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Articles from Aids To Forensic Medicine And Toxicology

Signs Of Death

Potash Soda And Ammonia

Copper And Its Preparations

Antipyrine Antifebrin Phenacetin And Aniline

Mental Unsoundness

Belladonna Hyoscyamus And Stramonium

Death From Lightning And Electricity

Examination Of Persons Of Unsound Mind

Cause Of Death In The Foetus

Evidence Of Poisoning


Under the term 'mania' are included all those forms of mental
unsoundness in which there is undue excitement. It is divided into
general, intellectual, and moral, and each of the two latter classes
again into general and partial.

=General Mania= affects the intellect as well as the passions and
emotions. Mania is usually preceded by an incubative period in which the
patient's general health is affected. The duration of this period may
vary from a few days to fifteen or twenty years. When the disease is
established, the patient has paroxysms of violence directed against
himself as well as others. He tears his clothes to pieces, either
abstains from food and drink or eats voraciously, and sustains immense
muscular exertion without apparent fatigue. The face becomes flushed,
the eye wild and sparkling; there is pain, weight, and giddiness in the
head, with restlessness.

=General Intellectual Mania=, attacking the intellect alone, is rare;
but some one emotion or passion, as pride, vanity, or love of gain, may
obtain ascendancy, and fill the mind with intellectual delusions.

A delusion may be defined as a perversion of the judgment, a

chimerical thought; an illusion, an incorrect impression of the
senses, counterfeit appearances; hence we speak of a delusion of the
mind, an illusion of the senses. Lawyers lay great stress on the
presence of delusions as indicative of insanity. An hallucination is a
sensation which is supposed by the patient to be produced by external
impressions, although no material object acts upon his senses at the

=Partial Intellectual Mania=, or =Monomania=, also called =Melancholia=,
is a form of the disease in which the patient becomes possessed of some
single notion, contradictory alike to common-sense and his own

=General Moral Mania.=--This is a morbid perversion of the natural
feelings, affections, inclinations, temper, habits, moral dispositions,
and natural impulses, without any remarkable disorder or defect of the
intellect, or knowing and reasoning faculties, and particularly without
any insane illusion or hallucination. It is often difficult to
distinguish this form of mania from the moral depravity which we
associate with the criminal classes.

=Partial Moral Mania--Paranoia--Delusional Insanity.=--In this form one
or two only of the moral powers are perverted. Delusions are always
present, and very frequently are those of persecution. The patient's
conduct is dominated by his delusion; thus murder and suicide may be
committed. There are several forms:

Kleptomania, a propensity to theft; common in women in easy
circumstances. Dipsomania, or Oinomania, an insatiable desire for
drink. Morphinomania, a craving for morphine or its preparations.
Erotomania, or amorous madness. When occurring in women this is also
called Nymphomania, and in men Satyriasis. It consists in an
uncontrollable desire for sexual intercourse. Pyromania, an insane
impulse to set fire to everything. Homicidal mania, a propensity to
murder. Suicidal mania, a propensity to self-destruction. Some
consider suicide as always a manifestation of insanity.

=Insanity of Pregnancy.=--This may show itself after the third month of
pregnancy in the form of melancholia. It is not recovered from until
after delivery.

=Puerperal Mania.=--This form of mania attacks women soon after
childbirth. There is in many cases a strong homicidal tendency against
the child.

=Insanity of Lactation= comes on four to eight months after parturition,
either as mania or melancholia. The mother may repeatedly attempt

=Mania with Lucid Intervals.=--In many cases mania is intermittent or
recurrent in its nature, the patient in the interval being in his right
mind. The question of the presence or absence of a lucid interval
frequently occurs where attempts are made to set aside wills made by
persons having property. In these cases the law, from the reasonableness
of the provisions of the will, may assume the existence of the lucid
interval. A will made during a lucid interval is valid. When an attempt
is made to set aside the provisions of a will on the ground of insanity
in a person not previously judged insane, the plaintiff must show that
the testator was mad; when the provisions of the will of a lunatic are
attempted to be upheld, the plaintiff must show that the will was made
during a lucid interval.

A testator is capable of making a valid will when he has (1) a knowledge
of his property and of his kindred; (2) memory sufficient to recognize
his proper relations to those about him; (3) freedom from delusions
affecting his property and his friends; and (4) sufficient physical and
mental power to resist undue influence. The fact of a man being subject
to delusions may not affect his testamentary capacity. He may believe
himself to be a tea-kettle, and yet be sufficiently sound mentally to
make a valid will.

=Undue Influence.=--Persons of weak mind or those suffering from senile
dementia are often said to have been unduly influenced in making their
wills, and subsequently their dispositions are disputed in court. Before
witnessing the will made by such a person, the medical man should
satisfy himself that the testator is of a 'sound disposing mind.' This
he will do by questioning, and his knowledge of the home-life of the
patient will either confirm or set aside the idea of influence.

A person who is aphasic may be competent to make a will. He may not be
able to speak, but may understand what is said to him, and may be able
to indicate his wishes by nods and shakes of the head. Ask him if he
wishes to make a will, then inquire if he has 10,000 to leave, then if
he has 100, and in this way arrive approximately at the sum. Then ask
him if he wishes to leave it all to one person. If he nods assent, ask
if it be to his wife or some other likely person. If he wishes to divide
it, ascertain his intention by definite questions, and, having
ascertained his views, commit them to writing, read the document over to
him, and ask if it expresses his intentions. That being settled, a mark
which he acknowledges in the presence of two witnesses, preferably men
of standing, will constitute a valid document.

In certain forms of neurasthenia, the 'phobias' are common, but must not
be regarded as evidence of insanity. 'Agoraphobia' is the fear of
crossing an open space, 'batophobia' is the fear that high things will
fall, 'siderophobia' is the fear of thunder and lightning, 'pathophobia'
is the fear of disease, whilst 'pantophobia' is the fear of everything
and everybody.

=Epilepsy in Relation to Insanity.=--The subjects of this disease are
often subject to sudden fits of uncontrollable passion; their conduct is
sometimes brutal, ferocious, and often very immoral. As the fits
increase in number, the intellect deteriorates and chronic dementia or
delusional insanity may supervene. (1) Before a fit the patient may
develop paroxysms of rage with brutal impulses (preparoxysmal
insanity), and may commit crimes such as rape or murder. (2) Instead of
the usual epileptic fit, the patient may have a violent maniacal attack
(masked epilepsy, epileptic equivalent, psychic form of epilepsy).
(3) After the fit the patient may perform various automatic actions
(post-epileptic automatism) of which he has no subsequent
recollection. Thus the patient may urinate or undress in a public place,
and may be arrested for indecent exposure. Epileptics who suffer from
both petit and grand mal attacks are specially liable to maniacal
attacks. Such insanity differs from ordinary insanity in its sudden
onset, intensity of symptoms, short duration and abrupt ending. To
establish a plea of epilepsy in cases of crime, one must show that the
individual really did suffer from true epilepsy, and that the crime was
committed at a period having a definite relation to the epileptic

=Alcoholic Insanity.=--This may occur in three forms:

1. Acute Alcoholic Delirium (mania a potu), due to excessive amount
of alcohol consumed.

2. Delirium Tremens, due to long-continued over-drinking. The patient
suffers from horrible dreams, illusions, and suspicions, which may lead
him to attack people or commit suicide.

3. Chronic Alcoholic Insanity. Loss of memory is the chief symptom,
with paralysis of motion, hallucinations and delusions of persecution.

=Responsibility for Criminal Acts.=--To establish a defence on the
ground of insanity, it must be proved that the prisoner at the time when
the crime was committed did not know the nature and quality of the act
he was committing, and did not know that it was wrong. At the present
time, however, the power of controlling his actions is usually made
the test.

The plea of insanity is brought forward, as a rule, only in capital
charges, so that the prisoner, if found guilty, will escape hanging. If
proved 'guilty, but insane,' the person is sentenced to be kept in a
criminal lunatic asylum 'during His Majesty's pleasure.'

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