The medical jurisprudence of insanity / J.M. Pagan.

  • Pagan, J. M. (John MacMichan), 1802-1868.
Date:
1843
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    behold mountains raising their heads to the sky. Now, if such persons had not the means of correcting these errone- ous perceptions, they must believe them to be real, and they must become insane. In these cases the faculties of attention and comparison remaining in a sound state, cor- rect the errors of perception. Illusion may exist without the intellectual faculties being diseased, just as the acute- ness of the senses is found to diminish, not unfrequently, without the mental powers participating in the decay. Now, the faculties of the mind likewise may become diseased; some one or other, or all, or some combination of them may perform their functions erroneously, imperfectly, or not at all; and these states may or may not be accom- panied with imperfect function of the organs of sense. But although disease of sensation is corrected by the sound state of the mental faculties, the converse of this is not true, for disease of the intellectual faculties is not remedied by the sound state of the organs of sense, as is familiarly illustrated in the well known case of the hospital patient, who fancied that the hospital in which he was confined was his residence, its servants his attendants, and so forth, yet who confessed that notwithstanding all his magnificence, and his being attended by the first-rate cooks, yet every thing he ate tasted of porridge. Esquirol relates the case of a patient who was allied to the family of Napoleon; he believed that all those who came near him were members of the imperial family; he got into a passion whenever he saw the servants performing any menial duty. He would throw himself at the feet of one of them whom he took for the Emperor, and ask pardon and protection. Esquirol one day bandaged up his eyes, and instantly he became calm and tranquil, and spoke reasonably of his own illu- sions. The same thing happened in subsequent experi- ments; and for twelve hours, upon one occasion, when the
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    faculty of attention being most probably disordered also. The letter contained a quotation from scripture, and after transcribing the words to which she wished to call the attention of her friend, she gave a correct reference to the part of the Bible where the passage was to be found; thus, Philippians iii. and 7. and immediately added, " These islands lie in latitude north ■—, longitude —;" most pro- bably referring to the Philippine Islands. Now, it appears from what has been said, therefore, that the senses perform their functions incorrectly; that the faculties of attention, comparison, and association, &c., are likewise in a diseased state, and the person of course is insane. But it is not to be presumed that in every case of insanity, all the intellectual faculties are in such a state of disease as to be incapable of performing, in some degree, their usual office. There are cases of general insanity in which the function of no one of the faculties of the mind can be observed to be performed, even in the most imperfect manner. There are other instances in which all the faculties seem to be annihilated; no mental operation, so far as we can judge, is capable of being per- formed. But it far more frequently happens that the men- tal and moral powers are partially diseased, or partially destroyed. Now, the degree of this state of disease or decay is very various, and the kind of it is equally so: these varieties most probably being dependant upon the extent of disease in certain faculties, and the integrity of others, the combination of faculties affected, how far the senses perform their functions incorrectly—in what manner, and to what degree. For example, in refer- ence to the sense of sight, whether objects appear larger or smaller, of what colour, at what distance, and so forth. The whole of the faculties of the mind are liable to be- come diseased; they may each or all of them be affected,