to throw vitriol on it, and again he purchased a supply, and repeated the acts of the day before.

He now began to consider more fully than he had yet done the nature and consequences of his conduct, and the next morning came to me for advice. He stated very frankly his entire conviction that his acts were in the highest degree immoral and degrading, but expressed his utter inability to refrain from their perpetration.

"A handsome dress," he said, "acts upon me very much as I suppose a piece of red cloth does on an infuriated bull: I must attack it. The bull uses his horns, while I use vitriol. I do not know why the idea ever came into my head. I certainly never would have conceived of such a thing if I had been blind. I was altogether excited by the sight of that handsome silk dress the first day, and it was impossible for me to resist after the idea had once had a lodging in my mind. I have often seen fully as handsome dresses in the street before, but never previously was the sight followed by such an impulse."

After the most careful examination, I could discover no evidence of disease, except in the one point of wakefulness, with which he had suffered for several months past. I therefore prescribed bromide of calcium for him, and insisted on his removing himself from further temptation by taking a sea voyage on a sailing vessel upon which there were no women passengers. He went to sea in a fishing schooner, and returned in three or four months perfectly free from his morbid impulse.

A gentleman, who came about once a week to consult me for cerebral congestion, the result of excessive application to business, and who lived in a neighboring town, informed me that during his journeys by rail he invariably experienced an impulse to throw himself from the train. Finally he was so strongly impelled that he stated the case to an acquaintance in the car, and begged him to sit near him and restrain him if he made any such attempt. After that he never came without bringing a friend with him, who had instructions not to lose sight of him for an instant. In telling me of his impulse, he described it as almost overwhelming, and that it seemed to be excited by the rapid motion, and by the fact that he had heard of people throwing themselves from railway trains.

It is well known that many persons standing on great

heights experience an impulse to jump off. So many individuals committed suicide by leaping from the Colonne Vendôme and the Arc de Triomphe in Paris, and from the Duke of York's monument in London, that precautions had to be taken to prevent further acts of the kind.

Marc relates the case of a nurse who felt the impulse to murder the infant she took care of whenever she saw its naked skin. She threw herself on her knees before her mistress and begged to be discharged, declaring that the whiteness of the child's skin excited her to murder it, and that she could not longer resist the impulse.

Several years since, I had under my charge a lady who, whenever she saw the naked shoulders of a young child, felt an impulse, which she declared she could not resist, to bite the skin. She had thus inflicted very disagreeable wounds on the children of her friends, and was finally arrested on the charge of assault; but the matter was hushed up on her promise to abstain from such conduct in the future, and she kept her promise.

Morbid impulses to commit violent acts are often developed by the sight of a suitable weapon for the purpose. Persons have hanged themselves on the suggestion excited by the sight of a rope; others have committed murder or suicide from seeing knives, pistols, etc., lying in inviting situations. A lady, seeing a phial labelled "nitric acid" on a table in my consulting-room, seized it, and, putting it to her lips, would have swallowed the contents if I had not fortunately perceived her in time and knocked it from her hands. As it was, she only succeeded in spoiling an elegant gown.

Even a word spoken in jest may, under certain circumstances, be sufficient. Dr. Oppenheim, of Hamburg, having received for dissection the body of a man who had committed suicide by cutting his throat, but who had done this in such a manner that his death did not take place until after an interval of great suffering, jokingly remarked to his attendant : "If you have any fancy to cut your throat, don't do it in such a bungling way as this; a little more to the left here, and you will cut the carotid artery." The individual to whom this dangerous advice was given was a sober, steady man, with a family, and a comfortable subsistence. He had never manifested the slightest tendency to suicide, and had no motive to commit it. Yet, strange to say, the sight of the corpse

and the observation made by Dr. Oppenheim suggested to his mind the idea of self-destruction, and this took such firm hold of him that he carried it into execution, fortunately, however, without profiting by the anatomical instruction he had received, for he did not cut the carotid artery.

Closely allied to suggestion, and perhaps a more powerful cause of morbid impulse of the species under notice, is imitation. Thus, many crimes have been committed by persons who have had the impulse excited by reading accounts of the trials of other persons, or the detailed recitals of all the particulars of offences which the age requires the public press to contain. Epidemics of murder, suicide, arson, and other crimes are thus produced.

"Some years ago," says Dr. Forbes Winslow,' "a man hung himself on the threshold of one of the doors of the Hotel des Invalides. No suicide had occurred in the establishment for two years previously; but in the succeeding fortnight five invalids hung themselves on the same cross-bar, and the governor was obliged to shut up the passage."

Epidemics of suicide spread, according to Plutarch, among the women of Miletus, and, as is well known, in later days, among the women of Marseilles.

A careful study of the cases of suicide recorded in the daily newspapers shows that they are to a great extent influenced in character by the principle of imitation. A case of suicide by Paris green is published, and straightway half a dozen others due to this poison are the result. Or a man or woman jumps from a ferry-boat while it is crossing the river, and then this mode becomes the fashion for a while, to be followed in its turn by some other method.

When I was a medical student, a young gentleman from ' Georgia was on one occasion dissecting the same body that I

was.

He had drawn one of the lower extremities as his part of the subject, and he was assiduous and careful in his work. So far as my observation extended, he did not differ essentially from other medical students. He was cheerful in disposition, and gave no evidence whatever of mental derangement, or even of excitement or depression of mind. One morning we were told that he had been found dead on the floor of his bedroom. An examination showed that he had divided his femoral artery, and had died of hæmorrhage. It was then ascertained "The Anatomy of Suicide," London, 1840, p. 120.

that he had the evening before received a letter which had apparently caused him much unhappiness.

Now, suicide by division of the femoral artery is certainly a very unusual mode of self-destruction. I doubt if any case of the kind had previously occurred in New York. Yet within a week there were two others, one of which was Horace Wells, the alleged discoverer of the anæsthetic properties of sulphuric ether.

Here we have the principle of suggestion acting on the first victim, and then that of imitation on the others.

Imitation is of more force when the intellect is less fully developed. Even in the normal condition we find it more strongly exercised in women and children than in adult men. In the latter, the influence may be so powerful that actual disease is acquired. Thus, a child imitates the movements of another affected with chorea, or with stammering, and immediately contracts the disorder. Even squinting has been produced in this manner.

A lady received such a vivid impression at seeing her maid throw herself down a well that she never passed a well without feeling a strong impulse to throw herself into it.

An idiot, having killed a pig, felt impelled to kill a man, and obeyed the impulse on the first one he met.

A melancholic person was present at the execution of a criminal, and was immediately seized with an impulse, of which he was fully conscious, and could scarcely resist, to murder some one.

A child six years old strangled its younger brother. The father and mother, entering the room the moment the act was in process of accomplishment, demanded the cause. The child threw itself weeping into their arms, and answered that it was imitating the devil, whom it had seen strangle Punchinello.

Such cases as these, though not all of them, examples of intellectual objective morbid impulse, are at least of value if they cause us to recognize the force of the principle of imitation, and to render less public than they are now the slaughter of animals and the executions of criminals.

Intellectual objective morbid impulses have, according to their character, been classified as homicidal mania, or the impulse to commit murder; suicidal mania, or the impulse to perpetrate self-destruction; pyromania, or the impulse to burn

houses and other things; kleptomania, or the impulse to steal, and so on. The mere object of the impulse should not, in my opinion, be sufficient to elevate the act to the dignity of a distinct species of insanity. The names, however, are useful, as explanatory of the main symptom exhibited by the patient.

Again, many of the cases of each of the varieties mentioned are not instances of intellectual, but of emotional or volitional morbid impulse, or of epileptic mania, examples of which will be subsequently brought to the notice of the reader. The distinction of the intellectual objective morbid impulse being that it arises in consequence of an idea the fulfilment of which is in direct relation with that idea, whereas the impulse due to deranged volition or emotion has no such starting-point, still less has that which arises from epilepsy.

Intellectual objective morbid impulse is more apt to occur in persons who possess what has been called the "insane temperament" than in those of equally balanced minds. It may develop into some more pronounced and obvious form of insanity, or it may become continuous in the individual. Generally it is unaccompanied by illusions or hallucinations, but there are cases in which one or the other of these conditions of perceptional derangement has been the exciting

cause.

CHAPTER V.

III.

EMOTIONAL INSANITIES.

THE emotions are in most persons difficult of control, but they may acquire such an undue and morbid prominence as to dominate over the intellect and the will, and to assume the entire mastery of the actions in one or more respects. This effect may be produced suddenly, from the action of some cause capable of disturbing the normal balance which exists between the several parts of the mind, or it may result from influences which act slowly but with gradually increasing force. In neither case is there necessarily either delusion or error of judgment, but it very generally happens that the intellect sooner or later becomes involved.