obviously, he cannot be punished for an act which was the result of disease.

As a rule, too much stress is laid on the plea of real or assumed heredity. This question is strongly commented on by Bucknill when discussing the plea of insanity in the case of Guiteau, the assassin of President Garfield: The argument in favour of insanity founded upon the supposed transmission of an hereditary tendency to mental disease has of late been used in most absurd and unjustifiable excess, and I do not know that the interests of justice would be damaged if it were to be excluded altogether in judicial enquiries; for if it could be clearly shown that both a man's parents, and all four of his grand-parents, and all his uncles and aunts, had been unquestionably insane, it would afford no proof whatever that the man himself had been insane. Such evidence would, at the most, strengthen the presumption that he had been so under circumstances which would otherwise be more doubtful.'

Forms of insanity in which crimes are committed.-Mania, epileptic insanity, melancholia, impulsive insanity, moral insanity, periodical insanity, puerperal insanity, alcoholic insanity, delusional insanity, imbecility and idiocy, dementia, and early general paralysis.

Infanticide may be connected with insanity associated with the birth of a child, or with a transient mania associated with the secretion of milk, or with insanity due to exhaustion from over-lactation or excessive child-bearing. In any of these conditions a loving mother may murder her whole family; in such a case the law rightly considers the crime itself to furnish sufficient evidence of the insanity.

Medical tests and indications of insanity.-When a medical man is required to give an opinion as to the sanity or otherwise of a prisoner, it is occasionally necessary to have the person under observation for some time. Attention should be especially directed to the following points :

I. The assigned cause; whether there was an apparent 1 Brain, 1883.

causelessness for the crime or an utter disproportion between the crime and the supposed end to be attained. Enquiry should be made as to the relationship between the crime and any delusions. The acts of the prisoner immediately preceding and following the deed should be ascertained.

II. The history of any insane or nervous inheritance should be gone into.

III. If a number of murders have been committed at once, such as when an affectionate mother or father butchers an entire family, the acts are strongly indicative of insanity.

IV. If a murderer make no attempt to escape, but delivers himself up and confesses to the crime, the presumption is in favour of insanity. Such action is especially likely to follow a murder committed during an attack of impulsive insanity.

Criminal responsibility of drunkards.-No definite rules are laid down by the law to apply to cases when drunkenness is pleaded as an excuse for crime, or in mitigation of the punishment. An offence or crime is not excused if committed by a person who has lost his self-control from drunkenness voluntarily induced on his part. The loss of control is due to self-indulgence on the part of the individual, and although in such a condition he may not be, strictly speaking, responsible for his actions, yet he is responsible for his condition of irresponsibility. If, however, it can be shown that drunkenness had produced a mental disease, and that the crime was committed while suffering from such disease of the mind, then the irresponsibility of the individual must be admitted. Savage,' in discussing the complicated relationships between responsibility and irresponsibility of persons in a condition of alcoholic intoxication, says :-'A person, say, is given powerful stimulants, masked or concealed in some way, or being weak, or suffering from an old injury to the head, an amount which formerly would not have affected him now produces a great effect; in a state of acute alcoholism he commits a crime, and doubtless would be considered not guilty; but if he has experienced several times the danger which Insanity and Allied Neuroses.

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he incurs by taking stimulants even in small quantities, and yet continues to indulge, and then perpetrates a crime, he may justly be considered responsible, even although it may be proved that by inheritance, or in consequence of injury to the head, he is especially liable to be affected by stimulants. Next, if, in consequence of intemperance, he becomes slowly affected by mental disorder, and in a state of delirium tremens he commits a crime, he will probably not be considered fully responsible. If, instead of delirium tremens, alcohol produces chronic insanity or general paralysis of the insane, and in this condition of genuine insanity he does harm, he will not be considered responsible for his acts.'

The rulings of different judges with regard to the criminal responsibility of drunkards show some remarkable discrepancies. In the case of Reg. v Williams (C.C.C., 1886), Denman J. ruled that a crime committed during drunkenness was as much a crime as if it were committed during sobriety, and that the jury had nothing to do with the fact that the man was drunk. The prisoner was supposed to know the effect of drink, and if he took away his senses by means of drink, it was no excuse at all.' In Reg. v. Burns (Liverpool Ass., 1865), Bramwell B. ruled that drunkenness was

no excuse, and that a prisoner cannot by drinking qualify himself for the perpetration of crime; but if through drink his mind had become substantially impaired, a ground of acquittal would then fairly arise.'

These rulings are in marked contrast to the following. In Reg. v. Short (Glasgow High Court, 1889), the prisoner, a woman, was charged with the murder of her child by neglect and starvation. It was proved that between July 6th and 11th the prisoner neglected to provide the child with necessary food, and that it died on the 11th from starvation and neglect; it was also proved that on July 6th the prisoner was suffering from alcoholism, and on July 8th from delirium tremens. After hearing the counsel for the Crown, and without calling on the counsel. for the accused, Lord Young ruled that no evidence had been

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adduced which would legally justify a verdict of culpable homicide. . . . He denied that it was murder, culpable homicide, or any crime punishable by law in that court, for either a woman or a man to drink too much whisky, or get an attack of delirium tremens, which was insanity. In this case there was no intention to injure, and he must rule that there was no proof of any crime.' The jury, therefore, returned a formal verdict of 'Not guilty.' In Reg. v. Baines (Lanc. Ass., 1886), Day J. ruled 'that whatever the cause of the unconsciousness, a person not knowing the nature and quality of his acts is not responsible for them; and that if a man were in such a state of intoxication that he did not know the nature of his act, or that his act was wrongful, his act would be excusable.' In Reg. v. Mary R., 1887, Chief Baron Palles ruled that, if any one, from long watching, want of sleep, or deprivation of blood, was reduced to such a condition that a smaller quantity of stimulant would make him drunk than would do so if he were in health, then neither law nor common sense could hold him responsible for his acts.'

CHAPTER XLII

Methods of placing lunatics under restraint-Reception orders on petition -Urgency orders-Inquisition Summary reception orders-Orders by commissioners --Medical certificates -Testamentary capacity-Feigned insanity-Restraint of habitual drunkards.

LUNACY CERTIFICATES

BEFORE a lunatic can be placed under restraint, certain conditions specified by law have to be carefully observed. The consolidating and amending Lunacy Acts of 1890 and 1891 define the duties, rights, and liabilities of those who have the certifying and the charge of lunatics, and as these Acts have considerably modified and changed the mode of procedure previously in force, it is essential that medical practitioners should have a thorough knowledge of their provisions.

The term 'judicial authority,' frequently mentioned in the Acts, refers to judges, magistrates, and justices of the peace. The objects of the Acts are to place well-defined restrictions upon all persons wishing to place a lunatic under restraint; to provide for the summary restraint of persons whose condition is such that an extreme course of action is necessary for their own welfare or that of the community; and to ensure the proper treatment and care of lunatics while under restraint. As a general rule, a careful investigation is conducted by unprejudiced public officials before the commitment of the lunatic takes place. To this rule urgency orders, summary reception orders, and procedure under which pauper lunatics and persons improperly cared for may be detained, are exceptions.