of function, to greater or less extent, in the other. Finally, to adopt the words of Carpenter, " although every segment of the spinal cord, and every one of the sensory ganglia, may be considered, in common with the cerebrum, as a true and independent centre of nervous power, yet this independence is only manifested when these organs are separated-from each other; either structurally—by actual division; or functionally—by the suspension of the activity of other parts. In their state of perfect integrity and complete functional activity, they are all 243 (at least in man) in such subordination to the cere- brum, that they only minister to its actions ;—except so far as they are subservient to the maintenance of the organic functions, as in the automatic acts of breathing and swallowing. With regard to every other action, the will, if it possesses its due preponderance, can exer- cise a determining power; keeping in check every au- tomatic impulse, and repressing the promptings of emo- tional excitement. And this seems to result from the peculiar arrangement of the nervous apparatus ; which causes the excitor impression to travel in the upward direction if it meet with no interruption, until it reaches the cerebrum, without exciting any reflex movement in its course. When it arrives at the sensorium, it makes an impression on the consciousness of the indi- vidual, and thus gives rise to a sensation; and the change thus induced being further propagated from the sensory ganglia to the cerebrum, becomes the oc- casion of the formation of an idea. If with this idea any pleasurable or painful feeling should be associated, it assumes the character of an emotion / and either as a simple or as an emotional idea, it becomes the subject of intellectual operations, whose final issue is in a voli- tional determination, or act of the will, which may be exerted in producing or checking a muscular move- ment, or in controlling or directing the current of thought. " But if this ordinary upward course be any where interrupted, the impression will then exert its power in a transverse direction, and a ' reflex' action will be the result; the nature of this being dependent upon the part of the cerebro-spinal axis, at which its ascent has been checked. Thus, if the interruption be pro- duced by division or injury of the spinal cord, so that its lower part is cut off from communication wTith the encephalic centres, this portion then acts as an inde- 244 pendent centre; and impressions made upon it, through the different nerves proceeding to it from the lower extremities, excite violent reflex movements; which, being thus produced without sensation, are designated as ' excito-motor'—so again, if the impression should be conveyed to the sensorium, but should be prevented by the removal of the cerebrum, or by its state of functional inaction, or by the direction of its activity in some other channel, from calling forth ideas through the instrumentality of the latter, it may react upon the motor apparatus by the ' reflex' power of the sensory ganglia themselves; as seems to be the case with re- gard to those locomotive actions which are maintained and guided by sensations during states of profound ab- straction, when the attention of the individual is so completely concentrated upon his own train of thought that he does not perceive external objects, though his movements are obviously guided through the visual or tactile senses; such actions being dependent upon the prompting of sensations, are ' sensori-motor,' or ' consensual.' But further, even the cerebrum responds automatically to impressions fitted to excite its ' reflex' action, when from any cause the will is in abeyance; and its power cannot be exerted either over the mus- cular system or over the direction of the thoughts. Thus in the states of reverie, dreaming, somnambulism, &c, whether spontaneous or artificially produced, ideas which take possession of the mind, and from which it cannot free itself, may excite respondent movements; and this may happen also when the force of the idea is morbidly exaggerated, and the will is not suspended, but merely weakened, as in many forms of insanity," * and he might also have added in many transient dis- turbances of the health. * Carpenter's Physiology. Philadelphia reprint, pp. 439, '40. 245 ■■ the Medical Evidence in reference to the Disease of tlie Brain, and its Effect upon the Intellect. With these observations on the general arrange- ment and functions of the brain and nervous system, we are the better able to proceed in our examination of the opinions propounded by the medical witnesses in reference to the disease under which Mr. Parish labored, and the effects of that disease upon the func- tions of his mind, as well as upon the condition of his bodily organs. a. Organic Disease of the Brain admitted.—The existence of organic disease of the brain in Mr. Parish's case has, indeed, been admitted by Drs. Delafield, Markoe, and Wilkes: but the extent and character of this disease they leave open to conjecture; nor do they fully admit the intimate relation of such disease to the mental condition of Mr. Parish. b. But its Relation to the Condition of the Mind not fully acknowledged by the Witnesses.—The following questions were propounded to Dr. Markoe; I give them with his answers: " In cases of evident mental disease apparent in the lifetime of a subject, does anatomical post-mortem in- spection always discover any physical appearances to which, as causes immediate or mediate, the mental disease is assignable ? " To which he replies: " It does not; it does very rarely." (II. f. 2132.) "Does post-mortem anatomical inspection exhibit physical disease in the brain in cases where no symptoms of mental disease have been exhibited in life?" To which he replied: "It does very often." (11. f. 2132.) Now with regard to the two replies to these ques- 246 ^ « tions, I would simply say, that they are in direct op- position to the established principles of medical science; and that, as they stand in the evidence given before the Surrogate, without supposing Dr. Markoe inten- tionally erred in his answers, they are nevertheless in- correct. The proofs of this assertion I hope to estab- lish as we proceed ; and for the present I may simply say, that if the words " very often " had constituted a portion of the answer to the first question; and the w^ords " very rarely " had constituted a portion of the answer to the second question, transposing them inter- changeably, the two answrers wrould have much more nearly approximated to accuracy. c. No Post-Mortem Examination.—There was no post-mortem examination, " Because," says Dr. Dela- field, " I knew no useful end that could be gained by it; and further, I did not wish, without a good object, to wTound the feelings of the widow." (I. f. 3295.) But the opinion that no useful end could be gained by a post-mortem examination, is not sustained by the evidence of Dr. Markoe, who, on being asked—" After his death, was the propriety and necessity of a post- mortem examination presented to your mind ?" replied —" It wras ; it occurred to myself, and I spoke about it." " To Dr. Delafield; I believe, to no one else." (II. f. 2112.) "He stated that the family were op- posed to the thing itself, and referred, I think, to the fact, that it had never been permitted in his family, owing to this feeling." (II. f. 2131.) Dr. Delafield, however, was aware, as he himself admits, that the soundness of mind and intellectual capacity of Mr. Parish were likely to become a question of judicial in- quiry,—a question in which his own sister, Mrs. Parish, would be personally interested. He must have knowm, then, that as principal physician in attendance, every 247 medical fact that could throw light upon the case, would be required of him. Under these circumstances, neither his own theory of the case, nor his regard for the feelings of the widow or of the members of his family, at the moment, can be accepted as a sufficient reason for neglecting a matter so important to the elu- cidation of the case, as the post-mortem examination. Convulsions from Disease of the Brain.—Mr. Parish had, according to Dr. Delafield, " a number of attacks distinct from the general disease; but the most frequent depending upon its cause—or, in other words, depending upon the condition of the brain which led to the disease." (I. f. 2070.) Alluding to the nerves as connected with the loss of speech, he says, " They all come from the brain, and when they are affected, we infer that the part of the brain whence they are derived is in some way implicated in the disease." (I. f. 3169.) Again, in allusion to the convulsions, he admits that the nervous centre from which these emanate is the brain, (I. f. 3223;) and when asked whether he considered these convulsions to be connected with the general apoplectic disease, he answered, " It would be more proper to say they were connected with the con- dition of the brain left by the apoplectic attack." (I. f. 3223.) The foregoing are among the few pas- sages in which Dr. Delafield makes direct allusion to the brain as the primary seat of disease in Mr. Parish's case. Dr. Markoe's views on this subject are not always very explicit. " The case seemed to me," says Dr. Markoe, " to be one of the usual ones, in which the paralysis depends upon a lesion (organic disease) of the brain." (II. f. 1972.) Speaking of the condition immediately preceding death, he says, " It was a com- plicated disease, however, depending, I should say, as we supposed, upon the condition of the brain." (II. f. 248 1991.) He is asked what he considers the source or cause of the convulsions, and says, " It is mere matter of speculation." Yet he admits that they may have had some connection with the condition of the brain. (II. f. 2104.) e. Dr Markois theory of Aphonia, or Loss of Speech. —In attempting to account for Mr. Parish's inability to converse, Dr. Markoe turns away from the lesion of the brain to an hypothesis about paralysis of the " great function of association." And when asked to explain what he means by this " great function of association," he says, " It is a function by which the special functions of particular muscles are so combined and harmonized, that these single functions thus combined produce a great combined function, by means of the combination ; and though without such combination, each single mus- cle might produce its peculiar function, a great com- bined function could not be produced." (II. f. 2073.) This explanation not being clearly understood, he is again asked whether by this " great function of associ- ation," he does not mean that power " which guides into harmonious action the several muscles or organs required to co-operate in producing a certain effect ? " But this, he says, he does not mean, " because that guiding powrer may exist presently, and the instrument through which that guiding power acts may be wanting, as in the case of paralysis." He admits, however, "that this great power of association" must have an organ, or instrument, through which it acts, and that this instru- ment is " the nerves which go to supply the part act- ing." And again, that " the nervous or other centre from which the function of association take3 its source, or derives its power," is, after all, " the brain." (II. f. 2072-'5.) 249 f. Dr. Markoe!s Theory of Epilepsy and of Epilepti- form Convulsions.—We must refer to still another point to show Dr. Markoe's somewhat singular tendency to avoid associating Mr. Parish's disabilities with organic disease of the brain—a tendency which has led him to misapply some of the terms of medical science. He states that Mr. Parish " was subject to epileptic spasms during a large portion of his illness." (II. f. 2031.) But this word "epileptic" he proceeds to qualify, saying, " I use it in a very general accepta- tion, so as to include all habitual, sudden, convulsive seizures, whether from disease of the brain or from other causes." So far, of course, he is correct; but he goes on to say that, "Technically, it is confined to a certain class of cases not referable to disease of the brain, but depending upon general disorder of the nervous system ; cases such as those of Mr. Parish are called epileptic, more from convenience than any thing else—the term that would be precisely proper would be epileptiform." (II. f. 2032.) Dr. Delafield, also, on this point, speaks with hesitation. The spasms, says he, to which Mr. Parish was subject, " would be called simply convulsions; whether epileptic or not, would give rise to difference of opinion." (I. f. 3227.) What iyEpilepsy f—Now, a convulsion occurring but once, and from some temporary disturbance, would not, of course, be called epilepsy; although it might have the form of epilepsy. Such are the convulsions of children, from indigestion, and other temporary sources of irritation. A convulsion occurring in the female, when it assumes the epileptic form, might be erroneously judged to be epilepsy, especially if it be of occasional recurrence; yet even in the hysterical con- vulsions of females, there is rarely the foaming at the mouth, or the loss of consciousness, or the ensuing stu- 32 250 por of true epilepsy. But convulsions from some fixed disturbance, recurring at intervals for years together, in a male subject far advanced in life, with the symp- toms above indicated, would hardly go by any other name than epilepsy. "Diseases within the cranium, by irritating excitor nerves, or the medulla oblongata," says Dr. Marshall Hall, " induce convulsions or epilepsy, too frequently, alas! of an incurable character. Disease within the spinal canal may prove the source of con- vulsions or epilepsy still more immediate. This form of epilepsy is also, for the most part, incurable." These forms of epilepsy, whether cerebral or spinal, Dr. Mar- shall Hall classifies under the head of centric, while those forms which result from irritation in organs remote from the nervous centres, as in the stomach from indi- gestible food, in the intestines, in the uterus, &c, he classifies under the head of eccentric epilepsy* The term epileptiform is a qualifying word of very recent introduction, and is applied to convulsions depending on temporary disturbances and that are not of habitual recurrence, as in the eccentric epilepsy of Marshall Hall. Thus Dr. Carpenter, in his work on Physiology, speaks of " epileptiform convulsions," brought on by loss of blood in the parturient woman ; and of the " epileptiform paroxysm, induced by strangling or suffocation, or by the poisonous action of hydrocyanic acid." But of true epilepsy, he tells us, the primary seat is in that portion of the brain which is composed of the sensory ganglia. " We seem," says this able author, " entitled to con- sider the sensory ganglia, as the primary seat of that combination of loss of sensibility with convulsive move- ments which essentially constitutes epilepsy.'''' "The disordered action," he continues, " manifestly extends itself to the cerebrum; for a maniacal paroxysm fre- * Lectures on the Nervous System. Philadelphia reprint, 1856, p. 198 and 202, '3. 251 quentl}7" occurs in connection with the epileptic attacks, the attacks themselves are sometimes preceded, and very commonly followed by considerable confusion of intellect; the disease is seldom long persistent without impairing the memory and the control of the will over the mental operations, and in cases of long standing, the power of the cerebrum appears to be almost entirely de- stroyed."* In the still more recent work of Todd and Bowman, we find the same association of epilepsy with disease of the brain. " The convulsions of epilepsy," we are here told, " arise from a similar cause; namely, irri- tation of the brain, involving the whole or part of the spinal cord and the nerves arising from it. In many instances the convulsions are limited to one-half of the body; in such cases, there is generally lesion of the brain on one side, and the cerebral excitement is prop- agated only to one-half (the opposite) of the cord." f The modern writers on practical medicine are equally explicit on this point. "Epilepsy," says Dr. Wood, " may, therefore, originate in and be sustained by in- flammation of the brain, or by any other organic alter- ation, as tumors, osseous spicula, or exostosis, depressed bone, thickened membranes, effusion, &c, which shall produce a certain amount of irritation in the cortical substance sufficient to suspend function, and a some- what less amount in the white substance, sufficient only to excite and derange function. If the cause operated on the former substance alone, we should have coma or delirium; if on the latter alone, we should have spasm or paralysis, as in cerebritis. It is clear, too, that an irritation sent to the brain from any point of the body whatever, wrhich shall be equally forcible as * Carpenter's Human Physiology. Philadelphia reprint, 1856, p. 642, '3, §718. t Physiological Anatomy and Physiology of Man. By R. B. Todd and W. Bowman. Philadelphia reprint, 1857, p. 281. 252 that originating in the brain, and have the same special directions, will produce the same effect. The epilepsy, strictly speaking, is the same in both cases." * " Epi- lepsy," says Sir Henry Halford, " has this peculiarity about it, that the patient who is so afflicted, though an object of terror and of pity to those who witness his struggles under a fit, yet, by the mercy of heaven, he himself is unconscious of the frightful attack. He sleeps after his frame has been convulsed from head to foot, and awakens unawrare of all that has jxassed; ' himself again.' Repeated fits, however, at length weaken the faculties; his memory suffers decay, his judgment becomes unsound, derangement follows, and this alienation of mind degenerates at last into idiocy. I do not say that this is the cause of all epilepsies. Many attacks of epilepsy are symptomatic only of some irritation in the alimentary canal, or of some eruptive disease about to declare itself, or of other occasional passing ills. So far, Julius Caesar was an epileptic; and so far it has been said was Mahomet, also," and so far, he might have added, was the great Napoleon. " But these attacks were of no consequence in»deterioratin<* his [their] masculine mind [minds]. No; the dreadful consequences which I have detailed, as affecting the faculties, belong to epilepsy as a primary disease, con- nected with, and originating in, some organic mischief within the cranium." f Thus we see that modern writers are of one accord in placing the irritation of epilepsy in the brain; and, that this has always been allowed to be the principal seat of the affection, we learn from the writers of all ages. Such, we have already intimated, was the idea of Galen, who tells us * Treatise on the Practice of Medicine. By G. B. Wood, 4th edition ■ Philadelphia, 1855, p. 754. t See the chapter on the Influence of Some of the Diseases of the Body on the Mind, in his Essays and Orations. 253 that vertigo and apoplexy, as well as epilepsy, have their seat within the skull. " Ilingus enim est tene- brosa vertigo, quae fit quuni humor in capite movetur, ideoque epilepsiam et apoplexiam praececlit."* The force of these criticisms will be apparent as we pro- ceed. g. Dr. Delafield'; but in no other." (II. f. 2118.) Again, in reference to speech alone, " He could not reach, by utterance, any objects not present directly; it was only by asking him questions, that could be done." (II. f. 2125.) So, then, the failure to write and speak, was not an affair of unwillingness, but of actual inability. And Dr. Markoe, by his own showing, has upset the hy- pothesis upon which he rests his opinion of the mental capacity of Mr. Parish. But an hypothesis is unten- able, that will not furnish an easy explanation of all the facts which it is intended to embrace. That Mr. Parish ivould not write, or use the alphabet, or arti- ficial signs for expressing thought—and that he would not speak, might be, as two distinct propositions, logi- cally tenable ; provided that he had not frequently at- tempted, and failed, in respect to both the one and the other. But that he would not do the one, and that he could not do the other, is an assumption contra- dictory in itself. Granting, however, for the sake of argu- ment that Mr. Parish could, but ivould not, exercise a faculty so necessary to him, and so essential for the proper management and disposal of his affairs, as that of communicating exact thought by writing, or by ar- tificial signs of any sort, there would be no stronger evidence adduced than this to prove in him a perver- sity of intellect amounting to dementia. We know that the idiotic and demented are often prone to ob- stinacy ; * and it would be difficult, I think impossible, to adduce another instance of such long-continued and obdurate perversity of will, even in the demented, as in this alleged instance. * Mayo on Medical Testimony on Lunacy, p. 96. 278 Before leaving this topic, it is proper to allude to the case of Dr. Grayson, mentioned by Dr. Wilkes, as an instance of the loss of the faculty of writing, while this gentleman was still able to attend to his profes- sional occupation. I learn, however, from a reliable source, that Dr. Grayson's intellectual faculties were seriously impaired before he ceased to sign his own bank checks. But, that he could still go about the city and visit the sick, was no indication of integrity of intellect. The late Dr. Thomas Boyd of this city did the same thing for years after he had become an imbecile; and did so even after it was necessary to send a servant with him to prevent him from losing himself in the streets. There are other passages in the medical evidence which tend rather to avoid than to make an open ex- position of the facts. I may here refer in illustration to what is said on the tendency of restraint and con- finement, in giving rise to irritability of temper:—see- ing that the irritability and change of temper in Mr. Parish were but manifestations of diseased action with- in the brain. But it cannot be profitable to dwell upon these passages. t. No Tests instituted for determining the Force of Intellect in Mr. Parish by any of the Professional Wit- nesses.—There is, however, one more topic upon which it is proper to make a passing comment. When asked, " Did you yourself ever make any examination of Mr. Parish, or apply any test to him, for the exclu- sive purpose of ascertaining the state of his mind ?" Dr. Delafield answers very briefly, " No." (I. f. 3305.) We have already shown that Mrs. Parish's counsel, Mr. Daniel Lord, makes essentially the same admis- sion. And as to having been requested to make any such investigation, or apply any such test, Dr. Wilkes 279 says, " I never was in the slightest degree." And as to his having employed any test at all, he says, " I did not for that object." (II. f. 305, '6.) Again, Dr. Markoe, when asked, " Did you ever make any exam- ination of Mr. Parish, or apply any test to him, for the exclusive purpose of ascertaining the state of his mind ? " replies, " I never did in any shape or way." (II. f. 2055.) These admissions on the part of these professional gentlemen, are of some importance, as showing in what manner they have reasoned in the case before them. We need not stop to notice the opinions of the numer- ous other witnesses, who lay no claim to professional acumen. But something like definite and logical in- vestigation might have been expected from the physi- cians. To determine the degree of mental alienation, and settle the question of legal incapacity, or to dis- prove the supposition of such incapacity, knowing that this question was likely to be brought before them, was clearly the duty of these gentlemen; a duty re- quiring the most rigid scrutiny of facts, and the em- ployment of every means within their power for elicit- ing the truth. Physicians trained to such investiga- tions, even in dealing with persons able to give expres- sion to their thoughts, are often at a loss to determine, after a few interviews, the question of sanity or insan- ity. When placed under any degree of restraint in their inquiries on this point, they are frequently mis- led ; and with all appliances in their favor, they may require weeks of study and observation before arriving at the truth. In the majority of instances, however, the question may readily be settled by a well-arranged series of tests; and some of these are as applicable to the speechless as to other patients. For this purpose, as we have already shown, the countenance may be studied to little purpose; and the deportment, under 280 ordinary circumstances, especially in the fatuitous or demented, is too much the result of previous and long- continued habit, to be of any special service. The train of reasoning on abstract and remote subjects must be reached; and this, in the case of Mr. Parish, does not appear to have been attempted by any other witness than Mr. Folsom. The importance of resort- ing to tests for determining the sanity or insanity of the patient who is about to make a will, and whose affairs are in such a condition as may lead to litigation after his death, is ably set forth by Sir Henry Halford, particularly in his Fourth Essay, where he treats of tests, and gives a striking instance, in which he him- self had been at first misled; and where he afterwards corrected his own judgment by requiring the patient to recapitulate what had already been dictated as his will. This patient, too, knew how to speak; and though he appeared to his solicitor sufficiently compe- tent at the time of taking instructions for the will, yet he was ultimately allowed to die intestate. Sir Henry Halford, in this instance, used the common- sense test that Shakspeare puts into the mouth of Hamlet: " It is not madness That I have uttered: bring me to the test, And I the matter will re-word, which madness Would gambol from." Again, to show that many of our habits are exe- cuted independent of the intellect, I may remark that, persons unconscious of all that is transpiring about them, in consequence of severe injury of the head, and while unable even to speak beyond a mere syllable at a time, if even to speak at all, may nevertheless make the proper movements for complying with the demands of nature. I have known a person thus situated grop- ing beneath the bed for the urinal. And within the 281 past few days I have had charge of a patient who, after an injury of the head, was unable to speak, or tell where he was, or what ailed him, and yet he rose from his bed, dressed himself, and walked down stairs to the water-closet, wholly unconscious of what he was about at the time, and oblivious of it afterwards. Mr. Parish's rummaging in the wardrobe, his fingering of account-books, his strolling to the garret, to the cellar, to the market, and, doubtless, many other of the actions, upon which several of the witnesses have dwelt, are mainly to be accounted for in the same manner, as the automatic movements of these patients. Mr. Parish is not shown to have been able to cast up a column of figures, or to correct a mistake in addi- tion or subtraction, by pointing or by any other sign of intelligence. He is not shown to have understood the exact relation between two or more complex quantities, or compound proportions. He is never known to have expended money, giving the exact, or requiring the ex- act change. In fact, he was not allowed habitually to carry money about his person at all. We are told that he has pointed at the clock on the regular days for winding it, but we are not told that he has thus pointed only on such days, or whether his pointing was a spon- taneous movement, independent of any observation made in his presence by those about him. We are told that his sign of inquiry and suggestion was to hold up two of his fingers, and that this sign, when used for sug- gestion, sometimes meant two hundred, sometimes two thousand. Wherein would have been the difficulty of requiring him, if he really knew the difference, to point these two fingers upwards, when he meant two hundred, and downwards, when he meant two thousand, and thus obliging him by his own act to settle the question whe- ther he meant either the one or the other ? When Brown, the sexton, called upon him, we are told that 36 282 the two fingers were held up crosswise, and that this was the sign for two five-dollar gold pieces, or the sign for ten dollars. Would it not have been proper to re- quire of him to hold these fingers, thus crossed, upwards for dollars, downwards for dimes, and horizontally, to the right or left, if he meant any thing else than money ? "I would ask him," says Mr. Henry Delafield, "if I should draw it [the check in favor of Dr. Taylor] in gold." (III. f. 121.) Why not give him the choice between gold, sil- ver and paper money, requiring him to hold up one finger for gold, two for silver, and three for bank notes ? Ques- tion of this sort would not only have saved much trouble and perplexity to Mr. Parish and those about him, but would have tested his mental capacity and his reason- ing power, and so also his memory, and his comprehen- sion of his own personal affairs. But no such conven- tional signs, as far as the evidence goes, appear to have been instituted for his use, or desired by himself for the communication of exact thoughts, in any one single instance; and the inference is, that none such could have been instituted by others for him, or devised by himself; the intellectual powers of comprehension being at fault in him, by which alone any such signs could have been directed. The case, then, was not one of mere loss of language, or of mere inability or disincli- nation to resort to writing, or to the use of the alphabet in any way; but, in connection with these disabilities, it was further characterized by loss of power on the part of the patient to learn from others, or to devise for him- self any artificial means for the exact expression of his wishes, or to supply the loss of speech; and, as indica- tive of the most serious impairment of intellectual power, it was characterized by inability to discriminate between two or more simple abstract propositions, when so placed before the mind as to call collectively for its action upon them. 283 36th.—Review of an Article Entitled, " To what de- gree are the Intellectual Faculties Affected in cases of Apoplexy and Hemiplegia t" In connection with our review of the medical testi- mony, it is necessary to notice an article which has appeared in the New York Journal of Medicine for September, 1857, and which was originally prepared by its author, Dr. Benjaman W. McCready, with the direct view to its bearing on the investigation now pending before the Surrogate. This article is entitled, " To what Degree are the Intellectual Faculties Affected in cases of Apoplexy and Hemiplegia /'' It is made up, for the most part, of selections from a work of little note by a Mr. Cope- man, and from the orignal and more reliable research- es of Andral and Cruveilheir, and of a series of cases from the practice of Dr. McCready himself, and that of other physicians with whom he has been in communi- cation in the collection of his facts. The main effort of Dr. McCready is to show, from the cases which he has brought together, that the pro- fession at large are laboring under an error in believing that, "after recovery from the first overwhelming effects of an apoplectic seizure," " in all cases, the mind is more or less impaired;" and that, " in severe ones, the patient is apt to be reduced to a condition of partial or complete imbecility." He is ready, however, to ac- count for this alleged error on the part of the medical public, assuring us that "systematic writers on the practice of physic give often some color of support to this opinion." In thus apologizing for the profession at large, it is to be regretted that Dr. McCready did not go a little further, and grant that while medical practitioners and medical authors admit of exceptional instances, they 284 are, nevertheless, of one accord in maintaining that the tendency of apoplexy is always to deteriorate the intel- lectual faculties, and that not merely systematic writers on the practice of physic, but also the ablest and most reliable investigators in physiology, pathology, and morbid anatomy, give their sanction to this opinion. So that if it is an error, it is now for the first time pub- licly announced to be such, and only by the opinion of Dr. McCready himself. For notwithstanding the cases he has collected and published in this article, he has not been able, after more than a year's study of the subject, to name a single author, ancient or modern, whose opinion on the question, when fairly stated, is shown to be at variance with that of the profession at large. The "authorities" are all against him, hence he may very well add, " It is evident that the question cannot be settled by weighing authority against author- ity, and that the impressions of even well informed and experienced physicians are only valuable in so far as they are founded upon carefully observed facts." The " carefully observed facts," reported by other authors, are most likely to receive their true interpretation from these authors themselves. And as to the new cases from Dr. M.'s own practice or that of his friends, which he has brought to bear on the present investi- gation, we may very well accept his own remark when he says of them that "new observations, directed mainly to the condition of the mind, might be liable to the charge of bias in the interpretation of the facts on the part of the observer." (p. 203.) After a summary exhibition of some eight or nine cases from the two hundred and more collected by Mr. Copeman, and some sixteen or eighteen others from Andral and Cruveilhier, Dr. McCready finds reason to justify himself in stating that from these re- searches " no other conclusion can be drawn than that 2:5 any impairment of mind, as a direct consequence of apo- plexy, after the patient has recovered from its prima- ry effects, must be an exceptional occurrence." The facts upon which this conclusion is founded, I shall no- tice directly. The qualification implied in the words " direct consequence," is here evidently intended as the saving clause; the indirect consequences, however, are too closely associated with the primary attack to be entirely ignored. But Dr. McCready sees the difficulty of accounting for the impairment of mind which ac- tually ensues, and which he is not prepared to deny ; and he attempts to get rid of this difficulty by as- suring us " that the apoplectic seizure may hasten the approach of senile atrophy [wasting] of the brain," and that " when atrophy has already commenced, an apoplectic attack may undoubtedly quicken its pro- gress, and in such cases the friends of the patient would naturally attribute the rapid decay of the mind wholly to the apoplectic seizure." (p. 217.) He tells us, further, that "The confusion of mind, the difficulty in pursuing a train of thought, of which apoplectics are apt to complain, is in a great extent the mere result of diminished nervous energy." (p. 217.) He might have added that this diminution of nervous energy is permanent, is associated with disturbance in the equable influence of the nervous system throughout the body, and is the direct effect of injury of an organ- ic character, at the great fountains of nervous power within the skull. Of apoplectics, he says, " They comprehend well and judge correctly; but before their general health is confirmed they can no more think correctly than they can take a long walk, or perform any other act demanding a considerable expenditure of nervous force." (p. 217.) The logicians would tell us that judgment is the sequent, not the antecedent, of thought; 286 and if so, it is difficult to understand how apoplectics can judge correctly, when they cannot think correctly. But the power of comprehension, of thought, and of judgment among apoplectics, even in their best estate, is feeble, and easily disturbed, never equal to what it could have been before the attack, while the organic integrity of the brain was as yet unimpaired. For in the changes that precede, accompany or follow sanguin- eous apoplexy, the brain is injured, either by the rupture of its vessels, by the disintegration of its substance, by softening or unhealthy consolidation, by pressure, or by the growth of tumors. Changes of this sort, involving the intimate structure of the brain, leading to, or oc- curring in the train of apoplexy, it is out of the power of either nature or art to remedy. It is only in those slighter cases, arising from temporary vitiation of the blood, from undue fulness or congestion of blood, or from other circumstances not involving the integrity and intimate structure of the brain, that entire recovery after an apoplectic seizure is to be expected. He tells us, " It is not the brain specially that is af- fected, it is the system at large." But it is the brain which is principally, primarily, and particularly affect- ed. The affection of the system at large is the neces- sary consequence of the disorder in the brain; and the one is as permanent as the other. " Of all the faculties, memory," he tells us, " either special or general, is most apt to be impaired; and this impairment patients are always ready to admit and complain of." (p. 217.) This concession need not be questioned, though it is hardly in keeping with other views expressed by Dr. McCready. Having alluded to the memory, he might have pro- ceeded further, since other faculties are often quite as seriously implicated; and not the intellectual faculties only. The propensities, the passions and emotions, the 287 temper and disposition, the peculiar traits of individual character, are all subject to serious changes; and the sufferer may become imbecile in respect to the intel- lectual faculties, and mentally perverted in respect to his other qualities. " Before the physiology of the nervous system was understood as well as it is at present," says Dr. Mc- Cready, " it was pardonable to ascribe the emotional paroxysms under which hemiplegiacs are apt to suffer, to mental weakness; but it is strange that this error should still be persisted in." Here then is another error which people are still too perverse in their judg- ment, and too much disposed to rely on common-sense observations, to reject. It is to be hoped that Dr. Mc- Cready will furnish them with good reason for reject- ing it, and for persisting in it no longer,—when he finds one. But the following is insufficient, and is the only reason he assigns for it: " The bursts of tears or of laughter into which hemiplegiacs are often thrown on the slightest occasion, are not, necessarily, more con- nected with an enfeebled understanding, than the want of power over the muscles of the affected extremities. Both facts have a common cause, and the will can no more control the one than it can move the other." (p. 218.) There is then, after all, an actual loss of power in the will of the individual over his emotions; and that loss, as the loss of muscular action, is depend- ing on organic disease of the brain; and by Dr. Mc- Cready's own showing, not only the memory, but in like manner the will of the hemiplegiac, is deterio- rated or perverted. Dr. McCready has no new theory to offer in refer- ence to hemiplegiacs who have lost the use of speech, and who have no power to give expression to exact thought by written language; but he is not an advo- cate for the theory on this subject which has been pro- 288 pounded by Dr. Markoe; for, says he, " The patient evidently understands what is said to him, spoken words excite in his mind the corresponding ideas, but he is not only unable to speak, he cannot write. If he attempts it, he joins letters together in such a way as to convey no meaning, and is often conscious himself, on seeing what he has written, of his failure; in some instances, probably while he comprehends words when spoken, he cannot recall them. But there are still cases left which seem to defy our analysis. In the strange union between mind and its material organ, the brain, physical lesions sometimes produce phenomena that put at fault all our psychological theories." (p. 220.) If all the rest of Dr. McCready's article were as unobjectionable, and as sensibly expressed, as the two last sentences of the passage just cited, there would have been little else than commendation to bestow upon it. But a bias toward his peculiar opinion is sometimes too much for him ; and we find that, after an enumeration of cases of the most heterogeneous character, and which establish nothing positive, except that every apoplectic is not reduced to the lowest and most deplorate state of idiocy, he ventures upon the following statement: " In all the cases that have come to my knowledge, as well those recorded by others as those that are here given, where hemiplegia, with loss or perversion of the faculty of speech, has been unattended by coma or de- lirium, there is no evidence whatever that the intellect has been materially weakened." (p. 233.) This is surely quite enough to show the animus of his whole paper; but the following is the crowning thought: "So uniform," says he, "is the testimony in these cases, that it would seem as if the absence of speech in simi- lar instances must be looked upon as prima facie evi- dence of clearness of understanding!" (p. 233.) It is a common saying that " a wise man knows when to 289 hold his tongue;" but, surely, silence is not on that ac count a prima facie evidence of wisdom. Let us now turn our attention to his cases. Passing over the elaborate works in the English language that are commonly consulted in reference to the pathology and morbid anatomy of apoplexy, and other kindred disorders of the brain, and their conse- quences,—as Abercrombie on Diseases of the Brain and Spinal Cord, Copeland on Palsy and Apoplexy, Bom- berg on the Nervous Diseases of Man, Cooke on Nerv- ous Diseases, the great collections of Morgagni on the Seat and Causes of Diseases, as rendered from the Latin, and the numerous writers on Physiology and Morbid Anatomy that dwell particularly upon the brain, and without an allusion to any of the authors treating of mental alienation, Dr. McCready has con- fined himself in his researches for the most part to the three works above mentioned, only one of which is in English, and that a work which few of the profession in this country have ever heard of, and fewer still have ever seen. The book of Mr. Copeman, entitled, " A Collection of Cases of Apoplexy'' was published in London in 1845. It is a collection from other previous publications, and was prepared simply with the view of determining the value of bloodletting in the treat- ment of this disease; and with no view whatever to the pathology of the disease, much less to its direct effects upon the intellectual faculties. " The sole de- fect in this book," says an able reviewer, " is the scanti- ness of its materials." It is to be considered " not at all as the exposition of the present state of our practice and knowledge respecting the natural history and treatment of this disease," * yet such as it is, we are willing to accept its facts, in the form even in which * British and Foreign Medical Review for July, 1846, p. 198. 37 290 they are presented to us by Dr. McCready; who tells us that " Mr. Copeman has recorded, from various authori- ties, two hundred arid fifty cases of apoplexy: of these one hundred and seventy-five died without recovering from the immediate effects of the apoplectic seizure', of the remaining seventy-five cases, twenty-five have been rejected, because, from the detail of the cases given, evidence was wanting of their proper apoplectic character. Some of them were plainly cases of renal disease, others of puerperal convulsions, others of pro- found narcotism from alcohol, in two cases the attack might have been hysterical, and some were of doubtful character. All the cases thus rejected, are stated to have recovered, and no mention is made of any imper- fection or unsoundness of mind having been left by them. " Of the fifty cases of apoplexy with or without hemiplegia, which were analyzed, twenty-six were of apoplexy without paralysis; of these eighteen are stated simply to have recovered. " In one of these cases (83 of Copeman from Aber- crombie), a lady, 82 years of age, was seized at church with coma, lasting some days, attended with convul- sions and apparent paralysis of the left side ; she was restored to her usual health. This patient had had an apoplectic attack four years previously. In one case, (90 of Copeman from Cheyne,) the patient had had three previous attacks, the first of which had left his right arm paralyzed for twelve weeks. " In two of the twenty-six cases, (7 & 150 of Cope- man,) it is stated respectively, that after recovery the ' intelligence was sound,' and the patient was ' clear in the head.' " In one of the cases, (141 of Copeman from Por- tal,) the patient's health was re-established, but he 291 did not recover his memory until some months after- ward. " In twenty-four cases the apoplexy was attended with hemiplegia. " In sixteen of the twenty-four they are reported to have recovered perfectly, with the exception in some instances of slight paralysis still remaining; in two instances, (116 and 120 of Copeman from Bright's Medical Reports,) the patients are stated to have re- turned to their occupations, one a servant, the other a porter at a gate. In two of the patients, several years after their recovery, death occurred from a second at- tack." Such then are the statistics, after which, in Dr. McCready's article, we have an abstract of nine of the cases. These make but a sorry show in respect to in- tellect. I shall notice them only so far as they affect this question. In the first three of these there were remaining symptoms of paralysis, and nothing whatever is men- tioned in reference to the condition of the mind. The next, (23 of Copeman,) " though recorded as one of apoplexy, was rather a case of softening of the brain." He fell in a fit, recovered his consciousness in five minutes, was hemiplegiac, and "although he was sensible, the energies of his brain and nervous system were impaired, and the muscular power consequently diminished. He lay helpless upon his back, and passed his motions and urine in bed." " He would make signs for the urinal, and so on; he understood what was said to him, yet he was much embarrassed to answer. He died of gangrene two months after the attack. In the next, (30 of Copeman,) the patient, a female, aged 73, was left speechless, "but preserved, to a con- siderable degree, her intellect," and died in two days After the attack. 292 i In the next, (50 of Copeman,) a woman aged 65, was left ten days after the attack hemiplegiac on the right side, " somewhat lethargic, but ' quite sensible to what was addressed to her, though unable to reply,' except by signs. She gradually improved for five days, having become able to sit up, when a second attack supervened, and carried her off." In the next, (100 of Copeman,) the attack, in a man of 73, was induced by bad news. " After a time he recovered sufficiently to write for one of the weekly journals, although his memory became defective, and his mind frequently confused." Ten months afterwards a second attack left him feebler, " and with his head symptoms considerably increased, and thenceforth he was unable to engage in any occupation. A third at- tack after an interval of thirteen months, left him in a condition varying " between partial coma and delirium, though occasionally he would answer coherently ;" he had paralysis of the right hand and of both legs. The next, (137 of Copeman,) a patient aged 76, after the attack, recovered his consciousness, and was not left permanently paralytic; " but out of twenty words which he pronounced, there were eighteen not understood, and the other two were misapplied." " It was reported in Paris," according to Portal, from whom the case is taken, " that he was mad ; but I saw it was less a loss of reason than the power of expressing himself." The next and last of the series, (164 of Copeman,) a lady aged 60, after the fit " was not cured, though she had recovered her senses. She lived some time with a hemiplegia, and without being able to articulate a word." Such then is every thing that Dr. McCready has taken from Copeman, bearing on the question at issue. And it remains for us to discover by what process of 293 reasoning he is enabled to show from these facts, that " impairment of mind, as a direct consequence of apo- plexy, after the patient has recovere< 1 from its primary effects, must be an exceptional occurrence." Dr. Mc- Cready may, indeed, wish us to understand that in the patients reported as " recovered," there was a perfect restoration of all the intellectual powers; but those who are accustomed to examine medical reports, will not be ready to accept any such interpretation of the word; which simply leads us to understand that the patients were only so far reinstated as to be no longer under the care of the physician. Out of 250 cases of reputed apoplexy then, of which 25 must be rejected as dubious, and of which 175 died of the first shock, and of which only 50 are to be accepted as surviving the immediate effects of the attack, it is difficult to see how 34 recoveries justi- fy the remark that impairment of the mental faculties, as a result of apoplexy, is at most an exceptional occur- rence ; and yet this is the way in which Dr. McCready, by his statistics from Copeman, must have been led to the discovery, that the medical profession of the pres- ent day are in error in believing that the direct effect of apoplexy is to impair the intellectual powers. On reaching this point in his investigations Dr. McCready begins to suspect that " exception may be taken, by some, to the cases from Copeman." Though, he says, " I cannot discover the slightest ground for it." (p. 207.) Most other professional men will see ample ground for it. His next selections are from Andral; and the re- sults derived from them, he thinks, agree perfectly with those already arrived at, and " give them addi- tional strength and value." Of these selections, con- sisting of about ten cases from the fifth volume of the Clinique Mcdicale, I need not attempt an analysis. 294 M. Andral is the best interpreter of his own facts. I have already quoted his words in reference to some of the complications of apoplexy, and to his chapter on the intellectual faculties as affected by this disease (p. 578) I must refer for the full and fair expression of his own views on the subject. The most essential portions of this chapter I shall have occasion elsewhere to introduce as we proceed, leaving it to the common- sense of those interested in the question to discover how far Andral's deductions from his own cases can be made to tally with the " results derived from them " by Dr. McCready. We next come to the eight or nine cases selected and condensed from the Anatomie Pathologique of M. Cruveilheir. We shall have occasion elsewhere to in- troduce the opinions of this distinguished author, and consequently the individual cases from which these opinions have been derived, we may allow to pass un- noticed, further than to say, that in connection with the question at issue, they are of no importance, and that in his selections from the Anatomie Pathologique, as well as from the Clinique Medicate, Dr. McCready has given only condensed sketches, some of which are not quite free from bias, and not entirely in unison with the opinions of the authors from whom they are taken, and upon whose authority he seems desirous of re- posing. Dr. McCready also quotes from Cruveilheir some passages relating to the post-mortem examination of Dupuytren, but without alluding to the disease of which he died. Why this passage was here introduced it is difficult to understand ; since the apoplectic attack with which Dupuytren was taken, November 15th, 1833, (not, as Dr. M. says , in 1834,) was very slight. But it nevertheless disabled him from business, and he was, ever after, an invalid. He spent the following winter in Italy; and his last illness was a chronic pleu^ 295 risy, of which he died on the 8th of February, 1835. The autopsy evinced the traces of the old apoplectic attack; but the burthen of his disease was in the kid- neys. From which the modern pathologist will readily trace the starting-point both of the cerebral and the pleuritic maladies. The cavity of the pleura contained more than half a gallon of turbid serum, and the heart was somewhat enlarged; but each kidney contained calcareous deposits, and the right kidney was reduced to a state of putrilage of the consistence and color of the lees of wine, and it was smaller than natural. (Archives Generates de Medicine, torn. VII, Feb. 1835, p. 281.) The new cases, those which Dr. McCready himself thinks " might be liable to the charge of bias in the interpretation of facts on the part of the observer," come next in order. One or two of these are from his own practice, the others are contributed by his friends. There are some sixteen of them in all, overlooking such of them as are mentioned among the foot-notes. The greater part of them have no direct bearing on the question under consideration; and those which have any relevancy only show, what no one is disposed to deny, that certain individuals, after an attack of apo- plexy, may be so far reinstated as to enjoy a moderate degree of intellectual activity. The cases furnished by Drs. Van Wyck, Post, Parker, Clark, and Whiting, are those upon which he places his main reliance. Of the case of Wilcox, from his own practice, he very justly speaks with some Hesi- tation ; and still more so of his other case, that of the patient John White, which he throws behind the shield of a foot-note; for, both of these cases, be it ob- served, have already been somewhat carefully scruti- nized. Dr. M. has himself modified his first impres- 296 sions about them; and it would not do to speak of either of them with any confidence. Dr. Van Wyck's patient, his own brother, an assist- ant-surgeon in the navy, aged forty-two, became apo- plectic while at sea in December, 1838 ; and after the attack, was left hemiplegiac on the right side, speech- less, and at the end of six months he became subject to epileptic seizures which recurred at intervals for seven or eight years, and then disappeared. He is still liv- ing. " Several years after his attack Edward learned to communicate his ideas, as well by detached words as by reference to the dictionary, and to any newspaper, or, I may say, the word in a book or newspaper that would form the key to it." " Early in 1840 he com- menced learning to write with his left hand, at first single words, strangely spelt.', * * " After a while, by constant practice, he learned to sign his name, and now his chirography is quite legible." " He can now (June 16th, 1857) glean as rapidly as almost any one the news from the papers, and can sign his name quite legibly, and has, a dozen times, written short, discon- nected letters, all with his left hand, which, of course [?] would be unintelligible to almost every one but his intimates. He has, in many instances, communicated his ideas to strangers, so far as to enable them to write to me on matters of business, which they could not have understood, except from himself." But now comes a wonder:—" His family consider him, this day, more competent to transact pecuniary business with care and correctness than he was prior to his attack." But still we have this wonder with its qualifying clause, " i. e., before, he was careless and unmindful of small sums of money; now, in computing interest, calculat- ing his income, his board bills, travelling expenses, and in purchasing any articles of dress or the like, in dis- crimination in matter of presents, according to the ne- 297 cessities of the individuals; in all little matters of every-day business he exercises the closest care and scrutiny. I may say, indeed, that he thinks, reasons, argues, and performs all the offices of an intelligent, intellectual responsible individual, save only that he has a language of his own, made up of words, signs, expressions, and gestures. He manages all his own affairs, only sometimes employing a hand to execute. Indeed, he has certainly managed all his business since 1841, and I believe could have attended to it sooner," &c. But in all this he was exceedingly unlike the gentleman whose case is now in question before the Surrogate, and that is about all that need be said upon it. The case contributed by Dr. Post comes next on Dr. McCready's order of those in which " there is no evi- dence whatever that the intellect had been materially weakened." (p. 233.) This patient, a lady aged 40, be- came paralytic afew days after parturition in the summer of 1832. The paralysis was ushered in, not by apoplexy, but by an attack of puerperal convulsions, with profound coma, which in subsiding left her hemiplegiac on the right side, with partial loss of speech, and for a season, we are not told how long, subject to recurrences of con- vulsions of an epileptic character. But she soon began to say, " Dear me ; I don't know." She is still living. As her condition improved after the attack, she began to ride out. She was allowed to attend church, and occasionally to spend an evening at the house of a friend. Some years after the attack she became a com- municant of Dr. Spring's church. She is for the most part cheerful and fond of society; she takes an interest in all the ordinary events which are transpiring around her, and she is neat in her apparel. She neither writes nor uses written nor printed letters or words for com- municating her thoughts. " She has occasionally re- 38 298 peated a word, after it has been pronounced several times distinctly by one of her friends; but the word thus repeated does not afterwards form a part of her vocabulary; her inability to converse seems to depend on the loss of memory of words, and yet words spoken by others evidently convey to her mind distinct ideas of the things which they represent." Still Dr. Post says, " I do not perceive in her any evidence of men- tal imbecility," and his reason appears to be that, " al- though the process of communicating with her is some- times slow, I have the same conviction that we mutu- ally understand each other, that I would have if she were able to converse in the ordinary way." Now, granting all this, granting even that she had the power of speech to a greater extent, yet we have nothing in this case above the capacity of many an imbecile con- fined in our public institutions, or under guardians, and deprived of the control of his own affairs. Dr. Post sees no " evidence of imbecility" in this case. It is well to have a proper understanding of terms, let us see what this word imbecility means. Webster (in verbo) defines it as follows: " Want of strength, weak- ness, feebleness of body or of mind," and says, " we speak of imbecility of the body or of the intellect,when either does not possess the vigor that usually belongs to men, and which is necessary to a due performance of its functions. This may be natural or induced by violence or disease." Tried by these terms, I fear Dr. Post's case will be found, though in point of intellect and physical capacity much above Mr. Parish, yet still not above the condition of imbecility. Dr. McCready's next support is in Dr. Willard Par- ker's two cases. The first of these, a gentleman, after an attack of hemiplegia and loss of speech in March, 1857, has been so far reinstated that, " his intellect seems entirely unaffected. He perseveres in all his 299 former tasks, and passes his time as previously, largely in reading and writing." This, of course, is a brilliant case, and its fellow is not far behind it. For in this latter we have no apoplexy at all, but merely the symptoms which are frequently among the precursors of an apo- plectic attack; there was, however, a paralytic seizure with confusion of thought and of language. There was dragging of the right foot." " As to speech," after the attack in May, 1856, "he could articulate certain words, but they had little reference to the ideas he wished to express; he seemed to be aware of this, but could not recall the right word. He knew his family and friends, but could call neither his wife nor children by name ; his language was confined to monosyllables; he substituted time for distance, as years for miles; the pronouns, he, she, it, he used indiscriminately; a segar, he sometimes asked for a man ; at other, by some other word. At our desire, he attempted to write, but was uuable; after repeated efforts, he managed to write his own baptismal name, James, but could get no fur- ther. He recovered so as to walk and ride out." Dr. Parker says, " his understanding seemed unimpaired," but does not make this certain, and gives no reason to satisfy the dubious. Dr. McCready's next reliance is on Dr. Clark, whose first contribution includes three cases, the 1st, 3d, and 6th of the series. The first of these was in a consump- tive patient, who for an hour or so one night lost the power of articulate speech, and at the same time was slightly delirious, and unable to write. " Seeing that he could not command words, and must fail to communi- cate his wish in this way, he drew a pencil through what he had written, laid down his paper and pencil, and striking one hand on the other, to imitate the knocking, pointed to the door. His friend understood him and opened it. During the hour he made no other at- 300 tempt to write, and after that time his speech returned." No apoplexy, no hemiplegia, no epilepsy, the reverie, or delirium of an hour, and that is the whole of it! The next of Dr. Clark's cases, after recovering from coma, was found paralytic on the right side, and nearly speechless, being able to use but the simple word "same." The patient was an inmate of Bellevue Hospital, and his physician, while reporting the facts, is interested in showing, with Dr. McCready, that apoplexy does not necessarily lead to mental imbecility. " One day com- menting upon the case, Dr. C. cautioned the students lest they might confound the loss of speech with the absence of intellect. As a test how thoroughly the man com- prehended what was spoken, a number of different in- struments, with which he was believed to be unac- quainted, had been placed in another apartment, one of them was described, and the patient was directed to select it from the others. He listened attentively to the description, went for and obtained the required in- strument, and presented it with his usual' same, same.'" But the poor idiot had a return of his epileptic convul- sions, with increase of his paralytic symptoms, and the case terminated fatally by coma, in this second attack. The last of Dr. Clark's cases, in the first series, is that of Eliza Jane Pendergast, aged twenty-six years, who, when first admitted into Bellevue, some time about November, 1855, is said to have been " deeply apoplectic, and apparently near her end;" she recov- ered with hemiplegia of the right side, " and no power to articulate a word." In about a month she could sit up, could indicate her wishes, and understand what was said to her; she was discharged some time after- wards, but was again re-adnlitted June 6th, 1857; she is now able to " use her right leg a little, but her right arm is still almost completely paralyzed. She can utter no articulate sound. The word ' no' is the only 301 one she can make intelligible, and this only by accom- panying the sound with a negative sign." " Her intel- lect," says Dr. Clark, " is perfectly clear; she remem- bers my former care of her, and told me by signs when she saw me first; her memory is clear regarding all events of her sickness, now about twenty months' du- ration. She has concerted signs, so that, by her fingers and otherwise, she makes those about her understand her meaning. When I did not comprehend her, she would call on the nurse or house-physician to interpret for her. Her countenance is very expressive, though still the muscles of the right side have not the free action of those of the left." "She can read, and says that she could write before her attack." But her first effort at writing under Dr. Clark was a failure. On the 8th of August the experiment was repeated, and after some effort and urging, " she succeeded, in about five minutes, in writing Eliza, but she could not go any further. She would stop after every letter, handing back the pencil in a despairing manner, but, still urged, would renew the effort." " It is a stiff, cramped, and irregular, but legible hand." " The patient is of vi- vacious temperament, cheerful and hopeful, and devises a hundred gestures and attitudes to express her thought, so as to leave no doubt on the mind of any one who sees her, that her intellect is entirely free from any embarrassment. Her perception is quick, her memory of things entirely unclouded, and her judgment per- fectly sound. Yet," Dr. Clark is forced to add, " with all this, it is noticeable that this woman, after a long conversation, will sometimes give wrong answers, which, however, she at once corrects on repeating the questions. This seems to result from fatigue of the attention, which, it is evident, is intensely active in devising substitutes for speech while she converses." (p. 227, 228.) 302 Here, then, is a patient who has absolutely no power of articulation; but who has "concerted signs" so that by her fingers and otherwise she can make her- self understood; " she is intensely active in devising substitutes for speech" and has " a hundred gestures and attitudes for expressing her thoughts ;" her condition is, therefore, much above that of Mr. Parish. For, though he had considerable power of articulation, yet he could not apply it in speaking. In him the seat of intellectual activity, not merely the motive nerves of the larynx, had given way. But yet this poor woman, notwithstanding the glowing description of her abili- ties, is not above the condition of imbecility. Her mind is weak, and easily confused, according to Dr. Clark's own showing. But in looking more minutely into his description, we find nothing but generalities, nothing to prove the assertion that " her intellect is entirely free from any embarrassment." And as the concomi- tants of the case are "prima facie" against this view, it was incumbent on Dr. Clark to prove the assertion to the satisfaction of those who take nothing of the sort for granted, until it is logically established. At the time of making out his report of the case, the pa- tient was still under his observation; and if her mem- ory, and power of expression, were so accurate, he should have verified the assertions which he gives on mere supposition. Thus, at the period of her first reception at Bellevue, her condition is drawn only from imperfect recollections; for, says he, " Whether she had convulsions at that time, I cannot distinctly remember." If not, and he had still this intelligent, tenacious, and unclouded intellect before him, he should not have rested in this doubt of an important fact, which the patient herself should have been able to resolve. But this is not the worst of the omissions. This patient is deeply imbued with the venereal dis- 303 ease; she " bears the marks of an extensive and severe rupia, (the worst form of venereal disease, as it shows itself upon the skin,) and, says Dr. Clark, " some of her physicians have thought that the paralysis might have had its origin in a syphilitic taint;" a very natural thought in them, and very probably a correct one. " But," says Dr. Clark, " as there were no marks of that disease in her system twenty months ago, while in the hospital, there can hardly be a doubt that, if this eruption was specific, it depended on contamina- tion of a later date than the apoplexy." Now, all this is mere assumption; as every one at all acquainted with the history and progress of the venereal disease must very well know. The disease may exist, and often does exist, for years in the system in other forms, before the development of rupia; and the very symp- toms under which this woman labored at her first ad- mission, are among those of constitutional syphilis, where it has extended to the bones of the skull, or to the internal envelopes of the brain itself. I have known it to destroy the sight of both eyes, the nerves of taste, smell, and hearing, without involving the brain, or destroying the intellect; the patient being yet able to feel and to speak, although not able to hear his own voice; and receiving communications from without only by concerted signs, devised to reach his understanding through the sense of touch— signs, however, which no imbecile could have inter- preted—consisting for the most part in the tracing of letters, with the finger, on the palm of his hand; which, on perceiving, he joined together into words and sentences. The venereal disease affecting the bones and their envelopes near the base of the skull, even without producing organic changes in the substance of the brain, might have given rise to every symptom in the 304 case reported by Dr. Clark. Pressure in the trunk of the eight pair of nerves at the point of their departure from the skull, or near that point, resulting from thickening of the surrounding tissues, as occasionally seen in syphilis, might have destroyed completely the power of articulation; but could have left her able to articulate some words and not to articulate others. The hemiplegia under which she also labors, and the early symptoms of coma, which Dr. Clark attributes to apoplexy, and even epileptic seizures in connection with these, might all have originated independent of apoplexy, and been produced independent of primary disease of the brain, or any serious organic change in its structure; and the venereal origin of the whole diffi- culty is the more probable when we recollect that san- guineous apoplexy, as a spontaneous affection in a patient not over twenty-six years old, is rarely or never witnessed. But coma, convulsions, paralysis and men- tal imbecility, as the result of syphilis, and of the mer- curial treatment often necessary for its cure, are condi- tions to be looked for at any period of life, and which are not at all rare in the severer and more protracted forms of this disease. Again, this woman's antecedents and her condition in life, independent of any cerebral disorganization, or permanent impairment of nervous force in the brain, may account in some measure at least for her crabbed and difficult chirography. But be this as it may, the case is imperfectly reported ; we receive it from a wit- ness already committed in some degree to the support of Dr. McCready's new views of apoplexy, and his bearing may as readily have led him to over-coloring on the one hand, as it has to errors and omissions on the other. Thus far, then, for Dr. Clark's report. But ascer- taining that the patient was still at Bellevue Hospital, 305 I took occasion, September 25th, 1857, after making these strictures, to examine the case itself; and from my own inquiries, as well as through those of other gentlemen who have also examined the patient, I am now able to state that the whole of this woman's ail- ments are of venereal origin. Dr. Gr. T. Elliott, one of the physicians of the hospital, having the immediate care of the case, recollects distinctly that the marks of the venereal ulcers on her skin were perceptible at the date of her first admission. The patient herself, when questioned, gives us clearly to understand that she con- tracted the disease from her husband about five years ago; that she had ulcers or sores on the lower part of the body about that period; that some two years ago she began to suffer severe pain in her head, followed by the sudden loss of voice, and by the paralysis of her right side; and that about a year and a half ago, or rather about five months after losing her voice, she had her first convulsion. She states that altogether she has had seven convulsive attacks, the last about three weeks ago. But here her statements be- come confused. When questioned as to the epoch of these several convulsive attacks, at first she stated that she had two prior to her first admission, one during the period of her first admission, four after she left the hos- pital, and one since her return. But as this enumera- tion would have made eight in all, she was again ques- tioned ; and now she insists that there were seven fits in all, as before; but she denies that she had had any fit prior to her first admission ; and this ultimate state- ment she persists in. But as there would be but six under these circumstances, and she also insists on seven in all, it is clear that her statement in one way or an- other is incorrect; and the truth cannot be ascertained from her. I do not find her mind so intensely active as I was led to suppose. Her ideas come to her rather 39 306 slowly, sometimes quite so; and she is very easily con- fused, even when care and patience are taken to bring her thoughts to bear upon the questions. Still she has evidently continuity of thought, and is well aware of the import of what is said to her. She gave me to un- derstand that she is 29 years old; that she was born in the south of Ireland, and that she has been married 13 years; that she sailed for this country from Liverpool; that she has resided in America nine years ; that she has two children, the youngest about five years and a half old ; that this child has always been healthy ; that she contracted the venereal disease from her husband after the birth of that child; that at the period of her first admission into the hospital she had all her senses about her, and could hear, and see, and understand all that was occurring about her ; but she cannot now re- call any thing from the questions put to her. She gives me to understand that her husband is at present living in the city; that she knows the part of the city in which he resides; but the most carefully devised series of questions that I could invent failed in eliciting from her the street in which he resides. The woman has a strabismus, or squint, in her right eye, which she says has existed since she was five years old, in other re- spects her health has always been good. Now these various statements may be correct, or they may not; she gives them apparently with as much consistency as might be expected from any other person who has absolutely no voice at all, and who has always occupied an humble sphere in life. But it is sufficiently appa- rent that the condition which Dr. Clark says existed at the period of her first admission, was not from san- guineous apoplexy; and that her ailments, all along from the onset, have been the direct result of the vene- real disease. The worst of these ailments, the loss of voice, the hemiplegia, and the tendency to epilepsy, 307 still persist, accompanied by an enfeebled condition of the brain, and some confusion of ideas. Her faculties are in process of deterioration; a few more recurrences of the epilepsy will probably finish the work already commenced, and reduce her to a still more deplorable and unmistakable state of dementia. In closing the observations in this case, it is worthy of remark, that another patient who at one time lay in the same ward with her, and was under the immediate inspection of Drs. Clark and McCready, an apoplectic, as is believed, and who had been reduced to a hopeless condition of dementia, has been entirely ignored by these gentlemen. This patient, whose name is Margaret Pierrepont, has since been removed to the Lunatic Asy- lum on Blackwell's Island, where she is now residing. It appears to me that Drs. McCready and Clark could better have elucidated the condition of mind following an apoplectic attack, by a full account of her case than by several of the reports of cases which they have here presented; some of which are given on very equivocal authority; and one of them, I think, on no medical authority at all. I allude to the case mentioned by Dr. McCready, as that of a near relative, a person whom he has never seen. We have still to notice the case from Dr. Alexander B. Whiting. This patient was an oddity—a steady hard drinker, aged 48, with an exceedingly violent temper. After a fit of passion he became paralytic on the left side, and could afterwards only articulate the unmean- ing word, " Begum, Begum." " Perception and under- standing seemed unimpaired." "He gave vent to feelings of anger by violent, sharp repetitions of the word ' begum,' with passionate movements of the right arm and hand, and with all the facial expression of rage. The paroxysms of rage seemed to increase in frequency, c the ruling passion strong in death.' He did not at any 308 time give way to tears, as is common with paralytics, but preserved the same dogged pluck with which he had once exchanged six shots in a duel. His anger was particularly excited against his wife, and against a phy- sician who approached his bedside, with whom he had previously had a quarrel. He laughed violently at jests, and seemed indifferent at the announcement of the probably fatal issue of his disease. We endeavored to get him to communicate with us by pencil and slate, but he could not trace the letters, and, after trying, would drop the pencil with a look of sullen disappoint- ment. He died in about three months after the attack, without any change in his symptoms." (p. 229.) Here the right hand was not involved, and yet the patient could not use it for giving expression to thought by written words. A wreck of humanity, with the pas- sions of a bull-dog; as crazy before the paralytic seizure, in all probability, as he assuredly was afterwards. We have now paid our respects to the whole of Dr. McCready's model cases—those upon which he says, " In all the cases that have come to my knowledge, as well those recorded by others, as those that are here given, where hemiplegia, with loss or perversion of the faculty of speech, has been unattended by coma or de- lirium, there is no evidence whatever that the intellect had been materially weakened; on the contrary, in all the cases recorded by Cruveilhier, Andral, Osborne, Bright [the last two from Copeman], as well as those here given by Drs. Van Wyck, Post, Parker, Clark, Whiting, and myself, there is ample proof that the pa- tients possessed a large and competent share of under- standing." (p. 233.) Alas! it is yet too true, that " doctors differ." But fortunately for other men who listen to, and take the trouble to weigh their arguments, there is yet remaining in the world " a large and com- petent share of" common sense. 309 We have said all his "model cases." For he does not, as shown above, include among these the case from Dr. Benjamin Ogden, which, out of compliment to this latter gentleman's reputation for sagacity, we should not entirely overlook. The patient was an imbecile, and " the only difference they observed in him since his affliction was, that his temper was more irritable, and that amusement was apt to be expressed by uncontrol- lable laughter; and distress, by equally uncontrollable bursts of tears." The other remaining cases of the collection, the 12 th, 13th, 14th, 15th, and last, which is not numbered, still require a passing notice. Of these, the 12th, from Dr. McCready's own practice, was a well-built, athletic Irishman, working among liquors, and, when the doctor saw him, evidently suffering from delirium tremens. He was seen by Dr. McCready only about twice. But says the doctor, " I understood that after a number of days he recovered the use of speech, and that a gradual im- provement in the paralysis took place." But Dr. McCready has not clearly made out that this patient had ever been really speechless or paralytic. The 13th is from Dr. B. Duggan, and is just such a case as might have been furnished by the score from the records of any hospital for the reception of surgical patients. A stout, athletic Irishman had been knocked in the head, and could assign no cause for the pain su- pervening on a broken skull; " but after being ques- tioned, he remembered having got a stroke of a slung- shot just fourteen clays before the pain began. He died of suppuration of the brain, the marked symptoms, besides the headache, being, a rigor or chill, faltering of speech, convulsions, and towards the close, complete paralysis and coma." The 14th, 15th, and 16th, are a new series of cases contributed by Dr. Clark. The 14th was the case of a 310 medical gentleman, with disease in the bloodvessels at the base of the brain, which ultimately led to softening near the top of the medulla oblongata, and meningitis, or inflammation of the delicate investments of the brain at this part, and to the effusion of watery fluid in connec- tion with this inflammation. The case went through its progress, to a fatal issue, in six days. We may briefly state of it, that the patient lost the power of utterance a little while before he became totally para- lytic, and before "all evidence of intelligence had passed away," and that he continued living in this last condi- tion about twenty-four hours. The 15th case was in a man aged 55, with a cancer- ous growth, leading to congestion and partial disorgan- ization, near the base of the brain, towards the left, and rather far forward. His first symptom was a convulsion on the 16th of June, 1857. He from that time broke down rapidly, and died on the 11th of July. The symptoms need not detain us; confusion of speech pre- ceded total obliteration of intellect, and the patient failed to write, while yet he knew what the intention of those around him was, who were urging him to make the attempt. Dr. Clark's last case is an ordinary instance of epi- lepsy, lasting for many years, and leading to imbecility at last. The patient, as the disease progressed, became weaker in one side of the body than the other, and had confusion in his speech, " so that many words, were wholly lost, and often a succession of them; then no- body can understand him ; yet, commonly his nurse can catch his meaning, but often only on repetition." " He is often playful and boyish. He is, however, tenacious of memory in regard to the circumstances of his own ailments, and on other small matters he has still some remaining traces of intelligence." " He does not weep, but he laughs immoderately on every trifling occasion." 311 " His nurse said, with more physiology in her remark than she supposed, that his laugh ran away with him." " There is something of the emotional element in his breathing while he strives, to converse. He takes fre- quent, and almost convulsive inspirations preparatory to uttering his words, and while speaking." But it is time to take our leave of Dr. McCready's paper. We need say no more of his tilt with the " authorities." 37th.—Instances of Diseased Brain without Abolition of Intellect Anatomically Explained. Passing now from our review of the medical testi- mony, and of the memorial intended to have a bearing upon it, we may observe, as we have already granted, that there are scattered through the works that treat on morbid anatomy, numerous instances on which organic disease of the brain, to a greater or less extent, is said to have co-existed with apparent soundness of mind. Andral, for example, relates an instance of arrested growth in a man 28 years of age, the result of an injury during infancy, and in which the posterior portion of the right hemisphere of the brain was deficient, the patient being all his life paralytic on the left side, yet with his intel- lect as that of other men* Cruveilhier cites a some- what similar instance of a man aged 42, with incom- plete paralysis of the right side, from his tenderest years, with an ordinary amount of intellect; and with arrested development, but without organic lesion in the left hemisphere of the brain.f This same author also cites two other instances in another part of his great work.J One of these was a case of abscess in the deep * Andral's Clinique Medicale, tome V. p. 618. Paris, 1834. t Cruveilhier's Anatomie Pathologique, livraison VIII., planche V., page 1 folio. J Cruveilbier's Anatomie Pathologique, livraison XXXIII., planche III. 312 central portion of the right hemisphere, an acute affec- tion, in which during the progress of the disease, for a part of the time at least, the intellect appeared to be unimpaired, nor was there noted the usually accom- panying paralysis; but towards the close of life there was stupor, accompanied with confusion of intellect. The other was a cancerous tumor as large as a hazel- nut, growing from the membranes of the brain near the outer limits of the cerebellum, and involving the lateral sinus on the left side; and in this case the patient, a woman, on the day before her death, was able to re- late correctly the particulars of the accident, a fracture of the thigh, from which she had been suffering. Ab- ercrombie quotes from O'Halleram a remarkable in- stance of extensive injury of the skull from fracture, followed by suppuration, and the discharge of what is presumed to have been portions of the cerebral sub- stance, through the wound, the patient becoming par- alytic in the left side on the eighth day after the acci- dent, and dying on the seventeenth; but retaining, as we are told, his faculties to the last, " having been through the whole course of the disease perfectly com- posed and intelligent, and his pulse quite natural." But here we should add, that " no account is given of the dissection, or of the actual loss of cerebral matter, though the report shows that it might have been con- siderable."* Cases similar to these, I might relate from personal experience. I am aware at this moment of two cases at least of persons recovering, and enjoy- ing a moderate share of intellect, after a loss of a por- tion of the cerebral substance from one of the hemis- pheres ; two instances of tumors involving the brain, in which the intellect was sufficient to recognize and cle- o * Abercrombie on Diseases of the Brain, p. 204. Philadelphia reprint, 1843. 313 scribe ordinary occurrences, for most of the time, up nearly to the period of dissolution, one in which a pis- tol-ball entered the forehead and lodged in the brain for nearly 24 hours before the intellect appeared to be seriously disturbed by the injury. And still another of the same sort, in which the ball, having lodged in the internal portion of the base of the skull, had ex- cited inflammation, leading to an abscess, which in- volved a great portion of one of the hemispheres, and in which, for most of the time, and until within a few days of death, the patient could answer questions in- telligently. But in all these instances, it must be observed, the disturbance in the structure of the brain was confined to a single hemisphere; and in most of them to only a limited portion of that hemisphere ; leaving the other parts of the cerebral mass comparatively unaffected, and in a condition sufficiently sound for executing their functions. Now, the reason for all this, we have al- ready stated, and explained; and what we have ad- duced on the subject from Sir Henry Holland, Dr. Wigan, and Dr. Carpenter, as well as from Todd and Bowman, we need not here repeat. (See pages 241, '2 and 264-'7.) Again, in carefully analyzing most of the cases of this sort on record, we find that the allusions to the condition of the intellect are merely incidental, and not given with that degree of detail which should be required in order to judge of it correctly. In some of them, the meaning of the term, soundness of mind, as employed by the writers, is, that the patients could give a rational answer to a simple question concerning their health or the circumstances of the case,—in other words, that these persons were neither unconscious, comatose nor delirious ; but not by any means intend- ing to show that the individuals thus situated were in 40 314 the fair possession of their mental faculties, or mentally competent to transact business. For the very authors from whom these cases have been cited, when treating of the relation subsisting between the state of the mind and the condition of the brain, leave no room for misconstruing their firm belief in the existence of such connection; and almost every page of their writ- ings bearing upon this connection, is in confirmation of the truth of it. 38th.—Esquirol and Cruveilhier on the Connection be- tiueen Idiocy and Disease of the Brain. M. Esquirol, one of the most profound and reliable investigators of mental maladies, and of their connec- tion with the physical organization, speaking of demen- tia, or what is usually understood by the terms fatuity or imbecility resulting from disease, says : " The gene- ral results of post-mortem investigations upon those who*die of dementia, demonstrate a greater variety of cerebral lesions in connection with this, than with any other form of mental alienation." * And M. Cruveil- hier, one of the ablest morbid anatomists of the present day, on the same subject, speaks to the following effect: " Of all the diseases affecting the mind, there is not one upon which pathological anatomy throws greater light than upon idiocy. The brain, that immediate and necessary instrument of the mind in the exercise of the intellectual functions, when arrested in its de- velopment, or altered in its structure, leads to a dimi- nution of intellect amounting sometimes to total ex- tinction. Every noticeable diminution in the intellect- ual faculties, which permanently disables a man from holding his place in the world as a social being, is called," says he, " idiotism, or rather idiotie, by which is implied inaptitude for the duties of social life * Maladies Mentales, tome 2d, p. 244, Paris, 1838. 315 (IJI02Z, solitarius.) The study of the brain in its re- lation to idiocy, is intimately associated with some of the gravest questions of psychology, and particularly with that of the intellectual differences between differ- ent individuals ;—differences not less remarkable, not less numerous, not less appreciable than their respec- tive differences in physical organization. Now, are these intellectual differences associated with corre- sponding differences in the structure of the brain? Observation enables me to answer this question in the affirmative; and sound metaphysics cannot gainsay the acquisitions of anatomy. Physical truths can never be in opposition to the truths of metaphysics and morality. The physical and organic lesions of the brain, and the whole animal kingdom, are before us, proclaiming the influence of organization upon the intellect." " Having had, during seven or eight years at the lunatic asylum of Limoges, abundant opportunity for the study, I can," says he, " well appreciate the distinction between imbecility and idiocy established by M. Esquirol." But still retaining the common term as applicable to both forms, he speaks of idiocy as implying merely the congenital; and of dementia as including only the ac- cidental or acquired variety. And of these he says, " The first presents, on post-mortem examination, an incomplete development; or at most, traces of disease that may have occurred before the time of birth. But in the second we find traces of disease more or less severe, that must have originated at a later date." " Of congenital idiocy there may be as many varieties as there are of the organic causes by which they are determined. But the variety of idiocy which is ac- quired, is the last, the common result, of all the diseases of the brain; hence we have an apoplectic idiocy, an epileptic idiocy, and idiocy following all the other varieties of mental alienation." * * Anatomie Pathologique, livraison F., planches IV., V, pages 1 & 2. 316 39th.—Insanity, in its Statistical Relations to Apoplexy. But passing from the anatomical phase of Mr. Parish's case, we have still to examine the various ail- ments from which he suffered, in their usual relation to the state of the mind, as shown by the records of ex- perience. "Apoplexy," says M. Esquirol, (tome le,p. 74,) "may be often recognized by the ensuing fatuity (demence), which is then accompanied by paralysis." Among the physical causes of mental alienation, accord- ing to the same writer, not much less than one-tenth may be ascribed to apoplexy. His statistical exposi- tion of this point is worthy of careful examination, and is as follows: PHYSICAL CAUSES OF MENTAL ALIENATION, AS SHOWN BY THE CASES AT SALPETRIERE AND CHARENTON.* Hereditaiy Predisposition, at Salpetriere, 105, at Charenton, 150 Convulsions of mother during gestation...... " 11 " 4 Epilepsy, ..... " 11 " 2 Disordered Menstruation, . " 55 " 19 Results of Parturition, . . " 52 " 21 Change of life, in women, . " 27 " 11 Progress of Age, .... " 60 " 4 Exposure to the Sun,... " 12 " 4 Falls, and Blows upon the Head,...... " 14 « 4 Fevers,....... " 13 " 12 Syphilis,....... " 8 « 1 Abuse of Mercury, ... " 14 " 18 Intestinal Worms, ... " 24 " 4 Apoplexy,...... " 60 " 10 Total, at each institution, 366 264 * Salpetriere is a public asylum near Paris, devoted exclusively to females; Charenton, also in the vicinity of Paris, a private institution, then under the care of M. Esquirol, and open to both sexes. 317 In treating of impairment of intellect after apo- plexy, M. Andral (tome vi., p. 381,) speaks as follows: " After the escape of blood has been arrested, the lethargy [coma] may continue; the patient does not regain his consciousness; and, in this case, death speedily ensues. In cases more fortunate, and which are far from being rare, the state of coma may disappear, but on coming to himself, his intellect, at first, is apt to remain disturbed as before. In a very small proportion of cases, it is perfectly restored; most frequently it remains feeble; the patient retains sufficient intelligence for attending to the occupations of common life; but he is incapable of meditation, or of intellectual labor in the least degree prolonged; he cannot, without fatigue, attend to conversation any way protracted or serious, and it is necessary to guard him against it, in order to prevent an aggravation of his symptoms." " But in- stead of this simple enfeeblement, the intellect may be still more gravely injured. Thus, a certain proportion of apoplectics fall into a state of childishness, or into the imbecility of old age; they are particularly inclined to weep with singular readiness. Others of them are, from time to time, seized with delirium, such as often occurs in acute inflammation of the lining membranes of the brain; and, in fact, there is reason to believe that this delirium is caused by the periodical occurrence of irri- tation in the arachnoid membrane which invests the diseased hemisphere. In other cases, again, the mental alienation declares itself as the direct result of the es- cape of blood upon the brain." He goes on to show the connection between apoplexy and loss of speech. 40th.—loss of Speech in its Relations to Apoplexy. " Another symptom occasionally observed to result from the effusion of blood in the brain, is the loss of speech. This may coexist with integrity of intellect. 318 Sometimes this accidental muteism disappears promptly, sometimes the speech is restored after a very long period, and sometimes the loss is permanent." In reference to M. Bouilland's hypothesis as to the seat of lesion in the brain, where the loss of speech is a prominent symptom,* he says, (vol. v. p. 382.) " In thirty-seven cases observed by myself or others, rela- tive to hemorrhage or other lesions in one or both of the anterior lobes of the brain, there was loss of speech in twenty-one instances, and no such loss in sixteen instances." " On the other hand, we have col- lected fourteen cases, in which there was abolition of speech without any alteration whatever in the anterior lobes. Of these fourteen cases, seven were affected with disease in the middle, and seven with disease in the posterior lobes." 41st.—loss of Speech as Connected with Disorders in the Mental Faculties. Loss of speech, then, partial or complete, is not an unusual attendant upon apoplexy; or the condi- tion of the brain that gives use to, or follows apo- plexy ; and its relations to the mind are the same as those of apoplexy, the brain being an essential or- gan as well for the development, as for the verbal expression, of our thoughts. But on this point we must again turn to M. Cruveilhier, who, in allusion to the loss of speech as depending on the condition of the brain, says:— " The faculty of articulate speech has no special seat within the brain, and ceases wherever there exists * M. Bouilland, from some facts observed by himself and others, sup- posed that the lesion of the brain associated with loss of speech had its seat always in the anterior lobes of the brain, an opinion abundantly dis- proved by Cruveilhier, Andral, and others. 319 any extensive destruction of the cerebral mass, whether in the optic thalamus, the corpus striatum, the tuber annulare, or the medullary centre of either hemi- sphere." He goes on to describe the different causes and varieties. The Varieties of loss of Speech, and of Aphonia, Illustrated and Explained, in their Relation to the Case of Mr. Parish.—" The loss of speech, as I have else- where stated," says he, " may depend upon three causes: 1st, loss of the memory of things; 2d, loss of the mem- ory of words; 3d, the want of power of articulation. The frequency of the loss of memory of things," he con- tinues," has been singularly exaggerated, because it has almost always been confounded with the other two. Nevertheless, there is nothing more easily recognized ; for in connection with this loss of the memory of things, the patient is in the most complete state of idiotism. Falls upon the head—certain attacks of apoplexy, and ma- lignant fevers, determine this form of amnesia; which is sometimes partial; sometimes general; sometimes temporary ; and at other times permanent. " The loss of verbal memory coinciding with in- tegrity of the intellectual faculties, is much less fre- quent. Words, the representative signs of our ideas, are so associated with them, that it is extremely rare, as Condillac has proved, for the absence of words not also to denote the absence of ideas. Nevertheless, as this association is purely conventional and the result of habit, we may readily conceive, what experience has amply shown, that the sign for the idea may, under some circumstances, be lost. Hence it is, that our records are full of examples of individuals who appear to be in possession of all their intellect, although they may have forgotten certain words of their language, as substantives, proper names, or adjectives, or even almost every word." 320 " Finally, the loss of speech may exist:—1st, with- out disturbance in the memory of things, the patient being in the full enjoyment of his intellect; 2clly, without disturbance in the memory of words, since he can write with as much facility as when in perfect health; and what is remarkable, he can exercise all the movements of the tongue with great agility, though unable to articulate sounds. Interrogate him, and the expression of his face declares at once, that he under- stands you perfectly; a thousand ideas appear to take possession of him; in order to reply to you, he resorts to the most remarkable efforts; he commences a word, turns it in a thousand ways, and almost always wrong; he manifests his exultation in mastering a single word, he is m despair on finding his efforts useless ; and most frequently his articulate language is reduced to three or four exclamations, or insignificant words, or mono- syllables. One might be tempted to believe that this defect of articulation was always owing to the loss of the memory of words; for the patients often articu- late very distinctly the small number of words of which they retain the recollection, although the articulation of these words may be extremely difficult. But the proof that the memory of words is not lost, and that the faculty of articulating sounds only is wanting, is, that the patients give their sign of approbation when- ever they hear the word pronounced which they them- selves are unable to utter; gestures of approbation or the reverse, follow the success, or want of success, in our efforts to enter into their ideas; and they give ex- pression to joy, or grief, or wrath, in listening to dis- course calculated to excite these emotions. The diffi- culty of controlling the movements necessary for the articulation of sounds is such, that oftentimes many days are necessary for them to seize a single word. A hemi- plegiac female, he relates, " who was thus situated, had 321 completely lost the faculty of pronouncing her own name and that also of her husband. By perseverance she afterwards re-acquired the power of expressing these. Sometimes she would speak the word very well; at other times she would fail to seize it; and growing im- patient she would vigorously agitate her sound arm, and pronounce the word sacristie, which was her usual exclamation; but when any one spake to her the first syllable of her own name, or that of her husband, she could finish the word; and would manifest great joy in being able to accomplish it. She was also taught to say, Bonjour, Monsieur, which she did to her own great enjoyment, when, in the attempt, her memory did not play false to her ; which often happened."* The want of logical accuracy in the statement of some of these alleged cases of loss of speech, as M. Cruveilhier has intimated, is not to be overlooked. Some of them are loosely related, some are given on hearsay authority, and have never been properly tested, at least, in such a way as to render them worthy of implicit reliance. We must also remem- ber how readily the expressions, soundness of intel- lect, integrity of intellect, and the like, are employed not to convey the idea of the unembarrassed use of the mental faculties, but simply that the individual has so much intelligence as to know what is going on about him, and to be able to give a rational an- swer ; in short, that he is not crazed, nor stupid, nor unconscious. The feeblest degree of intelligence may in this way be taken for soundness of mind, or at least may inadvertently be said to be such, by those who are not guarded in qualifying their expressions. A man in the last stages of prostration from disease, may forget a whole language, or at least cease to use a * Cruveilhier, Anatomie Patholgique, Livraison XXXIII., Planche II., pages 3, 4. 41 322 whole language, which he had acquired after arriving at the age of manhood; but he rarely, under these circumstances, fails to revert to his mother tongue. Of his mother tongue, too, he may forget rare and un- usual words ; or he may, by wrong association, or from want of association, forget a familiar word or a series of words. But to forget the whole vocabulary of his language, implies a defect of memory that must be associated with forgetfulness of other things than words. The disturbed association of ideas, in fever, I have on several occasions known to cause a temporary loss of one's own language and the employment of the words of a foreign tongue, or to the mixing up indiscriminately of phrases of different languages. A German gentle- man was lately under my care for a bilious fever, contracted in crossing the isthmus of Panama. During his illness he ceased not only to speak English, which he knew very well, but also ceased to speak in Ger- man, never saying in his own language more than " Och Gott, mein kind." But he was continually exclaiming a series of phrases, which those about him could not in- terpret until his brother observed that they were words in modern Greek, a language which he also under- stood ; and the words employed were such as he had, years past, been in the habit of addressing to his little son. In what M. Cruveilhier states, he has reference only to loss of speech in connection with diseases or organic disturbances, within the skull. He makes no allusion in the passages which we have borrowed from him, to loss of speech from mechanical obstruction or local dis- eases within the air passages, or in the organs of respi- ration. Nor does he allude to such as depend merely on injury or loss of function in the laryngeal nerves, by which the small muscles at the top of the larynx, which open and contract it for modulating the sounds of the voice, are supplied with motive power. Instances of 323 loss of function in these nerves are now and then seen in Irysterical females. Iu these the abolition of function, and consequent loss of voice, are almost always tempo- rary; the affection being simply a manifestation of hysteria. Permanent loss of voice in males from dis- ease or loss of function in the nerves in question, is ex- tremely rare; but I remember to have witnessed one example of it in a young seaman of lively intellect, and who was otherwise in perfect health. In his case the loss of voice, I think, was after injury by lightning; and so complete was this loss, that he could not give utterance to any sound, even as loud as a whisper. But he carried his slate and pencil with him constantly, and was a young man of more than usual intelligence for his class. To cases such as this Mr. Parish's case holds not the most remote analogy. And in the pre- sent connection we may take it for granted, as already admitted' by Dr. Delafield, that the loss of speech in Mr. Parish immediately depended upon the primary lesion on the cerebral substance, and that it is to be reduced to one or the other of the three categories laid down by M. Cruveilhier. Now, in which of these three categories are we to place the case of Mr. Parish ? Surely not in either of the last two; for, with the loss of speech, he had also lost the power of giving expression to thought by writ- ten language, or by any artificial contrivance of his own, and while he had the power of enunciating many sounds, including such as are represented by a, e, i, o, among the vowels by the aspirate h, and by several other consonant letters, dental, labial and nasal, he was still unable to continue these sounds in such a way as to speak a single word, not even a mono- syllable distinctly, or give utterance to any sounds ex- pressive of the simplest train of ideas. He was not then simply a mute from want of power of utterance, but from want of intellectual power sufficient to give 324 direction to the simplest thought by the use of words : the organs of speech, however, being at the same time imperfect from the loss of nervous power; yet not so imperfect but that with a directing intellect, they might have been called into useful action. 42d.—Hemiplegia in its Statistical Relations to Insanity. But Mr. Parish, besides being apoplectic and de- prived of speech, was also hemiplegiac. And we are next called upon to examine the relation subsisting be- tween the conditions of the mind and paralysis. " Of apoplexy," says Sir Henry Halford, " I shall say but little, because before the blow be struck, the patient may have been merely torpid and indifferent to scenes of whatever interest in which he has lived." * * " But the sequel of apoplexy is palsy, and when that has supervened, and the frame has been dismembered, then, indeed, happy is the patient whose mind shall have been disciplined when in health, and whose habits shall have been well regulated by reason and by good principles be- fore he was taken ill; for otherwise, as all the passions are let loose by the malady (as is the case in many instances, at least, in this disease,) whilst the controlling power is enfeebled, an irritability succeeds which makes life in- tolerable to the sick man himself, and to all around him. The tenderest offices administered with the most prudent attention and care, fail to conciliate ; and he indulges his anger, and dissolves into tears alternately alike with- out reason, until at length, another apoplectic blow de- prives him of life. By this distemper the great talents of Marlborough were confounded in the latter years of his life, and his powerful mind impaired. By this, also, was extinguished the spirit of the celebrated Dean Swift. 325 " From Marlbro's eyes the tears of dotage flow, And Swift expires a driveller and a show."* That deplorable and always incurable form of para- lysis, known of late years as the paralysis of the insane, and which M. Esquirol was among the first carefully to delineate,-)- we need not here allude to further than to say that it pervades both mind and body, seizing on both alike, and always proceeding from bad to worse, until life itself is at last extinguished. But, in connection with Mr. Parish's case, let us look at the less aggravated forms of the disease, as we find them spoken of in con- nection with dementia, or accidental imbecility. " Paralysis," says M. Esquirol, " is more frequent among men than women under mental alienation. Some eighteen years ago, while on duty among the alienated at Bicetre, during the absence of M. Pariset, who had been sent to Cadiz to study the yellow fever, I was struck with the difference in comparing the number of men alienated and paralytic, at the hospital of Bicetre, with the number of paralyzed women at Salpetriere. The same observation may be authenti- cated at the institutions on which the alienated of both sexes are admitted. It has not escaped M. Foville of the institution of Saint-Yon, at Bouen, where, according to that physician, this complication is noticed in about an eleventh of the patients. Among 334 cases of mental alienation recorded by him 31 were paralytic; 22 men and 9 women." "At Charenton," continues Esquirol, " the proportion of paralytics is besides very considerable, amounting to one-sixth of the whole ad- missions ; in fact, out of 619 alienated patients admitted here during the years 1826, 1827, and 1828, 109 were * See Essay V. On the Influence of the Diseases of the Body on the Mind, in " Essays and Orations,'1'' by Sir Henry Halford, Bart., M. D. Second Edition, Lond. 1833. t Tome '2d, p. 261. 326 paralytics, and the proportion of men is enormous in comparison with that of women ; of 366 men among the alienated admitted into this institution, 95 were paralytic; and of 153 females, only 14 were affected with paralysis." * We need not follow him in his rea- soning for explaining this difference in the complications between the two sexes. He goes on to say—and the passage is not inapplicable to our present investigation —that " paralysis complicates all kinds of mental ali- enation, whatever be the form of the delirium; it com- plicates mania, melancholia, as well as ambitious mo- nomania, more frequent, indeed, in the last, and it is almost always a complication of dementia."-)- Dr. Cope- land, in his chapter on the Connection of Palsy and Apoplexy with Insanity, says, "Palsy is not infre- quently also associated with idiocy and with puerile imbecility." " When this affection occurs in the aged, it may be connected with atrophy of a lobe or portion of the brain, consequent upon antecedent disease." Speaking of the paralysis of the insane, he says, " This form of paralysis is often indicative of chronic inflam- mation of the meninges, and is distinct from the para- lytic affections consequent upon cerebral hemorrhage, or upon softening, tumors, &c, of the brain, which, however, may also be complicated with insanity, al- though much more rarely than the general form of the affection above described. Whatever form the mental disorder may have presented, it soon passes into chronic dementia, when complicated with paralysis." % * Maladies Mentales, tome ii. p. 271-2. f P. 276. J Copeland on the Causes, Nature, and Treatment of Palsy and Apo- plexy, p. 147-150. 327 43d.—Epilepsy in its Statistical Relations to Insanity. Again, Mr. Parish was not only apoplectic, deprived of speech, and paralytic; he was also, for nearly seven years, subject to occasional, and during a great part of the period, to very frequent attacks of epilepsy. I use the term deliberately, for there is no other word to convey the idea of convulsions of the whole body ac- companied with frothing at the mouth, loss of con- sciousness, and subsequent stupor or somnolency, oc- curring in an adult male, and recurring at frequent intervals for several successive years. Epilepsy, or periodically recurring convulsions, whether arising from disease of the brain or not, usu- ally tends more and more to impair the structure and functions of the brain, and to diminish, pervert, or de- stroy the intellectual and moral faculties; leading to idiocy in its various modifications of imbecility or fa- tuity ; to mania, or other conditions in which the mind of the sufferer is hopelessly disordered ; to unevenness of temper, and to occasional paroxysmal attacks of ex- citement, which might be attributed to passion, were they not more properly depending on causes wholly beyond the control of the sufferer. Every asylum for the insane can furnish evidence of the truth of this state- ment, and the more readily, from instances in which epilepsy and paralysis are united. Cook, in allusion to epilepsy, says, " After frequent attacks, it sometimes ends in apoplexy, sometimes in paralytic affections, par- ticularly of the nerves necessary to hearing and vision; but its -common termination is in idiotism or fatuity. The faculties of the mind, especially the judgment, the memory, and the imagination, gradually fail, and a total imbecility supervenes. Innumerable instances of this kind might be quoted from Van Swieten, Tissot, and others."* * Cook on Nervous Diseases. London, 1823. Appendix to Vol II. .p 23. 328 " Epilepsy, the seat of which is in the head," to use the words of one of our most sagacious observers, " seldom continues for any length of time without de- stroying the natural tone and soundness of the mind, rendering the patient listless and forgetful, indisposed and unable to think for himself, yielding without any will of his own to every external influence, and finally sinking into hopeless fatuity, or becoming incurably mad." * " Epilepsy," says Esquirol, " leads sooner or later to mental alienation, whether in infancy, or in more advanced life. Among the 300 epileptics inhabiting Salpetriere, more than one-half are deranged; it is the same at Bicetre and Charenton, some of them being idiotic or imbecile, some demented, and others maniacal, even furious. The fury of epileptics has a trait of fe- rocity which nothing can overcome, and it is this which renders them so much the subjects of alarm in every asylum." f Again, says the same writer, " Epilepsy is not only a disease fearful by the violence of its symp- toms, and hopeless by its persistent incurability. It is also disastrous by its effects upon both the physical and mental organization of those affected by it." And again, Mr. Esquirol tells usj that he has collected with the greatest care the history of the women occu- pying the epileptic department of Salpetriere, to the number of 385. Of this number, 46 were cases of hysteria, so that he had only to account for 339 epi- leptics. Of these, twelve were monomaniacs; thirty were maniacs, among whom were some predisposed to sui- cide, and who had made several attempts to destroy themselves; thirty-four were furiously maniacal, and * Ray's Medical Jurisprudence of Insanity, p. 121. Boston, 1838. t Loco Citat. torn. i. p. 74. t Tom. i. p. 282. 329 in three of these the fury was observable only after the epileptic seizures ; one hundred and forty-five were demented, among whom sixteen were constantly so, the others only so after the epileptic seizure, and two of these were subject to furious paroxysms; eight were idiotic, among whom one had been epileptic only seven or eight months, and had only had five paroxysms; fifty were habitually rational, but characterized more or less frequently by absence of memory, or by exalta- tion of ideas ; some of them were subject to temporary delirium, and all of them had a tendency to dementia; sixty had no aberration of intellect, but with great susceptibility towards it: irascible, obstinate, difficult to manage, capricious, whimsical—all with some singu- larity of character. Thus 269 [279] out of our 339 epileptics, that is to say, about three-fourths, were more or less deranged ; one-fifth only of them retained their reason, and such reason !" * 44th.—Mr. Parish could not use, and could not be taught the use of, Artificial Signs for the Expres- sion of Thought / and the Inferences from this, in reference to his Mental Faculties. But Mr. Parish was not merely apoplectic, speech- less, paralytic, and epileptic; he was incapable of giving expression, and could not be taught to give expression, to the simplest thought, by artificial signs. That apoplectics may be competent to exercise a fair amount of intellect—or that, to all appearance, they may in rare instances regain the full and free use of their mental powers—need not be called in question. Aphonia alone, epilepsy alone, hemiplegia alone, is not necessarily associated with mental incompetency. But 42 * Esquirol, tome i., p. 284. 330 we would hardly look for this in the combination of all these several forms of bodily derangement in the same^ individual; and when to all of them we have to associate the trait of Mr. Parish's case which we have now under consideration, we are no longer able to resist the conviction that the mental functions of the individual thus disabled, were also deeply implicated. The paralytic affection in Mr. Parish, as we have seen, involved merely the right half of his body and limbs. He could even make some use of his right leg, and he had still control over, and enjoyed a fair amount of muscular strength in, his left arm and hand, as well as in his left leg; his vision was sufficient to enable him to see letters and figures in print, and to point to small objects, as straws and crumbs upon the floor; nor were his other organs of external sense, as far as can be discovered, in any degree impaired. Now, were the mind under these circumstances also unin- volved, the individual, even without the use of his natural voice, would have still the power to communi- cate his ideas, clearly and distinctly, to other persons, not merely by natural gesticulations, but by artificial signs, by devices of his own, or by such as might be taught to him. Mr. Parish had not this power, and he could not be taught to acquire it. His mere expression of assent or dissent, of inquiry, as it is called; the ejac- ulatory and instructive cries of opposition or of pain; his power of attending in some degree to the ordinary transactions under the immediate cognizance of his senses, if such power indeed existed; and his respon- sive look to those who were addressing him, are, collectively, but feeble indications of intellect, and, of themselves, altogether insufficient to establish the ex- istence of a mental capacity above that of some of our domestic animals. Powers such as these, and even some of the higher traits—memory, affection, sorrow, 331 regret, habits of propriety, and sense of modesty—may be exercised not only by the imbecile incapable of mental development, but also by the confirmed idiot; and most of them, if not all of them, by certain of the brute animals. Cases of hemiplegia, cases of aphonia in the enjoy- ment of a fair amount of intellect, are too familiar to call for illustration. Even those that are born deaf- mute and blind, or who have been reduced to this con- dition in infancy or early life, where the brain is still intact, are capable of great intellectual development; so as to be able to comprehend moral and intellectual truths, the truths of history, of philosophy, of science, of religion; and, in proportion to the loss of one or more of the external senses, their remaining inlets for the acquisition of knowledge will be strengthened; and so also of the use of the limbs, the organs of ex- ternal action and locomotion. I recently witnessed an exhibition at the new institution of the Deaf and Dumb Asylum at Fainwood, near this city, in which a young gentleman, one of the inmates, a deaf-mute, exhibited in dumb-show every thought and sentiment in Dr. Oliver Wendel Holmes's ballad of the Oysterman. Not by the mere use of the finger alphabet, not word for word, as in writing; but by those natural signs which are perfectly intelligible to all persons, without the use of language. I have been told by the superintendent of the In- stitution for the Blind in this city, himself a blind man, that the loss of sight adds immeasurably to the faculty of hearing and of touch. By his own feelings, as well as by the sound of his voice, he can tell whether a door at the remote end of his large lecture-room is open or shut. The delicate perception of the fingers of the blind, playing along their embossed reading-books, is almost beyond belief. 1 have seen and heard them 332 reading from these prints, detached passages marked for them at random, as fluently and with as much ap- propriate emphasis as the best of our public readers are able to do even with the use of their eyes. The staff in the hands of the blind man becomes an organ of perception as delicate as the tentaculae of the lower animals. Dr. Carpenter speaks of an acquaint- ance, a blind gentleman, who could guide himself about, by the aid of a staff, with great facility; and who stated that his skill in so doing depended much on the flexibility, elasticity, and other properties of the staff; so that when he chanced to lose or break one to which he had become accustomed, it required a long time for him to obtain another that would suit him as well.** Saunders, the blind professor of mathematics at the University of Cambridge, was a connoisseur in medals, and could readily distinguish a true from a spurious medal, by the sense of touch. The works on physiology furnish innumerable examples of the same sort, showing the vicarious actions of one sense in sup- plying the losses of another.f Julia Brace, of the Hartford Asylum, deaf, dumb, and blind, from early infancy, if not from birth, could distinguish through the sense of smell the various in- dividuals of the institution, and even select their cloth- ing in the wash. Laura Bridgeman, also deaf, dumb, and blind, is another instance, as reported by Mr. Howe, of Boston, equally remarkable as the fore- going, and more familiarly known. The case of James Edward Meystre, of Switzerland, reported by his teacher, M. Hizel, and made known to the American public by Mr. Lewis Peet, of the Deaf and Dumb Asy- lum at Fainwood, near this city, is still more worthy of * Comparative Physiology, p. 1053. Philadelphia reprint, 1851. t See among the rest Carpenter's Human Physiology, p. 246, &c.; p. 252, &c. London, 1842. 333 attention. This youth, though deaf, dumb, and blind, from his tenderest years, was taught not only to know all that was taking place around him, to understand complex intellectual and moral truths, and to write and speak with his fingers; but he was actually taught to enunciate words intelligibly, and to hold discourse by means of his newly acquired language; though still un- able to hear the sound of his own voice.* The power of the mind in substituting the use of one organ for another, is equally well shown in study- ing the uses of the limbs. Not a dozen years since, a middle-aged man was exhibiting himself in this city, under the assumed name of the " Gnome Fly," who, with merely the rudiments of legs and feet, not of the length of one's hand, was obliged to do much of his lo- comotion by means of his arms and hands; and who, by means of wires, or ropes, could spring along the ceiling or walls of the theatre with as much agility as a fly might be supposed to do. At an earlier period, it is still within my own recollection, that another person, a female, was exhibiting herself at Scudder's Museum in this city, who, from never having had either arms or hands, had learned to make her toes supply the use of fingers, and by means of her toes could execute many of the delicate and minute performances that other persons accomplish with their fingers. The Bev. Dr. Brownlee, quite as far advanced in life as Mr. Parish, after a sudden attack of apoplexy, even more severe than his, and followed as in his case by permanent paralysis of the whole of the right side, though for a season deprived of intellect, and for a still longer period without the use of speech, ultimately re- gained to a considerable extent his intellectual powers; and with the restoration of mind, came the desire of * Proceedings of the Second Convention of American Instructors of the Deaf and Dumb, p. 169, &c. Hartford, 1851. 334 expression by writing. He at once resorted to pen, ink and paper, with his left hand, and his autographic signatures, as well as the specimen of his composition, which constitute portions of the exhibits in the printed evidence taken before the Surrogate, (see Vol. III. ex- hibits 252, 253, 268,) show that when the mind is not wholly overpowered, even where palsey supervenes late in life, the bodily organs will be made to adminis- ter to its wishes. Other instances of the same sort are also given in the evidence, and illustrated in the series of exhibits in the third volume of the case containing the printed minutes of the Surrogate. Many of the cases, too, collected by Dr. Benj. W. McCready, to bear upon that of Mr. Parish, and published in the N. Y. Journal of Medicine for September, 1857, are illustrative of this point. From facts like these we know, then, that wherever intellect exists, it will find the means of expression, whether in the young or old; and it would be difficult, I believe impossible, to produce an instance to the con- trary, in any case where, as in that of Mr. Parish, the patient still retained considerable voluntary control over the muscles of half the body; and where the pa- ralysis was co-existent with vigorous digestion and good appetite, for several successive years. 45th.—Conclusion in reference to Mr. Parish's In- tellectual Powers. Granting, then, for the sake of argument, and not- withstanding what has been already shown, that a fair amount of intellect, or a disposing memory, is compat- ible with hemiplegia, loss of speech, impairment of vision, frequently recurring convulsions, perversion of the natural temper and disposition, paroxysmal excita- 335 bility, blunted sense of modesty, and loss of control over the natural evacuations, all in the same individual, —yet in no case would I hold it compatible with in- ability to give expression, by some means or other, to a continuous train of thought, through such organs as in this instance were still under the control of the will. And when it is proved or conceded that such organs, after various attempts at tutoring them, and under the pressure of continuous necessity for exerting them, have failed, through a period of nearly seven years, to re- spond clearly, unmistakably, and intelligibly, to the demands which the mind, if it had any tolerable de- gree of power, would most assuredly make, the evi- dence of mental incapacity becomes irresistible. The mind, with any degree of vigor, even fragmentary vigor, yet remaining, will find expression for its wants, beyond such as spring merely from its physical neces- sities. Where one series of organs fail to meet its wishes, it will employ others in their stead, and where the natural means of expression fail, it will resort in course of time to such as are artificial. That Mr. Parish, then, during the many years of his bodily affliction, wras never known to put together two consecutive ideas, or to give expression by sound or sign to any continuous train of thought, or for any pur- pose much beyond the gratification of his own immedi- ate wants,—is itself a circumstance sufficient to show, that he had no such scope of thought to communicate ; and hence, that while his instinctive and simply animal functions and propensities still endured, and he still enjoyed considerable power over the left half of his body, and perhaps some confused notion of his former mercantile and business habits, yet his intellect was profoundly and irrecoverably damaged; and to such an extent that for all the proper uses of a disposing memory, for all the purposes of abstract reflection, fore- 336 cast, meditation, minute perception, or accurate details of any sort,—and above all, for the purpose of execut- ing any legal document, as for instance a will, or codi- cil to a will,—it may be said to have been utterly an- nihilated. 46th.—Summary Vieio of the Facts and Principles in Anatomy and Pathology bearing on the Case. Now to sum up the whole matter of this medical investigation, it may be presented in a few general propositions: 1st. The ailment of Mr. Parish was originally an organic disease of the brain, the nature and extent of which might have been determined by a post-mortem examination. 2d. The condition of the mind, the imbecility or dementia, as, well as the bodily infirmities of Mr. Parish, was the direct effect of morbid changes in the structure of the brain; and was as irremediable and permanent as the disorder in the brain which gave rise to it. 3d. There are organic diseases of the brain so slight, so limited in extent, or so situated, as only very partially to impair the intellectual powers or moral propensities; but very few, if any, such cerebral changes ever occur, without some mental impairment. 4th. The amount of disease sufficient to disturb the intellect and produce violent lunacy, with per- version of ideas and perception, is much less than is necessary to cause fatuity or idiocy, or some of the milder forms of imbecility. For, the latter diseases imply a permanent prostration in the functions of the brain, and corresponding change in structure; the former disease may be from mere temporary disturb- ance, where the structure of the organ is not very per- 337 ceptibly at fault. But in becoming chronic, lunacy de- generates into dementia, and with this come also the organic changes, which are almost invariably demon- strable after death. So that in mental alienation last- ing for any length of time, changes in the structure of the brain may be taken as the general rule, and nor- mal appearances the exception. 5th. But where such exceptional cases do occur, they are usually explicable on due attention to the at- tending circumstances; and are attributable either to our imperfect modes of examining the brain, to our yet imperfect knowledge of the anatomy of the brain, in its relation to the particular functions of the mind and body, or to the fact that the disturbance has originated from vitiations of the blood, depending on primary disease in other organs; or from an enfeebled circula- tion, the result of other concomitant diseases; or from sympathetic disturbance of the brain in connection with disease in other parts of the body. 6th. It must be accepted as a law of our organi- zation, that the brain, and particularly the cortical, cineritious or gray granular structure, constituting the superficial portion of the cerebral hemispheres, admin- isters to the intellect, and is the proper organ of the mind; this upper portion of the organ, however, acts not to the exclusion of its other parts ; and when the brain, or any of its parts, suffers from diseased action, the mental operations must in some corresponding de- gree be perverted or impaired—in the same way that sio-ht is impaired by disturbance in the organ of vision, or hearing by disturbance in the structure of the ear, or locomotion by organic disorder among the nerves and muscles going to supply the limbs. In a word, the organ being injured, the functions that are performed by that organ are necessarily implicated. 7th. A set of symptoms pointing irresistibly to 43 338 impairment of function in any organ, will find explana- tion by an examination of that organ, provided the ex- amination be thorough and complete, and the structure, function, and organic relation of that organ, be suf- ficiently well understood by the examining physicians. 8th. Now, though we are not yet sufficiently well acquainted with all the minuter functions of the brain, with its minute anatomy, or with the special relation of its particular parts to particular functions of the mind or body, yet post-mortem examination of this organ is of the greatest importance to us in our search for light upon the history of mental diseases, and often furnish- es the evidence of what we had reason to expect as ex- isting there, from the symptoms of disease manifested during life. 9th. There are particular phases of mental disturb- ance, which we usually find associated with particular impairments within the skull. Thus: a. Diseased action on the upper surface of the hem- ispheres, whether in the membranes investing the brain, or in the cortical granular substance, where the impair- ment has not led to actual disorganization, is apt to be associated with delirium, but not with fatuity. b. Where the disease in this part of the brain has led to effusions that press upon the hemisphere, and this pressure has come on very gradually, there may be no very well marked evidence of its existence, or of its effects upon the intellectual operations, until the pres- sure has seriously interfered with the circulation, or otherwise interrupted the organic action of the part; and then there will be paralysis of the voluntary mus- cles in some corresponding portion of the body, and almost always on the side of the body opposite that of the affected portion of the brain. c. Where pressure on the same portion of the brain, or actual disorganization here, has been produced, not 339 gradually, but suddenly, the paralysis will be the more clearly marked from the onset, and the mental opera- tions much more suddenly and seriously implicated. d. Yet the paralysis, even under these circumstances, may exist without confusion or obliteration, though hardly without impairment of intellectual power. For though the part which is injured no longer performs its accustomed functions, yet the part corresponding to it in the symmetrical arrangement on the opposite side of the bi'ain, may still remain sound, and the functions of this part, corresponding with those of the part that is injured, still go on; so that the mind still appears active and in its natural estate, in the same way that one eye sees while the other is blind, or one ear hears while the other is deaf, or one arm moves while the other is palsied. e. The brain is a double organ, its two lateral hemi- spheres, and all its ganglia being symmetrical or nearly so, the one side being intended to co-operate with and assist the other, and temporarily to supply its place during accident, or in the progress of disease, the right acting alone while the left is disordered, and the left acting alone while the right is disordered. But while both parts co-operate in executing the intellectual func- tions, each part has its own particular half of the body to supply with voluntary and sentient power, with feel- ing and locomotion. Hence the mind may be, to all appearances, performing its functions naturally, through the agency of a single hemisphere alone, whilst the other half is more or less disorganized, and the muscles which are supplied by this other half are hopelessly paralytic. /. But when this upper superficial portion of the brain is affected on both sides simultaneously, or where the organic disease on one side leads to sympathetic disturbance in the other, then we must expect disturb- 340 ance in the intellectual functions, or moral propensities, or both ; and when associated with any very appreci- able degree of disorganization, with paralysis also. No man can have organic disease in both hemispheres of the brain, and be at the time capable of the unembar- rassed exercise of his intellect. No brain can be ex- tensively diseased on both sides of the medium plane, without impairment of mind sufficient to be at once recognizable by the medical observer. g. But where the lesion or disease is at the base of the brain, the portions that are more immediately con- nected with the external organs of sense are the most apt to suffer; and instead of delirium, or paralysis of muscular power, and loss of voluntary control of the limbs, we usually find that coma, stupor, or profound insensibility, give character to the accidents. So much is this the case, that surgeons can usually determine with tolerable accuracy, whether the force of an injury to the head has been spent on the base, or other portions of the skull. And the indications which they derive from the symptoms enable them to determine where to apply the trephine for the evacuation of blood or other fluids, after injuries, and in what cases the application of the trephine would be useless. h. In idiocy, or that form of imbecility which is congenital, the brain is not found to be developed to its full size; and certain portions of it, particularly its up- per and anterior portion on one, if not on both sides, may be deficient. But in dementia, or that form of imbecility which supervenes after the brain has been fully developed, the organ will be found to have under- gone serious changes from its healthy state. In some cases it is throughout firmer, tougher, and harder than natural—in this respect corresponding to an arm or leg that has been recently somewhat inflamed, and in con- sequence, rendered rigid and unable to exercise its func- 341 tions, from the embarrassment of still remaining inter- sticial effusions. This, however, as respects the brain, is an exceptional condition, and not usual in chronic forms of imbecility. It is rather the result of over-use of the brain, and is seen in those who die before the imbecility has been of long duration. But in most cases of chronic dementia—besides the changes effected by the escape and clotting of blood, the softening, the dis- colorations, and the unhealthy adhesions brought about by inflammation; and besides tumors, and morbid growths of various kinds either in the brain itself, or attached to its investing tissues, or to the skull above these—we will find in the cavities of the brain, or be- tween it and its envelopes, a greater or less amount of watery fluid, more or less turbid, and the consistence or size of the brain itself varying from the healthy standard; and where the organs of sense have been long destroyed, we will find the nerves, and the portions of the sentient ganglia which supply these organs, also more or less wasted or diseased. So far, then, as these facts go, we do know something of the relations actually existing between the mental operations and the structure of the brain. And if our knowledge of the minute anatomy, and of the functions of this organ were perfect, we would, doubtless, be able to trace these relations much further than we can at present, even to the demonstration that no permanent disease can exist in any part of the brain without cor- responding injury to the mind, and to the every part of the physical frame over which the brain presides. To say, then, that in all probability a post-mortem examination in the case of Mr. Parish, would not have thrown light upon his symptoms, seeing that he had not the use of language, by which we might have deter- mined the measure of his intelligence, is to speak in plain 342 disregard of the principles of anatomy, physiology, and pathology. 10th. What, then, were the circumstances in Mr. Parish's case indicating disease of the brain ? a. He had threatening of cerebral disturbance for several years before his overwhelming attack of apo- plexy and paralysis in July, 1849. b. He had from that time onward, for every year of his life, and usually several times each year, violent epileptic convulsions, and at times, either associated with these or without them, gusts of excitement and irritability of temper, to such a degree as to render him difficult of management; and on the subsidence of these he was left more docile and tractable than he was ever known to have been in his best state of health. c. The violent attack of July, 1849, prostrated his intellect completely for a time, and to a very marked extent for the rest of his life. He never recovered the use of his right arm and hand, and his right leg was so much enfeebled, that he could not afterwards walk alone without artificial support. d. Ever afterwards he was at times unable to con- trol his natural evacuations, and was obliged to wear an apparatus to prevent him from rendering himself offensive to those about him. e. The muscles on the right side connected with the vocal organs, like the muscles in other parts of the body on the same side, were paralyzed, yet not to such an extent as to prevent articulation, since he could at times pronounce several words more or less perfectly, and use most of the vowel sounds, as well as the com- binations of these with several of the consonants; and yet he could not speak. He could not utter a dis- tinct sentence, or more than one or two different sounds in immediate succession, and nothing to indicate con- tinuity of thought. 343 / We are told he could recognize letters, words and numerals. But he never used these in such a way, by pointing to them, or collating them, as to make a sentence, or to indicate any mental operation. g. He had the full and free use of his left hand and arm, and yet he never wrote a single word, unless per- haps a portion of his own name; for, the allegation in reference to the word " wills," is shown by the exhibit 264, (Vol. III. p. 701,) to have been an absurdity. The following is the fac-simile. h. He never could be taught to give expression to thought, by movable letters, or. any other artificial contrivance to supply the loss of language. j. He was never made to comprehend, so as to re- ply to, a complex or alternative proposition, containing even as many as two clauses. Jc. He was, after the attack of July, 1849, never able to manage his own affairs. His estate was taken out of his own hands, and it would seem almost entire- ly out of his own control. He was permanently under the supervision of others, and managed, though it may be said with becoming delicacy,in entire accordance with their wishes. He was never afterwards his own mas- 344 ter, or at the head of his own household. He saw such persons as he was permitted to see, and at such times as he was permitted to see them, and none others. He was not indulged even with the expenditure of pocket-money. He was under constant supervision, as well for guarding as for amusing him. He was there- fore treated by those who were about him in every respect as an idiot, or imbecile not yet reduced to that last and lowest stages of fatuity requiring total and permanent seclusion. 11th. But dementia, however profound, does not necessarily destroy all traces of intelligence. It rarely even approaches this. It may exhaust the mental power, pervert the passions, and change the configura- tion of the body ; but it is apt to leave the higher in- stincts, and especially the long-continued habits which have acquired the force and character of instinct, un- impaired, or but very slightly discomposed. The pa- tient in his better moments acts in accordance with his former usages, as far as his faculties will permit. He attends to conversation, he appears to enter into it, he enjoys society, his countenance responds to that of the person who addresses him, he even acknowledges acts of courtesy and kindness; and the more cultivated and imaginative the minds of those that see him only in his better moods, the more likely are they to be misled by mere appearances. For even without thought, the countenance of man is reflected in the face of his friend as in a glass. 47th.—External Circumstances affecting Testamentary Capacity. The question of mental capacity in its legal aspect requires a moment's consideration. "The direct re- 345 quirements of law," says Dr. Mayo, " in regard to the understanding requisite for civil purposes, that is, in the disposal of property, is best expressed in the lan- guage of the Privy Council in the case of Harwood v. Baker; wherein it is said, ' In order to constitute a sound disposing mind, a testator must not only be able to understand that he is by his will giving the whole of his property, but also that he must have capacity to understand the extent of his property, and the na- ture of the claims of those whom by his will he may be excluding from all participation in that property— and therefore, the judgment proceeds—' The question, which their lordships propose to decide in this case is, not whether Mr. Baker knew that he was giving all his property to his wife, and excluding all his other re- lations from any share in it, but whether at that time he was capable of recollecting who those relations were, and understanding their respective claims upon his regard and bounty, and of deliberately forming an intelligent purpose of excluding them from any share of his property.' Assuming that the judgment here quoted * * * affords a standard of intellectual power in relation to the requirements of the law for the disposition of property, we learn from another part of the same judgment an important modification, which may be had recourse to in applying that judgment in some cases, in which the capacity of the testator might appear to fall below the standard: ' If their lordships had found (from other evidence) that Mr. Baker had, while in a state of health, compared and weighed the claims of his relations, and then formed a deliberate purpose of re- jecting them all,—but had omitted to carry that pur- pose into effect, during [before] the attack of illness under which he died, and that during that illness he had acted upon that previous intention, and executed the will in question, less evidence of the capacity to 44 346 weigh those claims during his illness might have been sufficient to show that the will propounded did contain the expression of the mind and will of the deceased.'" [See Dr. Thos. Mayo on the Medical Testimony and Evidence in Cases of Lunacy, &c. Lond. 1854, p. 41.] Now, according to this test, seeing that Mr. Parish by the codicils would have wholly set aside the deliberate judgments which he while in health had formed of the claims of his relations—it would become necessary for the proponents of the will and codicils to show that when these codicils were executed Mr. Parish's mind was equal to their execution, by the test above given. But behind this comes another question, not less wor- thy of consideration. The question of undue influence, is, in this case, one not calling for a medical opinion, except so far as to show how such influence may have been acting on a mind circumstanced as was that of Mr. Parish. That such influence was exerted, the evi- dence abundantly establishes ; and that it was effective, is equally clear, from the readiness with which Mr. Parish, a man who in health was never easily diverted from his purpose, nor ever known to act on impulse or hasty resolution,—could, without sufficient reason of his own, be brought to yield to the wishes of those around him, so far as to annul by codicils some of the most essential provisions of his will,—the very making of which codicils, or of some of them, is shown to have left no trace upon his memory. Among the considerations requisite for establishing the competency of an individual for executing a will, and, of consequence, for modifying or altering a will by codicil, as set forth by wharton, [in the Treatise on Medical Jurisprudence, by F. Wharton and M. StilU. Philada. 1855,] are the following: "He ought to have a disposing memory, so that he is able to make a dis- position of his lands with understanding and reason, 347 and that is such a memory as the law calls sane and perfect." [§ 5.] He should be protected from " extra- neous influence," and the over-importunity of friends standing in confidential relations." [§ 5.] " The existence of idiocy (as a bar to competency) when that alone is set up, can be determined by com- paratively simple tests." The test ordinarily applied is capacity for managing his own affairs:—for, says our author, " I will simply repeat what I have already in- deed said, that those who are affected with lunacy, sometimes have the management of, and can manage, their pecuniary affairs,—an idiot, never." [§ 7.] Again, " It should be kept in mind, that the ques- tion of competency is intimately affected by the char- acter of the act or instrument which it is sought to annul." [§ 8.] " In all cases, except those when the act sought to be annulled was committed during actual insanity, the question is not whether the party had a capacity to do the particular thing intelligently, but whether he had capacity and information enough to comprehend and disregard any attempt which may have been made to coerce or deceive him." [§ 9.] " Testamentary incapacity does not necessarily pre- suppose the existence of insanity, in its technical sense. Weakness of intellect from extreme old age, whether arising from great bodily infirmity, or from intemper- ance, when it disqualifies the testator from knowing or appreciating the nature, effect, or consequences of the act he is engaged in, works a similar disability." [§ 12-] " Wills have been set aside when they were preceded by over-importunity of friends standing in confidential relations,*—where the housekeeper and physician were * UeckeiM'. Newborn, Style, 427. tJ 348 shown to have earnestly urged a non-natural scheme of distribution ;* where the wife in fact dictated the will, the testator being at the time unable to speak, she pre- tending to understand him, and making herself the sole devisee for life, and imposing as a devisee in re- mainder a fictitious niece ;f where one relation produced the disinheritance of another by false representations as to his character,"^ etc. [§ 5.] 48th.—General Conclusions. Now, in connection with the conditions of compe- tency above cited from Mayo and Wharton, we have already shown that in Mr. Parish's case they did not exist. He had not a disposing memory, according to the description of such memory as there set forth ; he was not free from the importunity of controlling friends ; the reasonable disposal of his property as originally made by him while in health, is not in keeping with the provisions of the codicils made at the dictation of interested parties, whose mistakes and miscalculations he was incapable of detecting, and whose representa- tions concerning his absent relatives he had not the means of investigating; he had not capacity enough to comprehend or disregard attempts at fraud or coer- cion, especially if they were made directly or indirectly; his weakness of mind amounted to dementia in the technical acceptation of the term, as established by Esquirol, or to the acquired idiocy of Curveilhier; and * Ex parte. Fearon, 5 Fes. 633. t Scribner v. Crane, 2 Paige, C. C. P. 147. X Dietrick v. Dietrick, 5 S. and R. 207 ; Nussear v. Arnold, 13 S. and P. 323. Patterson r. Patterson, 6 S. & E. 55. For instances bearing on the same points which we have above considered, see also Beck, Medical Juris- prudence, \o\. I., p. 038; Albany, 1835 : and same work, Vol. IL, p. 147; p. 640, 641 ct seq. 349 was equal to, if not greater than, that dotage, or imbe- cility of the aged, which is admitted to work an incom- petency. But even granting that Mr. Parish, at the making of either of the codicils in question, was capable of un- derstanding them, and of comprehending all the facts essential to the proper disposal of his immense estate ; yet, from bodily infirmity, he was unable, by any means whatever, to communicate to others how he would have disposed of his property, had he been able to give exact expression to his own thoughts by speech, or writing, or any artificial sign. The codicils, and the disposal of property made by them, in which he ap- peared to acquiesce, were not devised by Mr. Parish; they were not the work of his own mind ; they were, at best, accepted by him, under moral restraint; a re- straint which neither he nor any disinterested person about him had means to overcome. They cannot be accepted as the unembarrassed expression of his wishes. Besides, he was in the position of one obliged to sub- scribe to these or nothing. The codicils, in short, were an affair of dictation, which at most he might reject or choose, but which he had not the spontaneous power to modify; and which, when accepted by him, were not the exposition of his will. For, it is an absurdity to suppose, even had he at the time of subscribing to them been perfectly sane—with his incapacity to give expression to thought—that any person, how intimate soever with his habits, could so enter into his views and secret motives, as to give a complete and thorough exposition of his wishes. But I have already, and independently of these ex- ternal influences, expressed my opinion. I believe that the organic disease of the brain was the determining cause of all Mr. Parish's ailments ; and that the loss of control of his body and limbs, with the various compli- 350 cations of disease attending this, was merely the exter- nal evidence of an internal disorganization involving the functions of both mind and body, and destroying the integrity of the former. Under this conviction, then, I hold that Mr. Par- ish was, from the primary occurrence of paralysis in July, 1849, permanently and irrecuperably disabled from executing any document of binding force; and, consequently, that he was thus disabled at the time his cross was subscribed to the several codicils in question. JOHN WATSON, M.D., Surgeon to the New York Hospital, &c. New York, September Ylth, 1857. OPINION OF D. TILDEN BROWN, M.D., PHYSICIAN TO THE BLOOMINGDALE ASYLUM. 45 OPINION OF D. TILDEN BROWN, M. D. I have examined the evidence " in the matter of proving the Last Will and Testament of Henry Parish, deceased," as given before the Hon. Surrogate of the City and County of New York, for the purpose of form- ing an opinion as to the state of mind of said Henry Parish, during the period commencing July 1, 1849, and terminating with his decease, and have therefrom drawn the conclusion that said Henry Parish was of unsound mind throughout the whole period above named. This opinion is founded upon the following reasons, viz:— First—On the 19th day of July, 1849, Henry Parish, having previously experienced several slight seizures of cerebral congestion, (Dr. Delafield, I. f. 2097 & 3131,) became the subject of a violent shock of apoplexy : a disease or affection of the brain which is frequently followed by derangement or impairment of mind, and which is recognized as an adequate cause of mental infirmity by eminent authorities in medicine. There is, perhaps, no abler English writer and no higher aifthority on this subject than Dr. Richard Bright, of London, who, in his great work, "Reports of Medical Cases," Lond. 1831, vol. ii. p. 328, bears the following testimony to the influence of apoplexy on the mental faculties. " The powers of the mind generally suffer in some degree, but this varies greatly: 356 sometimes the mind evinces great irritability, and some- times a childish tendency to excitement, and a trifling turn quite inconsistent with the former disposition or with the present situation of the sufferer. At other times the patient falls into a dull state of imbecility; while cases occur in which the affection of the mind is so slight that it is only by close examination it can be detected." See also Watson's " Lectures on Principles and Prac- tice of Physic."—Phila. ed., 1844, p. 278. Wood's " Practice, etc."—Phila., 1852, vol. ii.,p. 709. " Combe on Mental Derangement."—Edin., 1831, p. 134. Bur- roles' "Commentaries on Insanity?—Lond., 1828, p. 174. Esquirol, " Maladies Mentales?—Paris, 1838, vol. i.,pp. 64-74. Guislain, " Legons sur les Phreno- pathies?—Paris, (and N. Y, Bailliere,) 1852, p. 81, and Falret, " Recherches sur la Folie Paralytique?— Paris, 1853, p. 82. Secondly.—In the case of Mr. Parish, the afore- mentioned exciting cause was followed by great im- pairment of the intellectual faculties; the diseased -condition of the brain precluding the healthy exercise of its functions of thought, memory, judgment, and will. This proposition is, in my view, established by the following facts, all co-existing, and terminating only with Mr. Parish's life. 1st. Henry Parish, subsequently to his attack, lived six years in entire disuse of nearly his whole previous vocabulary, never speaking a sentence, though physi- cally able to articulate, as shown by his uttering a few monosyllables. 2d. Throughout the same period he never commu- nicated with others by writing, although he retained the natural use of his left hand, and possessed adequate vision. 357 3d. In default of speech and writing he employed neither books, words nor letters, printed or manuscript, by which to point out or to form words conveying any ideas he might have wished to express. 4dh. In place of the above means, and for the same purpose, he resorted to no varied and significant panto- mime which intelligent observers could generally and readily comprehend. 5th. The very few signs which he did employ scarcely exceeded those head movements usually sup- posed to indicate assent and dissent; beyond these two, his signs were often unintelligible to his most constant associates; they were apparently contradictory in many instances when he was interrogated on matters of im- portance ; and some of his most frequent and habitual signs were differently interpreted at different times by the same members of his family and household. 6th. One of his common gestures, or rather habits, performed by his unparalyzed hand, to wit, that of holding the fingers in his mouth, and, as it were, hang- ing his hand and arm upon his teeth, is one never habitually practised by others than idiots, imbeciles and demented persons, while it is not uncommon among all of these classes. Dr. Delafield testifies that Mr. Parish "often" did this. (Dr. Delafield''s evidence, I. f. 3164. 7th. He never improved on his mode of communi- cating with others, throughout the whole period of his life subsequent to his attack of apoplexy on July 19th, 1849, either in articulation, writing, or variety and sig- nificance of gesture. Thirdly.—Further proof of unsoundness of mind in Mr. Parish is furnished in the evidence that, by the apoplectic attack and disease of the brain following thereon, a great change was wrought in his affections, 358 sentiments, occupations, mental and personal habits, as manifested:— By frequent irritability, anger and violence toward his wife, visitors and servants; alternating with an in- difference to matters affecting his personal comfort and with a degree of docility equally unnatural to him in health. Also, by an excessive emotional sensibility never before apparent, and now following very slight provo- cation ; by a puerility or absurdity of demeanor which was not restrained even in the presence of strangers; and further,— By an unnatural indecision of mind or fickleness of judgment—if he formed any judgment at all—in several instances of business propositions being made to him; by great inconsistencies of conduct on other occasions; and by a disregard of propriety in personal habits, reconcilable only with a perversion of his natural self- respect, calmness, and regard for social obligations. In view of the above-mentioned conditions, follow- ing upon an affection of the brain which is the frequent precursor of insanity; continuing for a period of six years and until his death, and forming a marked con- trast to the mental and moral traits of Henry Parish prior to his attack of July 1849, I am of opinion, as already stated, that he was of unsound mind for the whole period following the attack and terminating with his decease. As there can exist no arbitrary standard by which to measure the mental capacity of any and every in- dividual ; and since mere loss of speech and of the power to write does not necessarily impugn the men- tal integrity of the sufferer from apoplexy, it is neces- sary in such cases to adopt some method of investiga- tion which shall be equally acceptable to science, to human reason, and to justice. 359 The course of inquiry which I have pursued in the examination of the present case is that of comparing the combined intellectual, social, and moral nature of Henry Parish, as manifested subsequently to his apo- plectic attack of July 19,1849, with the same qualities as exhibited previously to that time, when Mr. Parish is admitted to have been in the healthy possession of his natural powers of mind and body. This course is in strict accordance with the prin- ciple, asserted by the highest authorities on mental disease, that such comparison affords the most reliable test of mental derangement or impairment known to science. Vide Combe, "Observations of Mental De- rangement"—Lond. 1831, p. 219. Ray, Med. Jurisp. of Insanity, 3d Ed. p. 136. Forbes Winslow, "Lett- somian Lectures on Medico-legal Evidence in Insanity? Journal of Psycholog. Med.—Lond. Jan. '55. p. 127. Williamson "Unsoundness of Mind?—Lond. '56, p. 52. Bucknill on "Diagnosis of Insanity," in " The Asylum Journal of Mental Science?—Lond. Jan. '56 j p. 234, et seq. Sutherland, uLectures on the Pathol. and Treat, of Insanity? The Asylum Journal, Jan. '56, p. 152. Having thus presented a summary of conclusions, drawn from the evidence before the Surrogate, with references to authorities for the adequacy of the as- sumed cause of mental unsoundness in this case, as well as for the method of reaching these conclusions, I pro- ceed to remark upon portions of the evidence upon which they are founded. It will obviate complexity to consider the change in Mr. Parish's faculties, wrought by the apoplectic shock, in the order already followed, and I propose to compare, first, his intellectual functions, as manifest- ed prior and subsequently to the invasion of paralysis. It is conceded by all parties interested in this in- 360 quiry that prior to July 19th, 1849, Henry Parish was able to speak, read, and write with perfect facility, and that he possessed a mind of at least average capacity and firmness. No intimation of natural eccentricity of character is found in these volumes, but, on the contrary, the whole evidence bearing on this point shows that he was free from any remarkable idiosyncrasy, distinguishing him from other men in a state of health, or likely to be- come exaggerated by disease. He had exhibited great sagacity in business matters, and continued to manage his large estate with undiminished prudence. On the 19th of July, 1849, Mr. Parish suffered a violent shock of apoplexy which was followed by al- most absolute abrogation of speech, and by complete loss of command of his right hand. Thus deprived of his habitual instruments for com- municating his ideas, feelings and wishes, Mr. Parish was limited to such substitutes, as his own intelligence or the ingenuity of friends might suggest. As persons who have lost the right hand by am- putation, find in its fellow of the opposite side a nat- ural and immediate substitute for the purpose of writing, if they possessed the art before, so in all or- dinary cases of paralysis of the same hand, if the in- dividual's intellect and will remain intact, the left hand would be employed for writing, whenever the exi- gencies of the patient should urgently require. It is not necessary to refer to the numerous cases, establishing this proposition, to be found in medical works. In Vol. III. of the evidence before us we find its confirmation. The statements of Messrs. Macdonald, Brownlee, and Delaplaine show that, whenever the in- telligence of the victim of apoplexy or paralysis re- mains undisturbed, or so soon as it recovers its power of voluntary and comprehensible manifestation, it em- 361 ploys the best means at its command for its expression, and in default of its accustomed agents, avails itself of those substitutes, which at once suggest themselves to the common and sane mind. Slowly recovering consciousness after a prolonged state of absolute insensibility, and apparently recog- nizing his family, Mr. Parish remained speechless, and from the moment of the attack until his death never addressed them a sentence of any nature whatever. Of Loss of Speech in Mr. Parish. This complete extinction of speech was owing to one of two causes, or to the simultaneous existence of both. Either the brain—whether as a single organ or in some special portion fulfilling that function, it matters not—was itself paralyzed as an organ of thought and intelligence, or the nerves which in health con- stitute the messengers of its will, were deprived of their proper functions by pressure, rupture or disease, and were no longer able to convey the inspiration of the most fertile brain to a palsied tongue. One or both of these causes, and nothing else, except a per- verted, insane will, can explain the speechlessness of Mr. Parioh from that time forth. Which of these causes was the truly existing one, it is important to ascertain. The supposition that Mr. Parish persisted in silence for a period of six years, from mere wilfulness, and when perfectly able to speak, is not likely to be enter- tained by any one, and therefore needs no considera- tion here. That instances of wilful silence for a period not less protracted than is here presented, are not very unusual, every Insane Hospital occasionally contains living proof. But not of this kind was the mutism of Henry Parish. Many witnesses assert, with great positiveness, that Mr. Parish, after his attack, did articulate clearly and 46 362 distinctly a few monosyllables. Dr. Delafield says of the words used by his patient, " those in most common use were ' yes' and * no;' when in pain he would not un- frequently exclaim, 'oh, dear! oh, dear!' that was a common ejaculation; and at one period during the first year, when he had recovered to a great degree, and we were every day hoping that he might speak again, there were a few words pronounced which I do not re- member, and they were not repeated." (I. f. 2082.) Again, (I. f. 3151, '2) Dr. Delafield says Mr. Parish's utterance of the words "yes " and " no," was " distinct and intelligible," and "continued unimpaired to a period late in life." Also, Dr. Markoe. (II. f. 2076.) Dr. Delafield refers to words spoken by Mr. Parish which he does not remember, but all those mentioned by the various witnesses do not exceed a very few, viz: "yes," "no," "oh, dear," "her," "0,Gott,"&c. Buteven these few, distinctly uttered, make it plain that the nerves, whose integrity are necessary for speech, were not destroyed in their vitality, nor cut off from the organ of thought. There is one other explanation of Mr. Parish's prolonged speechlessness, and it is, in my opinion, the correct one. Dr. Robert Todd, of London, in his very able "Lectures on Paralysis and Disease of the Brain," says: " The palsy of the face, and that of the tongue, conjointly, give rise to the imperfection of articulation often present in hemiplegia. The patient speaks thick, and is especially indistinct in the pronunciation of labials and dentals, giving a guttural character to all his words. But sometimes (i. e. referring to another class of cases) the power of speech is wholly destroyed, even in cases where these nerves have suffered but little or not at all, and the powers of utterance are limited to ' yes' and 'no,' or either of these monosyllables; and this is a sign of very unfavorable portent, as denoting, with other 363 symptoms, extensive lesion of brain, superficial as well as deep? (Phila. Ed., 1855, pp. 124, '25.) These remarks furnish the true explanation of Mr. Parish's silence. Dr. Delafield says: (I. f. 3171:) " The right side of the face was slightly affected, less than usual, but this almost entirely disappeared in the course of his recovery. So quickly, that in about three months, I think, possibly even less, an ordinary ob- server would not have noticed it." Thus it appears that neither was there such " palsy of the face " in Mr. Parish, as indicated any considerable impairment of its nervous energy, nor yet such " palsy of the tongue " as forbade the " distinct and intelligible" utterance of a few monosyllables. His case was not then one of that class in which Dr. Todd first describes the patient as "speaking thick," but yet able, despite an imperfect articulation, to display an active intelligence by expressing rational ideas in appropriate language. It was, on the contra- ry, one of that other class in which "the powers of utterance are limited to 'yes' and 'no,' denoting, with other symptoms, extensive lesion of brain, superficial as well as deep." Of Mr. Parish's Failure to Write. So far as appears from the evidence, he never, spon- taneously, wrote with an unaided hand a single legible word other than his own name, during the six years following his attack. Though solicited so to do by his family and physicians, and though oftentimes exhibit- ing great agitation of manner and apparent distress, when he was supposed to be desirous of conveying ideas to others, yet he never in a single instance, by significant signs, or otherwise, called for materials to write, nor used them when they were presented to him. It is admitted that no defect of vision deterred him from 364 such a course, but it is suggested that the difficulty and awkwardness of employing an undisciplined hand in- duced him to refuse to write. When, however, important interests are jeoparded, information requisite to ensure the patient's welfare withheld, or humane exertions of friends in his behalf thwarted by his persistent refusal, such explanations lose all plausibility, and we are left to elect between intellectual incapacity or an irrational perversity of will as alone determining the individual's abstinence from an act, which would have at once allayed innumerable fears, and removed the doubts and perplexities which agitated all around him or connected with him: the very persons whose happiness he had once rejoiced to promote, and among them that person especially, in whom, if the codicils are to be taken as his act, all his tenderest affections were daily becoming more and more concentrated. Although it is not shown that any dictionary or vo- cabulary was ever presented to Mr. Parish, as advised by Mr. Kernochan, (I. f. 874' and 1072,) whereby he might have pointed out words expressing his wishes; neither is it shown that he ever pointed to such book in his library, or manifested any disposition to use any book whatever for this purpose. He certainly did not use the block-letters procured by Mr. Henry Delafield, (H. Delafield, III. f 372,) nor the card alphabet placed before him by Fisher, his attendant. (Fisher's test, II. f. 1174,'5 and 1181.) That Mr. Parish re- jected the aid of these articles as means of expressing his ideas, because he had succeeded satisfactorily in so doing without such help, and for the same reason pushed the card off the table, (Fisher, II. f. 1181,) can- not be said, for the case abounds with evidence to the contrary. And, besides, Mr. Henry Delafield expressly states that he, himself, procured the block-letters be- 365 cause " it was conjectured that Mr. Parish might be made to explain himself by means of them." (II. Del- afield, III. f. 364.) This failure to write, or to employ printed words or letters in his intercourse with others, might be ascribed to a loss of memory of printed and written words—a very common result of apoplectic paralysis— were it not claimed, and as well proven as any other fact asserted by the proponents, that Mr. Parish could and did read. The prolonged duration of this failure, however, renders it far more probable that he could not read, and that the loss of memory of printed or written words was even more complete than his loss of lan- guage, and, furthermore, that it was also like this last, directly dependent on the diseased condition in which the brain remained after the apoplectic seizure. This special lesion of memory in cases of apoplectic paralysis varies greatly in degree and permanence. In the four cases described in the volumes of evidence before us, this fact is well illustrated. Mr. Macdonald states that, after his own attack, he began to read in two or three weeks, (III. f. 2187,) and to write his name on the third day after the shock. (III. f. 2198.) Mr. Delaplaine observed that his father practised writ- ing with his left hand the day after his right arm was paralyzed. (III. f. 1912.) Dr. Brownlee proves that his own father began to write within six months after his malady set in. (III. f. 2048.) In the cases of Mr. Macdonald and of Dr. Brownlee success was limited on first attempts, but increased with practice. In Mr. Parish's case, whatever slight success attended the early attempts at writing (if any success at all ever did attend them), soon ceased so far as to discourage those around him from soliciting fur- ther efforts, (Dr. Delafield, I. f. 3050, and Dr. Markoe, II. f. 2093,) although what was due to mental incapa- 366 city was attributed to fatigue of his hand. (Dr. Dela- field, I. f. 3051.) Despite the diversity perceptible in the four cases thus collated, there remains the material fact that in each there existed disease of the brain, impairing in a greater or less measure, and for a shorter or longer period, many important mental faculties, and among others the memory, in its special application to both written and spoken language, and irrespective of mere vocal ability to utter words. In the cases of Mr. Mac- donald, Dr. Brownlee, and Mr. Delaplaine, knowledge and command of words, for the time suspended by the diseased condition of the brain, was gradually regained to a greater or less degree. This special lesion of memory may perhaps exist without lesion of other mental faculties, and it is possible that modifications of its extent, occurring in the course of the patient's subsequent condition, may not be neces- sarily connected with such other lesions. Thus Mr. John F. Delaplaine, who came under my professional observation, regained to a considerable degree his for- mer powers of speech, at the same time that his intel- lectual faculties became more and more impaired. It may be proper to proceed still further in an ex- amination of that phase of Mr. Parish's case now under consideration, since spoken and written language are the invention of man and wholly artificial. Though once acquired, they may be lost irrespective of disease, or any other circumstance than mere disuse. On the other hand, the language of signs is natural and uni- versal, comprehensible in its simplest expressions by the most diverse races or the most moderate sagacity, and in its more advanced development by almost all persons of average intelligence. It is suggested in- tuitively, and gathers new symbols from an observa- tion alike of animate and inanimate nature. That it is 367 more congenial to those whose lips are sealed in per- petual silence, while their minds revel in thought and imagination, and is therefore more generally employ- ed by them than the more exact but also more labo- rious mode of writing out their ideas, is shown by the following extract from a valuable essay " On the Legal Rights and Responsibilities of the Deaf and Dumb," by Harvey P. Peet, L.L.D., President of the New York Institution for the Deaf and Dumb:—"It is by no means true," says Dr. Peet, " that a deaf-mute who has been taught to read and write, however ex- pert he may be, finds writing the easiest and surest means of communication with his relatives and friends. In most cases, on the contrary, the relatives and friends of an educated mute find it much easier to learn to communicate with him by signs, than to suffer the tediousness and other inconveniences of having to write every communication. And there are few deaf-mutes from birth, however well educated, who do not under- stand signs skilfully made more easily and readily than writing."—American Journal of Insanity, Oct, 1856. To draw the analogy between conditions which can- not, with propriety perhaps, be forced into such rela- tions, may we not suppose that all knowledge of written and spoken language may be at once extinguished by adequate injury to certain portions of the brain, and that the individual be still left in the full possession of sound mental perception, reason, judgment, and freedom of will. If such a condition be possible, the individual must henceforth resemble, in a great degree, a sane but uneducated deaf-mute, possessing spontaneity of ideas, with the desire to hold intercourse, and the power of devising signs for that purpose. The exact limit of mental capacity in such an indi- vidual could only be determined by special tests; but the exhibition of intelligent comprehension, or of intelligent 368 assent and dissent on his part, could scarcely require such a process to call it forth. In the cases of loss of speech and inability to write with preservation of reason to be found on record, special tests of mental vigor and of integrity of judg- ment were applied to the patient, attended by satisfac- tory proofs of rational understanding and free will. In that of Henry Parish, his regular medical at- tendants, Dr. Delafield and Dr. Markoe, state that no formal tests were employed by themselves for the spe- cial purpose of determining his mental condition ; and we are therefore left to arrive at an estimate of it from his own manifestations, either spontaneous or respon- sive to questions and remarks not intended as mental tests, but in effect serving the same purpose, as far as they go. We must, therefore, resort to these manifes tations. Of Mr. Parish's Gestures of Communication. It thus remains to inquire what means Mr. Parish devised, of his own will, as substitutes for spoken, written, or printed words, to impart a knowledge of his ideas and wishes. The concurrent testimony of a large number of witnesses shows that his gestures were but few in num- ber, and that these few were habitually used without material modification. Nodding and shaking his head; raising his left hand before his breast, with one or more fingers ex- tended—" sometimes one, sometimes two, sometimes three, and sometimes all four, (Dr. Markoe, II. f. 2087,) and pointing with the same hand, constituted about the range of his pantomime. Adding to these a pecu- liar use of one or both hands on rare occasions, as described by Mr. Henry Delafield, (III. f. 329,) and" construed, by that gentleman, to mean a demand for 369 money, although he admits that no money was given him at such times, (III. f 329,) and in these few sim- ple movements of the head and hand were comprised all the arbitrary signs which Mr. Parish employed to hold intelligent intercourse with his family and ac- quaintances. The only other habitual use of his unparalyzed hand, described in the evidence, viz., that of thrusting his fingers into his mouth and hanging his hand upon his teeth, (L. M. Wiley, II. f. 95 ; Clark, II. f. 2205 ; Dr. Delafield, I. f. 3164,) was not interpreted, as far as appears in evidence, to be a sign of communication. No interpretation of this act is given by the witnesses; but to those whose pursuits bring them into frequent asso- ciation with unfortunates of a certain class, this act is full of the most discouraging significance. It is a habit, not infrequent among demented and idiotic persons, and is demonstrative of most deplora- ble " absence of mind," characterized by desuetude, alike, of good breeding, propriety, and intelligent con- sciousness of their own conduct. Aside from this, the gestures of Mr. Parish are said to have been regarded by his household and others, as intentional and significant. Of their intelligibleness, Dr. Markoe says: " Mr. Parish had the power to com- municate ideas only by giving an affirmative or nega- tive motion of the head in reply to questions proposed to him. (II. f. 2118, 2124, '5 ; see also Dr. Delafield, I. f. 3249 ; Daniel Lord, I. f. 517 ; Fisher, II. f. 1226, 1238, '9.) Mr. Parish's most habitual and frequent gesture, viz., raising his hand with fingers extended, (Dr. Delafield, I. f. 3164, '5,) and also his sign of pointing at persons or ob- jects, were generally regarded as calling for questions, and in his own household it was customary at such times to propound questions to him. (Dr. Markoe, II. f. 2002 47 370 and 2087 ; Fisher, II. f. 859 and 1199 ; Youngs, II. f. 683 ; Kernochan, I. f. 849 ; Dr. Taylor, I. f. 3361.) His supposed intention was often believed by his family to be ascertained within a very few moments ; but both gestures and questions were frequently con- tinued to a fatiguing and annoying extent, sometimes accompanied by great agitation of manner, and tears on his part, (Youngs, II. f. 781,) and with absolute failure to arrive at any probable recognition of his wishes. These scenes were sometimes continued for an hour, and yet Mr. Parish never resorted to any new act or gesture—to impart his meaning or to relieve the embarrassment of himself and others. Nor were these scenes of such rare occurrence as to permit the conjecture that he abstained from intelligi- ble pantomime, or clearer intimations, from mere wil- fulness. Numerous witnesses testify that they occurred under a great variety of circumstances, and were ascribed to Mr. Parish's inability to make himself un- derstood. (Dr. Delafield, I. f. 3006, '7, 3249 ; Dr. Markoe, II. f. 2002 ; Henry Delafield, III. f. 309, 310; Tileston, II. f. 478; Youngs, II. f. 779, 780; Dr. Wlieaton, II. f. 662 of page 228 ; Brown, II. f. 1510-'12 ; Whittaker, II. f. 1684; Fisher, II. f. 1226- 1238 ; Davis, I. f. 559-562.) Independently of these extreme cases, there existed on the part of different observers, even according to their own notions of it, a great diversity of success in inter- preting Mr. Parish's gesticulations. Fisher, William Brown, and Edward Clark, the coachman, say they found little difficulty in comprehending them, while Mr. Kernochan " attached no definite meaning to them of his own observation," (I. f 849,) and Mr. Gasquet " could not understand his gestures," (III. f. 2008, '9,) and says Mr. Parish " could not make himself under- 371 stood; I could not understand him." (III. f. 2011.) Mr. Wiley says, "I think I did say to Mr. Bronson that Mr. Parish could not make a suggestion or origi- nate anything that I understood." (II. f. 149.) This is only a specimen, various other witnesses testified to the same effect. This diverse facility of comprehension corresponds to what is frequently observed by guardians of the in- sane and of imbeciles. As a general rule, it is found that the confidence of the witness in his powers of in- terpreting enigmatical phrases and gestures is in inverse ratio both with his general and special experience. Again, to the few habitual gestures of Mr. Parish, widely various significations were assigned by different persons, and even by the same person at different times. That one which was supposed by some to in- dicate a desire for questions, (Dr. Markoe, II. f. 2002- 2087, and others,) was very differently construed on different occasions. Thus, in the interview with Mr. Tileston, when Mr. Parish raised two fingers, this ges- ture was interpreted by Mrs. Parish to mean two thousand dollars. (Tileston, II. f. 470.) At the time of Mr. Gibson's applications for subscription to a char- itable object, on the same sign being made, Mrs. Parish asked her husband if he meant two hundred dollars, and as other fingers were extended an addi- tional hundred dollars was named by Mrs. Parish until five hundred was mentioned. (Gibson, II. f. 1865.) When Mr. Donaldson. called upon Mr. Parish for a similar object, the latter held up his hand, extending five fingers, "appearing to count them, whereupon Mrs. Parish said she supposed he meant to inform me (Mr. Donaldson) that he had recently contributed to five different benevolent objects." (James Donaldson, II. f. 1580.) On another occasion, Isaac H. Brown being present, Mr. Parish "looked at the check,'' 372 which • Brown had received from Mrs. Parish for pew rent, "and began making a noise, crossing the first two fingers of his left hand, raising his hand? "As soon as she (Mrs. Parish) saw it," says Brown, "she gave me ten dollars." (I. H. Brown, II. f. 1713.) So far as appears from the evidence, Mr. Parish was not inquired of, in this instance, as to his intention of bestowing any gift whatever. Regarded separately, all of these interpretations, except the last, manifestly depend for their correctness upon Mr. Parish's intention to express a wish; upon his comprehension of the questions of his wife, and upon the character of the ensuing gesture, if any, as being responsive or merely automatic. Taken toge- ther, and as constituting the only occasions on which an unvarying habit, occurring frequently every day of his life, received, in each case, a construction attributed to it at no other time, and especially when viewed in the light thrown upon them b}7 other evidence, these in- terpretations must be adjudged by medical men, accus- tomed to see individuals in a state analogous to that of Mr. Parish, to be luhoUy arbitrary and inconclusive as establishing or explaining any intention on the part of Mr. Parish. No tests, worthy of the name, were employed in either of the above quoted instances to remove the doubts which might justly have existed as to Mr. Parish's intention, if, indeed, he had any intention; but a test is found in comparing them with other occur- rences of a nature not dissimilar. George Simmons, an attendant on Mr. Parish, says, "Mr. Story asked me if I thought that Mr. Parish wanted oysters; I told him yes; Mr. Parish put up his left hand, with all the fingers raised and extended, and said, 'yean, yean, yean, yean;' Mr. Story then asked him if he wanted 5( 0, and he said ' yean, yean, 373 yean,' and made the same motion; the oysters were sent home, 300 of them were returned back to Mr. Story," by direction of Mrs. Parish, as witness states. (I. f. 1724.) Wm. Youngs, who was much at Mr. Parish's house during his illness, describes the gesture of inquiry, (II. f. 683,) and says, (I. f. 743,) " he often put up his hand and fingers in that way in saying ' yes' and ' no' both • but when a matter of inquiry, the sound was nin, nin, nin, as near as I can pronounce it and spell it." As the sound made by Mr. Parish was inarticulate, it was doubtless the same when heard both by Sim- mons and by Youngs, as well when they supposed Mr. Parish to be making the sign of inquiry, as when they believedlie was giving assent to the inquiries of others. Thus it appears that not only was there no appli- cation of combined positive and negative tests to de- termine beyond doubt the existence of any such in- tention on the part of Mr. Parish as was inferred in the instances cited, but that decisions were sometimes made by the interpreter without interrogating him at all. (See Brown's ev. before quoted.) Moreover the very same signs and sounds supposed to have been used by him " to solicit an inquiry," are also said to have been employed, without any variation ivhatever, " to express both assent and dissent" to the suggestions of others. Another common gesture of communication im- puted to Mr. Parish remains to be considered—viz., the act of pointing. Mr. Parish is stated to have " pointed " at persons, at his check-book and bank-book, at a drawer containing account-books, at buildings, at his watch and house-clock, at the City Hall clock, at his carriage, at his horses, at meats and vegetables, and at sundry other things. But beyond pointing, he did nothing to indicate any idea or wish connected with the person or thing 374 pointed at, unless by nodding or shaking his head to inquiries from others; and when the latter failed to derive from these motions any idea of his meaning, Mr. Parish never made use of any new gesture or sign which was thought to express his purpose, or any pur- pose, more clearly and appreciably. The pantomimic gestures of Mr. Parish, which, had he retained any considerable degree of mental spon- taneity and force, should have been comprehensive, varied and significant, were exceedingly meagre and unmeaning. They never improved, and his sign-language through- out the paralytic portion of his life was so often unintelli- gible, and was so seldom varied to conform with the circumstances of the special occasion for its use, that it fails to indicate an intelligent adaptation of means to a given end, based on definite ideas of the nature of both. I infer, therefore, that his failure to employ a varied and competent pantomime resulted from the same cause as did his failure to write with his left hand— viz., from an exhaustion of mental power which was due to disease of the brain, and which so far im- paired the intellectual faculties, that with a loss of the special memory of words, there existed also a grave lesion of the general memory; an incapacity of con- ceiving any save the most simple ideas, and an inability to devise reliable media for spontaneously and inde- pendently expressing even these. Mr. Parish's brain was diseased, and, as one con- sequence thereof, his mind was greatly impaired and actually unsound. Mr. Parish was, ever after his apoplectic attack of July, 1849, in a state of dementia. This condition of mind greatly resembles congenital idiocy, and is not different in its consequences. This form of mental impairment is truthfully de- 375 scribed by Dr. Aubanel, physician of the Lunatic Asylum of Marseilles, France. In a medico-legal opinion respecting the mental condition of an alleged testator, Dr. Aubanel says: "Dementia is not mania, properly speaking, though dementia often forms the termination of acute mania. It declares itself whether followed by paralysis or not—more especially if ac- companied by paralytical phenomena—when the cere- bral irritation, by its continuity, its persistence and its intensity, ends by inducing organic lesion of the brain. In many cases the symptoms of dementia occur primarily; but whether it be consecutive to mania or whether it devolope itself as an essential disease, we may consider it, so to speak, as a wearing-out of the brain, as premature senility, or as a state of puerility. Thought becomes slow, obscure and laborious. Mem- ory, especially that of recent events, is gradually weakened. The patient preserves well the recollec- tion of his name, of his characteristics, and of those things which have pre-occupied his attention, or which constituted the peculiar habits of his life. But even this remembrance is often confused, and it is in general necessary, to fix his attention, to offer suggestions in order to obtain the clearness we solicit. Impressions are always more or less fugitive; they are rapidly effaced, leaving but slight traces of their existence. In dementia there are often momentary emotions of tenderness; tears are aroused on the occasion of a request or a remembrance; but they are extin- guished in a few moments, and there follows imme- diately, in many cases, excessive laughter, a feeling of joy, of satisfaction, and it might seem of happiness. The demented person exhibits neither spontaneity nor energy, and solicitation is requisite to procure any manifestations of thought. Volition, that faculty of the first order, is remarkably impaired. It is but a 376 shadow of what previously existed, and it no longer perceptibly governs the determination of the indi- vidual. From the demented man we may obtain all that we wish; we may guide all his actions; but, yielding at one moment, without resistance to those about him, he promises full compliance, but on the very same day, or after a period of greater or less duration, he decides contrary to those promises, and yields to a new influence which has been exerted over him, retaining no recollection of what he had before promised. Freedom of the will is greatly weakened in this form of cerebral affection, and more so than in mania, properly so called. In mania an intermission of the disease may occur, or a prolonged lucid inter- val ; but in dementia, though there may be at times suitable replies and momentary apparent clearness on various subjects, true intermission is impossible, and it never occurs. Dementia is sometimes susceptible of amelioration, but this alteration is far from perma- nent. It constitutes only the semblance of cure ; and if the patient is carefully watched during these periods, apparently so encouraging, there is always discerni- ble a lesion of the will, more or less marked, and an impairment of the intellect." (Annales Medico- Psychologiques—Paris, October, 1856, p. 564; and " American Journal of Insanity"—Utica, April, 1857, p. 398.) In thus closing a review of Henry Parish's intellec- tual condition, and in entering upon an examination of the changes effected, by disease of the brain, in-his moral qualities, it may be remarked that, in passing upon the question of the mental soundness of an indi- vidual, we are not necessarily confined to an investi- gation of the memory, understanding, and will of the party. Almost every victim of Dementia who has once 377 possessed a considerable share of intelligence retains more or less memory of persons and things, as well as of his former habits. He may recognize acquaintances; may reply with correctness and propriety to questions relating to his personal history or present condition; and may even read aloud without omitting a single word in a considerable portion of text. But it becomes important to ascertain how much of this is due alone to memory and habit, and whether it is accompanied by a rational perception of his rela- tions to others, and an intelligent understanding of what he perceives, narrates, and reads. Says Dr. Ray, in his well-known and authoritative work on the "Medical Jurisprudence of Insanity J' sec. 243, " We ought also to bear in mind a fact too much overlooked, that much of the ordinary working of the mind, whether sane or insane, becomes some- what instinctive and mechanical, and goes on, if not entirely independent, of the reasoning powers, certainly without their close and active supervision." But, adds the author, let the patient " be tried on something that requires a fresh and active exercise of thought, some- thing that requires control of his feelings, and then we shall see how feeble is the dominion of reason." Thus, not only is the act of the patient to be con- sidered, but the quality of the act must be learned if possible; the probable reasons which prompted it; its propriety under the circumstances of its occurrence, and the consistency both of the act and its motives with the patient's former habits of judging, feeling, and acting on similar occasions. In a word, the individual in his diseased condition must be compared with him- self when confessedly sound. And this comparison must refer to him in each state not only intellectually, but also as a moral being. A comparison of Mr. Parish's moral qualities, as exhibited in health and again after his attack, reveals 48 378 a change from his natural affections, feelings, domestic and social inclinations, temper, and habits, incompati- ble with continued mental soundness. And it should be kept constantly in view, that this change followed immediately upon the invasion of a cause, which all will admit was adequate to produce mental unsound- ness. The perversion of his natural sentiments and pro- pensities, thus induced, continued throughout his whole life subsequent to his attack, and taken in connection with the intellectual deprivation already pointed out, leaves no room for doubt that, in all material respects, Henry Parish's individuality as an intellectual, moral being, was thoroughly subverted at the moment of the apoplectic shock, and that it never recovered its normal integrity. On this second point there is far less discrepancy of opinion on the part of the associates and visitors of Mr. Parish, than on the one first examined. His con- duct and his emotions, generally, if not invariably, were patent to all observers. No apprehensions of ridicule, such as are supposed to have deterred him from writing, restrained the exhibition of his impulses; no arbitrary tests were needed to call forth a display of agitated feelings, otherwise concealed by the effort of a will responding to motives of delicacy and pro- priety. Although Mr. Parish generally presented the tran- quil, impassive appearance and manner of most de- mented paralytics, he yet preserved some degree of intelligence, slight as it was, and like all human beings, no matter how deplorably imbecile or fatuous, he re- tained propensities which still sought gratification, and mental habits and inclinations founded in early life and confirmed by years of daily routine. But "the governing principle of the mind" was gone, and the patient vacillated between a state of pas- sive indifference and of tumultuous emotion, which 379 discredits the supposition of a supervising and control- ling reason, such as in his former days of health had formed his character, determined his relations to socie- ty, and controlled his demeanor in the privacy of his own household, as well as in places of public resort. The testimony of witnesses is so full on this particular, embracing the whole duration of Mr. Parish's illness, and exhibiting him in a great variety of relations, that nothing more could be desired to throw light upon the inquiry. An analysis of the evidence of nearly every witness, as to Mr. Parish's conduct, would present a harmonious whole, irresistibly conclusive to all physi- cians practically familiar with mental alienation. Mr. Parish, when in health, is said to have possessed a good mind, not quick in perception or resolve, but very de- cided' when a determination was made. (Dr. Dela- field, I. f. 2040. Wiley, II. f. 64. Heny. Delafield, III. f. 22.) After the attack of July, '49, his gestures of the head, if intended to be responsive to queries ad- dressed to him by various persons upon important matters, frequently indicated great irresolution or in- stability of mind. Thus (I. f. 863) Mr. Kernochan says that when, in company with Mr. Folsom, he asked Mr. Parish if he desired to have his will, Mr. Parish both shook and nodded his head. Folsom (I. f. 1144) makes the same statement, and again (in I. f. 1141) he declares that similarly incongruous gestures were made by Mr. Parish on another occasion when the same question was addressed to him. The same wit- ness makes the same relation respecting an inquiry put to Mr. Parish about the Union Square property. (I. f. 1122 to 1125.) Mr. Ogden (I. f. 1475, '6) relates the same course of conduct when application was made at the Bank for Mr. Parish's trunk containing valuable papers, and Mr. Jones (III. f. 1642) says the same thing occurred when he sought to learn Mr. Parish's preference as to the form of his garments. Mr. Wiley (II. f. 53) states, that he made Mr. 380 Parish an offer for the Texas lands. Mr. Parish shook his head. Mr. Wiley' remarked that the other partners assented, whereupon Mr. Parish nodded. " Both ges- tures were made within a minute or two." (II. f. 94.) Mr. Wiley himself doubtless gives, in a measure, the true explanation of this contradictory course. (II. f. 79-80.) " He was perhaps not as firm after the at- tack, for in the settlement of accounts he would give way, yield his own opinion for others." But this dis- position to yield his opinion, however frequent in in- terviews with Mr. Wiley, was by do means universal on occasions of business propositions being made to Mr. Parish. Persistence in a supposed determination was sometimes observed under circumstances which ren- dered it quite as inexplicable as the supposed conces- sions at other times, and less reconcilable with reason. Mr. Youngs, in whom Mr. Parish, when well, seems to have placed much confidence, and who was fre- quently at work in the house, applied to Mrs. Parish for a loan on his property, Mrs. Parish at that time holding power of attorney to manage her husband's property and business. Says Mr. Youngs—" Mrs. Parish stated that she would like to take the loan, but did not know whether Mr. Parish would consent; she said I must see Mr. Parish." On receiving the application Mr. Parish first shook his head and then nodded. (Youngs, II. f. 700.) On a second occasion of the sanle kind, Mrs. Parish having expressed her own willingness to make the loan, Mr. Parish shook his head throughout the inter- view, without more apparent good reason than in the first instance. (Youngs, II. f. 706.) On a third application of like nature, with similar approval of his wife, Mr. Parish first shook, then nodded his head, and, as it would seem, with even less reason for a change of mind than in the preceding case. (II. f. 707-9.) Mr. Parish's conduct on these several occasions was 381 strikingly at variance with that tenacity of purpose admitted on all hands, and claimed by the proponent to have characterized him in health. Two similar scenes, described by Mr. Daniel Lord, expose either great irresolution, instability of pur- pose, or a mental vacuity, incompatible with accurate perception and understanding of the suggestions, united with a rational will in yielding thereto. Says Mr. Lord, (I. f. 438,) " at the sound of inquiry from Mr. Parish, the suggestions came from Mrs. Parish of his disposition to disturb the gifts to his brother's children," and (I. f. 439,) " it was acquiesced in by him, when it was made by expressing 'yes.' " "I said to him," adds Mr. Lord, " that that would be harsh, and making the difference between them to bear upon the children," (I. f. 444), "he forbore to make the sign of inquiry, and indicated a hesitating acquiescence by some sign or sound which I cannot now remember." (f. 445.) Mr. Lord states that substantially the same train of circumstances was repeated on a later day. (I. f. 471.) In direct contrast with this course of conduct, and equally inexplicable by his natural habits in health, was his supposed determination to purchase a certain amount of stocks. (H H. Ward, II. 1890.) If the remarkable scenes thus selected show only defective attention and want of concentration of mind on Air. Parish's part, they prove a great change in his mental habits on important occasions. If they also show vagueness of comprehension, instability of de- cision, and contradictory resolves, they still more estab- lish a profound obscuration of his natural faculties. Other than this conclusion no plausible one is left, in my opinion, save the more comprehensive one, that so complete was the prostration of Mr. Parish'sunderstand- ing, reason, and freedom of will, that he acted, as do most demented persons, from impulse and upon sudden suggestions, without true consent or reflection, and 382 even without knowledge of the import of many inter- rogatories to which they reply, or of their own res- ponses thereto. Of his disposition in domestic life, and as a member of society, we are informed that prior to his attack, Mr. Parish was " exceedingly affable, amiable, and courteous ; " (Hen. Delafield, III. f. 22 ;) that he " was amiable, kind, and indulgent toward his wife," (Dr. Delafield, II. f. 3010, and H Delafield, III. f. 22,) and that great self-respect, studious courtesy, and proprie- ty of demeanor in his intercourse with others, were marked characteristics of his life." (Dr. Delafield, I. f. 3231.) Subsequent to the commencement of his cerebral affection, though he was generally placid and tract- able, he frequently exhibited great irritation and even violence, at variance with his former self-control. Dr. Delafield says he " became irritable and changed in disposition." (I. 2098 to 3000, 3012.) He was some- times quite out of temper toward his wife on occasions when such conduct seemed especially irrational, in the absence of all explanation of his persistence ; as when Mrs. Parish declined to draw checks from insufficiency of bank deposit; (Wiley, II. f. 143. H H. Ward, II. f. 1890. Youngs, II. f. 722.) And again, when his wife remonstrated against going to Greenwood, as she was ill, despite which he would go. (Richd. Delafield, IT. f. 1767.) Dr. Delafield testifies, (I. f. 3014,) that "now and then, when he was apparently proposing a question to somebody, and anxious to get the informa- tion, he would not allow her to interpret for him, and was impatient, and this would, of course, get him into greater difficulty, and increase his impatience." When in health Mr. Parish was " not a man of sen- timent," (Dr. Delafield, I. f. 3011,) but throughout his protracted disease he continued femininely sensitive, and "any emotions were more easily excited in him than before/' so that he would often weep on seeing 383 former friends, as well as when not understood. (Dr. Delafield, I. f 2099. Wiley, II. f. 15 and 20. Tileston, II. f. 449, 529. Webb, II. f. 664 of page 232. Wieaton, II. f. 653. Youngs, II. f. 780. St John, II. 1844.) This kind of sensibility,-though common in para- lysis, is far from being universal, and however ex- plained, it still shows an infirmity of the will, i. e. that it is no longer able to control the emotional impulse. Despite his former politeness, " studious courtesy, and propriety of demeanor in his intercourse with others," he frequently used menacing gestures towards his attendants, and on one occasion was much excited, shook his head violently, and made a repelling motion with his hand towards an acquaintance entering his own house. (Tileston, II. 524. Heny. Young, II. f. 1619 et seq.:) see also (Austen, I. f. 1910.) The incident narrated by Mr. Campbell (III. f.1876) as witnessed by him in front of Mr. Parish's house, is one which could only have occurred to an imbecile or demented person. It presents a type of Mr. Parish's mental condition, and furnishes a key to the compre- hension of much of his conduct; that is to say to those parts of it which, to those unfamiliar with such exhibi- tions, might seem to be only mysterious and eccentric, but which is irrational, absurd, and insane in a man of mature years, whose previous life had been free from puerilities and folly. In strong resemblance to this scene was that enact- ed by Air. Parish, when his tin box was placed before him by Dr. Markoe. Fisher's evidence regarding it (II. f. 1108) as far as confirmed by Dr. Markoe, (II. f. 2056,) places the transaction in the same category of irrational conduct as the preceding. The change in the personal habits of Mr. Parish, dating from his attack, were such as could not have followed upon simple loss of speech, and paralysis of an arm and leg, without mental perversion. The tradesmen, with whom Mr. Parish had been accustomed 381 to deal before his attack, and his personal attendants during his malady, present in their testimony a da- guerreotypic representation of a man whose mental lineaments may be as easily recognized therein, as could his physical portraiture in a photograph from life. Mr. Case, of whom Mr. Parish had been accustomed to purchase market-produce before his attack, describes his subsequent conduct, and declares that his signs were so unintelligible that the witness " never could tell what he chose in particular," (I. f. 1893 ;) that articles were sometimes sent back, which were taken in the carriage with Mr. Parish, and that witness "told his men not to send things until Mrs. Parish gave the order, or until the waiter came back for them, after he had taken Mr. Parish home." (I. f. 1905.) Theodore Austen, poulterer, with whom Mr. Parish had dealt for twelve years, says that when he showed Mr. Parish some birds, the latter " took his cane, flur- ried it about and scared me," and that he (witness) told Mrs. Parish he " could not make Mr. Parish under- stand." (I. f. 1910.) Stephen Sammis, shoemaker, says he never saw Mr. Parish take any part in the selection of shoes intended for himself, in the several times, that witness supplied him. (III. f. 1617.) Wm. J. Jones testifies, that on two different occa- sions, one being at Mr. Parish's house, ajid the other at witness's store, he tried several times to learn Mr. Par- ish's preference of samples for garments, but without success. He says that Mr. Parish " would nod his head, and then in a minute after, when I thought I had got the answer, he would shake his head." (III. f. 1642.) On the second occasion, at the store, this witness, after repeated failures of the same kind, produced new samples for Mrs. Parish to show her husband, and states that "she showed him one piece, asked him if he 385 wouldn't like that, he would shake his head, and then he would nod his head j at last she picked out a piece, and said to make him a coat off that." (III. f. 164G.) Witness says, " I told her I could not understand him." (III. f. 1643.) Wm. Youngs, builder, says, (II. f. 723,) "I have spent from ten minutes to an hour trying to understand him;" "when I could not understand him, Mrs. Parish would assist me to find out his meaning;" "two or three times I went away from the house, not having arrived at his wishes." (I. f. 725.) " I have stated fifty times it was difficult to make him understand, because he couldn't talk." (II. f. 775.) Gibson, harness-maker, (I. f. 1867,) and Mulligan, blacksmith, (I. f. 1876-80,) observed no signs of in- terest on the part of Air. Parish, during their business conversations with Airs. Parish; and Youngs relates, that when he spoke to Air. Parish about his tenants, " sometimes he made response, sometimes he did not apparently; sometimes he would look at Airs. Parish, then at me; I then would address my conversation to her; he did not seem to take any further interest when that state of things existed? (II. f. 695.) From those who served Air. Parish as personal at- tendants during his prolonged malady, it appears that his general demeanor varied greatly, alternating be- tween the calmest docility, and a degree of irritation at times exhibiting itself in threatening gestures and even in actual violence and blows. Simmons, attendant on Air. Parish, testifies of Air. Parish, that his temper was "sometimes very mild, sometimes very much agitated," (I. f. 1701;) that when thwarted or restrained in his desires at table, "he would get very irritable, he would beat on the table with his hand closed," (I. f. 1696;) and that he "shoved" witness, and also Airs. Parish. (I. f. 1702,) Wingrove, also an attendant, substantially makes the same declarations as Simmons, (I. f. 1506, '18-'19-'20,) 49 386 and says, " When Mr. Parish was passionate there was no man nor woman either that appeared to have any control that might last 5, 10, 15 or 20 minutes, half an hour, &c, but when recovered from that you could lead him about like a child." (I. f. 1609.) " This witness describes scenes occurring when he was dressing Mr. Parish, (I. f. 1508-10;) at market, (I. f. 1514;) at Root's in Broadway, (I. f. 1523 ;) at the front door of his house, (I. f. 1531;) on occasion of a visit by Air. Daniel Parish, (I. f. 1540;) and with the statuary in the parlor, (I. f. 1650;) wherein the conduct of Mr. Parish was wholly inconsistent with the suppo- sition that his judgment and moral faculties remained sound and unobscured. James Clarke, attendant, testifies to rude conduct by Air. Parish toward his wife, (I. f. 1733-6,) as that "he would give her a push sometimes," and that " he gave her a drive," when she was endeavoring to minis- ter to her husband's comfort. (I. f. 1778.) That the restraint which provoked many of these exhibitions of temper by Mr. Parish toward his wife, was considered necessary, and was therefore recom- mended by his physician, Dr. Delafield, is shown by that gentleman's own evidence, (I. f. 3012.) The "an- ger" which, says Dr. Delafield, Mr. Parish "frequently betrayed" on these occasions, was exhibited toward his wife, whom he had, when in health, treated with the utmost kindness and indulgence, and it must there- fore be attributed to his inability any longer to appre- ciate the affection and sense of duty which imposed these restraints. Beside those perversions of all his natural traits al- ready referred to, Air. Parish exhibited at times a lam- entable disregard of propriety in his personal habits, under circumstances which permit but one interpreta- tion of his acts. AfL such times he resisted removal from the table, when it was apparent from his move- ments that his necessities required it, and the natural 387 dejections of his body occurred in his garments. (Sim- mons, I. f. 1718. James Clarke, attendant, II. f. 1744-5. Edward Clark, coachman, II. f. 2225.) The amusements in which Henry Parish had long been accustomed to indulge, terminated with the inva- sion of his disease. He had been fond of whist-play- ing, and was an habitual attendant at his club-house for such purpose, (Webb, II. f. 671.) After his attack he was never known to play, and, so far as shown by the evidence, was only once invited to take part in any game at home, on which occasion he " declined by shaking his head and saying 'No.' " (Henry Delafield, III. f. 180. ) In thus closing this comparison of Henry Parish's intellectual and moral traits in the two epochs of his life, preceding and following his apoplectic attack of July, 1849, we cannot fail to recognize a most painful contrast, constituting an entire transformation of his personal character. Perhaps this inquiry has not disclosed gross delu- sions cherished by this unfortunate man, and proclaimed to every new comer, not yet any ' settled melancholy,' nor, unless the disherison of his brothers because one of them visited him in his extremity, be considered his act, does it disclose any groundless yet persistent aver- sion to his kindred—any of which conditions would have been readily recognized by all sound thinkers as a subversion of reason. But in that class of cases to which Mr. Parish's essentially and in its primary and leading aspect belongs, the intellectual functions and the affections, instead of being perverted or oppressed as in cases of mania or melancholia, are to a greater or less degree obliterated; and instead of an intelligent, reasoning, moral being, in a state of feverish disturb- ance or driven from his track of normal action, there is exhibited only a mental wreck, shattered beyond all hope of present or future activity. Such a wreck was Henry Parish after the shock 388 July 19th, 1849. He labored under a disease of the brain, of which loss of speech and paralysis of limbs were symptoms, but by no means the only symptoms. With these came also loss of reason and paralysis of thought; from that time Henry Parish ever remained a demented man, blinded by obtuseness of perception and devoid of intelligent will. It is not surprising that many persons who were in the frequent, and for a considerable time, even in the daily habit of associating with Air. Parish, should have thought him capable of understanding all that was said to him, and of forming rational judgments on matters demanding a considerable scope and force of mind. Physicians whose lives are passed among the insane, constantly remark similar errors of judgment among the friends of deranged patients, as well as among general observers. Even a very considerable famil- iarity with insane persons does not insure against such misconstruction when the observation is merely casual, and the attention not critically applied to the detection of mental aberration. Thus non-medical men who, as trustees of institutions for the insane, are brought into frequent but brief asso- ciation with these unfortunates, often fail to recognize the extent, or even the existence, of very serious alien- ation, until pointed out or elicited by others. It is, therefore, not surprising that a much slighter experience with the subjects of mental malady, should disregard indications which would at once arouse the suspicion of a skilled observer. The Rev. Dr. Taylor "had not the least doubt of the soundness of his (Air. Parish's) mind," (I. f. 3389,) and probably found in the " uniformly devout and humble manner" in which Air. Parish received the Holy Communion, (I. f. 3344,) one of the evidences of his mental soundness. But in Air. Parish's inability to account for the emotion described at I. f. 3334-6, and in his conduct in throwing back the money to his wife, 389 in his "contemptuous mode of expression, frowning and shaking his hand towards her," (I. f. 3349.) there is something quite characteristic of insanity. If Dr. Tay- lor had devoted himself to that kind of scrutiny which alone gives value to the testimony of an observer in these cases, he would not have failed to remark what must strike any inquiring reader of his state- ment—a glaring inconsistency between these acts of Air. Parish and that "solemnity of the occasion" by which he (Dr. Taylor) informs us, "Mr. Parish seemed to be always very much impressed." (I. f. 3344.) Now, to an expert investigating cases of insanity, these last incidents are far more significant than a par- ticipation in the Holy Communion. The latter act is common in the large Asylums for the Insane of Europe and Great Britain, and is not rare in similar institutions of this country, though its comparative infrequencyjs probably owing more to the diversity of denomi- national preferences among our people, and to absence of chaplains, than to any other causes. In the Asylum under my charge, several patients are habitual recipi- ents of this sacrament, and a candid observer cannot doubt that its administration affords great mental com- fort to some unhappy beings whose intellectual facul- ties may be severely shattered, but whose religious sentiments established by long habit, and now, in their lowered condition, nurtured by these devotional prac- tices, may retain some measure of activity notwith- standing the intellectual disturbance. But the recep- tion of this sacrament by Air. Parish bears no resem- blance to the same act in the class of persons above described. It did not constitute the occasional repe- tition of a practice commenced when he was in the full possession of health and reason, and continued because of a remaining sense of its nature and spiritual efficacy. Nor, in my opinion, did Air. Parish's course in this act correspond to what is constantly seen in persons stricken down by physical disease, but retain- 390 ing a full consciousness of their dependence upon and responsibility to a Supreme Being, and a consequent longing for the consolations of religion. Rev. Dr. Taylor says that Air. Parish " was a regular and punctual attendant of his church," but that he did not know whether Air. Parish*" had ever been attached as a communicant, or otherwise regularly admitted member of any religious society." (I. f. 3391, '2.) I am unable to believe—for reasons similar to those given at length in this paper as to many other of his acts—that Air. Parish, after his apoplectic attack, was able spontaneously to solicit the administration to himself of the communion sacrament, or that in par- taking of the necessary "elements," he did so with an appreciation of the mystical character of the act as viewed by all Christian denominations. This act of Mr. Parish, like many others, was one of compliance with the suggestion of others. In him, it was the eating of bread and the drinking of wine, and nothing more. Comments similar to those which, with unfeigned respect, I have above made on Dr. Taylor's testimony, might be applied to that of other witnesses whose can- dor and sincerity of belief in Mr. Parish's mental in- tegrity are equally unquestionable. There is, however, in the statements of several wit- nesses, who affirm a belief that Mr. Parish retained possession of his reason, much internal evidence at variance with the verity of that belief, which merits consideration even by a purely medical expert, called to weigh all evidence bearing upon the decedent's state of mind. William Brown served as attendant to Mr. Parish for a term exceeding three years, and declares thus respecting his mental condition—"I considered, and do consider, that his mind was strong and healthy, per- fectly understanding all I ever said to him? (II. f. 1408.) Notwithstanding this opinion, the witness says, 391 (II. f. 1333,) "about nine o'clock, Mr. Parish would take a walk with me around the hall out of the front door; look around to see what sort of weather it was; inquire about the stars, and see if the stars were shin- ing, and ask me what sort of a night it was." Hoiv Air. Parish asked these questions, and how the witness ascertained Mr. Parish's wish, he explains at II. f. 1545,'4, but immediately after the remarks just quoted, he adds, "if it happened to be a cloudy night, I would tell him the time hadn't come for the moon to make its appear- ance in that quarter yet." (II. f. 1334.) Nothing in the evidence indicates that Mr. Parish regarded such remark as irresponsive to his sign of inquiry, or absurd, or offensive. The probability is, that he did not re- gard it at all, and simply because he never made nor intended to make any such inquiry as the witness con- jectured; and it is equally probable that he was inca- pable of distinguishing between a rational and an absurd response to any such interrogatory. The incongruity between the witness's interpreta- tion of Mr. Parish's sign of pointing, and his own answer thereto, seems to imply that he entertained very much the same conviction himself. In the same way do occasional observers of the insane, who declare that they can discern no irrational idea or singularity of conduct in certain individuals, address them ridiculous questions in a loud tone, and with unnatural distinct- ness of enunciation, showing that they instinctively recognize what they cannot logically infer. With the same inconsistency do persons occasionally bring a rela- tive to a Lunatic Asylum as a patient, declaring that he is not insane, but that he is wholly changed in feel- ing and conduct; that "he is no longer the man he used to be," since the invasion of some cause recog- nized by all medical men as a frequent exciting cause of mental aberation. Such are the fallacies of limited experience, or of 392 misconception as to the phenomena of disease, or of friendly bias. I have not in this inquiry gone into a critical ex- amination of those acts of Air. Parish, to wit, nodding his head, and making a mark with a pen, which were construed to imply a wish and determination to modify in a very material manner, the provisions of a will drafted by himself, when in sound health, and after mature deliberation, as shown by his conversations with Air. Havens at the time. (Havens, I. f. 769, '70.) The significance of these acts is to be determined in the same manner as in other instances of analogous nature. They were very simple acts, and unaccompa- nied by any further evidence of a natural and free will. If they were really and truly the reflex of intelligent comprehension and intention at the moment, they con- flict not only with Air. Parish's declarations to Air. Havens before his attack, (Havens, I. f. 769,) but also with his conduct at times toward Air. Daniel Parish during his illness. (Simmons, I. f. 1692, '3 ; Wingrove, I. f. 1535, '6 ; Fisher, II. f. 1114.) Believing that Mr. Parish was incapable of such complexity of thought as would be demanded by the revision of a will, framed before the access of his pa- ralysis, I am of opinion that on the occasions of nodding his head to the suggestions thereupon embodied in the codicils to his will, and in affixing his mark to the paper, (as well as in the other instances of attach- ing his name or mark to documents presented to him for that purpose,) Air. Parish acted as do many insane and demented persons, upon the suggestions of others, and without understanding, knowledge, and free will, in the sense in which these terms are ordinarily under- stood. He was not, in my opinion, capable of yielding intelligent assent or dissent to any questions relating to his estate, his will, or his business affairs generally. D. T. BROWN. ' Bloomingdale Astltjm foe the Insane. New York City, September, 1857. OPINION OF M. H. RANNEY, M. D., PHYSICIAN TO THE NEW YORK CITY LUNATIC ASYLUM, Blackwell's Island. 50 OPINION OF M. H. RANNEY, M. D. Having examined with care the testimony given in the matter of proving the will of Henry Parish, de- ceased, it is my opinion that from July 19th, 1849, to the time of his death, he was of unsound mind, and incapable of transacting business understandingly. The reasons for this conclusion are based on the fol- lowing premises: 1st. There existed in his physical condition an adequate cause for producing mental de- rangement. 2d. There was, in fact, a perversion of his affective powers, and a great impairment of his in- tellectual faculties. These premises hold to each other the relation of cause and effect. A knowledge of the actual condition of the mental manifestations, together with the cause, determines the question. As to the cause, it is shown that Henry Parish had a predisposition to apoplexy, and several premonitions of its occurrence previous to July 19 th, 1849; at which time he had an apoplectic attack, followed by hemiplegia of the right side, and nearly an entire loss of voice, dependent either on paralysis of the vocal organs or impairment of mind, or on both conjoined, which conditions were continuous until the time of his death, a period of more than six years; during which epileptic convulsions occurred at irregular intervals, with occasional non-control of sphincters. The permanency of these results indicates a very grave lesion of the brain. The probable pathological 396 changes involved in this lesion are distinctly pointed out by his attending physician, Dr. Delafield. (See I. p. 742.) " The clot of blood which was prob- ably left in the substance of the brain in the original attack may eventually have so far involved a large por- tion of the brain by softening and otherwise, as to pro- duce the effects in question." The character of the results equally proves the gravity of the lesion. (See " Todd on the Nervous System," p. 125.) In speaking of hemiplegia, he remarks:—"But sometimes the power of speech is wholly destroyed, even in cases where these nerves have suffered but little or not at all, and the powers of utterance are limited to 'yes' and 'no,' or either of these mono- syllables ; and this is a sign of very unfavorable por- tent, as denoting with other symptoms extensive le- sion of the brain, superficial as well as deep." That in the present instance the lesion left a cause of irritation in the brain is conclusively shown by the con- vulsions that occasionally occurred, the irritation from such cause being transmitted to the spinal marrow through portions of the brain not yet disorganized. Con- vulsions of this character are usually less frequent as softening advances, the pressure of the foreign substance becoming less immediate on portions of brain yet re- taining excitability. If great disorganization exist in any organ, the functions of that organ will be impaired. The brain forms no exception to this general law, and being the instrument for mental manifestation, it cannot be gen- erally diseased without a corresponding derangement of its functions. (See " Medical Jurisprudence of In- sanity, by Ray," 3d ed., p. 130.) " It can hardly be necessary at the present time to prove the dependence of the mind on the brain for its 397 external manifestations; or, in other words, that the brain is the material organ of the intellectual and affec- tive powers." In a word, the severity, permanency, and character of the symptoms connected with and depen- dent on the apoplexy, prove that there existed in Air. Parish's case a very grave lesion of the brain. From this grave lesion, I infer derangement of mind. Were not the startling doctrine presented by eminent medical men, witnesses in this case, that " a post-mortem examination of Air. Parish could not have thrown any light upon the nature of his diseases, or the connection of these diseases with the condition of his mind in life," (I. p.763), this point would be pursued no further. But the advances made in the physiology and pa- thology of the nervous system during the past few years, forbid any acquiescence in this doctrine. In- sanity is no longer considered a direct visitation upon the mind itself as an immaterial entity, but as being dependent on a disease of the brain arising from physical or moral causes. The evidence of this disease is generally accompanied by morbid changes in the brain apparent after death. Alodern writers agree that in cases where insanity has existed some years, pathological changes in the brain are usually found. The principal discrepancy of opinion is as to the rela- tion which these pathological changes hold to insanity, but this question does not affect the argument; for, if certain conditions of brain be usually found in men- tal disease, be they remote or proximate causes, or even secondary phenomena, it establishes the impor- tance and necessity of a careful inspection after death, when the state of mind is to be a subject of judicial inquiry. In proof of these general remarks, I make a few quotations. Pay's " Medical Jurisprudence of In- sanity? 3d ed., p. 132. " The very same observers who once could find nothing satisfactory in their post- 398 mortem researches in the brains of the insane, have changed their views, as their field of observation has enlarged, and their acquaintance with the whole sub- ject has been increased with time and practice, so that some have examined hundreds of subjects without finding one entirely free from some appreciable change." (" Trial of William Freeman,"p. 299.) Dr. Brigham remarks:—" There is nothing mys- terious about insanity when considered as a disease of the brain. It is such a disease, and I have never seen a case where after death marks of disease could not be found." (" The Asylum Journal of Mental Science" April, 1857. Article, "The Pathology of Insanity" by Charles Bucknill,M.D., p. 289.) " The brain, like every other organ of the body, for the perfect performance of its functions, requires the perfect condition of its organization, and its freedom from all pathological states whatever. Consequently, the existence of any pathological state in the organ of mind will interrupt the functions of that organ, and produce a greater or less amount of disease of mind, that is, of insanity." On this and the succeeding page, Dr. Bucknill explains "the organ of mind" as the gray matter of the cerebral convolutions. " Journal of Psychological Medicine? Vol. 7, article " The Medical Treatment of Insanity? by Forbes Winslow, M. D., D. C. I. pp. 211 and 212.—" With reference to the first position, I need only refer to the recorded opinions of all the great cerebral pathologists, from the great Alorgagni down to modern writers, to estab- lish beyond all question, cavil, or dispute, that in the great majority of cases of death after attacks of insani- ty, the brain, in some of its important organic elements, or its investing membranes, is found in an abnormal morbid state. It is true that Esquirol somewhat en- couraged the doctrines of the spiritualists, by asserting 399 that in many instances of insanity no change in the nervous matter could be detected after the most care- ful scrutiny; but that high authority was known to have materially altered his views upon this point at a more advanced period of his life ; and his later patho- logical investigations tended, I think, conclusively to establish that the nervous matter was always found modified in its structure after death from insanity. To this subject I have paid much attention, and have pa- tiently endeavored to ascertain what are the acknow- ledged opinions of those who have had opportunities of arriving at safe results, and whose names entitle every thing which they have recorded to our profound deference and respect. I have carefully, scrupulously, and zealously analyzed no less than 10,000 cases of the various shades and degrees of insanity, related by Es- quirol, Pinel, Foville, Georget, Guislain, Calmiel, Flourens, Bell, Haslam, Prichard, Solly, Burrows, Baillarger, Boismont, Abercrombie, Bennett, and other British, American, and Continental authorities; and as the result of these pathological researches, I have no hesitation in declaring that as the natu- ral effect of the influence of these well-ascertained data upon my own mind, I feel amazed that there ever could have existed a shadow of a doubt as to the phys- ical origin of insanity." Again, at p. 214, he says: " No morbid change can exist in the hemispherical ganglia without involving, to some extent, the operations of the mind." At p. 219: "I believe insanity (I am now referring to persistent in- sanity, not those transient and evanescent forms of dis- turbed minds occasionally witnessed) to be the result of a specific morbid action of the hemispherical gan- glia, ranging from irritation, passive and active con- gestion, up to positive and unmistakable inflammatory action." 400 " A Treatise on the Nature, Symptoms, Causes and Treatment of Insanity. By Sir W. C. Ellis, M. D? London edition,pp. 19 and20.—"In carefully looking over the post-mortem reports of those whose cerebral organization I have examined, I find that in 154 male patients, 145 had disease very strongly marked, either in the brain or the membranes." See Dr. Webster's report of 123 autopsies on the insane, in all of which either disease of the brain or meninges was found.—" Psychological Journal of Medi- cine," V. 1,pp. 626 to 637 inclusive—V. 8, pp. 139 to 147, and 282 to 292. But I will not multiply quotations on this point. In connection with this subject, however, it may not be improper to remark that over 300 post-mortem ex- aminations have been made by me of those previously insane, and I can recall to mind not even one in which some pathological change was not found, either in the brain or its membranes. It is true that lesions may exist in certain parts of the brain without affecting materially the intellect; to illustrate which I will simply quote from Dr. Bucknill's " Pathology of Insanity? pp. 289 and 290.—"It is also sufficiently proved that the medullary substance of the brain, forming so large a portion of its mass, is merely a conducting medium. Pathological conditions may exist in this white substance, in the cerebellum, the corpora-striata, and thalami, without affecting the men- tal functions." " Circumscribed effusion of the blood in the white substance of the brain often produces loss of mental function when it first takes place, from the pressure which it exerts on the gray matter of the con- volutions. And when the mischief occasioned by this pressure has been removed by the adaptation of the blood in the cerebral vessels to the contents and capa- city of the cranium, the powers' of mind return, while 401 those of motion remain injured until the integrity of the torn substance is restored. " Lesions, or pathological conditions of the conduc- tive or motive parts of the brain, frequently propagate themselves to the seat of the mental functions, and active pathological states of the latter seldom exist without implicating to a greater or less degree the in- tegrity of the former. They are parts of the same or- gan, essentially different indeed in function, but so in- timately connected that pathological conditions readily extend themselves from one to the other both by con- tinuity and by sympathy. All these points of diffi- culty being admitted, the important fact remains that diseased conditions which affect the mental functions must have their seat in the gray matter of the cerebral convolutions." With the opinions of so many enlightened and experienced authors before us, it seems impossible to doubt the importance of a post-mortem examination of the brain, where the previous condition of mind is likely to be called in question. A change in the mind of Henry Parish is conclu- sively shown by the testimony. Previous to the attack of apoplexy he was " placid and unexcitable." (Kernochan, I. f. 241.) " Very methodical, even-tempered, never showing any change of disposition." (Folsom, I. f. 309.) "He was a pleasant, rather a joyous man in his disposition ; fond of a frolic, loved lively and gay conversation, any thing that excited a laugh." (Dr. Delafield, I. f. 639.) Towards his wife "he exhibited no want of affection; he was always amiable, kind, indulgent, exceedingly; though he was not a man of sentiment." (Dr. Dela- field, I. f. 642.) " He was mild, gentle, unruffled, yet decided in all matters to which he gave personal attention." (Richd. Delafield, II. f. 606.) "He was 402 a most indulgent husband." (Richd. Delafield, II. f. 624.) He was " exceedingly affable and amiable and courteous." (Henry Delafield, III. f. 9.) To Airs. Parish he was " affectionate, kind, indulgent." (Henry Delafield, III. f. 9.) " He generally acted on his own judgment, as much so as most men." (Kernochan, I. f. 257.) "He generally adhered to an opinion once made up, or to a decision arrived at, and it was not easy to change it." (Kernochan, I. f. 257.) His judgment and strength of mind was " much above the ordinary." (Folsom, I. f. 310.) " His (Dr. Dela- field, I. f. 624) mind was good, not quick in percep- tion, not quick in action, in resolve that is." (Henry Delafield, III. f. 9.) As to quickness of apprehension, " I should say it was slow, deliberative, and having made up his mind on any subject, was firm and very decisive." (Henry Delafield, III. f. 9.) Subsequently to the attack a complete change was observed in his disposition, temper, and habits. " I very often saw him shed tears." (Kernochan, I. f. 241.) " Frequently he was quite irritable." (Kerno- chan, I. f. 241.) He exhibited irritability, manifested " by violent gestures with his left hand, and terminating generally with a push at Mrs. Parish." (Kernochan, I. f. 289.) " His nervous system became very much impaired, rendering him irritable, more easily excited than before, and to a certain extent changing his dis- position." (Dr. Delafield, I. f. 639.) His temper as to cheerfulness " was very constant, entirely changed from its previous condition—habitually unhappy ; his countenance always wore an unhappy expression, and it was a very rare thing to see him smile." (Dr. Dela- field, I. f. 640.) " He frequently betrayed anger, and exhibited it by violent gesticulation, but it quickly passed away." (Dr. Delafield, I. f 642,'3.) "He manifested towards me great irritation, accompanied 403 by gesticulation, to me so unpleasant that I determined never to thwart his wishes again." (Richd. Delafield, II. f. 614.) " He was much more irascible, easily ex- cited, when any thing roused him, and in general of a more irritable temper than I supposed he was before his attack." (Dr. Markoe, II. f. 699.) The impair- ment of his intellectual faculties is shown by an insuffi- cient exhibition of intelligence, and by his conduct. The manifestations of intellect were limited to expres- sions of countenance, a small number of uniform gesticu- lations with the left hand, and a few words of utterance. None of these were such as to enable one to be sure of his meaning, nor was result of searches for his meaning, by the presentation of various questions, ever better than a conjecture, more or less confident according to the temper of the inquirer. Indefinite expressions are ever interpreted according to the sus- ceptibility or spontaneity of those who behold or hear them; and even the most intelligent are liable to mis- take the suggestions of their own minds for intelligence in unmeaning expressions. There were opportunities presented in which he might have shown unmistakable evidence of his powers, had he possessed rational in- telligence. He was supplied with pen and paper, pencil and slate, and separate letters of the alphabet, with which to form words, and though possessed of sufficient control of his left hand, he yet failed to com- municate one intelligent idea. Had he possessed even moderate capacity, his gestures might easily have attained the manifestation of intelligent pantomime ; but his gestures were few, unvaried to any great extent, contradictory, and never of definite meaning except in reference to the simplest affairs of domestic life, with which he was very familiar, and for which his animal instincts were sufficient. A small degree of his original business capacity and discreetness Would have 404 prompted him (as was the case with Mr. Alacdonald, III. p. 769,) to adopt various other means to render himself intelligible. His conduct evinces not only a perversion of disposition, but also an impairment of intellect. As a few of the various instances, I would refer to his going to his wife's wardrobe in a state of nudity and ransacking it; his method of selecting changes of garments; his persistence in wishing Airs. Parish to accompany him to the cemetery, although informed that she was sick; his conduct in the carriage at Boot's, and his striking or pushing his servants, and even his wife. Such changes of the affective and intellectual pow- ers dependent on a disease of the brain, constitute the true elements of insanity. The existence and degree of derangement can be determined only by comparing the man with himself— See " Maladies Mentales par J. Guislain? 1852, p. 70. "II y a, au point de vue du diagnostic de l'alien- ation, un criterium assez general, que AI. Falret a fait tres-bien ressortir: c'est le changement qui survient dans les habitudes, dans la conception, dans les idees, dans les actes et les gestes de l'homme devenu aliene. Ce phenomene tranche les grandes questions, alors que dans l'appreciation de la maladie tout est encore obscurite: c'est la comparaison de l'homme avec lui- meme." See also Sir Henry Holland's "Medical Notes,"p. 136, and Ray's "Medical Jurisprudence of Insanity," 3d Ed. pp. 135, 136, 137. Place all his manifestations together, and give them the most favorable acceptance, excluding the too great latitude of conception and opinion on the part of those who testify, and they show no definite proof of rational intelligence or discreet understanding. Sufficient tests for determining the condition of the 405 mind under circumstances of this character, were ap- plied, and the results are unmistakable indications of incapacity. The various instances in which he is supposed to have evinced intelligence in pecuniary transactions, do not separately nor in the aggregate, show a capacity for transacting business understandingly; while there are concomitant circumstances and manifestations which suggest the idea that the conceptions of the witnesses, in these cases, were mistaken for the mean- ing of Air. Parish. The following items of asserted fact may be enumer- ated as affording the most plausible impression in favor of his continued sagacity and prudence. 1. His excitement at the presentation of a note by Air. Wiley, on the face of which there had not been in- serted " interest from date." 2. His noticing that a certain check had not been changed. 3. His dissatisfaction when interestwas not entered on bonds the day it was paid. 4. His donation to the Bible Society for building, and not for general purposes. 5. His dissatisfaction that $15 was given as a chari- table donation to Dr. Taylor, and his after approval of $200 for this purpose. 6. His demand of more security from the Phoenix Bank for the loan of his $200,000 bonds. 7. His appearing to count money and putting it in his pocket. 8. His indications to the carpenter to repair defec- tive roof. 9. His reading, writing, and examination of his ac- counts. In respect to all these transactions, assuming that there is no error in the description, and even had they not 406 been attended by the supervision of others, as in all in- stances they were, I may briefly say that they do not ne- cessarily involve any complicated mental action, continu- ity of thought, nor correct judgment. They might all have been performed by one who had been long accus- tomed to Mr. Parish's business sphere of life, by a sim- ple perception with an assent or dissent. The imbecile imitates the actions and even the words of others, and the demented, from habit, perform various acts automatically without any definite compre- hension or purpose. In dementia there is rarely, if ever, a complete ob- literation of the mental faculties; but they are so en- feebled that although perception, memory, comparison and judgment do exist, they are present in such an impaired state, and a degree so limited as to direct to no perfect or safe conclusions. They do not sustain comprehension or discrimination and a definite purpose. This was the form of the mental disease of Henry Parish, and it is not common to find even in a lunatic asylum, a grade of intellectual expression so low as that exhibited by the facts in testimony in his case. The attempt to account for his non-manifestations of mind by discouragement or unwillingness is simply absurd. Discouragement arises from loss of confidence in one's own ability to act, or from the belief that the matter proposed or desired is impossible to be perform- ed. Either of these states of mind in reference to such a process, as that contemplated, with the amount of instrumental availability within his reach, and the long period of time during which such great necessity for action constantly prompted him, would imply either that there was an insane delusion on his part or a real lack of power. With equal propriety the hypothesis might be presented to prove that an idiot could, but would not, manifest ordinary intelligence. 407 A knowledge of the fact that he did not show such mental power, and the truth of the principle that if it existed it could not remain hidden for so many years, is sufficient to decide the question definitively. The hypothesis that he did understand and could have given definite expressions yet was unwilling, is refuted by the exhibition of social qualities and complaisance, such as drinking wine, &c, with his friends. That he would not exhibit intelligence because of excessive sensibility to failure or ridicule, is not a rational supposition, in view of the fact that lack of intelligible communica- tions subjected him to so many and such great person- al annoyances. If he could read, it proves that the relation between the objective sign and the subjective idea was recog- nized; but the process of reading may be almost wholly passive after one has well learned the art. The presentation of words previously familiar, may stimu- late the mind to recognize and follow them to some de- gree, with all the apparent intelligence of former life, while there does not actually remain the power to origi- nate, retain, comprehend, and express a single sentence of the simplest structure. That he should seem to read, therefore, cannot be proof of his intelligent and sound understanding. On the contrary, under the circum- stances, if he could read and yet was unable to express his wants by writing, it argues a lack of the most im- portant powers of mind, viz: suggestion, continuity of thought, and discrimination. To recapitulate :—The adequate cause which exist- ed in his physical disease, the perversion of his affec- tive powers, his inability to make an original sugges- tion, the lack of continuity of thought, and the great enfeeblement generally of his intellectual faculties, which are shown in the testimony, his entire failure to exhibit mind when tests were applied, and the absur- 408 dity of any hypothesis save that of mental derange- ment, prove to my mind a want of capacity on the part of Henry Parish to transact business understand- ingly. Al. H. BANNEY, M. D. New York City Lunatic Asylum, Blackwell's Island. [ Sept. 1st, 1857. OPINION OF PLINY EARLE, M.D., FORMERLY PHYSICIAN TO THE BLOOMINGDALE ASYLUM FOR THE INSANE. AUTHOR OF " HISTORY, DESCRIPTION AND STATISTICS OV THE BLOOM- INGDALE ASYLUM FOR THE INSANE ;" " A VISIT TO THIRTEEN ASYLUMS FOR THE INSANE IN EUROPE ;" " INSTITUTIONS FOR THE INSANE IN PRUSSIA, AUSTRIA, AND GERMANY ; " AND "AN EXAMINATION OF THE PRACTICE OF BLOOD-LETTING IN MENTAL DISORDERS." 52 OPINION OF PLINY EARLE, M. D. The last will and testament of the late Henry Parish, deceased, being before the Surrogate of the City and County of New York for probate, the validity of the three codicils thereto appended is contested, upon the ground (among others) of alleged incom- petency, from mental unsoundness of the testator at the times at which the said codicils were severally made. The testimony in the case has been placed in my hands, with the request for an opinion, deduced there- from, touching the mental condition of the testator. A few preliminary remarks are necessary for an ex- position of the principles upon which my investigation has been governed. Among men in their natural condition, there is an infinite gradation or diversity of mental powers, or the germs of what become such diversity of powers, be- tween the limits of two widely separated extremes. Those extremes are, on the one hand, cretinism and the most abject idiocy, and, upon the other, that intellec- tual ability which readily comprehends the nature and the phenomena of the concrete, and explores the sub- tleties of the abstract; which almost intuitively grasps the finite, and then reaches forward toward the infinite; such ability as has been manifested by the discoverers, originators, expounders, and administrators, in physics and in metaphysics, in legislation, jurisprudence, and abstract science. 412 In this scale of infinite gradation, there is no natu- ral boundary between the sound minds and the minds unsound; and hitherto no artificial boundary has been established. Deficiencies, obliquities, aberrations, whimsicalities, caprices, and frivolities, more properly belonging to the persons in the inferior portion of the scale, are, one or more of them, so frequently associated with the more ennobling characteristics of intellect and emotion among men in the superior portion, that it appears impossible to fix upon such a boundary. The mind naturally sound, or belonging to the superior portion of the scale, may, by disease, become impaired or unsound, manifesting perversions, illusions, and delusions, and any or all of the characteristics of the minds at the lower extremity of the scale—the idiots and the cretins. Among the persons thus affected there is every gradation, every possible form, phase, genus, species, and variety of insanity, from the one extreme of slight impairment, eccentricity, aberration, perversion, or delusion, to the other, of acquired idiocy as degraded, debased and bestial as the utmost depth of congenital idiocy. So diverse and delicately graded are the character- istics or phenomena of both sanity and acquired insan- ity, and so heterogeneously are they commingled, that no line of demarcation, either natural, scientific, or conventional, has been drawn between mental sound- ness and acquired mental unsoundness. Often, especially in the manifestations of those mental operations which are remote from the border- land between sanity and insanity, that which in one man is generally recognized and received as sanity is, in another man, received for unequivocal insanity. The sanity of the natural buffoon would be insanity in a Bacon or a Newton. 413 Neither the loss, the impairment, nor the perversion of the perceptive faculties is necessary to constitute insanity ; for a large number of the insane still retain the normal use of those faculties. Nor is loss or im- pairment of memory a requisite element of mental un- soundness. Some of the most obviously and broadly marked insane persons I have ever known, had the most retentive of memories. The loss or impairment of the reasoning faculty is not an absolute condition of insanity. Some mental aliens are exceedingly acute reasoners, their arguments conforming to logical rules. Nor is it true, as has been intimated by a writer upon the subject, that the perversion of intellect consists always in their arguing from false premises. There are many exceptions to this. Some, less logical, ex- hibit that style of reasoning by which a child not un- frequently confounds and stultifies his wiser parent. Judgment, in the broad signification of the word, is not necessarily destroyed in insanity. A sound, pru- dent and wise judgment upon the ordinary every day affairs of life, in the sphere in which he moves, is some- times manifested by a person of very seriously impair- ed or perverted mind. The insurmountable difficulties thus set forth being in the way, no accurate definition of insanity has ever been devised. It necessarily follows that there is no test for it, no experimentum crucis which, in equivocal cases, may be applied with certainty of a positively accurate result, or demonstration, such as in the results of the exact sciences divests of all doubt the solution of a problem or a proposition. Insanity, in the extreme grades of all its species and varieties, is sufficiently obvious to every one upon but slight investigation. But it follows from what has been written that, where it is not so apparent, it can- not be proved that one man is necessarily insane, or 414 necessarily sane, because another man, who manifested some of the same or similar peculiarities, was so. As a consequence of the foregoing considerations, every case of alleged unsoundness of mind must be tried, primarily and chiefly, by itself. Where it may be done, as in this case, the condition, conduct, and mental manifestations of the person at the time of the alleged unsoundness, must be compared or contrasted with his condition, conduct, and mental manifestations antecedent to that time, or at a period at which it is acknowledged that his mind was sound. The relationship between the present condition and the past condition of the person, as deduced from data derived from all the channels of mental development or manifestation, is the test of sanity or insanity which nearest approximates to certainty. But there are ante- cedent, attending, or collateral facts or circumstances which also render assistance in elucidating the subject, and in determining the ultimate decision. Henry Parish, the testator, was a retired merchant residing in the city of New York. It appears in evi- dence that when in health he was " a sound thinker," his "mind good;" that he was " of sound judgment, slow to decide," " even-tempered," "placid and unex- citable ;" that he manifested " great self-respect, and strict observancy of decorum, great courtesy and affa- bility;" and that he was " very fond of his friends and of social intercourse with them." He kept an office in that district of the city which is most occupied by men engaged in the largest mer- cantile and financial transactions. He was " in the habit of keeping a supervision over and daily examin- ing his books and accounts," (Folsom, I. f. 1100,) generally being in his office from 9 o'clock A. AI. un- til 3 o'clock P. AI., "but frequently until 5 or 6 o'clock P. AI." Alost of his evenings were passed at 415 his club, where he generally remained until a late hour. On the 19th of July, 1849, he was attacked with apoplexy, immediately followed by hemiplegia and loss of speech. Other particulars in relation to him, which are of value in this inquiry, will be men- tioned hereafter. In prosecuting the investigation of the condition of Mr. Parish at the time of his alleged mental unsound- ness, in conformity with the principles or plan above- mentioned, I shall pursue the following course: A. Relationship of the testator's condition subse- quently to the attack of the 19th of July, 1849, to his condition antecedently to that attack. 1. Disposition; feelings and emotions. 2. Intellectual manifestations. 3. Habits and customs. 4. Will; force of character. B. Antecedent, attendant, and collateral facts and circumstances. 1. Hereditary predisposition. 2. Disease symptomatic of cerebral lesion. 3. The nature of the acts the validity of which is contested; that is, the tenor and spirit of the testa- mentary codicils. 4. Acts or acquired peculiarities in which the testator resembled the insane. 5. Treatment of the testator by his family. 6. Language of other persons in reference to the testator, in the course of his illness. 7. Opinions of witnesses in regard to the tes- tator's mental condition. 416 A. Relationship op the testator's condition subse- quently TO THE ATTACK OF THE 19TH OF JULY, 1849, TO HIS CONDITION ANTECEDENTLY TO THAT ATTACK. 1. Disposition; feelings and emotions. According to the testimony of Messrs. Wiley, Fol- som, Kernochan, and others, the testator, prior to the attack, was remarkably calm, equable in temper, un- excitable—a complete master of his feelings and emo- tions. After the attack, as shown by these and other witnesses, he shed tears upon very slight occasions, was highly irritable, irascible, and subject to sudden par- oxysms of anger. Air. Folsom saw him shed tears "•three or four times in front of the office "—" some- times thought it was pain, weakness of mind, or hys- terical ;" and many witnesses testify to similar evidence of inability to control his feelings and emotions. His increased irritability was exhibited not in private alone, as towards the several members of his household, but in public also, as at the Market of Case & Vandewater, Washington Market, and in Broadway, in front of Mr. Root's. That his irritation sometimes amounted to an explosive outburst of anger, is evi- dent from the testimony. In presence of Air. Wiley he insisted upon having a check drawn after his wife had told him there were not sufficient funds on deposit to meet it; and, as the witness avers, " appeared to get furiously mad.' (II. f. 38.) When urged not to go to Greenwood, because, as he was told, Mrs. Parish was not sufficiently well to accompany him, "he mani- fested towards me," says Alajor R. Delafield, "great irritation, accompanied by gesticulation to me so un- pleasant that I determined never to thwart his wishes again." (II. f. 1768.) Mr. Case testifies that upon 417 one occasion, when the carriage of the testator was about to leave the market, Mr. Parish rose from his seat and attempted to "catch hold" of Airs. Parish's bonnet. (I. f. 1894.) Air. Austin says, in allusion to the times at which he was showing poultry to Air. Par- ish, as he was seated in his carriage, Air. Parish "would be very mad at me," and at one time " took his cane and flurried it around and scared me.' (I. f. 1910.) In front of Air. Root's, Mr. Parish " got into a violent passion, and the coachman was afraid he would break the windows; and so," adds the witness, "was I." (Wingrove I. f. 1523.) It is testified that at several times Air. Parish pushed Airs. Parish; and the testi- mony tends to show that at two or three times he struck her. Such changes in the sphere of emotion as are here exhibited, may not, of themselves, and standing alone, be proof of impaired or disordered intellect, but they greatly augment the probabilities of such impairment or disorder. They are frequently among the first symptoms or signs of insanity, and often accompany it throughout its course. It is difficult to believe that a man constituted as was the testator, and occupying his social position, could he impelled, by the force of his feelings or emotions, to make so humiliating a public exhibition of himself as did Air. Parish in some of the cases above mentioned, unless his mind were very con- siderably impaired in the sphere of intellect, as well as in that of emotion. 2. Intellectual Manifestations. The operations of the intellect find expression mainly through the media of speech, writing, and pan- tomimic gesticulation, with facial expression. It be- 53 418 comes necessary to examine the condition of the testa- tor in these several respects. 1st Speech.—The only words alleged to have been uttered by him, in the course of his illness of more than six and a half years, are "yes," "no," and other sounds apparently intended for these words; "oh!" "ah!" "oh, dear," " oh, Got," " Why, yes," and, once only, a word or sound which, by Mr. Bryson and Air. Dunning, who heard it, was interpreted "her." The "yes" and the "no," if ever perfectly enunciated—and Dr. Markoe (II. f. 2076) testifies that "yes" was distinctly uttered for many of the first weeks of the testator's illness—were so during com- paratively a very short period. The •" oh, dear," ap- pears not to have been a frequent exclamation, and was enunciated "oh, thear:" while the "oh, Got," and the " why, yes," were heard but a few times. Besides these, a sound spelled " nin, nin," by some of the witnesses, was very frequently uttered. Of all these expressed sounds, articulate and inar- ticulate, those which are of the most importance in the communication of mental processes are "yes" and " no." These have a wide range of utility. What de- pendence, then, is to be placed upon them as employed by the testator? Mr. Kernochan says, "The sound was always very much alike ; (I. f. 847;) Air. Wiley, that he never heard him make any sound which, by itself, would be taken for'' yes " or " no;" (II. f. 92, 93 ;) and Dr. Alarkoe, that his negative was at first " nan, nan," and became " more approaching niah, niah;" and that he sometimes used the same sound, " niah, niah," for "yes." (II. f. 2077, '8.) The sound "nin, nin," was generally interpreted, by the witnesses, as a call for the attention of some person present at the time it was uttered; or as indic- ative of a desire to express some idea or thought, and 419 a wish for the person addressed to ask questions or make propositions, to which he might assent or dissent. If such were the intention, the sound was often used superfluously. Some of the witnesses intimate that it was uttered at every pause, however slight, in the con- versation—if " conversation " it may properly be called; and Air.Tileston says that he used it "almost constantly." (II. f. 522.) This sound was confounded with the sounds supposed to have been expressive of affirmation and negation. Air. Wiley says that the sounds were " al- ways about the same." (II. f. 91.) Dr. Taylor gives the signification of both interrogation and affirmation to " yah," but says the intonation varied with the differ- ence of meaning. (I. f. 3383.) Ed. Clark, (II f. 2155, 2156, 2158,) in a space of little more than one page of the printed evidence, attributes three significations, —interrogation, affirmation, and negation,—to "neay." This equivocal meaning of the sounds, and their con- fusion one with another, is fully testified to by Dr. Markoe, who says not only, as has already been men- tioned, that Air. Parish's negative "niah, niah," was sometimes used for "yes;" but also that he used ' nin, nin,' and 'niah, niah,' "somewhat interchangeably." (II. f. 2079.) Hence, it is evident that "nin, nin" was employed to express what was received as interro- gation, affirmation, and negation. From all this it necessarily follows that no confi- dence could be placed in these sounds, as definitely expressive of any mental process. Such, it appears, was the opinion of George S. Simmons, who, after having been the attendant of Mr. Parish ten months, says that he understood nothing from his sounds, (I. f. 1715 ;) and nearly the same is implied by the language of Dr. Delafield, his family physician, who intimates that he judged of his meaning as much by his coun- tenance as anything." (II. f. 3153.) 420 2d. Writing.—It appears in evidence that the testator wrote, with a pencil, and upon the fly-leaf of a book, a series of characters, (Exhibit No. 264, III, p. 701,) which, as a Avhole, were " interpreted ' wills.'' Dr. Alarkoe says that when he attempted to persuade the testator to write, he wrote with a pencil upon a slate "nearly the full words ' Henry Parish,' several times—he never wrote the full word ' Parish' *** he wrote sufficient of it to make it intelligible." Several signatures of " H. Parish," and " Hy. Parish," are also in evidence, introduced as his autographs. One wit- ness, Fisher, "thinks" that Mr. Parish once wrote the word "horse ;" but this witness's testimony upon va- rious other points is positively contradicted by other witnesses. The words and characters here designated, are the extent to which it is alleged that the testator wrote, in the long period of his disability. The characters first mentioned, i. e. those which were interpreted as wills, are rudely and irregularly made, the lines being of nearly uniform size, and the whole series so large that a rectangle enclosing seven and a half square inches of surface would scarcely enclose them. The strongest evidence that the signatures professedly the autographs of the testator, were written by him, is the fact that they are subscribed to attested business docu- ments. The witness to them died prior to the death of the testator, and therefore we have no explanation rom him. Two witnesses, Air. Bleecker and Air. Par- sons, think that the hand, when some if not all of them were written, was held and guided by the hand of some other person. The rudeness of the characters first mentioned, would lead to the same inference. Even if we grant the authenticity of all the words and characters in question, still, as those words and characters are but few, and as many gravely demented 421 persons can write not only as well, but far better, the testator did not manifest much intellect by writing in the course of his illness. His ability for such manifesta- tion will be discussed in another place. 3d. Pantomimic Gesticulation and Facial Expression.— From the nature of the testator's disease, his gesticula- tion was necessarily more limited than that of a person enjoying the free use of all his limbs. But, from the testimony in evidence, it would appear to have been much more limited than one would expect from a per- son laboring under Mr. Parish's physical disabilities, yet retaining the normal condition of his mental faculties. The principal, if not the only motions testified to as expressive of intellect, are, first, the nod or down- ward movement of the head; second, the shake, or horizontal rotation of the head; third, pointing with the fingers or hand; and, fourth, elevating the arm, the fore-arm flexed, with some of the fingers extended, the others closed. A few other motions are men- tioned, but they are chiefly indicative of emotion. As to the first two motions—those which are con- ventionally employed for the expression of affirmation and negation—there is a considerable discrepancy among the witnesses in regard to their ability to un- derstand the testator in the use of them. At the in- terview in which Air. Folsom asked him what his wishes were, in the event of his decease, respecting the disposition of the estates on Union Square and Wall street, the responses were a nod or a shake of the head, according to the verbal form of the same ques- tion. Mr. Kernochan (I. f. 863) and Air. Folsom (I. f. 1144) testify that when they went to Mr. Par- ish's, carrying the will, and asked him if he wished to keep it, he both nodded and shook his head. Mr. Nicholas G. Ogden says that when the testator and his 422 wife were at the Phenix Bank, and Airs. Parish had stated that Air. Parish wanted something, he asked Air. Parish various questions, and received "no answer but unmeaning motions," (I. f. 1475;) and that when Airs. Parish suggested the trunk, and he asked Air. Parish if that was what he wanted, he " made first an affirmative motion of the head, and then a negative motion to the same question." The testator, during a portion of his illness, frequently went to market; and Air. Case says, " We never could find out rightly what to send him," " we never could tell what articles he did choose in particular at all." (I. f. 1891, 1893.) So they sent to his residence whatever they " thought he had been in the habit of buying before, and Mrs. Parish would send back what she didn't want." Mr. Jones says that at his first interview with the testator, at the time he carried the samples of cloth for panta- loons, " when Mrs. Parish pointed out one or two— showed them to him—he looked at them and nodded his head ; then he looked at them again and shook his head; * * * * * this was tried two or three times." (III. f. 1640.) So no decision was made. At the second interview, when a sample was presented to him, with the question if he liked it, " he would nod his head, then shake his head," (III. f. 1645,) and the selection was finally made by Mrs. Parish. This testimony exhibits an utter inability clearly to express even affirmatives and negatives, or appro- bation and disapprobation, by the movements of the head. Persons whose mental powers are unimpaired, and who possess the unembarrassed use of the muscles of the head, can express affirmation and negation as distinctly, as definitely, as positively, by motion, as by the verbal monosyllables usually employed for those purposes. But, notwithstanding the tenor of the testimony 423 quoted upon this point, there is so much of an oppo- site import, that, in my apprehension, it cannot be doubted that, on some occasions, and within a limited range, the testator used the signs or motions in ques- tion, for the same purposes as they are used by others ; with the same intent, and with some degree of intelli- gence. He must have been mentally below the stand- ard of any but the lowest grade of idiotic mind not so to have used them. The pointing with the hand, or fingers, I conceive to have been employed with very much the same de- gree of intelligence and of uncertainty as to his intent, as the motions just discussed. The fourth motion was very much used, generally in connection with the sound " nin, nin." It was considered, by most of the witnesses, as inexpressive of itself, but simply as an adjunct to the sound. In three or four instances, however, it was regarded as indicative of number, from the number of fingers which were extended. At most, this gesticulation had but an exceedingly restricted power in the manifestation of intellect. The reader of the testimony is left in doubt whether it, and the sound "nin, nin," by which it was accompanied, were really used with any clear- ness of intelligence and intent, or whether they are not rather to be classed among those senseless habits which the demented are so frequently accustomed to form. Facial Expression.—There is a great diversity of testimony in regard to the expression of the testator's countenance. It varies, in divers grades, between the extremes, vivacity and stolidity, as well as between the other two extremes, almost constant cheerfulness or placidity, and habitual gloom. It is evident that, to some extent, he retained that tension and mobility of the muscles of facial expression which assist in the development and communication of the operations of 424 the mind. Yet, even with this, and with that degree of use of the other means of expression which it ap- pears, from the foregoing considerations, that he still possessed, Air. Gasquet, one of -his intimate friends through many years—although he asserts that " there were moments when he seemed to look intelligently,'' —says, " I could not understand him at all." (II. f. 2039.) Great stress has, by some, been placed upon the in- telligent expression of Air. Parish's countenance. Many persons so demented as to be entirely incapable of prudently disbursing ten dollars, still retain an intelli- gence of expression which, with no other means of deducing an opinion, might easily mislead a beholder into the belief of their mental soundness. This might result, in Air. Parish's case, from the fixedness of long habit during half a century of sound-minded life. From all the evidence touching the points thus far discussed under the head of intellectnal manifestations, I arrive at the conclusions that the testator retained the usual physical means or powers of communicating the intellectual processes, or their results, to but a very limited degree; that he used those means less fre- quently and less extensively than would be expected from a person of sound mind laboring under his bodily disabilities ; that he frequently employed them vague- ly, indeterminately, confusedly—the same one often even antithetically—and without having any intent to impart thereby definite ideas and thoughts. There are other considerations by which light may be thrown upon the inquiry into the intellectual condi- tion of the testator. Of these, it is proposed to notice the following: 1. The power of suggestion. 2. Ability to read. 425 3. Attention while other persons were reading. 4. Transaction of business. 1. The power of suggestion.—The extreme disability of intellectual manifestation by the testator, is well described by one of his physicians. Dr. Alarkoe, in answer to the question, "had he the power of communicating any idea, in reference to any subject or object not then before him, and to which he could point?" replies; " Not directly—no, sir." (II. f. 2118.) From this assertion is clearly to be derived the follow- ing significant and important conclusion. Beyond the limited sphere of objects, or of concrete sub- jects " before him, and to which he coidd point? all intel- lectual operations or results whatsoever which have been at- tributed to Mr. Parish, must have been suggested to him by some other person, previously to any indication that they were his. The involved idea or thought must have originated in another mind, and have been presented to him for his approbation or disapprobation, assent or dissent, acceptance or rejection. Hence, the authenticity of those operations or results, as being primarily those of the testator, must be a matter indeterminate and doubtful; and the uncertainty and doubt are greatly increased by the indecisive and inconstant manner in which, as has been shown, he employed the methods of affirmation and negation. Even on the supposition that he had the ability to form a just conception, i. e. accurately to apprehend and comprehend whatever was suggested or proposed to him, still, there is no evidence that he may not have assented to, or dissent- ed from, many propositions previously unthought of by him. If he could not so comprehend, the probabil- ities of assent to or dissent from previously unthought of subjects, are greatly increased. Thus the force ,of 54 426 nearly all of the most important testimony given in evidence of his mental soundness, is seriously im- paired. That a man of Air. Parish's normal intellectual ca- pacity, and his education ; with his firmness, his energy, and his enterprise; upon being paralyzed in the organs of speech, and in the limbs of the right side, but re- taining his sight, the use of the limbs of the left side, and the former powers of his mind, would, even in the course of a few days, find or devise some means of sug- gesting his wishes and his thoughts to the persons around him, is a proposition so reasonable, so consistent with what we know of human powers and resources, in short, so nearly self-evident, that it would command an assent almost, if not entirely universal. Thus, the witness Air. Macdonald, testifies, in reference to himself, that, after he was attacked with hemiplegia, it was his first desire to communicate his ideas to the persons around him, and that he persevered "in some form or other," until he succeeded. Resorting to " signs," he found them insufficient. He asked for a book, intending to make himself understood " by pointing to the words and letters." An alphabet was then procured, and he used it. He thinks that he attempted to write, upon " the afternoon of the first attack," and is " certain " that he did " within three or four days." He succeed- ed in writing his name with his left hand, " four, five, or six days after the attack ; " and this, although his left side was weakened "to a great extent," by the paralysis. Aside from the fact that he did not write, there is no evidence that the left limbs of Mr. Parish were at all affected. There is direct testimony that they were not. The signature of Air. John F. Delaplaine (Exhibit No. 261, III.), written with his left hand, "a very few days after his attack" with hemiplegia of the right 427 side, appears as if made without much difficulty, and bears a striking analogy, in all its prominent in- dividual characteristics, to the two signatures written anteriorly to the attack. Two cases, other than those mentioned in the evidence, in which the persons, to use the language of my informants, "write beautifully " with the left hand, recently came to my knowledge. One of the persons alluded to has hemiplegia of the right side. I suppose that any good—or even fair—penman, can write his name legibly with his left hand. Why, if paralyzed only upon the right side, and retaining his mental ability, should he not continue so to write it ? If he does not so continue, why shall we not infer that his mind, at least to some extent, is unsound ? As, in connection with this subject, in the case of the testator, there appears to have been a disposition, in some quar- ters, to resort to a species of transcendental reasoning which I cannot regard as sound in physiology, patho- logy, or psychology, the following remarks, how trite soever may be the thoughts therein involved, may not be inappropriate. Alind is recognized only in its manifestations. Hence by its manifestations alone can it be judged. These being idiotic, the person must be esteemed an idiot: and just in proportion as they are defective—the physical ability of manifestation remaining—must the mind be regarded as impaired. It will not do to say —True, these manifestations are idiotic, but neverthe- less the mind itself is all right, perfectly sound.—This is mere hypothesis, conjecture, an assumed conclusion. For aught that is known, the psychic element of our being may, in its abstract nature, be equally sound in all men, the idiotic and the insane, as well as the sane. No one can disprove an hypothesis to that effect. We have no positive evidence that it is not so; neither 428 have we any that it is so; for, in judging of its con- dition, we cannot go entirely behind the corporeal. Air. Parish lived more than six and a half years after his attack, without finding or devising any method of communicating his thoughts. Furnished with ma- terials of various descriptions for writing, he refused, after a few attempts, to use them. An alphabet upon a sheet of paper being placed before him, he neglected to avail himself of it; another alphabet, of very large letters, upon separate cards, being furnished, he treated this, so far as appears in evidence, with the same disre- gard. These facts, particularly when we take into view the numerous and powerful motives which, if his mind be in a healthful condition, must impel a man of Air. Parish's wealth and position in society, to restore, if lost, the means of interchanging thought between himself and those with whom he may associate, are, of themselves, sufficient to prove, beyond a doubt, a men- tal incapacity amounting to dementia. Such, indeed, would be the general deduction from the premises. Air. Parish either could not write, or, havimr the 7 7 f^ ability, would not. The result of his attempt, of which we have the most positive evidence,—the characters which were interpreted " wills,"—is so rudely exe- cuted, and so entirely ambiguous, as to force the conclusion that his ability to write was no greater than that of a child when first beginning to make characters simulative of letters. That he could hold a pen, and move it, is shown. Why, then, should he produce this scrawl, indicative of no definite idea in his mind? Why, but that his mental faculties were as much depreciated from their normal standard, as this series of characters is inferior, in its power of clearly conveying any idea, to his writing prior to the invasion of the disease by which he was disabled. But Dr. Alarkoe thinks that, retaining the ability to 429 write, he would not write ; that unwillingness "was the essence of the trouble." (II. f. 2109,) To this it may be answered, that if a man with Air. Parish's normal mental ability, with his vast pecuniary interests and relations, and his many social associations, should, through "un- willingness" to make the effort to communicate, thus isolate his mind from the external world during a period of nearly seven years, and, by so doing, subject his friends to all the labor, the annoyances, the anxie- ties, the embarrassments, and the difficulties to which the persons surrounding the testator were subjected by his failure to communicate, then, as it appears to me, that " unwillingness" must be a positive obstinacy, indicative of delusion, or perversion of mind, which would justify his friends in placing him and his inter- ests under a legally appointed guardian. The escape proposed to the proponent by this theory is from de- mentia to mania, from Scylla to Charybdis. Did the failure of the testator to use the alphabet originate, likewise, in "unwillingness?" If it did so originate, then the remarks just made are here of so much the more forcible applicability as the effort re- quired for the collocation of card letters into words is less than that of writing with the left hand. As a physical effort, it is of the very slightest kind; as a mental one, it is facile and amusing to the most child- like mind possessing any healthful relish for order, or the establishment of harmony in the relations of sur- rounding things. 2. Ability to Read.—The testimony introduced in reference to the testator's ability to read, is conflicting. If his vision was sufficiently good—and it appears that it was competent to the discernment of ordinary print —I perceive no reason excepting his failure to write and to use the card letters, to doubt that he could perform what may be termed the mechanical process of reading, 430 Persons who have learned to read well, upon losing their intellectual ability, even to a low grade of de- mentia, can generally read in this manner. The tes- tator might have understood the words, as words, but that he could comprehend the ideas, unless very sim- ple, conveyed by the language, that he could reflect upon them, analyze, compare, or " mentally weigh" them, and thence arrive at inferences, deductions, or conclusions, as he might have done previously to his attack, there is no evidence, at least I can see none in the case, which, in my opinion, is at all equivalent in force to the evidence of an opposite import. It has been suggested, in connection with this sub- ject and that which was last under consideration, whether it may not be possible, with mental abilities otherwise intact, to forget the normal relation between the idea and the characters used in conveying that idea. What is this " normal relation ? " In respect to words, it can, in my view, consist solely in the con- dition that the word shall fully involve, and accurately convey the idea. I can conceive of no abnormal rela- tion other than that which consists in the opposite condition,—that the word does not fully involve and accurately convey the idea. Thus, a man may have the idea "hat," and may intend to impart that idea; but if, in so intending, he use the word " cheese," he does not convey it. The above remarks are applicable to letters as well as to words. A person may know the signification of a word when he reads it, and yet, when he wishes to express that signification, at another time, he may be unable, from temporary failure of recollection, to recall the word. This is of constant occurrence with per- sons of sound mind, and there is no doubt that, in cases of mental depreciation, the phenomenon may be still more apparent. But that a person Ion- accus- 431 tomed to writing may read with comprehension, and yet be unable for years, in even a single instance, to form any word with letters, is a conjecture so un- reasonable as to repel every shade of credence. At any rate, so far as known by me, the proposition awaits, for its reception as truth, the first particle of any thing like evidence. 3. Attention while other Persons ivere Reading.— Upon this subject, as upon the next preceding, the testimony varies. AVingrove says, he " paid very lit- tle attention to my reading of the paper to him;" (I. f. 1500.) Simmons, " He was generally in the habit of sleeping after breakfast, during the time of reading the paper," (I. f. 1698,) and James Clarke, "He was generally asleep, or looking out of the window, —never minded it." (I. f. 1738.) On the contrary, others assert that he listened with apparent interest. That he had the ability to understand some of the simple ideas which may have been expressed in that which was read to him I cannot doubt. Otherwise he must have been below the lowest conceivable condition of abject mental imbecility, where any intelligence re- mains. Further than this, the same remarks may be made, on this head, as in reference to that which it is alleged that he read himself. 4. Transaction of Business.—Outside the walls of his dwelling, the testator transacted comparatively little commercial or financial business of any consider- able pecuniary magnitude after his attack. Neither abroad nor at home, so far as appears in evidence, did he at any time in the course of his illness engage in any negotiation or operation of the kind alluded to, without the presence of another person who was act- ing as his attorney. In the minor business of life, we have seen by the testimony of Air. Case, Air. Austin, and Air. Jones, that 43Z in general he utterly failed to make his wishes under- stood. In the more important matters of the will, and the trunk containing his valuable papers, it has also been shown that Air. Kernochan, Air. Folsom, and Air- Nicholas G. Ogden were unable to comprehend his desires or his intention; Air. Folsom further testifies, that when the testator and his wife came to the office door, with business papers, Mr. Parish "would fre- quently or almost always take up the package, but would fail to separate or select the required paper." " Airs. Parish," he continues, "would pick it out and hand it to me," (I. f. 1180;) and again, in allusion to the same interviews, " we always made great efforts to find out what Air. Parish wanted, but never, to the best of my memory, has Mr. Parish ever been able to convey his wishes to me to my satisfaction." (I. f. 1181.) The demand made to Air. Tileston for the indivi- dual security of the Board of Directors of the Phenix Bank, if not unprecedented among capitalists, was in- consistent with his former practice, at least in the sim- ilar negotiation mentioned in the testimony of Air. Withers. Air. Wiley testifies that the testator, at the time of the loan of $20,000, persisted in requiring that a check should be drawn, after he had been told " that they had not so much money in bank," even until " he appeared to get furiously mad." No testimony shows whether he was, or was not, accustomed, before his attack, thus to over-draw upon his bank account; but I suppose it not to be the custom, nor as considered a sound business practice, in New York. It is certainly remarkable that Air. Parish, with his wealth, and his regular, methodical, and long confirmed business habits, and accustomed as he was to having his accounts kept with considerable minuteness of detail, should have ceased to have them so kept, and to 433 introduce a new form of keeping them, soon after his attack. The testimony as to the manner in which, and the extent to which the testator was concerned in the management of his estate, in the privacy of his own residence, is so inconsistent with the larger part of that which portrays his transactions when more in public, as well as with much of that which regards his other habits, and the other evidences of his mental condition when at home, that it appears impossible to reconcile them. It is easily to be conceived that per- sons long associated with a man conditioned as was the testator; continually obliged to propose, to suggest, to inquire ; compelled, by the necessities of the case, virtually to perform most of the mental processes for both parties of the intercommunication, might, unsus- pectingly, sometimes mistake their own thoughts for his thoughts, and even acts essentially their own— being first openly suggested by them—for acts essen- tially his. Evidences of something like this are not wanting in the testimony. They are most conspicuous in that of the coachman, Edward Clark. The evident unconscious talking with himself, in the narrative of ostensible intercommunication with the testator, at their morning interviews, (II. f. 2147, et seq.,) would be ludicrous, if occurring in connection with a less serious subject. Alinds of greater intelligence are not free from some of the laws which govern minds of an inferior grade. Air. Henry H. Ward testifies that when Mr. and Mrs. Parish came in their carriage to the front of his office, for the investment of funds, Air. Parish selected, from the notes and securities exhibited to him, such as he wished to purchase. But Air. AVard thinks that Airs. Parish looked at the paper exhibited, and that "it is highly probable " that she said something, or 434 asked some questions about some of it. (IT. f. 1929, '30). Under the circumstances, no great degree of in- telligence, sagacity, or judgment was requisite to the selection. Doubtless his mind was habitually imbued with favor to that which Air. Ward would offer him. Habit, a slight degree of memory, and the other aids mentioned were sufficient for the purpose. I once had a female patient so entirely demented that she knew not the names of the persons with whom she had been associated for years ; did not even recog- nize them, at any time, as persons whom she had ever met previously to that time ; and who, while walking in the gallery of that ward of the asylum in which she was placed, said she was ' walking up----street,' men- tioning a street frequented in her early life; yet who would correctly repeat long articles of prose which had been committed to memory prior to the invasion of her mental disorder. The act of the testator, in mak- ing the supposed selection of paper as above-mention- ed, requires a memory no better than that of this patient, and a mental capacity but little, if any thing superior. Air. Bryson says that the testator made his mark upon two transfers of stock without being shown upon what part of the paper to place it. (II. f. 226, 331.) If the fact is accurately stated, it merely represents an act which might be done by a person with mental faculties greatly impaired. Several gentlemen have testified to their belief of the testator's ability to transact business,—some of them specifying the particular business which they, with the usual assistance which he received, had done with him in the course of his illness ; and others con- veying an idea of more general, or broader ability. No one of these gentlemen has said, or intimated, that he would have intrusted the negotiation or transaction 435 of any important commercial or financial matter of his own, to the testator. A question seeking an answer upon this point, might, I think, very pertinently have been proposed to them.* Former habit, a comparatively small degree of memory, and the constant presence of an interested per- son, to suggest, to prompt, to interpret, to explain, and generally to execute, might enable a man of very se- riously impaired mind, to transact, in the method in which he did it, all the business which was transacted by the testator between the day of his attack, in 1849, and that of his death, in 1856. Had his intellectual capacity remained intact, who can doubt that, under all his disabilities, he might have performed much of his out-door business alone; and not only so, but that, had he—as we assume that he would have done, if his mental powers were perfect, —prepared himself in some way to communicate his * A suit to set aside a contract, on the ground of the alleged mental unsoundness of one of the parties thereto, was tried before the Supreme Judicial Court, sitting at Lenox, Massachusetts, in May, 1856. I was called to hear the testimony, and give an opinion deduced therefrom. One of the witnesses was a gentleman, well known as one of the most success- ful financiers in the city of New York. He testified that at a period sub- sequent to the date of the contract, be requested the party whose mental condition was in issue, to show him the boundaries and surveyor's monu- ments between the estates of said party and himself; that they went over the grounds together, and said party pointed out, with perfect readiness and accuracy, the boundaries and monuments, and conversed intelligently about them. As this was the only subject upon which the witness was called to testify, nothing was elicited from him, in either the direct or the cross-examination, which evinced impairment of the mind of the said party. Meeting the gentleman afterwards—but before either counsel had commenced his argument,—I remarked to him that, notwithstanding his testimony, I had testified to an opinion that the party was in a condition of dementia. Said he—" Had they but asked me if I would have taken the man's paper, believing it to be legally valid, at the time he showed me the boundaries and monuments, I should at once have answered—'No;' " or words to that effect. The Court set aside the contract for reason alleged. 436 wishes and thoughts, he might have continued his business habits, unassisted by an attorney, and in his old sphere, almost as fully as before. 3. Habits and Customs. After the apoplectic attack, the testator lived so monotonous a life, moved in a sphere so comparatively limited, and was so constantly under the surveillance, and, to some extent, the direction of other persons, that it might almost be said that his former habits and customs were all superseded by the routine of a few new ones. This is true to an extent which, as appears to me, is incompatible with the supposition that his intellectual powers retained their normal integrity. There was nothing in his physical disability which need have prevented him from frequently going to his office, and to other places of business, unaccompanied except by his valet; nothing absolutely requiring him entirely to relinquish his old associations at the club ; nothing necessarily detaining him, throughout his nearly seven years of invalidity, from church. It is consonant with what we know, to believe that the millionnaire, limited in his mental resources, and attached to his business associations, if disabled as was Mr. Parish, but still vigorous in intellect, would, even more frequently, if possible, than before, resort to his place of business; that he would make considerable effort, if necessary, so to do; and if his store or office were difficult of access to a person so disabled, that he would at once procure another, which might more easily be reached. The testator relinquished, quite unnecessarily, if his mind were sound, one favorite custom to which, on the condition just mentioned, he doubtless would have clung with still greater tenacity than before, for 437 the purpose of relieving the tedium of his compara- tively solitary and routine life. Prior to the attack, ac- cording to Air. Gasquet, he was very fond of his game at whist; and, as testified by Alessrs. Webb, English, and Emmet, he frequently played that game at his club, to which, it appears, he was accustomed to repair nearly every evening; and, agreeably to the testimony of Mr. Henry Delafield, he had card-par- ties at his own house. Subsequently to the attack, he never went to the club ; never had card-parties at his residence; never played whist or any other game; never attempted so to play; and was never even in- vited to take a hand at cards when his family were playing. In my view, this important change is very strong evidence of mental impairment. If the intel- lectual ability and the desire to play had remained, the physical obstacles could easily have been sur- mounted. 4. Will; force of Character. From the tenor of the evidence bearing upon the subject, it appears to me that the chief power of the will, which remained to the testator after his apoplectic attack, was merely the impulsive force of irritation and anger; not that calm, self-reliant and effective energy which demands and commands not only personal respect, but obedience to the mind's known behests. Thus he could frighten Air. Austin, but he had not that force of character which would enable him to go to his store alone, in contravention of the orders of another person. By " gesticulation," he brought Ala- jor Delafield to a determination never again to thwart his wishes ; but he could not make his coachman drive to the store from Mr. Root's, nor did the force of his presence, in his own library and kitchen, when he 438 was attempting to give directions for breakfast, pre- vent a call of the roll of breakfast edibles, instead of the immediate mention of buckwheat cakes. B. Antecedent, attendant, and collateral facts AND CIRCUMSTANCES. 1. Hereditary Predisposition. In the whole range of physiology and pathology, nothing is more positively established as a truth than the transmission of disease, or a predisposition to dis- ease, from parent to child. Tuberculous, arthritic, and other diatheses are thus very frequently perpetuated. All forms of cerebral disease accompanied by insanity, are far more frequently found among the descendants of persons who suffered from those diseases, than among any equal number of persons descended from parents who had not so suffered. It appears in evidence that the father of the testator was subject to attacks of cerebral congestion, in the last of which he died. (Kernochan, I. f. 902. ) 2. Disease symptomatic of Cerebral Lesion. In the case of the testator, there was a remarkable combination of diseases the symptoms and signs of which are indicative of encephalic lesion. Prior to his departure for Europe, as asserted by Air. Kernochan, he had two or three attacks of deter- mination of blood to the head. (I. f 902.) When at Baden Baden, in the summer of 1843, he had a similar attack, but, in his own language, (III. Exhibit No. 235,) 439 " more severe;" and, in the language of his wife, (III. Exhibit No. 133,) "frightful." " During the latter years preceding his attack," (the one next to be mentioned,) says Dr. Delafield, " he had several slight seizures threatening apoplexy." (I. f. 2036.) AVhether this allusion includes the attacks already mentioned, or not, is not shown. On the 19th of July, 1849, he was again seized in like manner, the attack now being of such severity as to constitute apoplexy. This was immediately follow- ed by hemiplegia of the right side, and destruction of the power of articulate speech, entire for a short period, and, as has been shown, nearly entire throughout his subsequent life. Commencing in the autumn of 1849, and extend- ing over nearly the whole period of his subsequent life, but becoming less frequent as time progressed, a paroxysmal, convulsive disease affected him. This was evidently epilepsy. Dr. Afarkoe speaks of it as such; and James Clarke, in describing the paroxysm, used the following language: "trembling, choking, froth- ing, and foaming at the mouth—black in the face." Dr. Wilkes, who visited him in consultation upon his impaired vision, about the beginning of the year 1852, says that he then had traumatic amaurosis. (I. f. 222.) This succession and combination of disorders ema- nating from the great nervous centre, shows that there must have been very considerable cerebral disease; and, as the hemiplegia and loss of the power of speech were permanent—the paralyzed leg alone improving to some extent—it also shows that at least an important part of that disease was organic. In cases of apoplexy followed by paralysis, there is generally some mental impairment. It differs in degree in different cases, the extremes being some slight peculiarity, upon the one hand, and utter de- 440 mentia, upon the other. Even in cases where recovery ensues after a duration more or less protracted, a defect of memory, or some eccentricity of mental manifesta- tion is generally observed, growing less and less appa- rent as convalescence is being perfected. The tendency of epilepsy is perhaps always towards depreciation and perversion of the mental faculties. Large numbers of epileptics are found in many of the institutions for the insane. As there was no post mortem examination in the case of the testator, the source of the epilepsy is merely to be conjectured. But, as that disease supervened upon the apoplexy, it is not un- likely that the former originated in the lesion which caused the latter. We have, then, from this catalogue alone of central nervous disease under which the testator suffered, much reason to infer that there was serious mental impair- ment. The conclusion is not absolute—it is not a ne- cessary deduction from the premises ; because, in cere- bro-psychic pathology, there are few, if any, rules of universal application. Still we have here causes very adequate to the effect which is supposed to have been produced. 3. The Nature of the Acts the validity of which is con- tested; that is, the Tenor and Spirit of the Testa- mentary Codicils. After making his will in 1842, the testator lived nearly seven years without adding to it, or in any way modifying its conditions, although he talked with Mr. Havens about making some modifications. As originally executed, it remained at the time of his attack with apoplexy and paralysis. Within the first five years next following the date of that attack, three 441 codicils were appended to it. These codicils not only alter it, but reverse or abolish some of its most impor- tant provisions. I allude to the revocation of the ap- pointment of Daniel Parish as one of the executors, " and the gift of ten thousand dollars to him, as exe- cutor;" to the revocation of the thirteenth article, by which Daniel Parish and James Parish were made resi- duary legatees; and to the introduction, into one of the codicils, of a clause making Susan Alaria Parish the residuary legatee. No canse is shown in the evidence which, as I ap- prehend, could possibly have suggested, in the mind of a man such as the testator appears to have been, and provoked to execution, so important a change in testamentary provisions and bequests. No cause of alienation of feeling towards James Parish is even hinted at. The letters of the testator to Daniel Parish, written when the former was in Europe, in 1843 and 1844, show that he and Daniel were then upon terms of the most kindly and friendly intercourse. No alienation is shown after his return from Europe, and prior to the attack. The only alleged cause for alien- ation after the attack, is the fact that Daniel Parish went into the sick chamber of the testator, unbidden and in contravention of the known wishes of the testa- tor's wife. But the manner in which the testator re- ceived his brother Daniel at a subsequent interview, gives no reason to believe that such alienation existed. If it did exist, so far as appears it must have been from an insufficient cause, and hence must have origi- nated in one of those whims or caprices which often produce a change of feeling in the insane towards those persons who have been among their most intimate and best friends. If the testator's mind had been unimpaired, it is more likely that, having determined to make changes 56 442 in the testamentary disposition of his property, he would have made a new will rather than alter the one already made, as it was altered. He hardly could have failed to perceive that his physical condition was such as to give rise to the suspicion of mental disorder or defect, and that, under these circumstances, were the will left as it has been left, there was a prospect that his large estate would almost inevitably become involved in litigation. To the issue of a legal contest, he could not have been willing to subject the estate ; and from the labors and annoyances of sudh contest, he would have endeavored to preserve his nearest rela- tives. 4. Acts in which the Testator resembled the Insane. First.—It is intimated that the testator ate voracious- ly. Air. Kernochan says that he sometimes ate " with rather too good an appetite;" Wingrove, that "eating seemed to be his predominating passion;" and James Clarke, that " he was very ravenous for dinner." But Dr. Delafield says, " In his best health, before his attack, he took a great deal of food." Of the relative quan- tity taken, before and after the attack, nothing is said in the testimony. A large proportion of the insane, especially those who are demented, eat rapidly, and in inordinate quantity. The gratification of his palate, as is evident from numerous assertions in the testimony, was one of the principal enjoyments of the testator, during his illness; and for the attainment of this end he set at naught the advice of his medical counsel. Second.—In his irritability and irascibility he re- sembled many of the demented, and a large proportion of the epileptic insane. Third.—The combined act of putting his fingers 443 into his mouth and making a guttural sound, as tes- tified by Alessrs. Wiley, Gasquet, and Clarke, is strik- ingly similar in its nature to the acts of the demented. Fourth.—The same may be said of the repetition of the sounds of affirmation and negation. One of the witnesses says that " yah " was generally repeated, and "nah" "four, five, or six times;" and nearly all who allude to the subject attest to this kind of repetition. Fifth.—The abundant use of the sound " nin, nin," may be placed in the same category. The determination of the testator to have the window-blinds open, when he slept iu the room under the conservatory and nearly on a level with the street, thus exposing his room and its occupants, at an early hour in the morning, to the passers by; and his con- duct as portrayed by Mr. Campbell, (III. f. 1879,) when the witness saw him in front of the house, hold- ing upon the leader which conducts the water from the roof, "looking up," and "uttering a cry," indicate a serious impairment of mind. AVhen he was in health, his justifiable pride, his self-respect, his respect for others, his sense of propriety, all would have revolted at the idea of acts like these, and his reason would have dictated abstinence therefrom. It seems impos- sible that he could have perpetrated them and yet retained any considerable degree of his former even purely intellectual faculties. 5. Treatment of the Testator by his Family. Several facts appear in evidence which betray a consciousness of the testator's mental impairment in the minds of the members of his family, though per- haps this consciousness was instinctive rather than the offspring of reflection. These are: 444 First.—The testator was rarely left alone with his relatives, friends and acquaintances out of his own household, and generally, in the exceptional cases, was so left only for a few moments. Secondly.—According to the testimony of Thomas Wingrove, (I. f. 1523,) he was not permitted to go to his store or office alone; that is, without the company of some person other than his valet and his coachman. There is no evidence that he ever did go thither, so unaccompanied, except on Sundays. Thirdly.—He did not ride alone, excepting at times, upon the Sabbath, and then the route taken was chiefly in the most unfrequented parts of the city, and the time during the hour of morning service at the churches. Fourthly.—He rarely carried money. William Brown, his valet for more than three years, says, "I have never seen him with money in his pocket." (II. f. 1422.) Fifthly.—When Mr. Folsom, in the course of an in- terview with the testator and his wife, proposed the trial of block-letters, to enable the former to commu- nicate his thoughts, Airs Parish, as is testified by Mr. Folsom, said to Air. Parish, "What impudence in Mr. Folsom to propose any such thing." (I. f. 1149.) The re- mark is such as might be made to a petulant child; and I can account for it only on the supposition that it was suggested by a consciousness that Mr. Parish had be- come so like a wayward child that he would be offended at a proposition to resort to means so trivial. If Mr. Parish's mind were at that time what it once had been, he must have felt—as any rational and reasonable per- son in his condition would feel—thankful to any one who might suggest an effectual method, how humble or insignificant soever, of relieving him from one of his greatest embarrassments. Sixthly.—It appears that the testator was particu- 445 larly fond of buckwheat cakes, and that his medical adviser was opposed to his eating them. He was ac- customed, before retiring at night, to call—in his way of calling—the attention of his wife or the cook to the subject of breakfast for the following morning. It appears to have been understood that he always wanted cakes of the kind just mentioned; but when sugges- tions were made to him "in the library," William Brown testifies that different kinds of food were men- tioned, " always omitting, if possible, buckwheat cakes." He would be irritated until they were named. Another witness, (Fisher,) whose testimony would not be referred to in this place were it not, in essence, corroborated by others, says that when the testator went to the kitchen, upon the occasions alluded to, the cook would ask him " a great many questions, to which he said no; when he came to these cakes he smiled and said 'yes.'" Seventhly.—Although, as has been shown, he enjoyed and frequently practised card-playing, previously to his attack, yet subsequently he was never asked to play when other members of the family were engaged in the game. Eighthly.—The shoes purchased for him during his illness cost, as says Mr. Sammis, " about ten shillings," or one dollar and twenty-five cents per pair. (III. f. 1618.) There is no evidence of the cost and kind of shoes worn by him prior to his illness, but there are many reasons for the belief that they were very dif- ferent from those just referred to. The facts contained in these eight clauses, trivial as some of them might appear at first view, throw more light upon the question at issue, than is de- rived from many of the matters in evidence, which, in some respects, are of far greater magnitude, but which are not susceptible of so positive verification. 446 6. Language of other Persons in Reference to the Testator in the Course of his illness. Theodore Austin says that after the testator ".flur- ried " his cane in the carriage, he (the witness) told Airs. Parish that Air. Parish "was crazy, or not in his right mind." (I. f. 1927.) Air. Folsom asserts that at the store, in presence of the testator, his wife, Air. Daniel Parish and Air. Kernochan, he said to Airs. Parish, in allusion to Mr. Parish, "If he should ever come to his mind," &c. (I. f. 1152.) He also testifies that he said to Airs. Parish, at the interview with herself and Mr. Parish, on the 25 th of August, 1849, " I consider Air. Parish to be of unsound mind, and incapable of transacting business." (I. f. 1126.) Air. Kernochan states (I. f. 854) that on the 18th of August, 1849, Drs. Johnston and Markoe thought that Air. Parish's mind was not in a condition to transact business. Both of these physicians, however, testify that they do not recollect that they expressed such an opinion. Air. Campbell says that he mentioned, soon after its occurrence, the scene in which the testator had "hold of the leader " of water from the roof, " was look- ing up" and "uttering a cry;" and being asked if, when he mentioned it, he also expressed his judgment that Air. Parish was an idiot, his answer is, " yes, sir, I have said that." (Ill f. 1897.) Thomas Wingrove says, (I. f. 1575) " I explained to Air. William Delafield, as early as the third day of my being in the service, that if I thought he was en- gaging me to attend or wait upon a gentleman like Air. Parish, I would not undertake the situation on any con- sideration. I said so, my belief being that Air. Parish was much astray." 447 It appears that the remarks here quoted were made in all seriousness, and under the full belief that what is therein expressed was true. Hence they are of no inconsiderable value in the resolution of the problem to be solved. 7. Opinions of Witnesses in regard to the Testator's mental conditio)!. Air. Kernochan, who "knew Henry Parish fifty-six years," was for many years one of his partners in busi ness, and "in the constant habit of visiting at his house," says, in allusion to the whole period of the testator's illness, "I didn't think he knew much, * * * I didn't think he had much mind." (I. f. 889.) Mr. Gasquet, during eleven years a partner of the testator, and " on terms of intimate acquaintance with him," and who visited him from seven to ten times, an- nually, on several of the years of his illness, says, " I should have judged that he was not in a state of mind to conduct any business. * * * * j should say that his mind could not have been active and clear." (III. f. 2011.) Mr.. Folsom, who kept the testator's accounts twelve years, and who testifies that he had " a friendly inti- macy " with him, says, " I think through the whole period (of his illness) he was not far removed from an imbecile." (If. 1185.) Air. Wiley alone, of all the persons immediately connected, as partner or accountant, with the testator in business, testifies in a manner implying belief of his mental soundness. He says, "his mind appeared to be well-regulated as to business he was familiar with, or had been familiar with in good health." (II. f. 71.) Air. N. G. Ogden, speaking of the testator at the 448 time of the interview relative to the delivery of the trunk, says, " I could not satisfy myself whether he was of sane mind, or knew what he wanted, or not." (I. f. 1474.) Of the five men who were employed as nurses or valets of the testator, George S. Simmons (I. f. 1717) testifies, in reference to his mental condition, " I should not think it perfect;" Thomas Wingrove, (I. f. 1556, '7,) "I considered Air. Parish very much astray in his mind; " and James Clarke, "I think his mind was not right," (I. f. 1752). AYilliam Brown, on the con- trary, says, (II. f. 1751,) "I considered his mind strong and healthy, perfectly understanding all I ever said to him." The fifth of these witnesses (Fisher, II. f. 993) says, " I always thought, and think still, his mind was sound;" but Mr. Barber testifies (III. f. 1593) that this witness told him that Mr. Parish was not in his right mind." Air. Case, who was acquainted with the testator be- fore the attack, and who subsequently, at his market, saw him many times, when asked for his opinion says, " I never could make him understand anything at all— of course I could not tell what he thought." (I. f. 1896.) Air. Austin, likewise previously acquainted with him, and who often saw him, after the attack, at Wash- ington market, thinks he " was not in his senses, or right mind." (I. f. 1914.) Mr. Sammis says, (III. f. 1621,) "I got the im- pression the first time that he came to the store, that for some cause or other he was not capable of doing business, and I never lost that impression;" Air. Jones, " I consider he was imbecile," (III. f 1649 ;) and Mr. Alulligan, " I think it (the testator's mind) was rather in a state of disorder." (I. f 1886.) Air. Sammis had no inter-communication with the testator, although he saw him at the carriage in front 449 of (the witness's) store, a considerable number of times. Air. Jones had but two interviews, and those only in reference to the selection of cloth for garments; and Air. Alulligan, but one. The opinions of these wit- nesses are, therefore, of less value than that of those who here precede them. Other than Dr. Delafield, the family physician of the testator, four physicians who had visited him pro- fessionally in the course of his illness, have given their opinions of his mental condition. Dr. Dubois says, "the condition of his mind ap- peared to be clear, sound." (II. f. 190.) Dr. Dubois was called to see the testator specially in consultation upon the disease of his eye, and had no intercommu- nication with him upon any other subject. A large part of the demented patients in the institutions for the insane could have answered intelligently upon such a disease. Dr. Wilkes says, " I think his mind was clear and capable of transacting the ordinary avocations of life." (IT. f. 229.) Dr. Wilkes questioned him only in re- gard to his vision, his diet, and the condition of his bowels; and all the questions proposed, excepting those upon the subject first mentioned, were answered by Dr. Delafield. Hence, the objection to the opinion of Dr. Dubois is applicable to that of Dr. Wilkes. Dr. Johnston says, " he appeared to" understand simple questions regarding his health." (II- f. 413.) The same may be said of a large majority of the inmates of the hospitals for the insane. Dr. Johnston cautiously adds, " I cannot say that he might not have understood questions equally simple regarding other affairs." Dr. Alarkoe, speaking of the testator's mind, says, " with the exception of the last few weeks, I believe it as sound—the last week or two I should say." (II. f, 2031.) In justification of this opinion, Dr. Markoe 57 450 testifies as follows: " he possessed memory, perception, comparison, judgment, and, in fine,' all the ordinary faculties of the mind," (II. f. 2029;) and in proof of this, or of his power of spontaneity, Dr. Alarkoe says, " he could call the attention of anybody that was near him, spontaneously and without suggestion; an act showing perception, memory, judgment, and many other faculties of the mind, which he could thus give expression to spontaneously." (II. f. 2124.) If the mere ability to call the attention of a person present be evidence of the existence of all those men- tal faculties, and consequently of soundness of mind, then there is little need of hospitals for the mentally alienate, and nineteen-twentieths of the persons now at those institutions are illegally and improperly detained. Air. Prime's opinion is, that "he knew what he was about." (III. f. 5.) This expression, in the case before us, is ambiguous. In the literal meaning of it, it is true of most demented persons. Air. Webb says, " I do not entertain a doubt that his mind was as clear in relation to ordinary inter- course, as at any time previously." (II. f. 669.) This is indefinite. As the phrase " ordinary intercourse " is usually understood, Air. Webb's language might be truthfully applied to some of the most whimsical of demented patients. Air. Grinnell, (II f. 1945, '6,) and Mr. Tileston, (II. f. 456, '7, '8,) believe, as appears from their testimony, that the testator, by sounds and motions, could give comprehensible expression to abstract thought. In all the testimony there is no evidence of such ability. On the contrary, all that bears upon the subject is of import directly opposite; and, as has been seen, Dr. Alarkoe expressly declares that the testator had not that ability. Thus, one of the most important premises whence the two gentlemen mentioned, (Alessrs. Grin- 451 nell and Tileston,) derived their opinion, is taken away. If they were mistaken in the premises, why may they not have been in the conclusion ? Some of the gentlemen who testify more or less strongly to a belief of the testator's mental soundness, had but little opportunity for observation. Mr. Donald- son and Air. Gibson each had but one interview with him; Air. AVebb but two short interviews in the street; Air. Bryson but two, and those upon the one subject of a transfer of stock ; and Air. Dunning, who conden- ses his opinion into the word " sound," had no inter- communication with him, but was present as a witness at the two interviews between him and Air. Bryson. Several witnesses to whose opinions no allusion has been made, and who had considerable—some of them extensive—opportunity for intercommunication with the testator, have testified, with a diversity of expres- sion, to the general proposition of his mental sound- ness. Some of these gentlemen were intimately con- nected, by social alliance, with the testator. I well know that there are cases in which the mental ability of a person is regarded, by his casual acquaintance, as much inferior to what it is known to be by those who are in daily social intercourse with him. Yet, friend- ships long-enjoyed, and the interest and sympathy which are among its results, are not without their in- fluence ; and, in the present case, there is such a mass of testimony, derived from various sources, tending to the demonstration of the fact that the testator's mind was impaired, that I am forced to the belief that those gentlemen were mistaken. With this exposition of opinions, and the comments upon them, I leave this portion of the evidence. The other matters so fully set forth in the testimony, are sufficient for the purpose of this investigation. A 452 brief resume of them, or of the inferences derived from them, following more nearly than in the foregoing in- vestigation, their natural order, is as follows: 1. The father of Henry Parish died in an attack of cerebral congestion. 2. Henry Parish had several attacks of cerebral de- termination; and, at length, on the 19th of July, 1849, apoplexy, immediately followed by hemiplegia of the right side, and loss of speech. 3. During a large part of his subsequent existence he was subject to epileptic convulsions; and, at one period, had symptoms of traumatic amaurosis. 4. During the whole period of his life, after the apoplectic attack, some of his emotions were easily ex- cited. He frequently shed tears, was irritable, irasci- ble—sometimes yielding to violent explosions of anger. 5. The principal energy of his will appears to have rested in those paroxysms of anger; his force of char- acter having become so far impaired that his servants did not hesitate to annoy him by evasions, and to act in contravention of his wishes. 6. He uttered but few sounds, and those which were apparently intended for words, were mostly so employed that no confidence could be placed in them as expressive of a determinate wish or thought. 7. He sometimes used the motions of the head ex- pressive of affirmation and negation, in the same in- definite and indeterminate manner. 8. Although retaining the use of his left hand, he did not learn to write, and of the results of his few at- tempts, the only one that is fully authenticated is so imperfect as to be entirely unintelligible. 9. Large letters, upon cards, being furnished for the purpose of communication, he failed, so far as ap- pears, to use them. 10. Thus, for more than six years, and until his de- cease, " he had not the power of communicating any 453 idea, in reference to any subject or object not then be- fore him, and to which he could point." 11. He not unfrequently utterly failed to convey an opinion, a wish, or a preference, even when this might have been done by pointing, or by the usual affirmative or negative motion of the head. 12. He never attempted the transaction of any im- portant pecuniary business without the presence and, almost invariably, the assistance of another person, act- ing as his attorney. 13. He did not go even to his own office, on busi- ness days, unaccompanied by that attorney. 14. From a period but shortly subsequent to his attack, the former mode of keeping his accounts was entirely abandoned. 15. In one negotiation a condition was required inconsistent with his former practice ; and in another, a paper was drawn under circumstances incompatible with the principles usually followed by mercantile men. 16. He forsook his usual places of resort—those of business almost entirely—his club, the houses of his friends, and his church, absolutely. 17. His card-parties at home were discontinued, and his favorite game of whist wholly abandoned. 18. In several respects, his acts and his acquired peculiarities resembled those of some classes of the in- sane. 19. Some of his acts were so entirely repugnant to the self-respect, sense of propriety, and judgment of a gentleman such as he had been, that they can be ex- plained only upon the supposition that his intellect was seriously impaired. 20. The course pursued with him by the persons in whose charge he was, or by whom he was imme- 454 diately surrounded, appears, in several respects, to have been based upon a consciousness that his mind was impaired. 21. No single act or mental manifestation is proven, which, under his circumstances at the time of its oc- currence, is inconsistent with serious mental impair- ment. 22. Some of the witnesses expressed their opinion, during his life, that his mind was unsound. Comprehended by these clauses, there are so many evidences of mental unsoundness, extending over all the sphere of means by which emotion and intellect are manifested, and over all the relationships of the testator to the world around him, that I arrive at the following conclusion : It is my opinion that .the mind of Henry Parish, from the time of his attack, on the 19 th of July, 1849, until the day of his decease, was in that condition of unsoundness, or impairment, which is technically termed dementia; and that this unsoundness or impairment, was of such extent as to disqualify him for the execu- tion of the codicils in question, or the transaction of any important business. PLINY EARLE. Leicester, Mass., September, 1857. -----•-*-*----- APPENDIX. Since my opinion upon the mental condition of the late Henry Parish, deceased, was written, my attention has been directed to an article headed by the proposition, "To what degree are the intellectual faculties affected in cases of apoplexy and hemiplegia ?" and published in the September issue of the " New York Journal of Medicine." This article appears to have been suggested by the case of Henry Parish. It would be a work 455 of supererogation to notice it in this "place, if the arbiter in the said case were practically conversant with insanity;—if by long association with the insane he had learned not only the powers of which their disease has deprived them, but more especially the powers which it still has left. This not being the fact, I take the liberty to raise the following objec- tions against the applicability of the contents of that article to the case now in issue. 1st. Nearly all the cases mentioned in it were observed and recorded "for a different purpose " than that of ascertaining the mental condition of the patients. The author of the article appears to think that this fact clothes those cases with especial value, as authority. Upon this point I cannot agree with him. The allegation or the intimation that the best method of ascertaining the truth upon one medical subject, is to resort to the recorded investigations upon another subject, is a doubtful compliment to the sagacity, skill and judgment of the medical profession. 2d. Being observed and recorded "for a different purpose" it is not even to be presumed that the observers always, or generally, directed their attention to the mental condition of the patients, with that close and persevering scrutiny which is essential to a correct decision. Most of those cases were undoubtedly observed under the common opinion quoted in the article aforesaid, from Valleix: " It is rare that a moderately severe attack of sanguineous apoplexy does not produce a certain degree of alteration of the intellectual faculties," &c, and the observers, looking mainly toward their principal aim—the morbid anatomy of thejdisease—did not question that opinion, or seek at all to investigate its claims to truth. No better evidence of this is needed, than the fact that Andral, in the fifteen pages of comments which follow his seventeen cases of apoplexy, makes no allusion whatever to their mental condition. 3d. Those cases were not observed by experts in mental disorders. I claim for men long engaged in the specialty of insanity—that which I freely grant to the surgeon, the obstetrician, the oculist,—supe- rior knowledge and superior skill in the diseases to the observation and treatment of which they have been devoted. 4th. In a large proportion of the cases no mention is made of the mental condition of the patients. In the cases thus defective, the supposition that some mental im- pairment existed is as justifiable as its opposite. 5th. In some cases classed among the mentally sound, such sound- ness is doubtful. Of one patient it is said, " she lost her speech, but preserved, to a considerable degree, her intellect;" of another, " after a time he recovered 456 sufficiently to write for one of the weekly journals, although his memory became defective, and his mind frequently confused ;* of a third, " the patient was not cured, though she had recovered her senses ; she lived some time without being able to articulate a word ;" and of a fourth, "it was reported in Paris that he was mad, but I (Portal) saw that it was less a loss of reason than of the power of expressing himself." It does not strike me that in these cases absolute integrity of intel- lect is shown to have existed. 6th. The entire absence of strict analogy between these cases and the case of Henry Parish ; and, in the larger part of them, the compara- tively few points of resemblance. In some of these cases consciousness, at the invasion of the disease, was not lost, in that of Henry Parish it was lost; in many of them speech was unimpaired, in his it was nearly destroyed; in several of them, even of those classed among the sound in intellect, death oc- curred at periods varying from two days to twenty-five days after the attack, in his, life was protracted more than six years ; a considerable proportion of them terminated in recovery, his only in death; in some of them the attack was comparatively slight, in his, severe ; in some of them the patient learned to write, he did not; some of them used a great diversity of gesticulation for the purpose of expression; his ges- tures were few and inexpressive. Other points of non-resemblance might be mentioned ; but these are sufficient. 7th. In some of the cases of loss of speech, it is assumed that the intellect was sound because the patients themselves were unconscious of its impairment. The patient's opinion of his own mental condition, especially in dis- eases generally or often accompanied by impairment of the mind, is a very singular criterion to be adopted by a medical man. If applied to the inmates of the hospitals for the insane, those institutions would soon be vacated. 8th. In most of the cases accompanied by loss of speech, the inference of mental soundness cannot, in my view of the subject, be drawn from the premises. An intelligent expression of countenance, the apparent comprehen- sion of conversation upon simple topics, and the ability to reply, by * The first series of italics in this case, are those of the author of the article : the second are mine. The author remarks that a man who could thus " lahor for his support by writing for the weekly papers, may be esteemed to have still pos - sessed a fair share of intellect and energy." I am not disposed to deny the pro- position, but I recollect that periodicals are or have been published at three, if not more, of our institutions for the insane; that a very considerable proportion of their contents were written by the patients; and that many of the articles of this class would do no discredit to " the weekly journals." A moderate library of works written by the insane might be collected. 457 signs, to questions, and to perform, when requested, some trivial act, are received as evidences of an Unimpaired intellect. Thus, in one of Dr. Clark's cases, it is assumed that the patient's mind was sound because his " countenance was intelligent, he heard and understood all that wa paid to him, would do as directed, assisted in taking care of the patients and administering their medicine." Apparently as a positive demonstra- tion of the intellectual integrity of this man, it is related that, upon re- quest, he went to an adjoining room, and from a number of instruments of the use of which it was supposed he was ignorant, selected one, ivhich had been described to him, and returned with it. A large majority even of what are called "demented" patients, are able to perform errands more difficul than this, more intricate, and requiring a greater degree of intellect. This is verified daily in the hospitals for the insane.* In the schools for idiots, at Paris and Berlin, I have seen many of the pupils engaged in exercises which, in their requisitions of intellectual power, throw entirely into the shade this test act of the patient of Dr. Clark: and it is no unjustifiable presumption to aver, that if those pupils were suddenly deprived of speech, still retaining all their other faculties, they would be able to exhibit all the evidences of mental capacity which, in most of the cases in the article in question that were observed in this country, are relied upon as proofs.of unimpaired mind. We need no more convincing evidence that an undue estimate of mental power has been placed upon the expression of the face, and the pantomimic gestures, in the cases accompanied by loss of speech detail- ed in the article under notice, than the fact that the author arrives at the following very strange conclusion: " It would seem as if the ab- sence of speech in similar instances must be looked upon as prima facie evidence of clearness of understanding !" As no one will attempt to deny that there are apparently perfect re- coveries from all the effects of apoplexy, so all must acknowledge that there are divers degrees of mental as well as of physical lesion, where those effects are permanent. Each esse must be judged upon its own facts. Mind repressed by corporeal impediments struggles for release, and eagerly seizes upon every available means of expression. So far as it is expressed, clearly, definitely, and unmistakably, so far it may be accepted and judged ; but if its manifestations exhibit but one measure of capacity, we have no right thence to attribute to it a twofold or a threefold measure. In a few of the cases included in the article under notice, the patient gave unequivocal proofs of restoration to a large amount of mental ability; Henry Parish, so far as is proven, exhibited no positive evidence of an intellect superior to a low grade of dementia. * A remarkable case in point is related in the American Journal of Insanity, vol. iv., p 163. 58 458 As in the former examples, so in the latter case, the mental power must be judged of according to the evidence in each instance respectively. There is nothing in the article in question wliich clianges or in any way modifies my views, as expressed in the foregoing opinion. P. E. October 22d, 1S57. OPINION OF LUTHER V. BELL, M.D., LL.D., PRESIDENT OF THE MASSACHUSETTS MEDICAL SOCIETY, ETC. (LATE PHYSICIAN AND SUPEPJNTENDENT OF THE McLEAN ASYLUM FOE THE INSANE, NEAU BOSTON.)] OPINION OF DOCTOR BELL. I have entered upon the consideration of the ques- tions involved in this case, under the best lights. af- forded me in a professional experience of nearly thirty years; two-thirds or more of which time has been passed in the care and treatment of those mentally disordered, while at the head of the oldest and one of the largest of the curative institutions for the insane in the country. During this period I have been very frequently called upon to appear before the courts of justice, and afford the aids of my experience in the so- lution of medico-juridical questions touching the condi- tion of the mind. It has been my privilege to approach this inquiry unembarrassed by any acquaintance with the parties in interest, and indeed, up to a period when my judg- ment was settled and recorded, without knowing on which side my professional assistance had been solicited. There are two prominent divisions under which the consideration of Mr. Parish's competency to make a valid testamentary instrument naturally presents itself to my mind. 1. The true value of the facts testified to by, and the opinions thereupon, of the various witnesses in fa- vor of and adverse to such competency, and the possi- bility of explaining and harmonizing differences in opinions so conflicting. ■102 2. The exact significance of the prominent and essentially undisputed fact, that Mr. Parish ever after his apoplectic fit, July 19, 1849, if capable of communi- cating the operations of his mind to others at all, did so in the difficult and indirect method of assenting to, or negativing by certain imperfect gestures, and nearly inarticulate sounds, such propositions as were made to him orally, and in one or perhaps more than one in- stance by something written and placed before him, as if for his perusal and reply. In endeavoring to weigh the testimony for and against his competency, it will not be my province to expose or even measure defects of credibility where they might be believed to exist, or to strike a balance between conflicting witnesses. The province of the medical expert is rather to select and consider such facts and opinions as are within a strictly professional purview. In doing this, it is not necessary to make a complete analysis of all the testimony which may have such a bearing. It is obvious, that if enough is selected to illustrate the principles on which statements appa- rently contradictory are reconciled, and the precise opinions of witnesses, based upon their observations, shown to be well or ill-founded, a just conclusion may be approximated. If, for example, it can be shown in one unequivocal instance, that Mr Parish's supposed signs for yes and no did not necessarily imply a corre- sponding assent of his understanding, it would not be of essential importance to apply the same test to every other instance presented in the testimony, in which the same signs are described and like inferences drawn from them. My intention has been to select the most promi- nent and pertinent facts, on both sides, and to reason from them, leaving out the entire testimony of many of the witnesses, and considerable portions of that of 463 others, as affording nothing which could aid the medical witness in coming to an opinion. That numerically, those who regard Mr. Parish as of sound mind, are in the majority, is a fact which I have considered of little moment, in view of the cir- cumstance that the minority is too large, and com- prises too many having the best opportunities of form- ing opinions, to permit the suspicion that the last class were influenced by partiality or caprice. Beyond a certain point only, can the evidence either of one or the other side of a question like this, be cumulative. A hundred witnesses who thought they could understand Mr. Parish, and a hundred who de- clare that they could not understand him at all, would leave the uncertainty to be solved just as great and no greater than if there were only ten on each side. And any explanation which might harmonize the opinions expressed by the twenty satisfactorily, would apply with equal force to those of the hundreds. In weighing the character and significancy of the testimony in favor of or adverse to the mental sound- ness of this testator, it is natural to look in the first instance, for that of the medical experts. The physicians who were in attendance on Mr. Parish during his pro- tracted illness, were Drs. Delafield, Wilkes, Dubois, Johnston, Wheaton and Markoe; of this list Dr. John- ston does not profess to have seen him under circum- stances such as would warrant the expression of an opinion as to his mental competencj^. And Dr. Whea- ton, a venerable army surgeon, appears to have been rather the friend than the medical adviser of Mr. Par- ish. It is not possible to avoid noticing the fact, that no one of his medical attendants appears to have been pe- culiarly conversant with mental diseases. Indeed, I think no one of them would have been received under 404 the practice of the Massachusetts courts, as qualified to express opinions at all in such case as to a testator's mental condition, for no one of them brought himself in any degree within the category of a medical expert in mental affections. In view, also, of the fact that three, perhaps all four of these gentlemen, have a right to claim an emi- nent position in another professional department, /. e. the specialty of ophthalmic diseases, a branch most dis- tinctively specific and widely separated from the theory and practice of dealing with the mental affections, it may not be deemed irrelevant or disrespectful to say, that a body of physcians, presumptively less fitted for the appreciation of such a case, can scarcely be ima- gined. A consultation of insane hospital physicians in a delicate and complicated disease of the eye, would hardly be more incongruous. Considering also, that it was well understood by the parties in interest on one side, and, indeed, entered into the acts and suggestions of the counsel who drew the codicils, that the capacity of the testator would eventually come before the courts for adjudication, it is quite extraordinary, as well as, in my opinion, much to be regretted, that at no period in these many years, was any expert in mental diseases engaged in the eluci- dation of Mr. Parish's actual condition. This omission can hardly be explained on the supposition that it was overlooked, or that its importance was undervalued. Experts in one department of medical science are less likely than others to despise the peculiar skill and at- tainments of those trained in other specialties. One skilled in the nice discriminations of ophthalmic prac- tice, both in diagnosing and treating disease, and con- scious that his attainments have been the result of good natural gifts, persevering application and wide experi- ence, cannot be supposed capable of undervaluing the 465 same order of powers, the same enthusiasm in pursuit, and a like enlarged experience, when applied to the still more delicate ana complex affections of the human mind. A vulgar opinion exists to some extent, that any man of good common sense is as well qualified to judge of a patient's or a prisoner's insanity, as the most ex- perienced hospital director. Gentlemen of professional distinction, like those who had the professional manage- ment of Mr. Parish, never could have participated in an idea so absurd and untenable. The absence, then, of the highest attainable order of experts in mental diseases, in a case so long recognized as being destined for future litigation, and where the interests at stake were of such vast magnitude, ought to be explained by those in whose hands the patient was, or else presumptions ad- verse to them as fearing the fullest investigation are justifiable. How do these medical witnesses bring their skill to bear in elucidating the exact character of this tes- tator's capacity ? It is to be recollected, that however plain and usual the case seems now to one, under the evidence as contained in the printed volumes, these gentlemen believed him to have suffered little or no men- tal affection, and if such was the fact, his peculiarity of non-communication, except in one strange, unique method, must have made his case one of the most ex- traordinary and anomalous kind—one of which they now scarcely pretend to give any explanation, or sug- gest any pathology. If unable to fathom a mystery so strange as this must have seemed to them, under their theory that Mr. Parish was a rational man, were they not bound, in view of its moment, to apply such tests as would have relieved the court from doubt as to its true character ? As oculists, we find them measuring; with commend - 59 466 able delicacy and careful accuracy each circumstance bearing upon the degree and quality of his eyesight. But I have been able to discover no method or system, in their endeavors to reach his grade of mental vision, no application of tests to render obvious what was evidently so obscure that a body of intelligent wit- nesses with equal, and as regards many of them, the best opportunities for forming a judgment, arrived at opinions absolutely antipodal from the same kind of facts ! What methods of procedure, and what appli- cation of tests might have presented themselves to those specially skilled and experienced in the treatment of mental diseases and infirmities may be considered here- after. It is enough at this stage of our inquiry to say, that in the absence of all proof or intimation that these gentlemen employed any other means of discrimina- tion than those which were common to all who were in a position to take notice of Mr. Parish, we must pass their testimony into the mass of common proof, inferi- or to some, as for example, that of his immediate nurses and personal attendants always around him, and superior in character only to that of mere acquaintances and friends calling to see him occasionally on purposes of business or courtesy. Let us commence our search for the facts bearing on the medical question in the case, with an analysis of the testimony of his immediate attendants. We have a succession of these from the day or two after Mr. Parish's illness commenced until within less than a year prior to his death. The first of these was James C. Fisher, who commenced his services July 22d, 1849— the apoplectic seizure having been on the 19th,—and remained until the 27th of the next December. Of course, if correct in his dates, he was there during the execution of the first codicil, August 29, 1849, and its re-execution on the 17th of the following December. 467 He gives many and minute details of his manner of waiting upon his charge, most of which indicate that Mr. Parish was in a state of great physical feebleness, but throwing little light upon his mental condition. Fisher says, that within three or four weeks, Mr. Parish began to speak words, and make signs. When, for example, he wished for the chamber utensil, (II, f 826,) he put his hand out of the bed ; when he desired the bed-pan, he turned down the "spread ;" and that he made other signs when he wanted more or less light, that Mrs. Parish should be called, tfec. Fisher, indeed, represents that these signals were agreed upon conventionally between his patient and himself, within three days of his going to serve him. All these signs, of themselves, give the impression —even if there were nothing behind to lead to the belief that Fisher was in error in supposing that they understood each other—that these were nothing beyond the natural instinctive indications of physical wants in an exceedingly reduced sufferer, which an experienced nurse would necessarily catch, and subsequently avail himself of. No experienced observer of human dilapi- dation and extreme weakness of body and mind, can fail to have noticed some signs like these by which some want or some distress is indicated. They are in- voluntary signals by which the young infant, the aged imbecile, or the demented invalid, show forth some painful sensation, and in association with it an instinc- tive desire for relief. A parallel indication of indefinite distress and un- recognized demand for relief is shown in the testimony of another witness, (I, f. 1745), where Mr. Parish's pressing call to evacuate the bowels is manifested by his eating with great rapidity, " at the same time ap- plying his hands to the front of his pantaloons, as if he wished to open them." 468 Further notice will be taken of this last symptom as one characteristic of extreme dementia. So legible are the class of movements described by Fisher, to the experienced and sagacious nurse, that they would not be overlooked even where all intelli- gence and all use of the senses are annihilated by injury of the brain from fracture of the skull, with compression or concussion. Some slight movement of the finder or of the lips, makes a language which is readily interpreted, and its meaning acted upon. A curious English surgical case is reported, or rather repeated, in most modern works on surgery. A sailor who had received an injury to the brain in the Medi- terranean, remained in a state of entire coma or uncon- sciousness for more than a year, until he was transport- ed to one of the London hospitals, where the operation of trepanning at once restored him. During this long period of insensibility, deeper than that which exists in sleep, his rude companions recognized some little move- ments, having no significance in themselves, but found tentatively that they indicated his wants. The call for food was shown in one slight muscular movement—that for drink in another, that for an evacuation of the ex- cretions in still another. These hints were obeyed by the kindly nurses of the ocean, and their shipmate was thereby saved. I have myself been called within a few years to consult in a case where a lad, from a fall on his head, had lost all consciousness, all power of movement, and lay like a lifeless corpse for more than a month. Yet an anxious mother hanging over him, day after day, learned by her observation that a slight sucking move- ment in one corner of his mouth indicated a wish for drink; some other equally minute sign that he would make an evacuation, and so on. Of this character, as it seems to me, were these 469 movements of Mr. Parish, if they really occurred. I judge so, because his possessing intelligence sufficient to arrange a conventional language within five days after a shock of apoplexy, the sad effects of which un- derwent but little amelioration for over six years, is not verified by any other circumstances or witness. The incidents are explained with so much facility, and in conformity with so common an experience, that it is not necessary to presume any want of truthfulness in Mr. Fisher, as connected with his discrepancies from the quasi parallel accounts of other witnesses. Yet after all, Fisher could not trust implicitly to his signs, prearranged with his patient. In vol. II. f. 826, he tells us, that when Mr. Parish wished to have his wife called, he pointed towards her door. In vol. II. f. 831, Fisher states that when he saw this movement, he inquired of Mr. Parish if he wished to see Mrs. Parish. The general tenor of Mr. Fisher's account of his pa- tient, and his mode of management with him from day to dajr, carefully studied, carries with it the impression, that his nurse regarded and talked to and administered to his charge much as he would have done to a young child, or an aged imbecile, or a demented person. He was taken to see the horses, the chickens, the spy-glass; the newspapers were handed to him, he was led out to see the moon, and the like; but it is difficult to trace, from what Mr. Parish did, any signs that he ever had an intelligent idea of what was said or done. Perhaps Mr. Fisher's wish to see his patient doing well, led him to misinterpret encouraging symptoms. At one time he sees Mr. Parish engaged in so intelli- gent a conversation with Mr. Kernochan, and is so sat- isfied that Mr. K. seemed so well " to understand Mr. Parish," that he did not feel it to be necessary for him to pay much attention. His services to aid in inter- 470 pretmg were superfluous. Mr. Kernochan says he had no reason to believe that Mr. Parish understood him at all! Compare vol. II. f. 935 with vol. I. f. 863. So the statement as to Mr. Parish standing before the clocks, on the 1st and 15th days of the month, when they required winding, appears not so much like a fact indicating clearly a recognition of time, and the necessity of a given act, as some movement or sign of recollection of having seen the clocks wound up, which attracted the valet's attention, as such indications of unfolding intelligence in the infant gratify the nurse, and are rehearsed by her to pleased parents. Such evidences of memory, thought, calculation, do not quadrate with the general account of the patient's feebleness and torpidity. To assume intelligent recol- lection and appreciation in this case, and in all similar instances adduced by this witness, is to ignore the manifold indications of mental imbecility presented, over and above the overwhelming demonstration here- after to be considered, of his incapacity to commuuicate one idea independently—one wish, if at all, except by the more or less careful and laborious cooperation of another mind. To assume that a person could so far exhibit memory and judgment as to carry into effect the winding up of a fourteen-day clock at its exact pe- riods, and to be able to compare his watch with others', and note the difference, or to indicate on its dial the precise time which his nurse was to be allowed a leave of absence, and yet without any symptoms of undue physical irritability or entire paralysis of the excreting organs, he should be unable to govern his own evacu- ations, is contrary to all human experience. The testi- mony proves too much altogether! Mr. Fisher's hopefulness of disposition or desire to lend encouragement to anxious friends, (no unusual or blameworthy trait in professional nurses,) evidently 471 prompts him to convert every indication capable of such interpretation into proof of Mr. Parish's intelli- gence. For example, in Vol. II. f. 907, he permits this proclivity to generate in his mind a belief that his pa- tient, at an alarming period of his disease, (if, as it seems to have been, about October, 1849,) not only evinced an intelligent appreciation of the necessity and character of the medicinal agent prescribed, but a per- severing determination despite the nurse's judgment, that it should be used to the utmost dose, and what is more extraordinary, employed in his determined pur- pose the vocables, heard, as it is believed, by no other person, and at no other time, not merely yes and no, (about which other witnesses disagree, whether they were ever articulately uttered or not,) but " why, yes'' two monosyllables involving as much difficulty in enunciation as any others in the English language! The same sanguineness of temperament is manifest- ed in Mr. Fisher's account of his patient, (II. f. 969,) writing the word " wills " on the fly-leaf of a book, as contrasted with Dr. Delafield's less assured account of the same transaction, (I. f. 3045,) and by the pregnant correction of both in the actual chirography itself as produced before the Surrogate, (see Exhibit No. 269, Vol. III. p. 701.) No stronger proofs, how much his anxiety to believe in a favorable progress of his patient, biased his judgment can be imagined. The trustworthiness of Fisher's narration as to his patient's symptoms has been impeached. I have not failed to notice this fact, but regarding him as one of the sanguine, encouraging, hopeful members of his pro- fession, I am able to see little in his testimony which is inconsistent or incompatible with the theory that Mr. Parish's real condition was that of extreme demen- tia, where passiveness and a limited variety of sounds and movements could be interpreted honestly into almost 472 any class of manifestations already in the mind of the observer. The next personal attendant in succession was Simmons, who came in December 1849, and left in December 1850, having served, as is stated, about eleven months, a period of time rather more than twice the length of Fisher's service. He describes the daily routine of his patient's life much as it is done in his predecessor's narration, while the conclusion he deduces from what he saw was di- rectly the opposite. The prominent acts of apparent intelligence in Mr. Parish, described by this witness, (Simmons,) seem to be his pointing at certain articles as if he wished to have them, as articles of food, his spectacles, brandy and- water, &c. It was his habit to be carried to the provision dealers, where he would point at the various articles of food, "sometimes one thing, sometimes another." These indications per se hardly rise higher in their value as evidences of mental capacity than would the attracted attention which idiots of the higher degree, in the classification of these unfortunates, manifest in things around them, prove that they understood and appreciated the idea of wants, and providing for them. Any presumption of active and disposing mind, predicated of such incidents as those occurring in the provision store, is entirely negatived by the subsequent explanations of this witness, showing that Mr. Parish failed to go one step beyond mere optical looking at the things around him, connected perhaps with some dim and evanescent association-idea of pleasurable gratification. Simmons, with apparently equal intel- ligence, and more than double opportunities of obser- vation, as compared with Fisher, the preceding nurse, disclaims any ability to explain the meaning of Mr. Parish's gestures, and much less indeed could other 473 parties, anxious and concerned to fathom his meaning, if any there were, succeed in comprehending him. (I. f. 1700, 1724.) This witness also describes the attempts made at different times to induce Mr. Parish to write upon a black-board and a slate. " A copy" was set for him, and he was coaxed and persuaded (I. f. 1709, 1712) into making marks, but nothing like a word or even a letter seems to have been produced. It is important to note that in the progress of these trials nothing was manifested of antipathy or reluctance—nothing of ir- ritability or aversion to the attempt. He was unwil- ling to start, (I. f. 1709,) but under coaxing did try several times, during some three or four days, on the black-board, and two or three weeks on the slate. It is difficult to apply any other solution to his entire failure on these thoroughly tried experiments, than that his mind was in a condition of too much imbecility or torpidity to grasp the idea of what was required. Simmons also testifies (I. f. 1718) to an indication of a deplorable grade of demency, when not explained by obvious physical conditions, the incapacity of his charge to control his evacuations. I regard the vari- ous accounts of this weakness as so characteristic of dementia in Mr. Parish's case, that they are worthy of a more specific consideration, and shall receive it in a subsequent stage of this opinion. Thomas Wingrove, the next in succession of Mr. Parish's personal attendants, began his services about June or July, 1850, and remained until September of the next year, a term of about fourteen months. His general account of his charge's condition and move- ments coincides with that of the preceding witnesses. His account of Mr. Parish's searching his wife's ward- robe, divested of his clothing at one time, and makino- a like search at some five or six other times, at first 60 474 sight would seem to indicate an extreme of dementia, but may not, under all the circumstances, be deemed inconsistent with the idea of a man incapable of ex- pressing his wishes, and under a high degree of irrita- tion at not making himself understood, pressing for- ward to do that for himself which he cannot make another do for him. But the fact that he did not re- cognize the pantaloons he had just ivorn, when they were thrown in among others, after he had evinced a strong desire to change, is in strong analogy with the various marks of imbecility already presented by these witnesses. The account by Wingrove of Mr. Parish's ways at the provision dealer's, (I. f. 1514,) while generally coinciding with that of the previous witness, would convey the idea of a still greater mental weakness, as he is here represented as not even pointing to the arti- cles around him. The dealer brought them to him, and then sent them to the house, and were kept or returned by Mrs. Parish, in the exercise of her judg- ment as to their being wanted or not. It is manifest that neither nurse nor dealer obtained any meaning in these transactions, from Mr. Parish's own sounds or signs. In I. f. 1521, we have very striking manifestations of his inability to express an idea, if there were any floating in his mind, as to the' direction in which he would be driven. The scene here depicted will bring vivid recollections to any mind habituated to the ways of the demented. They very often exhibit a strong degree of indefinite will, an obstinate persistence in pursuit of an indistinct and unascertainable something, after the faculties of knowing and judging are essen- tially extinguished. The same remark will apply to the account (I. f. 1523) of what occurred when Mrs, Parish, the guiding spirit of his shattered and appa- 475 rently almost annihilated intellect, was accidentally absent from him during a brief period. So also in the freaky and capricious endeavor to place himself in positions reached with the greatest difficulty, and at- tended with imminent hazard, as related in I. f. 1527, 1531, we cannot but notice indications perfectly in harmony with the every-day actions by those exceed- ingly demented. They pursue, with an amazing tenacity of purpose, some vague, indefinite, indistinct impression, scarcely clear enough to come under the word delusion—an impression which, from its misti- ness, is incapable of being conveyed to another mind, even though the power of using language remains intact. Here again (I. f. 1556) we have further illustration of that sad condition of imbecility marked by an ina- bility to command, or even indicate the calls of nature in the evacuations of the bowels and bladder. It is true that, in certain conditions of paraplegiac palsy, where sensation is destroyed below some points in the spinal column, the broken nervous channels may not convey to the sense or mind of the sufferer a notice of such calls, even though the mind is comparatively but little affected. Again, in other conditions of morbid sensitiveness of the pelvic organs, the calls to evacuate the bowels and bladder may be so sudden, and so im- perious, as to permit the distressed invalid no option but to yield to the intensity of the demand on the spot, wherever he may be, and how much soever he may be pained. But this repeatedly named difficulty with Mr. Parish had no symptoms which would allow it to be classed under either of these heads of disease. His disorder, so far as the palsy was concerned, was merely hemiplegia, where one-half of the body or the other, (ordinarily, as in his case, the right half,) in a vertical ine, is paralyzed. In these cases the organs of animal 476 life continue their functions, and such is the distribu- tion of nerves that an incapacity to command the fcecal or urinary evacuations does not exist. Nor in the description of this or the other witnesses on this point, can we find traces of morbid sensitive- ness of these organs. The medical opinion that such might be the case, seems to have been arrived at by a very forced supposition, as e. g. the symptom must have some explanation ; such palsy or such morbid irri- tability would explain it, and it was therefore inferred to exist, without any positive evidence. The defect in the explanation is, that such marked sensitiveness or paralysis is not the sole occasion of this symplom. Neither of these grounds existing, the only adequate explanation left for the sad manifestation mentioned as being of no infrequent occurrence by his personal at- tendants, is, that his mind was extinguished to a lament- able degree. The next witness in the class of nurses is Mr. Wil- liam Brown, who was with Mr. Parish from October 13, 1851, to the middle of November, 1854, about three years and a month. The whole tone of this wit- ness's testimony is evidently affected from his regard- ing his patient as much less seriously diseased than any of the preceding nurses, or the medical gentlemen deemed him to be, both as regards his physical symp- toms and his mental condition. A clew to his disposi- tion to look at every thing in a hopeful light, is indi- cated in the general summing up of his opinion, viz., that he " considered Mr. Parish's mind strong and healthy, perfectly understanding all I ever said to him." He states that Mr. Parish's right leg was " slightly affected," " he just made a drag of his toe in walking," (II. f 1297,) while all the other witnesses saw an absolute paralysis of that side, and an entire loss of the use of that limb. And in order to show 477 (II. f. 1302) how little aid Mr. Parish required in walking, he says he did not help the lame foot, " as I could not do that, and have his arm linked in mine," giving the impression that all the aid his patient re- quired was slightly to support himself on the attend- ant's arm. Compare the degree of weakness thus intimated with Dr. Delafield's account of Mrs. Parish's remarkable knack in lifting up his foot with hers so as to enable him to walk. (I. f. 2079.) Brown's general account of Mr. Parish's visit to the provision dealers, agrees substantially in most of its features with that of the other nurses, except that in a most important particular he manifests the same san- guine temperament before alluded to. He gives the idea that Mr. Parish not only was equal to the duty of examining and selecting the various articles needed, but that he evinced skill in chaffering and bargain driving. (II. f. 1411.) The facts he states, even with his own col- oring of them, do not warrant his conclusion, and that in giving them this interpretation he went beyond the true significance of any signs or sounds which he wit- nessed on the part of his patient is rendered certain, not only from the testimony of the other attendants on the same duty, and the provision dealers themselves, but by the sending home of provisions of which Mrs. Parish thought fit to return the whole, or a portion. This fact demonstrates that neither she nor they re- garded Mr. Parish as equal to purchasing such supplies. In looking at and endeavoring to weigh the value of many little facts and incidents testified to by Mr. Wm. Brown, we cannot but see this bent of a sanguine mind, anxious to comprehend his patient's movements, and self-satisfied on altogether too little evidence. That he was successful in his hopes is clear because to no other witness amongst those having the same degree of experience with him, did the incidents convey any 478 such degree of intelligence and meaning, as they did to him. Nor would it seem that any improvement in Mr. Parish's condition at the somewhat advanced period of his disease, at which Brown's services commenced, ex- plains his (Brown's) more favorable views. Indeed, on all the grounds of probability, the continued succes- sion of severe fits of epilepsy would necessarily involve the idea of diminished mental power, if he were not in that state of dementia from the first, which would not permit the measurement of descending degrees in men- tal capacity. Mr. William Brown evidently considers himself a complete " master of signs." Mr. Parish nods his head (II. f. 1314) " as if yes,"—points to certain places in the newspaper for witness "to read to him," going through more movements in selecting the paragraphs than would have been needed to have perused them himself, if capable of reading; lays aside the journal for Mrs. Parish—points out some interesting articles to her,—she would read, and "if it was a death, he would make inquiry," &c. Indeed, this witness habitually alludes to Mr. Parish as if he had not even an infirmity of speech; he makes " inquiries," (II. f. 1317, bis 1333,) examines a book of accounts called a " tickler," to ascertain questions of indebtedness; notes the last en- tries in his book of bank deposits; and the witness undertakes to state that the degree of Mr. Parish's attention to his books of account varied with "the amount of business to be done at certain dates," and " in the morning would layout a certain amount of business to be done the next day," o finds in Mr. Parish an ability to utter words to a far greater extent than any of the nurses who were in attendance upon him at an earlier period of his illness —or indeed than any other person at any time. lie not only says yes and no, but, " Why, yes, with a smile," and " Oh, dear!" or, " Oh, thear!" " Oh ! Got, Got, Got!" Even Mr. Parish's habitual expression of coun- tenance, which is proven by many witnesses to have been uniformly sad and melancholy, Mr. Brown found always (II. f. 1296) " pleasing and healthy." It is not necessary to follow this witness through the entire detail of his experiences; the most promi- nent and significant points have been presented, without making, on the presumption of untruth, any deductions from the couleur de rose tint with which he invests his charge's mental condition; and it is easy to see that his mode of interpretation brought him to a result such as no other witness reached. If this witness's inferences from his facts are war- rantable, then is his opinion as to the perfect soundness and understanding of Mr. Parish legitimate. But the theory of absolute and perfect integrity of mind such as Mr. William Brown and several other leading friends adopt, augments and thickens the darkness and mystery which envelope our second division of inquiry: why did not Mr. Parish communicate in some better way than that suggested as his ? A man with some mental change, some monomaniac caprices, could readily be thought to refuse to do any single thing; while the question might be an open one, as to the soundness of his other intellectual operations. But to assume com- plete integrity of mind with so striking a peculiarity to 480 be harmonized is no easy task. Hereafter this topic will be brought under consideration. It is enough now to say that the judgment of Mr. Brown, and the other witnesses of his way of thinking, prove altogether too much to allow Mr. Parish's great peculiarity—his anom- alous symptom to be brought within the class of minor mental defects, or eccentricities or sensibilities which might exist, and still leave him, in a condition of capa- city, adequate to making an unimpeachable testament. The next witness of the class of personal servants is James Clarke, whose term of personal service was about a year and four months, beginning in December, 1854, and terminating the latter part of April, 1855. His duties were essentially the same as those of the previous attendants, and we have the same sad narra- tive of his patient's extreme feebleness of body, and the same uncertainties as to his ability and degree of comprehension. We note in this witness's examination the same indications that Mr. Parish was treated essen- tially as a child or an imbecile, by those around him. The coachman is sent for; he appears, and announces that "the horses are well;" "that there is plenty of feed," &c. (I. f. 1728.) When carried to his store, this wit- ness calls down Mr. Parish's friends, as if he had sent for them, without any pretence of such direction from him. In Vol. I. f. 1732, we see that when Mr. Parish was taken to the door to see the moon and stars, his wife entirely fails in her efforts to attract his attention, and at various places in Clarke's testimony, we see that Mr. Parish pushed his wife rudely away, and this without the slightest indication of a cause. (I. f. 1730, 1733, 1736.) This act is entirely inexplicable. Extreme irritability might account for even a high-minded gentleman— constitutionally as is proved of perfectly controllable temper—so far losing himself as to be guilty of such an act, but under this supposition the occasion of offence 481 ivould be apparent even if the act ivas most unreasona- ble. Did not these rude pushes originate in the same general class of angry, obstinate, misty impressions, too dreamy and indefinite to be worthy the designation of delusions, which were controlling him when he insisted that his carriage should be directed in some unintelligi- ble way, or when, during his wife's absence at the da- guerreotypist's, he evinced such a frightful degree of anger as to invoke a curious mob about him ? In vol. I. fol. 1738 of this witness's evidence, we have rather an amusing comment on Mr. William Brown's account of his patient's care in having the newspaper read, selecting paragraphs for his wife, &c. James Clarke speaks of Mr. Parish's habit being that of sleep- ing or looking out of the window when the newspaper was being read! In vol.1, fol. 1744, '45 we again have this witness's testimony to what is probably an unquestionable fact, that Mr. Parish had lost the power of appreciating the calls of nature. The cumulative testimony touching this symptom, is very important, as demonstrating that it was no single or rare occurrence, and that it did not occur merely at some rare periods of local disease. Each witness, except perhaps Brown, of his immediate nurses, as well as some of his medical attendants refer to this infirmity. Yet it does not seem to have been uniform, but only occasional. Now if it was due to morbid irritability it would have been existent at one or more periods when the local disease was most urgent. If from palsy of the sphincters, it would have been uniform and constant. But it happened occasionally, now and then, just as it does in the demented patients of every insane hospital. If the attendant is vigilant; if he watches the little accidental signs, such as his pa- tient's wandering around as if in search of some place to relieve himself, perhaps passing again and again before 61 482 the door of the very water-closet where he has eased himself for years, without recognizing it as the place wanted, or such as his patient's fumbling at the open- ing of his pantaloons—or some petty movement still less connected with the want—and recognizes them in time, such an accident as his patient, while continuing in usual health, defiling himself, may not occur once in half a year. But if he is inexperienced in such duties, if he is deficient in tact or in vigilance under the occur- rence of accidental looseness in his patient's bowels, this disagreeable accident might occur at any time, and at any number of times in each year. The recognition of this accident as occasional—not very frequent, nor yet very rare, is the best proof that its causation was in the mind, and did not depend on local weakness or palsy. This is, I am aware, a painful and disagreeable topic to be introduced so often or at all. Yet it seems to me so important in its meanings, so pathognomonic in deciding the probable condition of Mr. Parish's mind, that I should not have expressed my full views, had any sentiments of false delicacy per. mitted me to slide over it. In I. f. 1752, '9, of this witness's examination we note an approximation towards a test, where a question is twice put, and a negative and an affirmative response successively given. It is on many accounts to be re- gretted that this test could not have been more fully put into practice by investigators of a more competent and cultivated class. The result in this instance is one among the many corroborative indications that Mr. Parish's ability to show assent and negation was ex- tremely questionable. This witness (I. f. 1752) enters his final judgment that Mr. Parish's " mind was not right." He does not attempt a confident precision of statement like the pre- ceding witness, William Brown. His facts manifestly 483 warrant this extent of assertion. He has nothing; of the positiveness of many witnesses, whose facts are less pregnant, but few persons can read his plain matter of fact statements without the feeling that they are ob- taining the exact facts. I may say, that they are facts which tell to the experienced observer the story of a most common every-day type of dementia. I do not perceive that the succession of nurses is continued in the testimony after Clarke, i. e. from April, 1855, to the death of Mr. Parish, March 5, 1856. From the accounts given by his medical at- tendants of his progress to the close of his life, it seems probable that there were few marked incidents to vary the sad spectacle thus far traced. We now come to the testimony of the medical gen- tlemen in attendance upon Mr. Parish. It is to be re- garded as next in importance, as they had the next best opportunities of observation. The first in order of time is his brother-in-law, Dr. Delafield. His acquaint- ance with his patient's case commencing long anterior to the fatal stroke of apoplexy, and continuing until his eyes were closed in death, naturally prolongs the narrative of events through many pages, from which I shall endeavor to abstract the facts, which bear upon the question of mental condition. The first facts throwing light upon this are at vol. I. fol. 2085, '6, where Dr. Delafield explains what he re- garded as Mr. Parish's sounds of affirmation and nega- tion, his inquiring looks and his gestures, but none of these as described would necessarily carry the same convictions to a disinterested, unconcerned observer. The same explanation of the possibility and probability that all these signs and sounds were misapprehended— that there was actually no meaning behind them which has been before suggested, may be thought to detract much from their value as proofs. They were brought 484 to nothing like a test; the apparent accordance some- times noticed between his signs and acts, might be nothing but accidental coincidences. At vol. I. fol. 2087, Dr. Delafield assumes without one particle of evidence, and contrary to the whole tenor of the facts, as I interpret them, that the impor- tant symptom of Mr. Parish's losing the command of his evacuations, was of doubtful causation. He says it might be from morbid irritability of the bladder and rectum, or from a loss of power, that is palsy, of their sphincters. The doctor does not allude to a cause, (that before in this paper named,) which must sponta- neously suggest itself to every one experienced in men- tal affections as much more in consonance with the whole series of symptoms in this case, viz. :—that this inability to regulate the faecal and urinary evacuations resulted from no local disorder, either of excessive or annihilated sensibility, but because the mind to which such calls are addressed was wanting. Dr. Delafield belittles the gravity of this symptom when, at Vol. I. f. 2087, he says that " the sphincter muscles and the bladder and rectum were to a certain degree affected, so as to impair somewhat their func- tions," and this is represented to have been a symptom of the latter part of Mr. Parish's life. Now, Simmons, whose term of service was in 1849 and 1850, testifies to its existence in his time. Wingrove, the nurse for the next fourteen months, testifies to its continuance in his, (I. f. 1556,) and James Clarke, in a service of sixteen months from December, 1854, gives a still more minute account of the same still continuing: af- friction, (I. f. 1744, '5.) and his account closes almost a year before the death. If this symptom really were more prominent during the latter part of life, as Dr. Delafield says, it doubtless is explained on the ground of still more extreme demency than had before ex- isted. 485 To conclude my views touching this symptom, which I regard, occurring as it did, as quite pathognomonic or characteristic of mental, rather than physical imbecility; I would suggest that this might have occurred from morbid irritability of the mucous surfaces, or from ab- solute paralysis, and yet have left the mental faculties unimpaired. But if it did not occur from either of these conditions, there is only one other recognizable cause, that is, dementia, a state, and this symptom of it always present in abundant examples in any consider- able hospital for the insane. And such dementia is a natural, legitimate, usual sequel of apoplexy, or of se- vere epilepsy, or, as in Mr. Parish's case, of both these diseases in continued action. Morbid irritability of the rectum is a condition re- sulting from inflammation of its lining membrane, as in dysentery. The bowel is sensitive to the touch of any foreign matter or of its own secretions, or even without any thing in contact it may evince tenesmus from mere congestion and inflammation. It is not a disease that could possibly be overlooked or mistaken by the medical attendant, or even by the common nurse. If it even be chronic in its nature, it is but too palpable, and so pressing as to give its viatim scarcely any relief from painful and disagreeable symp- toms. Palsy of the sphincter is still less capable of being misunderstood; it is one of the saddest of those calamities which make life insupportable. It is a chronic and permanent affection; ordinarily the patient can have no intermissions of governing and then losing the control of his evacuations; the power which nature, by one of the most wonderful of her many curious contrivances, employs to close these passages when at rest, so that they are released by the will in order to exercise their functions, is destroyed. The extremity of the bowel or bladder becomes nothing but an open 486 tube, which permits any thing which is present to es- cape as from an inanimate opening. Fortunately we are not often called upon to ascer- tain the existence of, or advise in such cases as present the forms of disease last described. They are not the concomitants of ordinary apoplectic paralysis, which is of so common occurrence from lesions within the brain. The cause in most cases is from injury to the spine; most frequently from a short doubling or curvature from falling from a hay-cart, or some similar circumstance. The bladder itself, in such cases, may be so affected as to confine its excretion while the sphincter ani is abso- lutely released and open. Death usually supervenes in a few weeks under this form of injury. No prac- titioner can have failed to meet it. Now, from the accounts of all the witnesses, neither the one nor the other of these two specified conditions can be presumed to have existed in the case of Mr. Parish. It is evident that his trouble in evacuating uncon- sciously was one which came on occasionally, at irregu- lar intervals, during several years. The solution of its so presenting itself was, doubtless, in the circumstance that a vigilant observation of Mr. Parish's indications was sometimes neglected, or some error of diet or effect of atmospheric changes deranged for a time the functions of the bowels and the character of their contents as re- gards acridity or fluidity, so that the usual impression conveyed to the sensorium was lost. Let us assume for a moment that Mr. Parish was in the full possession of his faculties, as so many of these witnesses believe. Is it to be supposed that with a morbid irritability of the rectum, or a palsy of its sphincter, as Dr. Delafield hints, a gentleman would have ventured to do what Mr. Parish did every-day of his life for some years, ride out, receive company, dine with the invited guests, and the like ? 487 The existence of this inability in demented patients, their habitual manifestation of some indefinite idea of a call, such as Mr. Parish evinced, leave no doubt that this was the true explanation of his infirmity. No other circumstances suggested by the evidence will explain it, nor can I conceive of any. Dementia does account for it fully, naturally, and, as I believe, cer- tainly. Dr. Delafield continues throughout his testimony, frequently to express an opinion that Mr. Parish was capable of understanding what was said and done, but it is not easy to perceive how his facts warrant this belief. His natural and honorable anxiety to see his friend and patient relieved, prompts him habitually to look upon every encouraging indication with too sanguine and flattering impressions. In Vol. I. f. 3045, he says that certain characters made on the fly-leaf of a book with a pencil, " and always the same," were construed to mean the word, " Wills," and that Mrs. Pa- rish, on seeing them, suddenly exclaimed," Wills!" with a good deal of emotion, as if it were an unexpected, startling thing to her. Now, any person looking at the marks, so construed, in the original or in the printed fac-simile, cannot but appreciate the tendency to mis- color testimony, (without any implication as to entire good faith,) which obtains, where the feelings are deeply involved. Dr. Delafield's account (I. f. 3051) of the faithful and persevering efforts made to induce Mr. Parish ^to use his left hand in writing, demonstrates their failure, beyond a supposed writing of his name. The fact of success, even to this moderate degree, might be of mo- ment in entirely removing his case from an alleged class of patients, where the connection between thought and its symbol of expression, that is, language, is dislo- cated and lost. More will be said hereafter of this 488 pretended symptom of the phrenologists. It may be further observed, that Dr. Delafield (I. f. 3265) alludes to the attempts which were made to secure this object of writing, by placing a copy of his name before him, " to see whether, by fixing his eye steadily upon the name, properly written, it would aid him. It did no good." This experiment approached somewhat to the idea of a test, although not so close as could be desired. Why did it do no good? His eye was equal to the task; so also was his left hand. What else induced its failure, unless it was the absence of the powers of mind which connect and guide such movements as were sought for \ I have already referred to the fatal absence of any system of tests calculated to determine the precise grade of Mr. Parish's capacity. Dr. Delafield testified (I. f. 3294) to his being aware, that Mr. Parish's " soundness of mind and mental capacity were likely to become a question of judicial inquiry, and that his sis- ter was interested therein," and in Vol. I. f. 3304, he expressly declares, that he " never made any examina- tion of Mr. Parish, or applied any test to him, for the exclusive purpose of ascertaining the state of his mind." When cross-examined, the doctor avers that he con- siders each visit to his patient to have been " a test." The expert in mental diseases might suggest that a professional visit to a patient, with a delicate, protract- ed, ophthalmic disease, without any critical examina- tion, by a physician skilled in mental phenomena, would equally well deserve to be called " a test." Many exceptions might be taken without hyper- criticism to Dr. Delafield's views of cerebral lesions, and their effect upon the mental state of the patient. There is, however, no necessity of entering into any such field. The value, too, of an examination, post-mortem, of a 489 patient's brain, in establishing a presumptive integrity of the mind by an absence of all abnormal signs; or confirming the probability of mental aberration or im- becility, by the discovery of organic changes within the cranium, it is safe to say, would be quite differently estimated by those whose professional studies had been in a different specialty from his. But when we have as in this case an abundant supply of facts, carrying with them an indisputable interpretation, it is not ne- cessary to enter the fields of pathological controversy. The next medical witness is Dr. Dubois. His testi- mony may be dismissed with a very few remarks, as he declares, (II. f. 210,) that he never had a suspicion that he would be called upon as a witness in relation to Mr. Parish's condition of mind. He visited him ex- clusively for his disease of the eyes, and made neither examination of, gave reflection to, or tried any tests touching Mr. Parish's mental capacity. He waited upon him as an ophthalmic surgeon, and as such manifestly discharged his whole duty with sagacity and fidelity. He asked the necessary questions on the subject-matter of his specific duties, and when he received certain sounds and gestures, as indicating affirmation and nega- tion, he accepted them as such without doubt, hesita- tion, or inquiry. Mr. P. nodded his head with a sound for the one, and shook it with a sound for the other. Dr. Dubois, intent on reaching the exact character of the eye disease, would not naturally doubt that he was understood and properly responded to. How easily a reliance upon simple expressions of yes and no would mislead, even if the patient's own story were of vastly more moment than it usually is in ophthalmic diseases, where the oculist judges more by what he sees than what he hears, will be considered as we pass along. Dr. Dubois, (II. f. 191,) in giving his opinion, mod 62 490 estly, and as if suspicious that it was not based on the carefully and thoroughly tested substratum of facts, which unquestionably would have underlaid any of his ophthalmic judgments, qualifies that opinion by saying that Mr. Parish's "mind appeared to be clear and sound"—an opinion natural enough in view of his methods of examination. Dr. Wilkes, the next medical witness, and an emi- nent ophthalmic surgeon, when questioned as to his visits to Mr. Parish, states that he saw him in 1852, " and for an affection of the eyes," and so far as appears, without any reference to the mental condition of his patient; a condition which incidentally, it may be re- marked, was a very ordinary, commonplace one, view- ed from one standpoint, namely, as demency; but certainly of a most interesting, anomalous, and rare character, if regarded as that of a person perfectly sound, yet incapable of making any external manifesta- tion of such mental integrity—a case so extraordinary among the rare cases of medical science, that one med- ical man could hardly avoid gratifying a friend by in- troducing it to him, as one of the wonderful examples of psychology. Dr. Wilkes made his patient seven or eight visits, and evidently made a thorough investigation of his case, as an oculist. We note that he tried his visual powers with type of different sizes, pictures, vases, dif- ferent degrees of light, &c. He thinks, (II. f. 218,) that he was very happy in obtaining Mr. Parish's meaning. " If I presupposed any symptom which did not exist, he would immediately object to it, by shak- ing his head, and a marked expression of manner that that was not the symptom." How did Dr. Wilkes know that the symptom did not exist ? Did he ask for symptoms, where his own observation would correct or confirm his inquiry ? Did he ask Mr. Parish wliether 491 he could trace ordinary print with his disorganized eye, and receive a positive yes, or no? Were any such tests as this applied, which would have determined whether he were understood or not, and that the re- plies were not made hap-hazard ? We see no account of any. The responses, yes or no, might on the doctrine of mathematical chances fit, if uttered alternately, one- half of all indiscriminate interrogations, capable of be- ing answered by simple affirmation and negation. Dr. Wilkes states, that on the occasion of his visits, Dr. Delafield " would ask him (Mr. Parish) questions, and Mrs. Parish would state about his diet." We can well conceive with the natural impressions thus derived, ab extra, one topic, the condition of the sufferer's eyes being alone prominent, that Dr. Wilkes might arrive at the unhesitating opinion, that Mr. Parish's " mind was clear, and capable of transacting the ordinary avocations of life." Dr. Wilkes, in his anxiety to determine the precise accuracy of the optical apparatus of his patient, appears to have overlooked the consideration of that more subtle interior condition to which all the mere ma- chinery of lenses, humors, retinal expansion, and so forth, are secondary. When after various abortive attempts to fit himself with a pair of spectacles, the Hibernian was asked by the anxious vender whether he could read at all, he replied, "Do you think if I could read I would be such a fool as to buy spectacles ?" The dialogue is recorded as a proof of the Irishman's folly; but it is no greater error than that of the oculist per se, who overlooks the office of the brain, while anxious about the integrity of the mechanical appliances, which only transmit to it the materials for appreciation. Dr. Wilkes evidently has no very clear explanation 492 to give of the great difficulty of the proponent in this case, i. e. how Mr. Parish, if sound in mind, should re- fuse to communicate in the usual way of such patients. In vol. II. fol. 282, he seems disposed to consider this repugnance or refusal to write as a monomania, and would explain the difficulties of a supposed analogous case, by the idea of the patient's mind being sound on other subjects; of course diseased quoad hoc, or mono- maniac. At vol. II. fol. 2S4, he is disposed to consider the refusal to write as wilful, or to use his own words: "It appears as if there were a perversion of his mind upon that subject." At vol. II. fol. 285, he puts the refusal neither on the ground of delusion nor perver- sion, but of mere irritability. Paralysis, he reasons, makes its victims irritable; the use of the left hand re- quires more than ordinary exertion, therefore the pa- tient, finding his efforts to fail on trying, refuses abso- lutely to continue his endeavor, yet all his mental faculties are in perfect integrity. At vol. II. fol. 309, Dr. Wilkes illustrates another view of Mr. Parish's case, still differently, by a refer- ence to the case of a Dr. Grayson, who was unable, pending an apoplectic attack, to write the final syllable of his name. Dr. Grayson's seems to have been one of those not infrequent forms of apoplectic disease or symptoms, where the power of connecting certain words with their ideas may be lost; some Christian name is not capable of being justly applied to its own- er, or some wrong word will insist on taking the place of the one which should come in. In cases like Dr. Grayson's, the current of thought may be quite normal, notwithstanding this difficulty of a few words being unmanageable, while in Mr. Parish's case, the fact of any mental activity is only obtained by inference. Dr. Grayson's power of articulating intelligibly was scarce- ly affected at all. Mr. Parish's power of articulation was extinct, almost, if not quite, in toto. 493 Dr. Wilkes's other case, (vol. II. fol. 300,) of a hypochondriac who kept' his room and yet did business for a long period, is interesting as a curious example of hypochondriasis, but not elucidatory or instructive in our inquiry, as there is no evidence of Mr. Parish's having been in any sense a hypochondriac. Dr. Wilkes seems to have omitted all consideration of the possibility of a condition,—that of dementia,— which would meet adequately all the indications pre- sented. The remaining medical gentleman in attendance on Mr. Parish, Dr. Markoe, the business partner of Dr. Delafield, saw him soon after his fit of apoplexy, and through his entire illness to his death. The first facts in his testimony which throw any light upon Mr. Parish's mental condition, are presented in vol. II. fol. 1997, where the doctor describes his manner of investi- gating his case. He asks such questions as would per- mit an affirmation or a negative response, " and received from him always readily and promptly, what I con- ceived to be an affirmative or negative answer to my questions." At vol. II. fol. 202, Dr. Markoe further explains what meaning he attached to Mr. Parish's ges- ticulations or motions. I have been unable to perceive any thing in the facts or opinions recorded in Dr. Markoe's testimony in the application of the signs or sounds, which he inter- preted as yes or no, which necessarily fixes them as having been accompanied by intelligence; and the re- marks hitherto made, and hereafter to be made, upon the strong probability of these supposed expressions of assent and dissent being entirely hap-hazard and with- out intelligence, will apply alike to the opinions of this witness as of the others who declare like opinions. Dr. Markoe gives a reason why a post mcyrtem ex- amination was not made:—an inquiry which doubtless 494 every medical man has made, after he has reached the slightest acquaintance with the case. It was that " he was informed by Dr. Delafield that the feeling of the family was strongly opposed to it, and I said no more." It is truly remarkable that an eminent physician, who had the rare fortune to be the witness of what he be- lieved to have been an actual separation and dejection of a portion of bowels, and that followed by recovery, and carrying on the functions of life subsequently, could have rested so easy, under a first and not apparently insuperable refusal to admit an autopsy! One of the previous medical witnesses suggests a ground for not having an examination, that it is not usual in paralytic subjects "in private practice." A case of paralysis, involved with so extraordinary an organic lesion as to be almost beyond belief, certainly would have justified a more pressing application than seems to have been made, independently of any light which might have been thrown upon the great medico-juridical question now sub judice, by proof of the presence or absence of marks of extensive cerebral disease. The medical gen- tlemen, and especially Dr. Delafield, who had in the rights of his sister an interest more than merely pro- fessional, could not have failed to consider the value of the medical fact, if it existed, that Mr. Parish's brain was found free from other relics of diseased action than the ordinary, expected marks of apoplexy, such as a clot, a cyst, or a cicatrix, as the processes of recupera- tion had been more or less completed. Confident as they were of his mental soundness, they could have no grounds for expecting any thing except the specific apoplectic damages. They knew how strong the evi- dence would be in support of their opinion of his men- tal soundness, were his brain sound, with the exception referred to. Is it to be supposed that Mrs. Parish, the only party whose wishes were to be deemed imperative 495 on such a subject, in view of the magnitude of the stake, could have resisted an application, based on such grounds ? What then is the weight of the inference from the fact that no such solicitation was urged, and no such examination made ? Passing now to the third order of witnesses, the business and social friends of the testator, it is not pro- posed to look at the testimony of each individual. For there is running through the whole of the details given by these, as by the previously mentioned witnesses, a generally concurrent account of Mr. Parish's habitual condition. The disagreement is more in the conclu- sions which are drawn than in the facts themselves. Prominent among these, both from his opportuni- ties and the full detail of occurrences, is Major K. Dela- field, a brother of Mrs. Parish. As is most natural, his mind was unavoidably biased throughout the course of Mr. Parish's long illness towards the least painful aspect of his friend's infirmity, and we notice a consequent rea- diness in him to speak with entire confidence as to Mr. Parish's ability to understand and to make himself comprehended—a confidence at great variance with the inability of various others, nurses and old friends, to recognize the slightest intelligence in Mr. Parish. We find (IL, f. 1747) Mr. Parish "agreeing " to the selection of a lot at Greenwood, " assents " clearly and distinctly by an affirmative "yes" , $400, and $500! It does not seem to me necessary to analyze any more of the testimony of those who regard Mr. Parish as a sound man. In examining the minutes of the tes- timony of each in succession, I find no facts of a differ- ent type from those already considered; nothing which is substantiated by any tests; nothing where his signs of assent and negation would not fall under the same principles of explanation offered in relation to the statements of Major Delafield, Mr. Tileston, and the others named; nothing which offers any hint to recon- cile the entire competency of mind which they deduce from the mere application of yes and no by him, with the great fact of his utter inability to express one idea in the manner used by all sane paralytic men in all times and places. The testimony of the other class of witnesses who re- garded Mr. Parish as essentially void of comprehension, requires no analysis, because theirs is not so much the expression of an opinion, where we are to see whether its basis of facts warrant it or not, as the statement of a fact, viz., that they could not understand him, or as far as was perceptible to them make themselves comprehended 504 by him. Many of this class of witnesses had a strong interest in recognizing; his true condition. The testi- mony of his old partner, Mr. Kernochan, before alluded to, and his confidential clerk, Mr. Folsom, carry with them an element of great importance in this regard. Each was placed under circumstances requiring him to decide in reference to momentous acts involving pecu- niary risk, and very probably involving reputation, whether he was, or was not, sound and competent to do business. They declined to act, because to their minds the evidence was adverse to his soundness. Mr. Kernochan, in his anxiety to decide correctly, instituted the simple test before alluded to, almost the only one referred to in the case, and refused to receive a power of attorney from one whom he believed to be no longer himself. And Mr. Folsom, abandoned as it were to his sole unaided judgment in a most embarrassing and responsible position, where those to whom he seemed to look at first for relief, refused even to advise in so delicate a matter—that of deciding whether he should deliver up the valuable papers of Mr. Parish, including his will—cannot bring himself to an affirmative belief in his soundness. How much must judgments arrived at under the pressure of such circumstances as sur- rounded these witnesses, overbalance the mere impres- sions or notions adopted without test or examination, by the great body of those who have spoken confi- dently of his perfect mental integrity! The practical decisions of such men as the provi- sion dealers, Case and Austin, have in them an element of earnest attention to Mr. Parish's manifestations, su- perior to the off-hand impressions of casual visitors, or of those who thought they transacted business with him, when some one claiming and exercising full authority, was at hand to decide and promptly to declare a reason- able import for every inarticulate response he made. 505 When, for example, Mr. Parish appeared to be trans- acting business to an extent of thousands of dollars, instead of that appertaining to the purchase of a few chickens, vegetables, or oysters, it must not be forgot- ten that Mrs. Parish was at his side, and that her ex- plications of his decisions were naturally, and as a mat- ter of course, accepted as his exact wishes. If Mr. Parish had visited Mr. Ward accompanied only by a nurse, would the notes and securities which he was examining, have been delivered on the mere strength of his imperfect sounds and gesticulations ? Is it to be presumed that a person who cannot make a tradesman comprehend how many and which of his stock of fowls or oysters he would order, is equal to the purchase of securities in the stock market ? I have alluded at various times to the consequential fact, that tests might have been applied to substantiate impressions or to disperse them. I may be asked of what tests, what methods of verification would I have availed myself? This is very easily answered; many tests would at once occur to any earnest investigator. I will suppose one. At a suitable time and in a proper manner, some one of those who believed, as many of the witnesses profess to have done, that his mind was perfectly sound and intact, should have approached him with language essentially of this import: "Mr. Parish, I wish to have a full, frank conversation with you on a subject, which it may not be pleasant to you to have broached, as certainly it is painful for me to present, but feeling that you ought not to have any thing of moment in your affairs concealed from you, especially as I and your immediate friends are aware that you perfectly understand every thing, although you cannot speak to us; I will tell you frankly and fully what we all think you ought to be informed of; you know that you have directed several codicils to be 64 506 prepared and have executed them, which entirely change the purport of your will, while you have re- fused, and doubtless for good and sufficient reasons, to have the original will abrogated. You know that the first of these codicils, having been executed when you were very ill, was, by the advice of Mr. Lord, re-exe- cuted some months afterwards to avert danger of doubt or question respecting your capacity to execute it in the first instance. The subsequent codicils effect most essential changes, and as the whole matter is a good deal more involved by your giving to your wife large sums as gifts, which Mr. Lord says are of ques- tionable validity; therefore, as things now stand, it is certain that your testamentary dispositions and these gifts to your wife will be contested by those who will think, from the tenor of your original will, which you prefer to stand uncancelled, that they have a better right to a part of your estate than she has to the whole. "That will may be considered by some to be a natural disposition of your estate, and, consequently, there may be an endeavor to sustain it and give the go-by to the codicils. The event of lawsuits is prover- bially uncertain, and of course you would be distressed to feel that it were a possible thing to dispossess your wife of the liberal provision which you have finally and maturely decided to give her. Now, to put all this beyond question, it is absolutely necessary for you to make a brief effort to counteract any chances of dispute. "To do this, you must give us at this time, when your pressing illness is over, a more clear and definite expression of your wishes than we can reach in your ordinary way of merely assenting to or negativing what we offer, not, of course, for the satisfaction of your friends, who understand you well enough, but to demonstrate to all who care to inquire, that there is 507 not the slightest ground for disputing your will. It is very easy for you to do this; it is not necessary for you to go through the tiresome processes of endeavor- ing to write with your left hand on slate, paper, or blackboard, as persons who have had a shock of palsy often do, but to which we know you have a great aversion, still, if you would consent to practise two or three days, and thus write, it would be a conclusive thing;. " There is, however, an easier way. I will simply turn to an alphabet, which we can find in any primer, grammar, or dictionary, and point along to each letter until I come to the one which you need to make the first letter of the first word of what you would say. When I reach the one you want, raise your finger or touch my arm, and I will write it down. In an hour, yes, in half an hour, you will have dictated a commu- nication which will leave nobody in doubt about your having clear ideas of all that has been clone in relation to your estate. Just spell out some sentence to the effect that you desire these codicils to be regarded as the expression of your precise wishes concerning the disposition of your property. Any other views or wishes you may have, especially any which will explain your singular reluctance as to communicating with us otherwise than by saying ' yes' and ' no' to our ques- tions, would render ' assurance doubly sure' as to your mental competency. Or, my dear friend, if you cannot follow my pointing to these letters of the alphabet, I will slowly call them over by their names, and when I reach the one wanted to make the word you would express, just press my hand and I will write it down. You see there cannot be much trouble in this, and how perfectly it will cut off the objections of any who think that you have not the full possession of your mind, and that you cannot make a valid will." 508 What man in his senses thus addressed, seeing; be- fore him, as he could not fail to do, a foreshadowing of what we are now engaged in, his beloved wife and his friends exposed to sore troubles from the question of competency, just as fully expected to be the inevi- table subject of litigation in 1849, as it is known to be this moment, and realizing that his own infirmities would necessarily be dragged out before the world, could have resisted a call so reasonable, so just, so much a demand of honor and of duty! To comprehend the emergency of the future and to refuse meeting and counteracting it, where the effect would require so little power, mental or physical,—indeed, vastly less than he was exerting daily, as those who believe him sound aver, in buying notes, settling accounts, ringing to a test the mere impressions of mental soundness received by many of those around him 511 In view of the eminent intelligence of many of those interested in Mr. Parish, and of those domiciliated with him, it is difficult to understand the reason for not subjecting him to such tests, if not for their own satis- faction, still to meet what they could not but foresee would be the first demand of those who subse- quently to his decease would require to be satisfied of the exact truth. The omission, especially under the six years' opportunity for considering every thing con- nected with so great a contest as was impending, like the failure to call in a single expert in mental disorders, is to be explained by those in whose power it was to employ any method of investigation which the case might require. The inference is irresistible that such forms of proof were pretermitted because it was felt that their application would operate adversely to those who wished to uphold his acts, as those of a sound, responsible agent. We have now arrived at a point in this inquiry, where we may lay aside all concern with the mere in- ferences and opinions of others, as well as with all the experiences and observations which are not in perfect harmony, and judge of Mr. Parish's condition in the light of conceded and virtually agreed facts. It is true that touching the material facts of his case, what his sounds and movements and looks, habits and infirmities were, there is as general an accordance of testimony as could be expected from witnesses at different stand- points. We can, therefore, bring him and the scenes of his daily life almost as clearly before us as if we had been present ourselves, and almost disassociated from any impressions traceable to this or that witness. To be sure, a witness may represent his expression to have been uniformly pleasant and cheerful, while others recollect him only as sad and melancholy; some never could perceive any thing like an articulate sound, capa- 512 ble of being expressed in words or letters in his vocal attempts; others recognized yes and no, and nothing more; some heard other short phrases, to the extent of two or three, in distinct articulation. Yet after reading over the great mass of testimony of so many persons, very many of them having had fair opportuni- ties of observation, it is not likely that there will be any great degree of discordance in opinion as to his ac- tual situation, among dispassionate and disinterested judges. The evidence will leave about the same gene- ral impression as to the facts. Mr. Parish heard with readiness; his eyesight, so far as one eye was concerned, is represented by those around him to have been good; one side, in its muscu- lar powers, had been unaffected by the shock which had annihilated all power in the other. Those who regarded him as mentally sound, of course believed that he had a full and clear comprehension of all that he saw or heard. They are satisfied that there was not merely an abstract power of intelligence, but an active exercise of every function of the perceptions, the volition, and the judgment. He was equal in their opinion to the high responsibility of negotiating for the great sum of $200,000 in one mass, passing out of his hands; he was equal to trading for a house, decid- ing upon the repairs of his roof, and attending to the daily marketing of his household. Yet with all this completeness of capacity, this in- tegrity of intellectual powers, believed to exist by these witnesses, they all without exception agree that his power of communicating his thoughts to others, was singularly, nay, to an unprecedented and anomalous degree, limited and restricted. He could not articulate to any degree—he could not write with his affected hand* There was nothing peculiar or unusual in these defects among the victims of apoplectic disease. But 513 he could not indicate his wishes in any of many ways which are common to paralytics from apoplexy. He did not write with his left hand. He did not search out the words he wanted to indicate his meaning, in the dictionary. He did not place block-letters in the collo- cation required to express his wants, nor point to the letters of the alphabet. He did not raise his finger to or press the hand of a friend, who might call off the letters, when that one was reached which would make part of the word and the sentence required—a method so much in vogue of late years in certain mesmeric or spiritualistic experiments, that its facility and effective- ness are recognized all over the country. Unlike the great body of paralytics from apoplectic lesion of the brain, deprived of the use of the vocal organs and the right hand, Mr. Parish only communicated, assuming that he did communicate at all, by assenting or dissent- ing when propositions were made to him orally, or per- haps in a few cases presented to him in writing. Such assent or dissent was expressed in sounds and signs, in- terpreted by his friends then about him, all deeply in- terested in establishing his sanity. Such an indirect method was indeed of the most clumsy and uncertain nature, and it is without surprise that we read of the long persevering, yet fruitless endeavors, to catch his meaning through it. At times, indeed, this was im- practicable, and the attempt was, under the trials of those who held themselves out as interpreters of this strange language, necessarily adjourned to be resumed another day, or was abandoned in despair. As before stated, a method so crude, imperfect, and unsatisfactory, was not acquiesced in without some struggles for a better. Abundant trials were made to induce him to write with his left hand, a process inva- riably, in my experience of many cases, performed with exceeding ease. This capacity is attainable with 65 514 so much readiness, in fact, that I confess myself sur- prised at the presentation of facsimiles and testimony on this point to the Surrogate. Paper, slate, and the black board were brought into use; copies were set of his name to fix his attention, but all in vain. It is stated that he sometimes went as far as " II. Par.," and that his name was more than once written by him. But though " coaxed " and " persuaded," this was the extent of his post-apoplectic success in chirography. I perceive among the facsimiles various of his al- leged signatures, made after the attack, differing con- siderably from each other, and greatly differing from his veritable sign manual. I am at a loss to explain them in the light of his proven incapacity to go so far. But as we find in the account of his most important signatures, i. e. his mark to one of the codicils, his counsel aided him by placing one of his hands on Mr. Parish's forearm and the other on his hand—positions in which a stuffed image could have been guided into some form of chirography—it is possible that all these dissimilar facsimiles resulted from such auxiliary manipulation, to meet his fancied wishes. We at least need more di- rect testimony and precise explanations, as to the modus in quo these signatures were made, before they can be received as palpable exceptions to the admitted fact, that for some reason or other he did not use his left or sound hand, as ordinary paralytics do. The utter ob- scurity of his earlyi effort at chirography, received by his wife with so much emotion as being the word Wills, when it carries no such significance, indeed no significance at all to any unprejudiced observer, seems to warrant a demand for information more definite than can be found in the evidence, as to some of these very legible, if not characteristically individual specimens of his alleged autograph attached to various important documents. 515 I pass over these trifling attempts at handwriting, as of little moment in any scale of proofs touching ca- pacity to use the pen—a capacity in fact stopping far short of the power daily exhibited by a vast majority of those almost vegetative forms of dementia, found dozing around any large receptacle of incurables under mental disease, and inquire how it could be, assuming his mental integrity, that his powers of communication should have been circumscribed and restricted to the narrow limit of signifying assent or dissent to some pro- position presented to him, by some accepted sound and movement. We can imagine no other than the following possi- ble explanations why a sound, intelligent man, accident- ally deprived of the use of his voice, and his right hand, should not take advantage of the methods commonly used by persons so afflicted, except the following:— 1. The possession of an irritable, impatient temper, contrary to his natural disposition, as proved through- out in this case, and ascribable to disease, which in- duced him to set himself against any attempts to write or communicate by letters or words, and refuse simply because he ivould not, without reasons, and disregardful of consequences present or future. He would not be pestered, and plagued, and teased into writing copies, or picking out children's play-things in the shape of block-letters,—he did not please to point or have others point to the letters of the alphabet or to words of the dictionary, nor, in fact, to resort to any other process, except that of saying yes or no to questions put to him by diligent guesses as to his possible desires. The reply to any such explanation has already been suggested in part. There is proof that Mr. Parish mani- fested at times a vague, unexplained irritability, occa- sionally rising into a state of wild fury, as where he gathered a mob about him, when his wife was absent 516 a short time at the daguerreotypist's, and leading to repeated attempts to push and strike her, actions abso- lutely incompatible with the whole tenor of the man's life and being, as delineated by all who had known him from his youth to the fatal nineteenth of July, '49. But if the views of his friends concerning his state of temper after his attack, are correct, as doubtless they are, there was no such habitual condition as to make him recoil from any thing in the way of common every-day duties. He evinced, taking their account for the reality, no disposition to avoid a thousand duties, far less in importance, while equally as difficult, as certifying to his wishes respecting his estate, either in the manner intimated, or in some other method, so clearly as to leave no doubt as to his inten- tions or capacity. As before suggested, nothing but a continuous and unbroken series of monomaniacal ebullitions of temper in the one sole direction of making known his wishes, (which would of course include his testamentary dispositions,) can be conceived of to ex- plain such incapacity to communicate. Such a mono- mania may be conceived of, but there is no evidence whatever of its presence in Mr. Parish's case. If it did exist, when these codicils received their cross-mark of authentication, they should of course be rejected. 2. That Mr. Parish was suffering under a peculiar, specific condition of mind, of which some few alleged specimens are found on record in the books, where it is assumed that the intellect is clear and normal, but where the connection between the thought and the oral or written symbol, through which it is conveyed to another mind, viz., spoken or written language, is brok- en off and lost. In such cases as described, the power of receiving ideas from others by language is not anni- hilated, but the capacity to originate speech in reply— the calling up the symbols and presenting them to others—is extinguished. 517 The first objection to this explanation of Mr. Par- ish's case is, that the alleged instances of loss of power to communicate by language, while capability of re- ceiving through it continues, are not satisfactorily sub- stantiated. The assumed cases are among the rarest of the rare in the described phenomena of psychology, and these few described or reported cases come in a very questionable shape. They are confined mostly, if not wholly, to the writers on phrenology, who are nat- urally anxious to bolster up their imaginative science by any thing which looks like proof that there is a specific organ of language, and that a portion of its functions might be obliterated, without influencing the remaining organs. It never has been my fortune to witness any approach to such a condition. I never have known any one who has seen any thing nearer to it than the inability to connect here and there a word or a name with the thing signified, an occasional sequel of lesion of the brain from apoplexy. The second objection obtains in the certainty that Mr. Parish's mind was not intact and natural in all the rest of its operations. No person, it seems to me, can read over the whole detail of his actions and bring him- self to the belief that there were not wide divergen- cies from soundness, irrespective of this one point of not communicating. His random searchings, in doors and out, his eating rapidly when an evacuation was im- pending, with no intelligent way of protecting himself, his wild and indefinite wrath at various times, his push- ing his wife, &c, will all occur as proofs, at least of some mental infirmity in other directions, while the theory of this incapacity to originate language is, that it co-exists with entire mental integrity. The third objection to this theory is, that if the witnesses who think him sound are to be believed, he did originate language. Dr. Delafield testifies to his 518 originating his signature " more than once," and such a signature is several times repeated in the facsimiles; he originated the word, a most important one, too, in its connection, " wills." If such were the facts, the theory does not meet the case. So far as I have examined these unproven and, (even as dubiously reported,) most rare cases of the cas rare of medical science, the incapacity to avail one's self of language, extends also to the non-use of its writ- ten or printed forms. These cases, it should be re- marked, do not appear at all in the authoritative trea- tises, monographs, or systems of medical science. They are buried in the almost forgotten pages of peri- odicals devoted to phrenology, and in works devoted to the possible eccentricities of cerebral action. If these patients are assumed to be capable of re- ceiving written language, and their gist is in non-ability to originate alone, it is obvious that Mr. Parish did not fall at ail within the description. If there be proof that there was any degree of comprehension at all— that his faculties were not under a complete dementia, there is evidence that he did comprehend something at least, of what was written and printed. The selec- tion and reading of paragraphs in the newspapers, of the matter respecting the loan to Mr. Tileston, on the slate, and five or six times varied, of the broker's list of notes, of the footings in his bank deposit book, are all cases in point. While I am ready to show that if such a condition as that referred to, is a reality at all, it did not accord with Mr. Parish's symptoms, and while I am willing to give respectful hearing to the rarest narratives of professional experience, I cannot, even by a possible implication from my silence, permit it to be sup- posed that I have a personal belief in any such state 519 of mind as that under consideration. I can scarcely conceive of a state in which the images of things should be brought distinctly to the invalid's mind, by means of words used by another, and yet he, the recipient, should have no capacity to conceive of the language by which the same or similar images could be depicted in return. Independently of its innate impossibility, it seems to me that the cases supposed to prove its ex- istence are too few in number, and too closely connect- ed with a fanciful theory, to be accepted as at all de- monstrative of it. 3. As Mr. Parish was an aged, afflicted invalid, with trials and ailments enough to be spared any thing which was painful to him, it may be urged that so long as those around him had no doubt of his mental com- petency, it was not worth their while, nor consistent with due tenderness, to plague and harass him with attempts to make him express his mind in any manner other than that which he saw fit to adopt. If the reason was mere inertia, or prejudice, or indifference, it was kinder to indulge him, than to unduly urge him to exertions in learning to write, &c. To this I reply: the importance of his giving bet- ter evidence of his competency was felt and shown in the re-execution of his first codicil; repeated attempts were made, and that sometimes under what was evi- dently considerable irritation, with slate, paper, black- board and block letters, to induce him to express him- self; he was " coaxed" and " persuaded," again and again, but it was all in vain. It is certain, that neither of these three suggestions gives us the clue to the cause of the non-communicability of his supposed wishes, through any one of the many con- venient and certain conduits which were within his reach. It becomes necessary to consider what recog- nized condition of mental change will meet and cor' 520 respond with the indications which Mr. Parish present- ed, during the long and dreary history of his affliction and infirmity. We think we see clearly a progressive tendency of disease in the brain, commencing with vertigo (and which might have been connected with hereditary pre- disposition) manifesting itself in the slighter attacks in Europe, and coming to a climax in the overwhelming stroke of apoplexy, in July, 1849. That there were other and more extensive pathological changes in the brain than such as pure, uncomplicated apoplexy would occasion, appears highly probable. Indeed, this is nearly certain, for he had from an early period in his disease, very frequent and severe paroxysms of epilepsy. These were so well marked, so perfectly in accordance with the universally recognized manifestations of this not uncommon malady, that one is entirely at a loss to un- derstand why any question is made as to their charac- ter, or why the fits should be called " spasms," " spas- modic," or " epileptiform." They were plain, every- day epilepsy, nothing more, nothing less. There is no evidence that he was subject to epilepsy prior to the decisive apoplectic fit. There is no reason to believe that the specific cerebral lesion, which ac- counts for apoplexy, and its consequent palsy, is ever the cause of or connected with epilepsy. The two diseases co-existing, it is highly probable that an aug- menting cerebral disease, after inducing apoplexy, per- haps by increasing the circulation within the cranium, or weakening the strength of the vessels, or other inci- dental cause, went on to produce these epileptic fits. I consider that epilepsy occurring as a sequence of apoplexy, would be a most probable ground of belief that extensive disease existed within the brain. And it is hardly necessary to observe, that while some occa- sional examples of lesion, especially of one hemisphere 521 of the brain, with no mental impairment, are reported, the general law is the reverse. Where organic brain disease exists, tlie functions of the organs are impeded / the intellect is perverted or weakened. Even the continuance of epilepsy for a few years in its mildest and most uncomplicated forms, as most general experience amply shows, is not compatible with soundness of mind. The powers of observing, reflect- ing, comparing, judging, are enfeebled and lost, consti- tuting progressively the various stages of dementia or imbecility—a form of mental impairment running through a wide scale of gradations, until it terminates in almost vegetative fatuity. It is worthy of observation, as an important ground to infer the existence of extensive brain disease in Mr. Parish from a very early period, that the constant recurrence of these intense epileptic seizures did not seem, from the evidence of those who looked upon him as intelligent, to have affected his intelligence. He is represented as just the same from the first to the last. If, as is most probable, his mind was reduced to a deep grade of dementia, ever after his first attack in July, 1849, and that the belief in his having mind was due to a misinterpretation of his sounds and motions, and a self-deception in thinking they meant something, this uniform dead level, this absence of change, under fits, sometimes as frequent as every ten days for many years, is accounted for. But on the assumption that he was perfectly himself, as several of the witnesses believe, from within a few weeks after the apoplexy to within a brief period of his death—undergoing in all that time no deterioration, certainly his case is anoma.- lous and contrary to all ordinary experience. To fix upon the degree of imbecility which existed, becomes an important element in deciding upon his competency to execute a valid testamentary instru- 66 522 ment. As he could neither speak, nor write, nor com- municate, except in a method which, as we have shown, it was extremely difficult to say carried light from the mind within, and Avas most liable to induce mistake, it is scarcely practicable to say from what he actually did, how low the grade of mental power was. A pa- tient who writes disconnected, incoherent jargon, indi- cates his mental change at once ; one who has a power of ready muscular movement, may indicate his demen- tia by the absurdity and grotesqueness of his gesticula- tion, or he may show, by placing himself in positions of danger, that he is reduced below the point at which the instinct of self-preservation remains. To witness an intoxicated man dancing on a railway while the train was approaching, would leave no place for doubt as to his mental incapacity. But when an invalid is too much physically diseased to walk, when every effort at muscular motion is avoided, when, from some cause, he can neither speak, write, or communicate in any of the usual ways of such invalids, we must look at all we have—the mere passive indications, and see what they suggest or prove. As an expert in mental disorders, I am ready to stake any reputation I may have, in saying that I regard the circumstances con- nected with Mr. Parish's involuntary, disregarded evacuations, as pathognomonic of his condition. I say that the symptoms alone of a man eating his dinner with augmented rapidity, and fumbling at the same time at the opening of his pantaloons when an invol- untary faecal evacuation was about to occur, are pre- cisely such as extremely demented persons constantly exhibit, and such as no others than such demented subjects ever would manifest. Were I a priori to lay down the most significant characteristic symptom of such dementedness in cases otherwise in doubt, I could devise nothing more graphic, or more certainly de- noting that condition. 523 If demented, there can be no more sure proof that it was of that extreme grade which would allow little further deterioration. As there seems scarcely any evidence of change from first to last, it necessarily fol- lows that, if demented, it was continuous and uninter- rupted, as well as complete. Such is my full belief. And under the whole evi- dence in the case, in my opinion he never had any comprehension, clear or obscure, sound or perverted, of what he was doing when these codicils were exe- cuted, and that they do not in any sense represent any rational act of his own. LUTHER V. BELL. Monument Square, Charlestown, Mass., Sept. 5, 1857. P. S.—Since writing the above, I have been desired to look over an article in the September number of the New York Journal of Medicine, upon " the Intellectual Faculties in Cases of Apoplexy and Hemiplegia," avow- edly addressed to the present suit, and to express my opinion as to its bearing and importance. I have done so, with as much care and thorough- ness as was in my power. Arriving at the conclusion that there is nothing in its facts or reasonings to dis- turb the views which I had reached, under the direct evidence as to Mr. Parish's mental condition, I have not thought it necessary or desirable to encumber these already extended commentaries by analyzing the foundations on which its conclusions are grounded. In fact, I see no reason to differ from the writer in the conclusion to which he arrives, after a pains-taking exhumation of the multitudinous relics of European hospitals, that there are occasional examples where, after decided apoplexy, and sometimes with epilepsy 524 superadded, the patient may exhibit a good degree of mental power. I should, however, dissent from the suggestion that a careful inquisition into the mental condition of such sufferers would generally develope a less degree of im- pairment, than at first view of the external indica- tions might have been anticipated. On the contrary, I think that the physician is often amazed to find how deep and extensive is the dilapidation of the faculties, where the external manner, the effect of routinal habits and the self-deception of friends, had betrayed him into the feeling that his patient was escaping the com- mon doom ! But the spontaneous response to all the reasonings and illustrations of this paper, as to apo- plectic patients having more intellectual power than has been generally supposed, is, that whether the fact be so or not, whether the world and the profession be mistaken or not on this head, it has no possible bear- ing on the case of Mr. Parish. For he failed through- out, under any form of ingenious intonation of the same sound, of sign-making or pantomime, of acting under the request of others, and the like methods em- ployed by the various subjects of these cases as proofs of their intelligence, just as much as he did in the greater methods of speech, of writing, and of arranging the elementary letters, when offered in separate blocks, or pointing at them when in order before him. He is brought into no resemblance to or parallelism with these examples. A second and a much more important point is most amply demonstrated in the cases adduced in this paper, and especially in the last sixteen, furnished in the recent experience of this vicinity. This is the fact, that how- ever much the ordinary methods of communicating with others are cut off, the individual never fails, if he has ideas to convey, to transmit them in an iutelli- 525 gent and satisfactory manner. He may be deprived of the use of speech, of the use of hands, so far as writing is concerned, and yet leave no doubt on the minds of those communicating with him that there is a perfect exchange of ideas. The celebrated cases of Laura Bridgman and the Caswell boy, both, a while since, pupils of the Blind Asylum at Boston, both deaf-mutes and totally blind, illustrate very fully to how great a degree the ma- chinery of intercommunication may be destroyed, and yet a perfect substitution be found, so far at least as the proofs of interchange of ideas are concerned. It being then admitted, as this paper demonstrates, that if there be mind, it will not fail to give its outer manifestation, the converse of the proposition stands on the same basis. If there be no external exhibit of mind, there can be no reason to believe that the fac- ulties are other than in a state of absolute dilapidation or are absent. Bringing the case of Mr. Parish to this standard, is it not but too apparent that any power of expressing his ideas is not shown in all this seven years' history of his life, or rather of his existence ? Can any other deduction be justified than the painful one that he gave no signs of mind within, because there was no mind? L. V. B. October, 1857. OPINION I. RAY, M.D., rnysiciAN to the butler hospital for the insane ; AUTHOR OF "THE MEDICAL JURISPRUDENCE OF INSANITY." OPINION OF DR. RAY. The last Will and Testament and three Codicils of Henry Parish, de- ceased. New York : 1856,1857. Three Vols. 8vo., pp. 778, 772, 794. Having examined the testimony contained in the three volumes, bearing the above title, I have arrived at the following conclusions, respecting the mental con- dition of the testator during the period which embraced the execution of the several codicils. Henry Parish, a prosperous New York merchant, made his will in the year 1842, being then 54 years old. It is a long and elaborate instrument, distributing his property, supposed at that time to be worth about $750,000, among a considerable number of relatives, and indicating a nice balancing of their respective claims on his bounty. Having provided liberally for his wife, and distributed a large share of the estate among his kindred, he constitutes his brothers Daniel and James the residuary legatees. While in Europe, in 1843, he had what seems to have been an apoplec- tic attack, from which, however, he shortly recovered, and continued as well apparently as ever, both in body and mind, until the 19th of July, 1849, when he had another apoplectic attack, much more severe. In the course of about a fortnight, he was out of immediate 67 530 danger, but never recovered his ordinary condition. His right side (including the upper and lower limbs), was found to be paralyzed, the power of articulation was lost, and his natural elasticity and vigor were gone^ These traits continued with little or no change until he died in 1856. Within a year from the date of the attack, he be- came able to walk with a crutch, and the aid of another person, generally. It does not appear that he ever ob- tained any use of his right hand. Until within a few months of his death, he continued able to utter a few monosyllables, such as, " 0 dear," " yes," and " no," and a few inarticulate sounds. During this period he had several attacks of bodily illness, such as cholera morbus, inflammation of the lungs, abscess under the jaw, and intestinal inflammation. The functions of the bladder and rectum were somewhat disturbed, a part of the time at least, and hence arose an increased frequency of evacuating these organs. Epileptic fits occurred within a few months of the apoplectic attack of July, 1849, at intervals varying from eight days to six months or more. When not laboring under a particular illness, he sat in his library, walked to market with his servant, or drove out in his carriage with his wife, or one of her brothers. On the 29th of August, 1849, his cross in lieu of a signature was subscribed to a codicill to his will, which gave to his wife the house he then occupied, and a certain store and lot, all which had come into his possession, subsequently to the execution of the will, the house devised to his wife by the will having, in the mean time, gone out of his possession. This codicil was in like manner executed 17th of Deer., 1819. On the 15th of September, 1853, a second codicil, was subscribed in like manner, which repeats the be- 531 quests of the first, and bequeathes to his wife some $350,000 worth of certain stocks and bonds. It also bequeathes $50,000 to various charitable institutions, and revokes the appointment of Daniel Parish as one of the executors of the will, as well as the bequest to him of $10,000 as executor. On the 15th of June, 1854, a third codicil was made in like manner, which substitutes his wife in the place of Daniel and James Parish as residuary legatee. These codicils are contested in the Surrogate's Court on the ground that, when they were made, the testator had not a testamentary capacity, and the question before us now is, what was the mental con- dition of Henry Parish during the period between the attack in 1849 and his death in 1856. Paralysis, the sequel of apoplexy, is not invariably accompanied by very obvious mental impairment, but such is very frequently the case, especially after the attacks have been repeated once or twice, The occur- rence of epilepsy in the present case, subsequently to the paralysis, is an additional indication of a high degree of morbid action in the brain. Under these circumstances, therefore, some degree of mental im- pairment might have been naturally expected. The manifestations of mental impairment may not be so patent in a person deprived of the power of ar- ticulation, but they cannot easily be mistaken by those who are practically conversant with mental affections. Speech is but one means of expressing ideas and emo- tions. Signs, writing, actions, may be less perfect, but are none the less accurate or accessible. Deaf mutes are a standing exemplification of this fact. The mental condition of the testator, therefore, is to be ascertained from his acts and demeanor—by observing what he did, and by considering what he omitted to do. 532 For a few years previous to his attack in 1849, he had retired from business, except the investment of his income in real estate, bonds, mortgages, and stocks. There is nothing in this requiring much exercise of thought. The essential points in any transaction of this kind are few, easily accessible, and easily com- prehended. If he had retained his mind unimpaired, it might have been reasonably expected, that he would continue to manage his affairs in this way, especially too as it had been a favorite occupation with him. If he were competent for any thing, he was for this. He could have indicated the securities he wished to pur- chase, by pointing them out in the papers or writing the name. If he wished for commercial paper, he had only to visit, or send for, a broker, and select from his stock such as he preferred. His dividends he might have collected for himself, and the little assistance he may have needed in any of these transactions, could have been furnished by his book-keeper or some friend. With his love of accumulation, and the gratification he derived from a good bargain, he never would have delegated, in any degree, the business of investing his income, even to his own wife. It appears, however, that within a year from the attack, he gave his wife a power of attorney for selling his securities, and that she usually collected his dividends. While it is impossible to say how far his opinion was consulted in the greater portion of his purchases, it is doubtful at best whether any single transaction was entirely the result of his own free will and unguided understanding. The usual practice of his wife was to drive into Wall street with him, and there, stopping before some broker's office, to send for one of the firm, who came to the carriage, and having ascertained how much money it was desired to invest, the broker offered various notes and stocks. It is said that as these were read to him, he expressed 533 what was regarded as his token of assent or dissent. Sometimes the business was finished at this interview, at other times—and this seems to have been the more common proceeding—a day or two was taken for con- sideration, when the result was communicated to the broker by Mrs. Parish. In the latter case we have no means of knowing how much Mr. Parish had to do with the result, and in the former, his agency, even if ap- parently independent, might really have been only the expression of her wishes. There was no reason why she should interpose, except to prevent him from ac- cepting unsatisfactory paper—a contingency not likely to happen when dealing with such men as the Wards. If his sign or sound was thought to indicate a refusal of what he might as well have accepted, it was of no consequence, because there was enough more, equally good, from which a choice may be made. His assent or dissent, therefore, might have been expressed with- out the slightest reference to the quality of the paper offered, and yet the actual purchase been perfectly satisfactory. In the loans, too, which were habitually made, it is impossible to discern his controlling agency. Dr. Markoe, who hired $10,000 of his funds, says he ap- plied for the loan through Dr. Delafield, and never ex- changed a word with Mr. Parish about it, except to thank him for the accommodation. Mr. Youngs, the builder, applied to him for loans of money, but always in the presence of Mrs. Parish, and the result, whatever it was, was always by her knowledge and consent. The same is true of the loans to Wiley. One of them, it seems, was larger than the amount of his funds in the bank ; and when the fact was pointed out by his wife, he appeared to be much irritated, became "fu- riously mad," the witness said, "and rapped his hand as hard as he could on the table three or four times." 531 Mr. Tileston's account of his negotiation with him for the use of $200,000 worth of United. States Scrip, besides exhibiting the agency of others in the matter, throws much light on the question of Mr. Parish's ca- pacity. When asked on what terms he would allow the bank to place this stock in the hands of the Con- troller, he held up two fingers, which, Mrs. Parish said, meant $2,000 per annum. Then he began to manifest some uneasiness, and after repeated attempts to ascer- tain his meaning without success, Mr. Tileston was obliged to leave the transaction unfinished. Two or three days after, he was told by Mr. Delafield that Mr. Parish was not satisfied with the security, viz : the ca- pital of the bank and the liability of the stockholders for $1,200,000 more, but required the individual se- curity of the Directors. This Mr. T. declared to be out of the question, but he offered a mortgage of the bank building, appraised at $175,000. This also was declined, and further negotiation was abandoned. Now, if Mr. Parish understood the matter correctly, and the three witnesses present are quite sure that he did, the transaction shows very equivocal proof of any capacity for business; the more striking, because a few years before he had loaned the same stock for the same purpose, and security far less perfect than that now offered; and if Mr. Parish did not comprehend the matter, it shows that these witnesses entirely mis- understood the meaning of his "signs and looks. The exclusive agency of others in somejof these investments is established by the ttestimony of Mr. Kernochan, who says that Mrs. Parish often consulted him about the " investments that were being made, or about to be made." From all these transactions, I cannot resist the im- pression that Mr. Parish was no longer the same man. In all probability it was not his custom before his ill- 535 ness to consult his wife about investments, nor her cus- tom to consult others. The testimony also shows abundantly, that Mrs. Parish took a prominent part in many other matters of business, which men do not usually delegate to their wives. Mr. Kernochan speaks of their both coming to the office, and of Mr. Folsom's showing and explaining the books to Mrs. Parish. On these occasions, she com- monly spoke to him, he says, about the renting of property and the collection of dividends. In regard to much smaller matters in which he seemed to take a part, the indications of capacity are not very obvious. At one time in the summer of 1850, he was in the habit of accompanying his servant to market where he would point to various things, but no one could understand what he wanted, and if they guessed at his meaning, and sent the articles to his house, portions of them were sometimes returned as unsuitable. Austin, the poulterer, says, that on one occasion when various kinds of poultry and game were carried out to him in order that he might choose for himself, he only flourished his cane, and acted as if he were crazy. When accompanied by his wife in his visits to the market, it seems to have been the custom for her, finally, to order the dinner. Just before going to bed, he usually went to the kitchen, and ordered his breakfast, which order, as interpreted by the cook, was sometimes countermanded by his wife, and some- thing more suitable for his condition substituted. The evidence of Sammis shows that his wife regarded him as not competent to purchase his own shoes, and Jones's testimony shows the same thing in relation to his clothes. Again, it appears that during the whole period of his illness, he never played a game of whist, nor engaged in any other amusement. Now, when 536 we consider that he had of late years been passion- ately fond of whist, that it was often played by his wife and her friends in his presence, and if his mind were unimpaired, that he must have been ready to adopt any means of whiling away the tedious hours of confinement, it seems impossible to account for his ab- stinence from this game, on any theory, which sup- poses his mind to have been untouched by disease, or that its reduction could have been to any grade much above the lowest form of dementia. The knowledge of such games is among the last things that fade from the disordered mind, and in every hospital for the insane, patients, reduced to an almost vegetative existence, may be seen playing at games of checkers, or whist, if not as skilfully as in their best days, yet in compli- ance with all the rules of the game, and with more or less gratification. Among the facts which seem to be relied on as proofs of the testator's mental soundness, I need notice only some of the principal. He recognized his old friends. He went through the ceremony of taking wine with his guests. To a person standing by him in the open air uncovered, he made the motion to put on his hat. He is said to have smiled at the time when a joke was ut- tered in his presence* on one or two occasions. He would point to his head or other parts to indicate that he had pain there. When the affairs of a neighbor were spoken of, he is said to have pointed out of the window in the direction of that neighbor's house. He indicated a wish to change his clothes when soiled. One attendant says he had taught him to turn down the coverlet when he wanted the urinal. He listened with apparent attention to certain conversation, and manifested displeasure at interruption. A nurse says when the hour for taking medicine came around, he would point to the pill-box. These incidents, even if 537 correctly represented, indicate but a very small meas- ure of mental capacity. They are not incompatible with any of those forms of dementia in which every idea of cause and effect, of the value of property, of the ties of consanguinity, and the relative claims of family and friends, has long since disappeared. A few other facts of a higher character are men- tioned in the evidence, which may seem to require a more particular notice. Youngs, the builder, says that when he read to him bills for work, Mr. Parish would sometimes stop him, and look inquiringly, whereupon, Youngs would ask if he wanted any explanation, when Mr. Parish would say " yes." [The force of this testi- mony is greatly weakened, if not entirely destroyed, by Youngs himself, who says that Mr.'Parish made two sounds, uttered in quick repetition, "eh," "eh," "eh," and " nah," " nah," " nah," as he spells them, and which, he supposed, meant respectively yes and no.] The same witness says, that after some repairs of the roof had been projected but not begun, Mr. Parish would call his attention to it whenever he saw him, " by pointing upwards with his first forefinger, though it might have been two sometimes, raising his hand as high as the lower part of his face, and at the same time looking upward." On being asked if he referred to the roof, " he would nod his head ' yes.' " This piece of testimony is open to the same objection as the last— the point on which its whole value depends, is a mat- ter of guessing. Mr. Parish did not really say yes, but only something which, the witness supposed, meant yes ; and even if Mr. Parish really intended to remind him that the roof needed repairing, the fact would only show a degree of intellect far below what is required for testamentary purposes. Mr. Wiley says, that having borrowed some money of him, he handed him a promissory note; "after 68 538 looking at it, he made a motion to me, uttering a con- tinued kind of sound, putting the note on his knee, and striking it with the ends of his fingers several times, as much as to call my attention to it, I thought; I took hold of the note then and looked at it, and I saw there had been omitted " interest from date." Another note, correctly written, being given him, he looked at it as before, "bowed his head several times," and put it into a satchel. Now, even if Mr. Wiley were per- fectly correct in his conjectures respecting Mr. Parish's meaning, the fact would prove little. A man who, like Mr. Parish, had been giving or receiving such notes all his life, would readily observe so important an omission as that, if he observed any thing. It would show only one of those automatic movements of the mind, like those concerned in playing games, and implying no more exercise of thought. Again, the same witness says, "he would sit quietly on the reading of the paper, and when the price of any particular stock had advanced from the previous day's sales, he appeared to take notice of it; would rise in his chair, make a motion with his hand, and sometimes nod his head, and sometimes shake his hand, always uttering a noise." The witness thought that Mr. Parish would make no such sound, gesture, or motion when any other subject was read about. At the best, this fact would indicate only a little attention and memory, such as are generally witnessed in all but the lowest forms of dementia. The Rev. Dr. Taylor states that he administered the Lord's Supper to him at least seventeen times dur- ing his illness. He says, "his manner was uniformly devout and humble. He seemed to be always very much impressed with the solemnity of the occasion." In place of the regular responses he "made a sound of acquiescence," and with his left hand he conveyed the bread and cup to his mouth. 539 All this displays but little intelligence. Like every person born and educated in a Christian land, he was well acquainted with the ordinances of religion, and in partaking of them, no more exercise of thought was required than in partaking of his regular meals. The fact that during these six years he never en- tered a church, would seem to imply that the religious sentiment had little of that activity which might have been expected in a sane mind. The same witness states that after every service Mr. Parish gave him money from his own pocket; but this act, with the thousand others which are performed by the insane with the utmost correctness, show no exercise of the reasoning powers. Fisher says, he would put the newspaper on his knee and point to the part he wished to have read. If this were so, it would only prove that he knew how to read, but nothing at all respecting his mental capacity. Without noticing other acts of a similar character, many more of which appear in the evidence, let us see what inferences may be drawn from the manner in which he was managed by his family and attendants. Wingrove's description of a morning's operations— of his motions with his hands and head, his " yanne, yanne, yanne," his searching his wife's wardrobe, though assured that it contained nothing belonging to him, his taking up his pantaloons one after another, putting them to his mouth, and repeating his custom- ary sound, "yanne, yanne, yanne," of his visit to the market, where he would sit in a chair, and take the game handed him, and put it to his mouth as he did the pantaloons—strikingly illustrate that mental de- crepitude so frequently the sequel of paralysis. Many other scenes in his domestic life tell the same story. Clark, the coachman, who was in his service during 540 the whole of his illness, says it was his custom to visit Mr. Parish in his room, every morning, between nine and ten o'clock. " I would go in," he says, " he would nod his head, a smile on his countenance, and then he would up one finger or two, and say, 'nea, nea,' or ' aney, aney,' to know how the horses were ; then he would hold up the fingers again, just repeat it; then I would ask him if it was about feed ; I would tell him the horses were very well, and I had plenty of feed ; then I would say, ' Good-bye, Mr. Parish,' and then he would nod his head, a smile on his countenance, and say, ' Neay, neay, neay,' as much as to say/ Good- bye ;' I took it for that." Henry Delafield says that it was his custom to drive out with him on Sundays, and that when they drove down town, the carriage would stop near his stores in Wall, Pearl, Water, and Pine streets. " He would point at the building ; then look- ing at me inquisitively, I would ask him if he wished any information about the building; he would say, yes; I would then tell him the building appeared to be in order and all occupied." Mr. Wiley says, that when he visited him at Hell Gate, as he often did, " I would recount the business of the day in the city, such as I would think would be interesting to him." " How long a time," he was asked, " would you spend in talking with him ?" " From two to five minutes," was the reply. The only possible theory whereby all these indica- tions of mental infirmity can be explained consistently with the supposition that his mind was unimpaired, is, that being unable to express his thoughts by means of speech, he necessarily appeared deficient in understand- ing. This theory receives but slender support from the facts in the case, and the general experience of men. Let the question be put to any one in the full possession of his faculties: ' Were you to be suddenly 541 deprived of the power of speaking, and of the use of your right hand, your mind remaining unaffected, do you suppose that, for six or seven years, you would continue as incapable of making known your thoughts as Mr. Parish was ? ' There certainly would be but one answer to that question. A tolerable facility of writ- ing with the left hand could be obtained by a little practice, and in the mean time a dictionary, block letters, hieroglyphics, and maps would enable him to convey his meaning without fear of mistake. Every day would also witness an improvement in the use of signs and gestures. In every actual case of this de- scription on record (i. e. mere loss of speech), so far as I know, the integrity of the mind was shown either by what the patient did, or by the ideas communicated in the manner here mentioned. In one, the patient, a collector of taxes, pursued his customary duties; in another, a blacksmith went to his shop, and gave di- rections to his workmen; in another an old gentleman continued to enjoy his game at whist as much as ever.* The facts that through this whole period of six years or more, Mr. Parish never wrote, unless, indeed, it might be that he wrote his own name, in a few in- stances ; that his signs and motions were very few, and not one of them having an unmistakable meaning ; and that notwithstanding his great desire, at times, to make known his wishes, he frequently failed, much to his own discomfort and irritation, render the conclu- sion unavoidable that his mind was reduced to a very low grade of dementia—that state in which its opera- tions consist of a few feeble, disjointed efforts of per- ception and memory. His whole pantomime consisted * For cases of this kind, see Pinel, Sur VAlienation, 90 ; Kay, Med. Jurisprud. of Insanity, p. 163 ; Cooke on Nervous Diseases, p. 246, Boston ed., 1824; Ed. Phrenological Journal, II. 410; do., III. 316; IX. 17; IX. 471; X. 352. 542 of a nod and shake of the head, and a motion in which he raised his left hand, (with two fingers point- ing upwardjmd the rest closed on the palm,) towards his mouth, and finally rested his fingers upon his teeth. The nod and shake of the head were supposed by some to indicate assent and dissent, and his communication of ideas was confined entirely to making one of these motions in reply to any question whatever. Thus every thought or wish attributed to him originated with somebody else. This, of course, might not be objectionable, necessarily, provided there could be no doubt respecting the meaning of these motions, and also that the questions were clearly understood. Ker- nochan and Folsom, however, state that the same ques- tion repeated after a short interval, or in different terms, elicited both the nod and the shake. Jones, the tailor, makes a similar statement. In regard to the motion of the hand, Kernochan says that those about him supposed that he meant by it to invite suggestions, or gain information, but that he could never make that out with any certainty. In reply to Mr. Tileston's proposition to hire his U. S. stock, it seems that he made this motion, or something very like it, where- upon Mr. Tileston says, " I believed that he intended to convey the idea that he required $2000 per annum for the loan of the stock, which was confirmed by Mrs. Parish saying that that was exactly what he intended to convey." Gibson states that when he solicited from him a subscription to some charity, he made this motion, and that Mrs. Parish, who was present, immediately asked if he meant $200 ; to which he as- sented, bowed his head. By some of the witnesses it was stated that he, at times, said, " O dear," and " yes," and " no," quite distinctly; but Kernochan, who visited him more or less frequently, during his whole illness, says that he 543 never heard him utter an articulate sound. He was in the habit of making a few inarticulate sounds, always repeating them rapidly, but as each witness expresses the sound in his own way, there is some doubt as to their number and identity. As written by them, they are " yanne, aney, yah, neay, jey, yet, nay, nan, nin, niah, nich," and some others. The first five or six were probably the same sounds differently rendered by different persons, and by some supposed to express assent. This, certainly, was not always their meaning, for some of them were used when he was irritated; and at other times, the same sounds were uttered when he was under no excitement. Some of them were re- garded by some of the witnesses as equivalents of yes or no, but they seem to have been used at times when he was supposed to have the power of uttering dis- tinctly those words. It is certain that the nod and shake of the head were not always accompanied by any sound, articulate or inarticulate. The most proba- ble conclusion is, that these inarticulate utterances had no meaning at all, but were merely ejaculatory sounds accompanying the feeling or emotion of the moment. On the question of Mr. Parish's mental capacity, these signs and sounds are not without great signifi- cance. Considered under any possible aspect of the case, it is quite impossible to believe that a person in the full possession of his mind, though without the power of speech or of his right arm, would not, during the space of six or seven years, have acquired greater facility in the communication of his ideas. The moral traits which made their appearance after the attack are also very significant in this connection. Some degree of irritability is not an uncommon sequel of paralysis, and does not necessarily imply intellectual 544 impairment. But in this case there was a kind of petu- lance and of anger, never exhibited in connection with soundness of mind. It was not merely excessive and frequent, but irrelevant and puerile. It was the anger of a child, and signified as plainly as any other fact in the case, that the manly, vigorous, and well balanced mind of Henry Parish had been reduced by the shock of disease, to a lower level than that of the feeblest child's. Dashing at and striking his wife, with other manifesta- tions of childish displeasure, seem to have been a fre- quent incident, and many witnesses speak of his exhib- iting irritation when the people about him failed to ascertain his wishes. The scene at Root's, where the violence of his movements attracted the attention of the passers by, and occasioned solely by his wife's not returning to the carriage the moment he expected her, was a striking illustration of this trait of disease. And so was his conduct with the box, as related by Dr. Markoe. On this occasion, after much questioning, which failed to elicit his wishes, his wife asked if he wished her to get a certain box, "and as soon as this suggestion was made to him, he assented to it most vehemently." Accordingly, the box was obtained from the bank and placed in his lap, but, says the Doctor, " he was very much displeased with something con- nected with the presentation : the box was not opened and was conveyed back to the bank that same after- noon." Another witness present says he threw it upon the floor, and pushed it about with his hand. Is it possible that a person of sound mind, or any mind at all, would indulge in such conduct as this? Exceed- ingly anxious to obtain his will, and when, after much trouble, he has succeeded in getting it within his grasp, he dashes it upon the floor unopened, and cares for it no more! It would appear that many persons of intelligence, 545 education, and knowledge of the world, who visited Mr. Parish more or less frequently, came to the con- clusion that his mind was not materially impaired, that he understood any proposition made to him, and was capable of transacting business. The fact may be easily explained without discredit- ing their honesty or sagacity. They arrived at their conclusion through^ series of errors, both of fact and opinion, which any one might readily commit who had no practical knowledge of abnormal states of mind. To form a correct opinion in a case of doubtful sanity requires, in addition to this kind of knowledge, a mind free from bias, and full opportunities of observation. Few, if any, of the gentlemen who have borne testi- mony to the mental capacity of Mr. Parish, possessed these qualifications. They called on him, some for business, and some for old acquaintance sake. They were impressed, in the outset, with the idea that he labored under no other disability than the loss of the power of speech; and for the most of them, if they entertained any suspicion of the correctness of this impression, it would have been neither convenient nor proper, to test the measure of his capacity by ap- propriate means. He greeted them with a look of recognition, and perhaps a shake of the hand; they put to him questions respecting his health or a matter of business,—to these he replied by a motion of the head, to which they very naturally affix the same meaning that they would to a similar motion in any other person; any doubt on the point is removed at once by the suggestions of others, who are supposed to be familiar with all his signs and sounds, and per- fectly to understand their meaning, and they go away quite satisfied that he understood every thing they said, and was capable of understanding a great deal more that was not said. The conversation, if such it 69 546 might be called, was confined, with one or two excep- tions, to simple ordinary matters which required no exercise of thought, and which were within the com- prehension of any degree of mind not unequivocally imbecile. Matters of some moment, requiring some effort of the reasoning powers, such as testamentary dispositions would imply, were never introduced. It will be observed that these persons also com- mitted the common mistake of supposing that if Mr. Parish understood the terms of a question, he neces- sarily understood its merits. This is not true of sane people always, while nothing is more common among the insane than expressions of assent or dissent in reply to propositions far beyond their comprehension. In every institution for the insane, may be found patients with the dress and deportment of gentlemen, going through all the little commonplaces of life wi h unex- ceptionable correctness, but ready to assent to any proposition, however absurd. Without the careful ap- plication of some test, most persons would conclude that these patients, who replied so promptly with a yes or no, to the questions asked them, really understood the subject talked about. Thus, when asked to purchase the paper of a cer- tain mercantile house, Mr. Parish might have recog- nized the name, estimated the sum correctly, and been conscious that a bargain was to be made, without having any clear idea of the standing of the house, the nature of the security, or the actual value of the paper. In deciphering the meaning of such signs and sounds as Mr. Parish used, in his interviews with these gentlemen, it is obvious there would be much room for the play of the imagination. Even careful and cultivated minds might easily be led astray by some casual bias, and thus have mistaken their own fancies 547 for actual facts. Mr. Isaac H. Brown, in describing one of his interviews with him, says that he held up his hand with the two first fingers crossed, signifying, as he understood it, that he wished Mrs. Parish to give him (Brown) ten dollars. Mr. James Watson Webb says that, on meeting him once and referring to a for- mer acquaintance abroad, he burst into tears, which he (Webb) supposed was produced by his inability to speak. The Ptev. Dr. Taylor speaks of his "sensible and intelligent replies," and Major Delafield of his " complaining of his sight," and of "his eye beaming with intelligence." So difficult it is even for the most honest and sagacious, to refrain from mixing up their own inferences with the impressions that are made upon their senses. During the period in question, Mr. Parish was attended by several physicians for some bodily ail- ment, and these gentlemen, though not professing to be particularly conversant with mental disease, and though at the time of their professional attendance they made no investigation of the point, were re- quested, on their examination before the Surrogate, to state their opinions respecting his mental condition. Their opinions are entitled to most respectful consid- eration, but can claim our assent only so far as they are supported by facts. Whether a certain person is sane or insane, imbecile or demented, is a question not to be decided by vague impressions, or a superficial observation, but by facts sufficiently numerous, defi- nite, and clear, to admit of but one construction by those who are qualified by their studies and experi- ence to appreciate them properly. Dr. Johnston, who visited him professionally from the beginning of the at- tack till the 27th August next, thought he understood the questions put to him about his ailments, but he de- clined to express any opinion respecting his mental 548 condition generally. Drs. Wilkes, Dubois, Markoe, and Delafield, who visited him more or less frequently (the two latter during the greater part of the period in question, and the two former during a few weeks only for affections of the eyes), concur in the opinion that his mind was unimpaired by his disease. The kind of facts which lead them to this result has been already indicated and examined. They adduce noth- ing stronger. Indeed, few of those facts were wit- nessed personally by any one of these gentlemen, and the only ground on which they can claim some confi- dence in their opinion must be that impression which was made upon them by signs or sounds that cannot well be imitated, or by facts which, while they might be well enough described, might be differently inter- preted by others. It cannot be denied that this may be legitimate ground for an opinion. Facts which in- dicate little or nothing to one person may be pregnant with meaning to another. Still they should be facts, and admit of an accurate description, otherwise the opinions that are founded upon them cannot obtain the confidence of others. Such facts, though they be more significant to one and less to another, will at last be appreciated at their true value. Dr. Markoe states that at an early period he and Dr. Delafield recognized the importance of the question respecting Mr. Parish's mental condition, and that they had several consulta- tions about it, and yet, in reply to the question, "did you ever make any examination of Mr. Parish, or ap- ply any test to him, for the exclusive purpose of ascer- taining the state of his mind," he says, " I never did in any shape or way." This is to be regretted. Many insane persons are free enough in their communica- tions to render experiments and tests unnecessary, but Mr. Parish's case was just one of those where the spon- taneous manifestations are so obscure and uncertain, 549 that nothing less than a course of systematic observa- tions, managed expressly for this purpose, could have established the fact of his mental soundness against all the presumptive evidence to the contrary. The Dr. puts it forth as one of the grounds of his opinion, by implication, at least, that Mr. Parish "possessed the faculties of memory, perception, comparison, judg- ment, and in fine, all the ordinary faculties of the mind." What is meant exactly by this last phrase is not very obvious, but surely it cannot be denied that all the fac- ulties here mentioned are manifested more or less in almost every form of mental derangement, including even imbecility and dementia. The fact proves noth- ing as to the soundness or strength of the mind. In any case of doubtful mental condition, the question at issue is, not whether the patient possesses these fac- ulties, but whether they exist in their normal state. Dr. Delafield also states that he never applied a test ex- pressly for the purpose of ascertaining Mr. Parish's mental condition, for the reasons that he had no doubt about it, and that every visit he made was a test. Such reasons are calculated to produce surprise rather than conviction. Dr. Delafield must be aware that in any scientific inquiry the object is to obtain a degree of proof satisfactory, not only to the inquirer himself, but to every one else. He is quite sure, no doubt, that Mr. Parish could read, but the fact is disputed by others, and yet how easily it might have been placed beyond the reach of contradiction by some simple test. We are therefore forced to conclude that the medical testimony, laboring as it does under these defects, can- not affect any position respecting Mr. Parish's mental condition, which the other testimony warrants us in taking. Before closing my remarks on the medical testimo- ny, I would advert to Dr. Markoe's explanation of Mr. 550 Parish's inability or unwillingness to learn to write, though perhaps there would be no danger of its pass- ing for more than it is worth, even if left unnoticed altogether. It seems that within a few months after the attack, various trials were made to teach Mr. Parish to write with his left hand, but beyond perhaps writing his name wholly or partly a few times, nothing was accomplished. After a number of trials, estimated by Dr. Delafield at from five to twenty, he refused to proceed, and at no subsequent time were the trials re- sumed. This unwillingness to persevere in the attempt to obtain a means of communication, which would have been of inestimable value, is attributed by Dr. Markoe to " his early discouragement acting upon a somewhat peculiar temperament." This explains nothing. It only substitutes one difficulty for another. The proper question is, why a man like Mr. Parish, naturally of a strong will and much firmness, and supposed to be in full possession of his mind, on finding himself deprived of the power of speech, should become so easily dis- couraged in attempting to learn what was so neces- sary, not only to his interests but to his hourly conve- nience and comfort. Any one who will make the experiment will find that it is not impossible to write with the left hand, even at the first attempt, and that a little practice will enable him, as it has many others, to write with considerable facility. Another and an insuperable objection to Dr. Markoe's theory is, that it does not explain Mr. Parish's unwillingness to make up words by means of the separate letters of the alphabet on cards. This device was tried after the attempts to induce him to write were abandoned, but with no better success. He would not try to use them, and refused to have any thing to do with them. I find it impossible to account for his refusal to avail himself of so simple and easy a means of communication, upon 551 any theory which supposes him to have been able to read, and competent to the transaction of the very smallest matter of business. Unquestionably he was easily dis- couraged, and the cause of it is obvious enough. The same stroke which shattered his intellect, also deprived him of his firmness, his perseverance, his resolution, his manliness, and, in respect to all these qualities, reduced him to the condition of a child. This state- ment is confirmed on almost every page of the testi- mony. Every witness who saw much of his daily life, and some who saw but little of it, speak of his frequent tears, his petulance, his freaks of ill humor, and his gusts of passion, characterized in every instance, by extreme puerility. How much of this unwillingness or inability to learn is fairly attributable to discourage- ment, is not very obvious. It scarcely required the resolution of a child to construct words with the sepa- rate letters of the alphabet, and his refusal to make the attempt, admits of no other explanation than ex- treme insensibility to the importance of the object— an explanation utterly incompatible, of course, with the measure of understanding which is claimed for him. Enough has been said, perhaps, to prove the men- tal impairment of Henry Parish during the latter years of his life, but it may be proper also to scrutinize the performance of those acts which are the subject of the present contest. Here, if any where, we ought to meet with unequivocal traits of a judgment and saga- city equal to the occasion—unquestionable proof that he fully understood both the terms and the merits of the various testamentary dispositions which he adopted. They might counterbalance many facts of an opposite character observed under other circumstances, if not turn the scales decidedly in his favor. The actual facts, however, are of the same complexion as the rest. 552 Mr. Lord, who prepared all these codicils and wit- nessed their subscription, says that in each instance he reoeived the necessary instructions, not from Mr. Par- ish, but from another person deeply interested in their provisions, and present on the occasions when the various dispositions were discussed and adopted. Each particular provision was read aloud, and Mr. Parish was asked if he acknowledged that as a part of his will. He replied by nodding or shaking his head, im- plying thereby assent or dissent, and that provision was retained or rejected accordingly. These motions were accompanied by a sound represented as being, on the occasion of the second codicil, a pretty distinct yes or no, but on the occasion of the first, they were supposed to be only an attempt, scarcely successful, to imitate these words. By the second codicil he gave to his wife various stocks, most of them then standing in her name, having been purchased by the receipts from his property since his attack, and also a considerable sum to various charitable institutions. Considerable difficulty occurred, ostensibly, in perfecting the differ- ent arrangements according to his wishes. When de- sirous of making a communication, the usual practice was resorted to of mentioning interrogatively various things, and if the right one happened to be hit on, it received his assent, and was supposed to express his will. It was not until after several interviews and much ineffectual questioning, that this codicil was finally executed. Mr. Lord observing that this new arrangement of the property would place Mr. Daniel Parish in an awkward position, as one of the executors, he suggested the revocation of his appointment as executor, and of the legacy of $10,0C0 that accompa- nied it. This suggestion was adopted. At the re-exe- cution of the first codicil, Mr. Lord was told by Mrs. Parish, that Mr. Parish wished to revoke the legacies 553 to his nephews and nieces, but he says (although Mr. Parish assented to it in the usual way) that he dis- suaded her (Mrs. Parish) from pressing it, because it would fatigue and disturb him, and might as well be done at some other time. "In this he (Mr. Parish) acquiesced, with an expression rather of pain or re- gret." At the making of the third codicil, between three and four years after, the same suggestion was made again, and again Mr. Lord dissuaded, telling Mr. Parish "that would be harsh." A careful examination of the circumstances connect- ed with the preparation and execution of these codicils reveals some incidents strikingly incompatible with soundness of mind. At the execution of the first codicil, and also at its re-execution a few months afterwards, neither the will nor a copy was before them. This, certainly, is not the way such things are usually managed, and it ap- pears still more strange, when we bear in mind that either just before its execution, or between it and the re-execution, Mr. Parish was supposed, by those around him, to be exceedingly anxious to get possession of his will; yet when the box containing it was placed in his hands, from some unaccountable caprice it was thrown upon the floor, and returned to the bank un- opened. Such conduct admits of no other explanation than that of insanity. The fact, too, that it was left for Mr. Lord to sug- gest the revocation of the appointment of Daniel Parish as executor, shows a dulness of perception that could hardly have been expected from Henry Parish in the normal condition of his mind. Then again, his course respecting the proposed re- vocation of the legacies to his nephews and nieces de- serves attention. At the making of the first codicil he is, apparently, very desirous of revoking these legacies, but is easily diverted from his purpose. Four years 70 554 after, when he is engaged in making new dispositions of his property, (having in the mean time allowed it to pass over in silence,) he again reverts to it, and is again turned from it by Mr. Lord. Now all this a per- fectly sane man might do, but in one of doubtful sanity, and surrounded by those whose interests were advanced by these contested changes in his testamen- tary dispositions, it certainly has a very suspicious appearance. Again, it is not denied that every item in these contested codicils originated in the mind of some one else, though sanctioned and adopted ostensibly by him. This, too, might occur with a testator of unimpeach- able soundness, but when we bear in mind that Mr. Parish was undeniably unable to communicate his wishes in regard to any person or subject, unless such person or subject were first mentioned to him, then it is obvious that these codicils might have only very partially expressed his will—namely, just so far only as others chose to help him to express it. True, this may not have vitiated these codicils necessarily, but, under all the circumstances of the case, it must weaken our confidence in his testamentary capacity. It may be contended, perhaps, that even if a con- siderable amount of mental impairment were proved, he might still have retained mind enough to constitute what the law regards as a testamentary capacity. What this is exactly, has never been authoritatively decided, but it is a favorite doctrine of courts, that, in case of mental decrepitude, much less capacity is re- quired to make a will than to make a contract, and that, in the exercise of the testamentary privilege, men's minds are not to be too accurately gauged. As the recognition of a pretty general fact, there can be no objection to the doctrine, but to apply it as a uni- versal rule, without discrimination, would be unphilo- sophical and unjust. 555 In a case of admitted mental impairment, where the extent of that impairment is involved in doubt, certain other considerations should have place in deciding upon the validity of a testamentary act disputed on the ground of incapacity in the alleged testator. Some wills require more capacity than some con- tracts ; and many a man who might be able to sell houses or lands, with a tolerable understanding of the matter, would be quite incapable of making a pro- per and judicious distribution of a large estate among a considerable number of relatives, friends, and public institutions. So, too, the same understanding might be adequate to one description of will and not to an- other. A man having a small estate, and no relatives besides his wife and a single child to leave it to, might be safely trusted to indicate the proportions he would wish them to have, who would be utterly incompetent to devise his property under a wholly different state of circumstances, large and complicated possessions, and multitudes of relatives with very unequal claims on his bounty. The only practical principle is, sufficient capacity for the occasion, and that implies, in the tes- tator, a memory strong enough to bring before the mind all the various persons who would naturally be remembered on such an occasion, judgment enough to discriminate fairly between their respective claims on his bounty, together with a knowledge of the value of property and the relations of numbers. And inas- much as the moral sentiments are often weakened and perverted by the same disease that enfeebles the intel- lect, it is also required that his own proper intellectual discernment should appear by affirmative proofs, un- affected by the direct and special influences of others holding at the time a relation to the individual which made him dependent upon them for every thing, es- pecially if such others are wholly or mainly interested in the contested act. 556 That Mr. Parish had not sufficient capacity for the occasion, according to the requirements above men- tioned, is, I believe, abundantly shown by the facts in evidence, and already referred to concerning the tes- tamentary acts and his ordinary mental manifestations. The conclusions to which 1 have been led by a careful examination of the evidence in this case, may be summed up in the following propositions: In consequence of the apoplectic attack of 1849, the power of speech was lost, and the mind was greatly impaired during the rest of his life. This impairment was sufficient to render him in- capable of any transaction requiring any exercise of thought. The codicils in question disposed of large amounts of property in various ways, and required, in a much higher degree than can be supposed to have been pres- ent, the exercise of memory, judgment, and discre- tion ; an appreciation of the numerous claims on his bounty, and a knowledge of numbers and quantities. The mental powers here indicated were not po- sessed by Mr. Parish subsequent to the attack in July, 1849, and consequently these codicils, so far as they exhibit any of these powers, express, not the will of Mr. Parish, but the will of other persons, and are there- fore invalid. I. RAY. Butler Hospital, Sept. 1857. APPENDIX. Dr. McCready on the Intellectual Faculties in Apoplexy and Hemi- plegia.—New York Journal of Medicine, vol. III. p 203. Dr. M'Cready thinks that intellectual impairment is not so frequently a sequel of paralysis and apoplexy as 557 it is generally supposed to be, and so quotes from various writers all their cases, (50 in one, 17 in ano- ther, 9 in another, 8 in another—84 in all,) to show that in two only were there unequivocal proofs of in- tellectual impairment. From these facts he concludes that " any impairment of mind as a direct consequence of apoplexy, after the patient has recovered from its primary effects, must be an exceptional occurrence," (p. 217.) Whether intellectual impairment is or is not a frequent result of apoplexy, is a question that has little practical bearing on Mr. Parish's case, so long as it is admitted that it does sometimes occur. It may be doubted, however, whether Dr. M'Cready's conclu- sion is strictly warranted by the cases he relates. They occurred, for the most part, in large hospitals, where hey were treated as subjects of disease, not of psycho- logical investigation. No particular pains were taken to ascertain the mental condition, because that had very little to do with the cause or the cure. Consider- ing that a casual visitor to a lunatic hospital would fail to discover the nature or extent of the mental disease in a large proportion of the patients, it could hardly be expected that the physician of a general hospital would be able, in the hour or two devoted to some hundred patients, to investigate very closely a trait of disease having no remedial importance. He comes to the bed of one recently stricken with apoplexy, and finds him either comatose or not. If not comatose, if he looks up when spoken to, answers questions about his feelings, asks for food, knows his friends, &c, the fact is noted by such expressions as these, "he retains his senses," "his intellect is perfect," " his understand- ing is unaffected," &c, &c. These expressions in the reports of these cases signify merely that the patient does not happen to be comatose,* and nothing can be * If the medical gentlemen who reported these cases had been called L. 558 more unwarrantable than to suppose that they signify any thing more. Such an inference would be as well founded as that of an official inspector of a public insti- tution in Massachusetts, who, in the course of an annual statutory visit to the McLean Asylum for the Insane at Somerville, with some other functionaries, ran up to the Governor, who was one of the party, exclaiming— "I have found a half a dozen people here unjustly confined. I have been talking with them, and they are no more insane, may it please your Excellency, than you or I." Persons much conversant with mental diseases have abundant opportunities of seeing how fallacious are these, bed-side observations respecting the actual con- dition of the mind. A case in point is now under the charge of the writer, and, as a specimen of a class, is worth noticing. II. B., aged 40, organist and music- teacher, was attacked with acute dementia in the spring of the present year. He continued, with little or no apparent change, till September, when he had a stroke of paralysis. After lying insensible and unconscious several hours, he began to come to himself, and, the next day, seemed to have regained his usual condition. He recognized every body, described his sensations, and conversed with his friends on family matters, pleas- antly and appropriately. The lower extremities only were paralyzed, and the organs of speech were unaf- fected. Here the evidence that the mind was unim- paired was as much stronger than it was in any of Dr. M'Cready's cases, as spoken words are more reliable to the stand as witnesses, and asked the direct question, as to general men- tal capacity, which was put to Dr. F. U. JohnstonJ in this case, they would, no doubt, in nearly every instance, have answered, as he did, " My opportunities [of observation] were very limited. * * He appeared to understand simple questions regarding his health. / cannot say that he might not have understood questions equally simple regarding other affairs." (vol. II. f. 413.) 559 than any interpretation of another's signs and gestures, and the casual observer would have said that the mind was all right, and yet it was obvious enough on a little investigation, that this man was incapable of making a will, or doing any other business correctly. He had no sense of time, and in the middle of a bright day would inquire whether it was morning or evening. The day of the week and of the month he never knew, though repeatedly told. One day he received a visit from his wife and her father, but the next day, though he remembered the visit of his wife, he denied that he had seen his father-in-law. When it was pro- posed that his clergyman should visit him, he assented very cordially, and the gentleman came. The next day the following colloquy occurred in his room:— " Well, Major, what did the priest say to you? " He wanted me to confess my sins, and I have no sins to confess. I never did any wrong." " What is his name?" "I don't know; he was a humbug; he was no priest." "Why, it was Father L." "No such thing, doctor; I know Father L. I played the organ in his church. He was a humbug." Though con- scious that he was very ill, he never asked to see his family, and gave no directions about his affairs. Now, as cases are frequently observed and reported, this patient would probably have been represented as un- impaired in mind, especially if his speech had been lost, and he had resorted to signs. This case presented another feature, after the par- alytic attack, of some interest in the present inquiry. On many subjects he conversed, for a few moments, intelligently and pertinently ; he had the air and de- meanor of a gentleman, and he observed tolerably well the little proprieties of life. As far as the train of thought was mechanical, so to speak, he got on pretty well; but the moment any effort was needed, his mind 560 utterly failed. He would assent to any proposition, or dissent from it, according to the form of the question. For instance, " Major," (he had held a commission in the French army, under Louis Philippe,) " you were in the battle of Waterloo, I believe?" "0, yes, I was there." "In Jerome's division, in the assault on Hougoumont." "Yes, I was with Jerome." "But, how could that be, Major ? The battle of Waterloo was fought before you were born. You could not have been there." "0, no, I was not there." The mental impairment following paralysis, it must be borne in mind, consists, not in delusion or extrava- gance, but in a loss, greater or smaller, of the natural power of disperning the relations, of cause and effect, of perceiving remote relations and consequences, of comprehending ideas beyond the ordinary routine of thought, of estimating the value of property and the claims of different individuals. It is obvious enough that the casual inspection of a paralytic can throw no light on such a condition, if it be at all doubtful. Of all the cases quoted by Dr. M'Cready not one presents satisfactory evidence, or indeed any evidence at all, besides the bare assertion of the reporter, that the mind remained unimpaired. The case of the gentle- man who wrote for the papers after his attack, might perhaps be an exception to this remark, did we know exactly his mental calibre before the attack. Dr. M'Cready next relates a considerable number of cases, from which he draws the following conclu- sion : "In all the cases that have come to my knowl- edge, as well those recorded by others as those that are here given, where hemiplegia, with loss or perver- sion of the faculty of speech, has been unattended by coma or delirium, there is no evidence whatever that the intellect had been materially weakened. * * * So uniform is the testimony in these cases, that it 561 would seem as if the absence of speech in similar in- stances must be looked upon as prima facie evidence of clearness of understanding." Of course, the practi- cal inference is, that Henry Parish's intellect was unaf- fected, because the attack was followed by inability to speak!!! Dr. M'Cready relates eleven cases of paralysis without coma or delirium, characterized by loss of speech, in which, as he alleges, there was no intellect- ual impairment. The proofs of the latter fact are open to the objections already offered in regard to the cases quoted by hospital writers, but as these cases are re- lated at some length by Dr. M'Cready and his friends, as if they possesed considerable importance in this con- nection, it may be well to see precisely what these proofs are Of Pendergast, (p. 227,) it is said, "by this time, she had recovered her intelligence so as to indicate her wishes, and understand what is said to her." At a subsequent period, it is said, " her intellect is per- fectly clear; she remembers my former care of her, and told me by signs when she saw me first; her mem- ory is clear regarding all the events of her sickness, now of about twenty months' duration. She has con- certed signs, so that by her fingers and otherwise, she makes those about her understand her meaning. When I did not comprehend her, she would call on the nurse or house-physician to interpret for her. * * * Her perception is quick, her memory of things entirely un- clouded, and her judgment perfectly sound. * * * She devises a hundred gestures and attitudes to ex- press her thoughts, so as to leave no doubt on the mind of any one who sees her, that her intellect is en- tirely free from any embarrassment." This woman could say no, and after many attempts and much urg- ing, succeeded in writing her christian name. Now 71 562 the intellectual manifestations in this case, separated from the construction put upon them by the reporter, refer only to her wants, and those simple things which an idiot even would notice and comprehend. There is not offered the slightest proof that she retained her original power of comprehension; nor, perhaps, is there any proof to the contrary.* Of Dr. Whiting's case, (p. 229,) it is said, " per- ception and understanding seemed unimpaired," but no proof whatever of the fact is given; on the contrary, the presumption is all the other way. True, it is also said that the only word he could utter, begum, he gave "a great variety of meanings to," "rendering clearly, through its aid, by change of intonation and of the force of utterance, together with the expression of his countenance, and the gestures of his right arm, recog- nition, inquiry, pain, anger, assent and dissent." All this remarkable power of pantomime may have existed —though it certainly looks as if the imagination of the reporter was responsible for the most of it—but it may well be doubted if it indicated much mind, when we read that he had "paroxysms of rage which increased in frequency," and that " his anger was particularly excited against his wife, and against a physician who approached his bedside, with whom he had previously had a quarrel," "and that he laughed violently at jests, and seemed indifferent at the announcement of the probably fatal issue of his disease." In Dr. Goddard's case, (p. 229,) it is stated that his family and friends regarded his intellect as unim- paired ; that " he can, not only comprehend questions of ordinary import, but those also involving business matters, and requiring the connection and association of ideas; in short, he can reason correctly and well." * See in Dr. Watson's opinion, page 305, how completely Dr. M'Cready Las mistaken the facts of this woman's case, and her actual ailments. 563 And yet the report speaks of his " inability to com- municate his wants," and, in fact, it appears that all their inferences respecting his understanding were derived from his assent or dissent to questions—a very unreliable source of information. Here again we cannot help seeing the force of the reporter's im- agination, which sees the power of reasoning correctly and well, in the simple replies of yes or no, to the reasoning of others. In Dr. Parker's first case, it is said, "his intellect seems entirely unaffected," but no reason is given for this conclusion, except that he read and wrote. In Dr. Parker's second case, (p. 230,) the same conclusion was drawn, but the patient could not write, and nothing is said about his signs or gestures. In Dr. Ogden's case, (p. 231,) the evidence of any degree of understanding is stronger than in the cases already noticed, but the intellectual manifestations were confined to very simple matters. No attempt was made to ascertain the exact measure of his ca- pacity. In the Irishman's case, (p. 232,) it is stated that he " seemed to understand what was said to him," and subsequently, he told the reporter " that his mind was perfectly clear " on the morning of the attack, when he replied, to every question put to him, something about "circumstances." In Kehoe's case, (p. 234,) the patient walked about the room, carrying his slate and pencil with him, and, by writing, asked and answered questions. This comprises every thing on the subject of his in- tellect. In the case of the physician, (p. 235,) it appears that, during the first few days, he managed to commu- nicate his thoughts, and, the report says, "was as sound in mind as ever in his life." No reason is 564 given for this opinion. Subsequently—third day from the attack—he tried to write, without success, and the next day, it is stated, "he seemed to recognize every person who came into the room." On this, and the next preceding case, no comment is necessary. No ground for any opinion, one way or the other, is furnished in the report. In Mr. K.'s case, (p. 238,) it is stated that, five weeks after the attack, "he could attend to his busi- ness as usual." Shortly after, his speech became more indistinct, but his family thought his mind perfectly clear. The reporter adds, "So far as an hour's exam- ination would enable me to judge, through its imper- fect modes of expression, it was far from being evi- dent that it was not." In another passage, he admits that, " in such a case, there is great difficulty in ascer- taining whether the mind is enfeebled or not, for the physician must first become acquainted with the pa- tient's new language of gesture, expression of face, and attitude." In Dr. White's case, (p. 243,) there was probably no appreciable mental impairment. The patient was able to speak, so as to be understood, after some fa- miliarity with his manner of speaking, and thus he convinced the reporter that "his opinions were sound, and his memory remarkably accurate." He was also found to be clear in money matters. These cases, thus scrutinized, certainly do not sus- tain the proposition of Dr. M'Cready, that the loss of speech, as a sequel of paralysis without coma or de- lirium, is prima facie evidence of clearness of under- standing. And were the proofs of mental soundness in these cases as strong as he supposes them to be, the only legitimate conclusion which they would warrant would be—what nobody ever doubted—that paralysis is not always followed by mental impairment. Whcth- 565 er, in any given case, it is or is not so followed, is a question that can be settled only by a thorough and sagacious investigation of that case itself. And for this purpose there is needed some knowledge of men- tal infirmities, some skill in eliciting mental manifesta- tions, much opportunity and patience, and, above all, a spirit of philosophical inquiry that discerns the proper object to be sought for, and shuns all hasty, superficial methods of obtaining it. As a contribution to our knowledge of apoplexy and paralysis, this paper of Dr. M'Cready is not without much value, but in re- gard to this particular point—the real extent of men- tal impairment produced by those diseases—it is worth little or nothing. He, no doubt, thinks that, in all those cases where, in his opinion, no mental impair- ment occurred, the evidence was perfectly satisfactory. Dr. M'Cready has a right to his opinion, but unless the evidence is satisfactory to others, they will claim the right to differ from him. If any one is led by this paper to suppose that the medical profession have always made a great mistake in supposing that the mind was apt to suffer in para- lytic attacks, let him refer to the reports of cases that have been adjudicated in courts of lawr, where the ex- istence of mental impairment was established by the most reliable method of eliciting the truth—a judicial investigation. "For this purpose, see Clark vs. Fisher, Paige, Chancery Rep. I. 171; King & Thwaits vs. Farley, Haggard, Eccles. Rep. I. 502; Marsh vs. Tyr- rel, Haggard II. 84; Croft vs. Day, Curteis I. 782. I. RAY. Butler Hospital, October, 1857. OPINION OF SIR H. HOLLAND, Bart., M.D.,F.B.S. OPINION OF SIR HENRY HOLLAND, Bart., M. D. I have attentively read and considered the evi- dence in the Parish Case, down to the date of May 16, 1857 (page 159, Vol. III.), and with more particular care the medical evidence brought forward ; being de- sirous, as far as possible, to limit myself to inferences drawn from this portion of it.* For the same reason I shall seek, in stating my opinion, to adhere as closely as I can, to a medical view of the points involved in the case. The main point in question obviously is, the ca- pacity of Mr. H. Parish, subsequently to his paralytic and other cerebral attacks, to comprehend, and trans- act such matters of business as those of the three codi- cils, added to his will ? In the absence of personal observation on the case, I do not think myself entitled to answer this question in any other way, than by giving my opinion as to his condition of mind during the period of time, as I de- rive it from the evidence before me. Upon this evidence, carefully considered, I cannot hesitate in expressing my. distinct belief, that Mr. Parish's habitual state, subsequently to the attack in July, 1849, was that of great mental imbecility—the effect of this attack succeeding to the slighter one in * The only evidence bearing on the mental condition of Mr. Parish subsequent to page 157, vol. III., is that given by James Campbell, page 659, Stephen Sam- mie, page 568, and William J. Jones, page 576 ; three witnesses produced by the contestants. Their testimony is strongly against the testator's capacity. 72 570 January—of the epileptic fits which followed—and of the other less defined seizures, intimations of which appear in the evidence. Admitting fully the greater difficulty of judgment, depending on the loss of clear articulate speech in Mr. Parish's case, the reasons which impress me with this decided conviction are mainly the following: Having in an active practice of forty years, seen and noted very many cases, in which successive para- lytic and epileptic attacks were conjoined, I do not recollect a single instance amongst these, in which the intellect was not more or less impaired, and very serious- ly impaired, when the epileptic fits were as frequently repeated as in the present case. I find from the evidence of Dr. Delafield, (page 654, Vol. I.,) and other witnesses that these seizures were at one period (I believe in 1850 and 1851) as frequent as two, three or four times in the month, and occasionally of such severity, as to give immediate alarm for life. And though less frequent at a later period, they continued to recur at intervals till the time of his death. I may repeat that I have never known a case, approaching even to this, in which the intellect has not been seriously affected and impaired. Though these seizures are generally in the evidence called "spasms" or "convulsions," I cannot for a mo- ment doubt their being epileptic in the received medi- cal understanding of the term. The descriptions given of them (particularly in pp. 512 and 711, Vol. Z, and p. 497, Vol. II.) distinctly characterize them as such. The manner of the attack coming on—the aspect of the convulsions, and their duration—the biting of the tongue—and the state immediately ensuing on their cessation—are all marked proofs to this effect. And not less so, the fact stated by Dr. Delafield and other witnesses, that an increased irritability of mind oc- 571 curred for some time, even days, before such seizures, with removal of this augmented disorder in sequel to them. This is well known as a common character of epileptic cases. The various disordered habits of the nervous sys- tem to which Mr. Parish is shown by the evidence to have been subject, (such as hysterical sobbing and weeping, sudden fits of irritability, odd gestures, sounds and tricks,) are precisely those which are com- mon where the mind has been weakened by paralytic and epileptic attacks. The mechanical character of his more general habits—even of many which are referred to by wit- nesses as proofs of intelligence—must here be noticed. Looking broadly at the evidence, I think it to be shown that the intelligence exercised by Mr. Parish himself, apart from all suggestion, had relation chiefly to physical wants and comforts, or to what had been, or had become, the diurnal habits of his life. With every allowance for the defective power of speech and bodily motion, it is obvious, as I think, that his habits and practices were to a great extent of the automatic kind; not going far beyond the acts common in the idiotic state, which in various respects they may closely resemble. One of the strongest proofs of imbecility of mind, I consider to be his inability to convey his thoughts or feelings, even when most earnest to do so, save by two or three half-articulate sounds, or by gestures which are interpreted for him—with the further fact, that even these feeble means of communication were little varied or rather deteriorated than improved as time went on. Put the case in its simplest and most dis- tinct form. If Mr. Parish's intellect had been unim- paired, what was there to prevent his finding a substi- tute for speech, by other modes of communication with those around him ? The use of the right hand, indeed, was also absent, but far greater difficulties than those are overcome, where the mind is not altered or enfeebled by disease. The mere want of power of articulate speech is not in itself alone a proof of want of intelligence ; though doubtless when long contin- ued, it concurs with other circumstances, in indicating some condition of cerebral disease. In simple cases of paralysis, speech is often lost for a time without any, or with very little notable impairment of mind. In a volume I published on " Mental Physiology" I have mentioned the case of a lady in whom the intellect was but slightly enfeebled, but whose whole speech was confined to the single monosyllable uyes." I at- tended an eminent public man in this country, in whom, after a third attack of paralysis, the power of utterance was limited (and so continued until his death about a year afterwards) to a succession, often rapid and eager, of inarticulate and unintelligible sounds. In both these cases (though in the second the age was much more advanced and the mind more weakened) there was the effort successfully made, to open and use other ways of communication. And the same result I have seen in other instances more or less analogous to these. I cannot but regard as singularly unsatisfactory that portion of the evidence which relates to the trials made to engage Mr. Parish to write,put together letters, or otherwise facilitate the expression of his feelings and wishes. I do not find proof any where that those means were adequately employed, considering the im- portance of the result sought for, and the same remark applies, as I think, to the means used to test his clear comprehension of things put before him. But even under this insufficiency of the trials made, I believe if his mind had not been already impaired and imbecile, 573 that he would certainly have availed himself of means derived from his own suggestions, for readier inter- course with those around him. I have now stated the points which have mainly guided me in forming my judgment on Mr. Parish's case. Though I seek to limit myself as far as possible to a medical view of it, I cannot forbear stating an impression I derive from the general tenor of the evi- dence, that the witnesses at large and especially those who were in closest and longest contact Avith him, deal with the case, as if they felt there was imbecility of mind as well as body. I mention this impression, but do not dwell upon it, for the reasons of limitation I have before named. I am better authorized, as a matter of medical opinion, in expressing my regrets that no post-mortem examination was made in this case. I am well aware of the difficulty in the present state of our knowledge, of substantiating any exact relation between mental disorders and organic lesions, or morbid appearances of the brain; but nevertheless such relations do ex- ist and in many instances (and very especially in those where paralytic and epileptic seizures have oc- curred, and been frequently repeated) can distinctly be detected. In the present case, without venturing to affirm it, I should undoubtedly, as a result of ex- perience, have expected to find some obvious condition of cerebral disease ; seeing the repetition of the apo- plectic and paralytic seizures, the frequency of the epi- leptic attacks, and the permanent loss of the power of speech. HENRY HOLLAND, M.D. Brook Street, London, June 26, 1857. NOTES IN REPLY TO AN ARTICLE ENTITLED "THE PARISH WILL." The manuscript volume, entitled "The Parish Will," which has been submitted to me for examina- tion, I have read with as much care and attention, as time and the urgent duties of my profession would permit: and I am led, from my examination of its con- tents, to believe that its author has never made him- self acquainted with the whole of the evidence which has been taken-before the Surrogate, bearing upon the mental condition of Mr. Parish. He has not attached his name to his performance, so as to authenticate it as the production of a physician, willing to hold himself responsible for the truth of the opinions which he advances. The work itself, however, affords sufficient evidence that its author is a well-edu- cated physician. And from the frequent repetition of the initials, A. C, scattered through the notes which accompany this volume, I presume that the gentleman to whom these initials apply is the author of the work. In the course of my remarks, I shall, therefore, speak * of him as such. Dr. A. C. then has, in this volume, undertaken to pronounce upon the mental condition of Mr. Parish, while yet unacquainted with certain facts of importance in relation to Mr. Parish's case; and it is not surprising 576 that, in speaking of Mr. Parish's ailments, he has made assertions which, by the evidence, are shown to be in- correct. He argues upon premises which cannot be admitted ; and he omits facts which can be supplied by the evidence, and which, when supplied, overthrow some of his most striking arguments and assumptions. Hence it is that his reasoning, however ingenious, and his professional acquirements, however great, have been brought to bear upon the question of Mr. Parish's men- tal competency, to very little purpose. He begins by asserting that " The prominent fea- tures in Mr. P.'s case were hemiplegia, or loss of the power of motion in one side, and loss of speech. For the first six years all other symptoms and physiccd manifestations seem to have been accidental, and unim- portant in considering the probable state of his intel- lectual faculties." (page 3.) Now had Dr. A. 0. carefully considered the evidence given by Dr. Delafield, he would have known that " all the other symptoms and physical manifestations" ■weve'not accidental, but were dependent upon the same cause as the hemiplegia and loss of speech. " He had a number of attacks," says Dr. Delafield, " distinct from the general disease, but tl^e most frequent dependent upon its cause; or, in other words, dependent upon the condition of the brain which led to the disease." (See the printed evidence, v. I., f. 2070.) Again, had Dr. A. C. carefully examined the evidence given by Dr. Markoe, he would have found that the disease of the brain which induced the hemiplegia and loss of speech, was the controlling difficulty in Mr. Parish's case up to the very last hours of his existence. " The last sick- ness," says Dr. Markoe, " occupied in its invasion and threatenings several weeks : in its serious aspect, prob- ably not more than a fortnight. The illness seemed to be congestion of the lungs, as a main feature: it was a 577 complicated disease, however, depending, I should say, as tee supposed, upon the condition of the brain" (II. f. 1990, '1.) Thus it is, that Dr. A. C, at the very onset, has fallen into error from his own inattention to the facts of the case. His effort is here, evidently to prepare the reader far looking on«fche epileptic attacks to wliich Mr. Parish was subject—as something apart and acci- dental. For in the very next passage he refers to these. But the "physical manifestations," and "the numerous distinct attacks," to which Mr. Parish was subjected, were not all which Dr. A. C. should have associated with the organic disease of the brain, as im- portant " in considering the probable state of his intel- lectual faculties." He should not have overlooked the very grave consideration that from the moment of the severe attack in July, 1849, Mr. Parish was no longer intellectually or morally the same as formerly. He un- derwent a total change of character; and, to use the very expressive words of Mr. Folsom, he never after- wards came to himself. For an account of the total change that overcame Mr. Parish in this respect, I must again refer Dr. A. C. to the printed evidence, or to the analysis of it, which, so far as it relates to what Mr. Parish was before the attack in contrast to what he was after it, I have given in the volume of Medical Opinions upon the mental capacity of Mr. Parish, (from page 13 to page 16, and from page 35 to page 40.) "He had," says Dr. A. C, "a series of convulsions, but it does not appear that these exercised any unfa- vorable influence on his mental state." (p. 3.) Here again is an assumption. This point I have already dis- cussed in the volume of Opinions, and it is only neces- sary here to say that these convulsions had an imme- diate dependence upon the organic disease of the brain 578 which lay at the foundation of all Mr. Parish's ailments ; that the frequent recurrence of these convulsions, in their severer as well as in their mitigated forms and threatenings, was a continual source of aggravation to the cerebral disease which gave rise to them at first, and that in their reaction upon the brain they had a direct and permanently de%terious influence on the mental condition of Mr. Parish. In judging of the effect of these convulsions it will not do to compare Mr. Parish's condition during the erethism or excitement which usually preceded each attack with the state of quiescence which immediately succeeded it. This, how- ever, is what Dr. A. C. would have us do, or what he would have us very erroneously infer from the evidence of Drs. Delafield and Markoe. The effects of the con- vulsions of which we are to judge, are those which are left permanently upon the individual, mentally, mor- ally, physically; his gradual deterioration in propor- tion to the persistence and severity of the epilepsy as a continuous and ever present malady. Again, on the subject of these convulsions, Dr. A. C. remarks: " If they depended on cerebral disease, it will be necessary to reason that that disease, what- ever its nature, was steadily improving through several years, inasmuch as these convulsions grew less frequent, and finally may be said to have ceased." (Page 3.) In reply to this passage I would say, in the first place, that the periodical recurrences of convulsions were but the open manifestations of epilepsy as a continuous and persistent malady which showed itself at other times in other ways, as in vertigo, sudden flushing of the head and face, paroxysms of ungovernable ill temper, and nervous agitations and irregularities too varied and numerous to be conveniently specified. But I hold that the convulsions in their severer form cannot be truly said to have ceased in the case of Mr. Parish, ex- 579 cept with the cessation of vitality. They continued to manifest themselves at longer or shorter intervals up to the last year of his life, and during the long period of his ailment they usually recurred several times each year, but how frequently we have not the means of determining accurately. The medical evidence on this point is unsatisfactory and insufficient. Dr. Delafield states that he never saw Mr. Parish in a fit, and Dr. Markoe witnessed these fits but rarely—probably not more than four or five times. (Evidence, II.r f. 2031 '33.) But we ascertain from Dr. Delafield that Mr. Parish was, ever after the severe attack of July, 1849, subject at irregular intervals to spasms, which made it " impossible to leave him alone, as a general rule." (I., f. 2091.) And from several of the nurses we ascertain that these fits were so common, and so much a matter of course, that they were managed by the inmates of the family without calling upon the physicians, except on occasions during which the paroxysms were of more than ordinary severity. And as for the minor attacks, the anomalous indications of nervous irregularities— those which, as a whole, the French medical writers have called ule petit mal," in contradistinction from the severer convulsive paroxysm which the same writers call " le grand mal"—they were throughout the whole period of Mr. Parish's ailments, of continual recurrence. But in the second place, it is not correct to assume that, because the violent convulsions were less frequent in the last year or two of life, the organic disease of the brain upon which they depended was in progress of amelioration. Indeed it would be proper to infer the very reverse of this. The lengthening of the intervals between the paroxysms, whilst the other symptoms re- mained fixed and Unmitigated, only shows that the brain had, from the protracted irritation to which it was subject, at length lost much of its reactive force, 580 and was now more rapidly than formerly yielding to the process of decay ; that the irritating cause which might at the onset have been of limited extent within the skull had now become widely diffused, and had led to the general prostration of nervous force, and that this general prostration had replaced to some extent the irregular reactive force which gave character to the convulsive paroxysms. Among surgeons it is well known that a minute splinter of bone pressings upon the brain will excite convulsions; and that a large fragment of bone, when pressed inwards upon the brain, will give rise, not to convulsions, but to hemi- plegia, stupor, and total loss of consciousness. The fact that the general convulsions had been of less frequent occurrence in the last year or two of Mr. Parish's life, has been noticed by Dr. Ranney, a gentleman more conversant with the anatomical appearances of the brain among those who die of mental alienation and of epilepsy than any other individual in this country; and he has very justly remarked upon it that " convulsions of this character are usually less frequent as softening advances, the pressure of the foreign substance becom- ing less immediate on portions of the brain yet retain- ing excitability. (Opinions, p. 396.) Again—" Regarding the nature of this lesion, there will," says Dr. A. C, " probably be little difference of opinion beyond the question whether it was apoplexy or softening of a portion of the brain. That it was one or other of these diseases, will not admit of any rational argument," (meaning, I presume, any rational doubt) " But," continues he, " it is important to remark here, that those who find it necessary to argue that the dis- ease was softening of the brain, for the purpose of de- monstrating the mental incapacity of Mr. Parish, sub- stantially abandon the medical probabilities, and, them- selves, prejudge the question in favor of the intelligence, 581 should it be shown that the disease was apoplexy'" (p. 3-4). Here, it will be readily observed, Dr. A. C. has become very ingenious. He would limit the terras of the discussion as to the anatomical chances that had taken place in Mr. Parish's brain, and force us into the acknowledgment that there could have been but a single elementary form of disease present, and that form either simple softening, or simple apo- plexy. But Dr. A. C. is sufficient of a sportsman to know that " In sight of any bird the fowler spreads his net in vain." We need not again argue this question— For, in the first place, we do not know what was the exact condition of Mr. Parish's brain. Had a post-mor- tem examination of it been made, we would have had something to rest upon in this matter. But this was not made; and it is folly to argue about a question which mere words can never determine. But judging from the symptoms to which the cerebral disorder gave rise—from their persistence, severity, and deplorable consequences—we are able to infer that the disease was as incurable as the symptoms to which it gave rise ; that it must have been of an organic character; that the work of disorganization within the skull must have been wide-spread; and that is about all that we need at present admit in regard to it. But it is here proper to remind Dr. A. C. that, in assuming the disease of the brain to have been either apoplexy alone, or soft- ening alone—he has run counter to the evidence of Dr. Delafield, who admits the probable coexistence of both of these forms of disease in connection even with other anatomical changes. For, in speaking of the intellectual dulness, which he admits to have been apparent towards the latter part of Mr. Parish's life, he says: "The clot of blood which was probably left in the substance of the brain in his original attach, may have eventually so far 5S2 involved a large portion of the brain by softening and otherwise as to produce the effect in question (I. f. 3304). But 1 have elsewhere shown that the changes of which Dr. Delafield here speaks must have occurred, if at all at a much earlier period than he supposes, and in the strength of his " otherwise" we are at liberty to suggest that there might have existed in connection with the diseased changes above specified several other compli- cations. As the growth of a tumor, chronic menin- gitis, thickening and irregular adhesions of the meninges, false membranes, induration of the cerebral substance) atrophy, sub-arachnoid effusions, or effusions of watery fluid in the ventricles, or several of these in combina- tion, most of these and other changes which may be classed among the organic diseases of the brain, often do coexist with apoplexy and softening, and may even, where these latter do not exist, be mistaken for them. Within the past few weeks I have had occasion at a public meeting of the New York Pathological Society, to exhibit the brain of a man who had been under the professional care of Dr. Ranney ; he had been an epi- leptic for about six years, hemiplegiac, speechless, and imbecile, but able to walk with the aid of a crutch, and his whole condition during his illness had more closely resembled that of Mr. Parish, than any other case I ever met with either in practice or in reading; and in this patient the disease of the brain, which had, during life, been ascribed to apoplexy, was found to be a tu- mor imbedded in, and growing from, the cortical sub- stance on the anterior portion of the left hemisphere, which tumor had led to softening so extensive as to in- volve nearly the whole of the left hemisphere, but in the midst of which the white matter of the anterior and middle lobes had been to a considerable extent destroyed and replaced by a chronic absoess which was filled to distension with a greenish jelly-like purulent 583 deposit. There were traces of chronic inflammation and partial disorganization within the left ventricle most marked on the surface of the corpus striatum. The ventricles contained about two ounces of turbid watery fluid, and there was also considerable watery effusion beneath the arachnoid membrane in the immediate vi- cinity of the tumor. The optic nerves were both somewhat atrophied, the olfactory nerves were also wasted. The substance of the right hemisphere was slightly indurated, but in other aspects, so far as the eye and sense of touch could discover, it appeared to be uninvolved in the organic disturbances. Among the medical gentlemen who had an opportunity of witness- ing these appearances, I may specify Dr. Alonzo Clark, Dr. Benjamin W. McCready, and Dr. Markoe. Thus far our notes and comments have been con- fined to Dr. A. C.'s introductory observations. After completing these, he proceeds to his investigation some- what more in detail, and under numerous distinct heads—throughout the whole of which it is hardly ne- cessary to follow him. In his first of these separate sections, or divisions of his memoir, he treats of " apo- plexy" in the abstract. The next is headed, " The At- tack and Disease" in which, after a very unreliable sketch of Mr. Parish's ailments, he propounds his own theory of the case, saying, " We have here an apoplexy in the second or middle degree of severity, and it will be difficult for human ingenuity to make more or less of it" (page 8.) In reply to this I would observe, in the first place, that human ingenuity can in no one way alter the facts, and that it is by the exercise of such ingenuity that Dr. A. C. has so much overshot the mark in his efforts to mask some of the broadest features of the case which he has undertaken to explain. . But as to Dr. A. C.'s theory itself, I may remark, that it is not con- sistent with the evidence of the medical attendant, Dr. 584 Delafield, as I have already shown ; and what is per- haps quite as much against it, this theory of " apoplexy in the middle degree of severity," is not sufficient to ac- count for the phenomena of the case, either before the severe attack of July, 1849, or afterwards. Dr. A. C.'s next section is devoted to " the convul- sions" in which he undertakes to show that these, in the case of Mr. Parish, were not depending on soften- ing of the brain. His ingenuity is here again remark- ably conspicuous, but it is all thrown away. Nothing but the post-mortem examination could have settled that question. And the scraps of extracts from sundry authors, however much they may have convinced Dr. A. C, instead of throwing light upon the case, serve only to mystify it. He is pleased to think that, in order to show that Mr. Parish was incompetent, it is neces- sary to prove the existence of softening of the brain, and that the only way, too, of determining this, is by the character of the convulsions. Here are his words: " The hypothesis must rest then on the occurrence of the convulsions. It must be remembered, that these were not the lateral convulsions, which are enumerated among the symptoms of softening, but convulsions af- fecting both sides and all parts. No partial convulsions are known to have occurred at any time " (p. 12). Now, in reply to this, I would say, that it is not essential to softening of the brain, that the convulsions should be partial or one-sided. In Dr. Ranney's patient, whose brain I have already spoken of, the convulsions were of the usual type of ordinary epilepsy ; and I hold it im- possible to determine, in the majority of cases, without a post-mortem examination, the exact condition of the brain. The patient to whom I have alluded had gene- ral convulsions; had hemiplegia of the right side ; was unable to speak beyond a few simple words, which he pronounced imperfectly; and his ordinary vocabulary 585 was limited to " aye," and " nye," and an occasional " Oh, dear." His sight was dim, but he could see suffi- ciently well to distinguish large letters. He often shed tears; he was at times docile and indifferent; at times, headstrong, passionate, and ill-natured. He was willing to try to write with his left hand, but he was unable to do so. He could be readily imposed upon by any per- son wishing to take advantage of his situation. He had been in this condition, with frequently recurring and violent convulsions, for nearly six years. He had not some of Mr. Parish's physical infirmities ; he could con- trol his evacuations. He was cleanly in his habits ; he could wait upon himself, dress himself, and walk alone with the aid of his crutch; he could recognize what was doing and what was said by those about him, and give a proper response to any simple question ; but he was nevertheless hopelessly demented; and, notwithstand- ing the fact which Dr. A. C. urges, in reference to par- tial or one-sided convulsions, as indicative of softening of the brain, the convulsions were of the ordinary epileptic type, and yet the great mass of the left hemisphere of the brain was found in a state of " softening." It is not necessary, in my own view of Mr. Parish's case, to deter- mine whether he had or had not softening of the brain in either of its distinctive forms, as a simple and uncom- plicated affection; and yet I may assert, that if any well informed reader will take the trouble to examine the extracts which Dr. A. C. in his notes has borrowed from Rostan, Andral, and other writers, and compare these with the established facts of Mr. Parish's case, he will be more ready to admit, that many of Mr. Parish's symptoms find easier explanation, on the supposition that they depended on softening of the brain, than upon what Dr. A. C. calls " apoplexy in the second or middle deo-ree of severity." But in the second place, how has Dr. A. C. discovered that Mr. P. was not occasionally 586 subject to what he calls lateral convulsions i There is no denial of any such convulsions in the evidence. He had at times partial and incomplete attacks ; and the medical witnesses, as I have already shown, were in- competent to give evidence as to the character and frequency of the attacks; so that there is quite as much reason for asserting that Mr. P. had these lateral con- vulsions, as that he had not; and I am disposed to think that circumstances are rather in favor than against the supposition that such attacks were of frequent oc- currence. Dr. A. C. is aware of the opinion of Rostan and other authors in regard to the permanently deleterious and destructive influence of softening of the brain upon the intellectual faculties; and he is aware, too, that these authors speak of vertigo among the characteristic symptoms of cerebral softening; and in order to maintain the opinion that Mr. Parish had not soften- ing of the brain, he undertakes to tell us that Mr. Par- ish was not subject to vertigo or any of the usually accompaniments of vertigo. " He had neither head- ache nor vertigo, nor numbness, nor increased [sensibil- ity, with pain in the affected limbs; nor diminished sensibility, nor creeping sensation, nor twitchings, nor early contractions, nor convulsions confined to the af- fected side," etc. (page 11.) Now, if Dr. A. C. had made himself familiar with the evidence, he would have known that there are therein contained certain facts, which give the quietus to much that he has assumed in this fine passage; for it is well established that Mr.' Parish was subject to vertigo and its concomitant symp- toms for years before his violent attack, and had he been, after that attack, able to describe his feelings, there is little doubt that he would have made complaint of the same symptoms in a more aggravated form. I need not go over the statements of the several witnesses 587 /ho have alluded to the^ symptoms in question. A ummary of them will be found in the volume of Opinions, page 10 to 13 and page 29 to 35, and what are not there enumerated, will be supplied from the evidence of Drs. Delafield and Markoe, from that of Mr. Kernochan, and from that of the nurses. The ver- tigo, the determination of blood to the head, the numb- ness or diminished sensibility, and the twitching, are expressly stated. The others are all either stated, or, from their usual association with the conditions of the case, we may infer that they were probably present. One of the nurses, in paring Mr. Parish's nails, states that he would at times draw blood without giving pain or awakening consciousness of suffering. As to the creeping sensations, these might readily have been over- looked in one unable to describe his feelings; and then we must remember how readily these may be mistaken for the signs of an intermittent; and that Mr. Parish was under treatment for what was supposed to be an intermittent, not long prior to his violent attack. (II. f. 1970.) But to continue the citation: " His paralysis," says Dr. A. C, " did not gradually increase, involving part after part, and steadily increasing in the parts affected, till it arrived at its height; the progress of his disease was not essentially continuous and increasing; his gen- eral health did not steadily decline," (page 11.) Grant- ing, for the sake of argument, that all this is correct, what then ? " These," he tells us, " are the symptoms of chronic softening," (p. 12.) But what if the softening proceed, in a short space of time, a few days or weeks, to its stage of complete disorganization ? What would then be the character of the symptoms, should the pa- tient, as in the case of Mr. Parish, survive the attack \ But these symptoms are not essential to chronic soften- ing. In his quotations (Note A), he has already 5S8 learned, if he was not already aware of the fact, that in such cases, sometimes "the change is sudden; some- times this change consists iu simple hemiplegia." Again, if the remark that " the progress of his disease was not essentially continuous and increasing," is to apply to Mr. Parish, we may ask what does this signify ? But was not his paralysis continuous ? His loss of speech continuous ? His epileptic tendency continuous ? Were not all the symptoms that depended on the disease of the brain continuous ? And if at any time the irrita- bility of the brain was so exhausted and enfeebled that all these symptoms were not apparent, or on the in- crease every moment, it is only because they are never so in any chronic ailment whatsoever. At page 12, Dr. A. C. says, "It becomes necessary to regard general convulsions in softening of the brain, as nothing less than a fatal symptom announcing the near approach of death." But I have already shown that this is not true in all cases. lie may have met with something in Rostan to justify him in this remark. But the quotation from Rostan will not alter the facts. In the acute softening of the brain which occurs in hy- drocephalus, or dropsy of the brain in children, the re- mark may apply with a good degree of force. But there are exceptions even here to all such general rules. It is hardly worth while to comment upon what Dr. A. C. has stated in reference to the duration of chronic softening of the brain as an argument against its existence in Mr. Parish's case. In the case to which I have already alluded, which had been under the care of Dr. Ranney, the disease appears to have existed nearly six years, and in Mr. Parish a few months longer. In children and in persons of middle life, the disease may pursue a rapid course. But the duration of the dis- ease is no argument against its existence. It is in this manner that Dr. A. C. resorts to every means in his 589 power to persuade us that Mr. Parish could not have had softening of the brain ; and in closing this part of his argument, he says, " There is, then, in truth, not only no ground, but really no apology for the hypothe- sis, that the disease from which Mr. Parish suffered was softening of the brain" (p. 14). This conclusion may be all very satisfactory to the mind of Dr. A. C.; but it is, nevertheless, contrary to the evidence fur- nished by Dr. Delafield, as we have already shown. It is, after all, nothing more than a conjecture which may or may not be true; and, whether true or not, it is not established by any argument advanced by Dr. A. C. His next succeeding sections are headed " General Health," " Causes of the Convulsions," " Sequel of Mr. Parish's Disease," " The Intellect in Softening of the Drain." In certain passages of these we again discover that Dr. A. C. has not been thoroughly informed of all the circumstances of Mr. Parish's ailments ; and his ever-watchful anxiety to persuade us that in Mr. Parish's case there was no softening of the brain ; and having, as he appears to think, allayed all fear on this point, he ventures to be particular on another. For, on page 19, he actually gives the heading of a new section in the following terms: " The Disease was Apoplexy, in or near the Corpus Striatum of the Deft Side." Here he has in view the doctrine of the modern physiologists in reference to the functions of the sen- sory ganglia, and the recent work of Todd, who in his Clinical lectures has attempted to apply this doctrine to the study of the diseases of the nervous system. But it might have been as well on the part of Dr. A. C. to speak with as much reserve as Dr. Todd himself has spoken. There is nothing gained by hardy guess- ing. There was a time when "the Divining Rod" was looked upon as a scientific instrument for discover- 590 ing hidden springs of water. But we have no divining rod for detecting those internal springs from which the hemorrhage escapes to give rise to a clot of blood within the skull. We may, as I have elsewhere stated, reach to something like conviction that the hemorrhage of an apoplexy is in one great division of the brain rather than in another. We may infer this from our knowledge of its relative frequency in one part rather than in another, and from our knowledge of the func- tions of the several parts ; but, after all, we cannot be very definite, except by mere guess-work. But Dr. A. O, as already said, is very precise in fixing the exact locality of the hemorrhage, forgetting the words of Todd, while he is attempting to imitate him. For even Todd, in his guessing, found himself at fault when he came to confirm his opinions derived from symptoms with the actual appearances discovered after the death of the patient, and hence his following observations to his students: "In making the diagnosis in this case, you will remember that I spoke with confidence re- specting the nature of the disease, but hesitatingly as to its locality. The various segments of the encephalon are so closely connected with each other by commis- sural and other fibres, that the parts in the immediate vicinity of the diseased part sympathize with it to a very great extent—almost as much as if they were themselves diseased. 'Hence it is very difficult, and sometimes impossible, to distinguish disease of the optic thalamus from disease of the corpus striatum, the intimate union of these two bodies causing a close sympathy between them : for this reason, lesion of the hemispheres, if situated close to the corpus striatum, gives rise to symptoms similar to those which would arise from disease of that body itself: and for the same reason, deep-seated lesion of the cerebellum causes the same symptoms as would be caused by lesion of one 591 side of the pons varolii. You will not wonder, then, that it is exceedingly difficult to diagnose the "exact locality of cerebral lesions. Certain broad distinctions may be sufficiently accurately made with due attention to the general principles which physiology points out as to the functions of great subdivisions of the brain ; but I look upon it as impossible to determine the po- sition of cerebral lesions with that minuteness and ac- curacy with which we can discover the locality of lesions of other organs—the lungs, for instance."— (Todd on the Nervous System. Philadelphia reprint, page 45.) Dr. A. C, in connection with the quotations on the subject of apoplexy which he embodies in Note I, makes some comments on the condition of the braiu in this disease. Through these it is not necessary to fol- low him further than to observe, that an apoplectic effusion of blood is rarely a primary or simple lesion. When not the result of injury, it is almost invariably the sequel of pre-existing pathological changes; and, when the extravasation actually does take place, it almost invariably acts as a source of further disturb- ance, and nearly as much so to parts not in its im- mediate vicinity as to those in the midst of which we happen to discover it after death. Medical writers, for the sake of orderly description and study, may speak of simple elementary changes of any sort, as *• existing alone; but the bed-side practitioner knows the exact worth of such descriptions; and knows, too, the difference between talking of diagnosing a simple lesion, and actually making the diagnosis, clearly and unmistakably, in the midst of the complications that take place between the several forms of elementary lesions in cases as they present themselves to him in daily practice ; and to no other part of the' body will these remarks apply so properly as they do to the dis- 592 eases of the brain. Dr. A. C. tells us, under a par- ticular heading, that " Apoplectics who survire the immediate effects of the hemorrhage, most frequently die of some disease of the lungs? (Page 18 Addendum.) Apoplectics often die, too, of recurrences of the attack, and they may die of any other ailment. But death by disease of the lungs is a very common termination of all chronic maladies, not even excluding such as result from external injuries, and is as common in these as in apoplexy. To follow Dr. A. C. through some of his other sec- • tions, would be to repeat much that has been already stated either in the present notes, or in the volume of Opinions. Thus, the section headed " The Mental Ef- fects not equal to the Paralysis" will find explanation in the Opinions. And that headed " Dateral Convul- sions in Apoplexy, but not in Mr. Parish's Case" has already been answered in these notes. But on this topic I may here remark, that Dr. A. C. appears to have associated lateral convulsions with permanent rigidity and contraction of muscles, and to give them the same pathological significance. But Todd, whom he cites at this point, appears to have reference to the latter changes, and not to convulsions. But the con- traction and rigidity usually occur where the cerebral disease is deteriorating slowly towards disorganization of the brain, and occur before that disorganization has been completed. Where the disorganization comes on rapidly they are not among the usual attendants. The convulsions on one side simply indicate irritation on the opposite side of the brain, or its envelopes of that side. In connection with Dr. A. C.'s section of " articu- lation," without repeating what has been stated on this subject in the Opinions, I must here remark that the tongue is not so essential to speech as is commonly sup- 593 posed. The vocal cords at the top of the larynx, the hard and soft palate, the nostrils, teeth, and lips, all perform their part in the act of speaking. The tongue may not merely be paralyzed, it may be actually cut out, and yet the individual who has an intelligent mind, and unimpaired body in other respects, may still speak well enough to be understood. " Such examples," says John Mason Good, " indeed, are not very common, but they seem to have occurred in all ages, and especially when it was the barbarous custom among the Turks, Goths, and other half-civilized nations to cut out the tongues of the unhappy wretches whom the chance of war had thrown into their hands as prisoners." " Hun- dreds of cases," says he, " might be quoted upon this subject," but he is contented to cite but three, one of these from the Ephemerides Germanicce, one from the Memoires de I'Academie des Sciences for the year 1718, and one from the Philosophical Transactions between the years 1742 and 1747. The first was the case of a boy whose tongue had been destroyed by mortification, and who was able to talk after its separation. The second was that of a girl born without a tongue, but who had, nevertheless, learned to speak as easily and distinctly as if she had enjoyed the full benefit of that organ. The third was a young woman who in early life had lost her tongue and uvula, but still retained the power of speech, taste and deglutition. "In reality," says Good, " out of the twenty-four articulate sounds which fill up our common alphabet, the only two in which the tongue takes a distinct lead are I and r, though it is auxiliary to several others; but the guttural, or palatial, as g, h, k, q; the nasal, as m and n; the labial, as b,p,f v,w, most of the dental, as c, d, z, together with all the vowels, which hold so large a space in our vocabularies, are but little indebted to its assistance, [Good's Study of Medicine, 594 Vol. 1, pp. 499-501; Boston reprint, 1826.] With these facts before us, it will not do to attribute Mr. Parish's inability to sj:eak to paralysis of the tongue, or to say, as Dr. A. C. does in the heading of his next section, that the " loss of articulation" in Mr. Parish was "a paralysis ond not loss of memory" (p. 29). But if we admit that the loss of articulation was in part a paralysis, we must also admit that this was a paralysis of the intellectual as well as of the physical powers. But we need not pursue a topic which has been already considered and disposed of in the Opinions. At page 35, Dr. A. C. again returns to " The Con- vulsions" this time " as an element in the case apart from the cerebral lesion." He considers that the con- vulsions, in association with the apoplectic attack are usually not a direct, but only an indirect effect of the clot of blood, and that " It is the congestion of the parts that will affect the mind, if it becomes affected unfavorably" (p. 35). I need not dispute with him on this proposition. But, says he, " It is important to in- sist that the apoplexy does not complicate this question- so far was it advanced in the process of healing (when the convulsions first occurred) ; and that perhaps it had nothing to do with the convulsions" (p. 36). But here is an assumption again, and it is opposed to the evidence of Dr. Delafield. Again, he would have it, that the earliest convulsions in Mr. Par- ish's case, was in December, 1849, about five months after the severe attack in July of that year; whereas, this very attack in July, 1849, was complicated with convulsions ; and, if we may believe the witness*Fisher, the next attack was in September; that is, about the usual time for expecting the recurrence in ordinary cases of epilepsy, and from the earlier history of Mr. Parish's ailments, it is clear, that the epileptic tendency preceded the attack of July, 1849; and may have been the determining case, rather than the consequence, of 595 the apoplectic seizure and of all the deplorable conse- quences of that attack. Dr. A. O, in this section, lays down a series of pro- positions, which, as they are neither very numerous nor wordy, we may stop to consider. In the first of these he says, "It is not the diminishing, but the augmenting paroxysms that overwhelm the mind" (p. 36). But his authorities are against him here, or at most, their opi- nions are contradictory. See what he has cited oh the subject from Calmeil and Copeland. But, without re- gard to these authorities, we might remark that when the mind has been already overwhelmed by a disorgan- izing disease of the brain, it matters little whether the epileptic attacks which follow that event are diminish- ing or increasing. The second proposition is, that " the direct influence of each paroxysm was not to depress, but to elevate and improve the vital energies and the mental condi- tion," (p. 36). This is a proposition that no man in possession of his reason will believe. To reach it, Dr. A. C. must, have given a forced and unjustifiable con- struction to the evidence of Drs. Delafield and Markoe. I have already in these notes alluded to this topic. But Dr. A. C. is not contented with this proposition as it stands. He propounds a decisive question upon it. " It is pertinent," he says, "to ask how many betterments of this kind work a deterioration ? " (p. 36.) In reply, we need not hesitate to say, that every betterment of this kind works a deterioration. His third proposition is, in reference to Mr. Parish, that " he could not have had over fifty paroxysms in the six years and three months, from their first occur- rence to his death," (p. 36.) But the facts upon which this statement is founded are not in the evidence, and if they were, it is of very little consequence. A single paroxysm is sometimes enough to produce complete de- • 590 mentia. The proof of this, Dr. A. C. might have dis- covered in Calmeil, whom he has so often taken occasion to quote, overlooking, to be sure, the particular passage to which I refer. On the very page from which Dr. A. C. has taken his quotations, Calmeil tells us, that in some cases the patient falls into dementia at the moment the epileptic seizure declares itself for the first time; and that mania frequently complicates epilepsy, but much less frequently than dementia. (Dictionnaire de Medecine, tome 12, p. 195.) His fourth proposition is, that " there was no in- stance in which the paroxysms occurred twice in the same day," (p. 37.) But how does he know this? Not from the evidence. And if it were true, what would it amount to ? Epileptic attacks rarely occur in this man- ner. The most frequent interval between them is about a month. It will, however, occasionally happen that at some of the recurring epochs the tendency to con- vulsions is somewhat persistent, so that the patient will pass out of one fit into another for several hours con- tinuously—but this is after all but a single paroxysm. And there is no evidence showing that Mr. Parish was not occasionally thus affected. But whether he was or not, is a matter of no consequence, as regards the main facts of the case. In one instance it is proved he was so affected, 25th Feb., 1850. His fifth proposition is, that " there was no vertigo so far as is known, even preceding the attacks, and none in the intervals of the attacks," (p. 37.) This statement is incorrect, as I have already shown. His last proposition in the series is, that " Mr. Parish had the advantages which belong to those in whom epilepsy occurs in adult life," (p. 37.) But it is not easy to discover what these advantages are. Convulsions of an epileptic character, beginning in early life, are apt to disappear entirely about the period of adult ao-e, 597 Those which first appear, after that epoch, are more persistent, and very rarely disappear. But at whatever age epilepsy first appears, where it persists, it sooner or later leads to deterioration of the intellect. The cases 'in which this effect is not observable, where the disease has continued for any great length of time, are rare, and are but the exceptions to the general rule. It may, however, be as Calmeil thinks, though I am not pre- pared to admit the remark as of any moment, or as in- tended by Calmeil to be accepted as a general rule, that " when the commencement of epilepsy takes place at advanced age, the loss of reason appears to be less frequent." It is this author, we must remember, who tells us that mental alienation is now and then induced by the epileptic seizure at its first onset. Dr. C. at page 38 insinuates, and nothing more, that what he has all along been speaking of as epi- lepsy, may be considered of that milder type of disease which has been characterized as epileptiform (p. 38) ; but this point has been disposed of in the Opinions. I may, however, here add, that in the convulsive parox- ysms Mr. Parish was frequently so profoundly comatose that he would bite his tongue (see the evidence of Dr. Delafield). Now if Dr. A. C. will refer to Todd, he will find that this able writer lays particular stress upon this as an unmistakable pathognomonic sign of true epilepsy. His expression is worthy of notice. In speaking of one of his cases, he says, " It seems most probable that this was an epileptic fit, which, however, wanted the very characteristic feature of biting the tongue. That symptom, however, is not always pre- sent ; and, although when it occurs along with the other symptoms it may be regarded as pathognomonic of the epileptic fit, its absence by no means proves that the attack was not of the epileptic nature."—(Todd on the Nervous System, page 94.) 598 Having now paid our respects to the main points in this memoir, we may venture to overlook the re- maining sections which are entitled as follows : " Weep- ing," " llefiex Action," " Emotional Action" "The Sphincters," "Writing, Block Betters, &c." "Separate Betters" "Irritability" " The Effects of Apoplexy on the Mind, Opinions and Cases." Most of the topics introduced in these sections have already been consid- ered, either in what has already been stated among these notes, or in the volume of Opinions. Let us then hasten to Dr. A. C.'s concluding observations, where he tells us that " In view of the sources of error already pointed out, appeal must be taken from the expressed opinions of systematic writers to the recorded cases." Here he is in the track of Dr. McCready. He would repudiate authority when against him, though making liberal use of that same authority where he thinks it may tell in favor of his own opinions; and, in repudiating systematic writers, he would undertake to reason upon their facts. But to proceed. Speaking of the recorded cases, he says, " These must be gener- alized ; and the conclusions which they force upon us, when the number of cases is sufficiently large, must be final." But what would he consider a number suffi- ciently large? The libraries of the city have been ransacked for the purpose of discovering such cases. The librarian of the N. Y. Hospital tells me that he has himself, to aid in this investigation, overhauled hundreds of volumes; and, after all, neither Dr. A. C. nor Dr. McCready has been able to adduce a single author who, when his opinions are fairly stated, can be named in support of the proposition that apoplexy does not tend to deterioration of the mental faculties, or that epilepsy does not tend to deterioration of the mental faculties; or that organic disease of the brain, from whatever cause, does not tend to deterioration of 599 the mental faculties; nor has either of these gentle- men been able to adduce a single instance of any pa- tient from the records of the profession, in which the combination of ailments and physical disabilities which existed in Mr. Parish, is shown to have been compatible with mental competency or a discriminating judgment. But Dr. A. C. has faith in his appeal from authorities to the collectors and compilers from authorities—to those who make papers from the facts of other writers. He says on this point that " Of this character is the paper of Dr. McCready, published in the July number of the New York Journal of Medicine, 1857. His researches render it in the highest degree probable that a person in the condition which Mr. Parish pre- sented for more than six years between his attack " and his death, would be of sound and disposing mind and memory" (p. 75). Well, I have already paid my respects to this paper of Div McCready's, and to the cases contributed by Dr. Alonzo Clark to that paper; and, of its value as a means of determining the mental competency of Mr. Parish, I am quite willing that, without a further word of comment on the sub- ject, the world should judge. Before concluding this paper it is proper to observe that I have looked over the two other documents which were placed in my hands in connection with the papers which I have ascribed to Dr. A. C, and that I find nothing in them influencing my judgment in any way. The study of Mr. Parish's case, in order to reach any rational and correct conclusion upon it, should be taken up as a study apart, as a collection of associated facts, or a series ■ of appearances and' circumstances, to be judged of by their own bearing. This, indeed, is the only way to arrive at the truth in any case; for in medicine, though for convenience we have genefal descriptions of diseases to which we may refer for our 600 practical guidance, yet every instance of disease, every individual case, has its own peculiarities ; and it is only by the close investigation of these that the cautious observer can hope to arrive at any reliable conclusion concerning it. It is hardly necessary to add that the cases which are brought together in the several papers which I have now referred to are from medical works of every degree of merit; some of them are from the writings of non-professional men; some of them are even from eulogies and funeral orations utterly unworthy of re- liance. Some of the cases themselves are familiarly known among the curiosities of medical literature, which tell but feebly upon the judgment of the unim- aginative practitioner, and some of them—as is often observable among the cases which are presented to the public in our medical periodicals, and indeed in"more ambitious works—may have been imperfectly and in- correctly reported. Very few of them have any direct bearing upon the case of Mr. Parish. JNO. WATSON, M.D., Surgeon to the New York Hospital. New York, November 18, 1857. NATIONAL LIBRARY nlm 03277?aa ? ■ II !ju'?: ma I'M** :4,?*iri* NLM032777887