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Published under the Auspices of Vie Medico- Legal Society oj I^ew York.

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CLARK BELL, Esq., Editor.

ASSOCIATE

LEGAL.

Hon. David Dudley Field. N.Y. Judge Calvin E. Pratt, Brooklyn. Austin Abbott, Esq., N. Y. Hon. Wm. H. Arnoux, N. Y. Richard B. Kimball, Esq., N. Y. Judge C. G. Garrison, Camden, N.Y. Appleton Morgan, Esq., N. Y. Hon. Myer S. Isaacs, N. Y. Z. S. Sampson, Esq. Morritz ElUuger Esq., N. Y. T. Gold Frost, Esq , Minn.

EDITORS,

MEDICAL.

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keepsie, N. Y. Prof. Edward Pa3''son Thwing.

M.D., Brooklyn. N. Y.

VOL. VI.

NEW YORK.

MRDTCO LEGAL JOURNAL ASS0CL\T10N.

THE MEDICO-LEGAL JOURNAL

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SUICIDE AND LEGISLATION,

By CLARK BELL, Esq., President of the Medico-Legal Society of New York.

It is a question of moment, well worthy our serious consideration, to consider what steps can be taken to prevent death by suicide, or to decrease its volume ; whether we view the movement as one to prevent the commission of crime, regarding it, as our laws always have done, as a criminal offense to take one's Ufe f or to punish the offender for its commission.

Notwithstanding the philosophy and teachings of the Stoics and ancient philosophers, there are few countries or peoples who do not now regard suicide as a crime.

^^ Mori licet cut vivere non placet ^' was the motto of the StoicSj who claimed that every man had the right to dispose of himself as he pleased. Indeed, it was con- tended in that philosophy that when the ills of life became too great for endurance, or one became an object of danger, disgust, dread, or to save from dishonor, it was not only right, but duty, to take one's life.

The maxims of Montaigne were doubtless based on similar considerations.

*Read at the Session of October 24, 1882.

f IV. Blackstone's Commentaries, chap. 14, p. 189, I. Hawk, P. C. 68. L Hal., P. C.,413.

2 SUICIDE AND LEGISLATION.

"A voluntary death is the most beautiful." ^'Life depends upon the will o.f others ; death upon our own." *

Amona; the Hindoos, Chinese, Japanese, and many savage tribes of men, suicide has been justified under certain conditions, and held up as a duty in others.

The death of Cato by his own hand was doubtless from his determination not to owe his life to Caesar, whose power he would thus recognize, which he had not done before, f

The Cynics, as well as the Epicurean school of phil- osophers, justified suicide. Diogenes, and many of his illustrious disciples, died by their own hands.

The Epicureans taught that suicide was commendable, and a duty under certain circumstances ; but in ancient and modern times, the laws of most countries have branded suicide as a crime, and frequently punished it with great severity.

The Koman law punished the suicide with refusal of honorable burial. $

Both Plato and Aristotle taught that punishment should follow the suicide, and he was also punished by confiscation of his goods in certain cases. § While in Greece honors were refused the memory of the suicide, his name was made infamous, and the body refused the usual Grecian rites. || By the Canon law the suicide was

* " Essay Montaigne," vol. 2, chap b

f Plutarch. Caesar's Tusculan Disputations.

:j:Laws B., ix.

§ Dig de-re-Militari liv. iv., s. 7,

II Potter, Greek Antiquities, B. IV. C. 1.

SUICIDE AND LEGISLATION. 3

regarded as a criminal, forbiddin the prayers of the Church, and punished with other severe penalties.^

In France, from the earhest times, and in the middle ages, the influence of the Canon law was felt ui)on the legislative statute to punish suicide. Prior to the abroga- tion of these severe laws, in 1791, frightful penalties were visited on the bodies of suicides, and their goods were confiscated, f

In England, the Roman and Canon law both found exponents in the early English statutes. Under King Edgar, the suicide was refused Christian burial and his goods confiscated, unless insane or grievously sick. This statute is cited by Dr. O'Dea from the old Saxon law, in his able work on suicide (page 183)

The old English custom, of burying the body at cross- roads, pierced by a stake, was stopped by an Act of 4, George IV. , c. 52, ordering their burial at night, between the hours of 9 and 12 o'clock.

These early English laws are not all abrogated. Many of them are still upon the statute books, but have fallen into general disuse, and may be regarded as obsolete.

In the present age, by general concurrence, it may be safely stated, that in all civilized countries suicide is regarded as a crime, because it is an offense against the laws regulating and ordering the general welfare of society. It has been well said that ^'obedience to the

*Law 12, Can. 23, quoest 4.

t Huryart de Vouglorns, pp. 183, 185. Serpillon Tome, II. p. 960. Loy sell 11 v., VI., Title II., regel 28.

4 SUICIDE AND LEGISLATION.

law is the highest duty of the citizen." Law is at the foundation of society, without which there is no per- manence or safety to the individual. The guarantee of safety to citizens by society rests upon the law which upholds and supports it. Protection of human life is the corner-stone of all social organizations, and punishment for homicide must, in the nature of things, rest inherent in society under the laws regularly passed for the pro- tection of the citizen. The suicide violates the social system by taking a human life, and strikes at the foundation upon which society rests. We cannot admit the legal right of suicide without at the same time con- senting to the destruction of the elementary principles upon which society is based.

For the purposes of this discussion we must then inquire :

1st. Is suicide, as a social evil, on the increase ? and

2d. What can be best done by society to diminish its increase, either by legislation or otherwise ?

As to the first proposition : Is suicide upon the in- crease ? From 1794 until 1804, the yearly average sui- cides in Paris was stated by Brierre de Boismont at about a hundred and seven. There seems to be no reliable data prior to 1794, at which time the laws were changed. Dr. O'Dea, in his valuable and careful work on suicide, already quoted, slates, however, upon the authority of M. de Foville, that during the period ending in 1837, and commencing in 1 791, the proportion of suicides in France lelative to the population had increased fifty per cent.,

SUICIDE AND LEGISLATION. 5

and that from 1837 to 1817 this proportion had further advanced to the frightful extent of seventy-eight per cent.

The total suicides in France for the forty-five years, from 1831 to 1875, on the authority of M. Lacassagne, in Precis de Medicine Judiciare, and of M. E. Maret, in his work Du Suicide en France, were stated in the Medico - Legal International Congress, at the session of August, 1878, in Paris, by M. le Docteur Jeannel, at 173,232, the yearly average of which would be about 3,850. The annual number from 1831 to 1835 was 3,317, which had increased from 1871 to 1877 to the number of 6,107.

These statistics show, in France, a rapid and steady in- crease since 1831 in the annual number of suicides.

M. Jeannel states that these statistics are loo low to embrace the entire number, for the reason that many suicides are never known to the public administration, and cites Esquirol as an authority that in his time many suicides were not known to the administration ; also Brierre de Boismont, who insisted upon the impossibility of obtaining complete or perfect statistics of suicides in France at that period.

M. Lacassagne, who was present at the session of the International Congress at the time, stated, that he regarded the statistics presented by M. Jeannel as very exact.

He conceded that there was constant yearly increase in France in the number of suicides. He also stated that Paris, probably of all the cities of the world, furnished

6 SUICIDE AND LEGISLATION.

the largest number in proportion to its population, and that, while this was true of Paris, it was not true of that part of France outside the larger cities. He stated that suicides in France, in the country districts, were exceed- ingly rare. It is more difficult to give reliable statistics for England. Quetelet gave this subject attention from the commencement of the present century, and came to the conclusion that there was a remarkable uniformity in the annual number of suicides, if considered in groups of ten or twenty years, and that while it varied in ex- ceptional years, the grouping of periods of ten or twenty years was quite uniform. In London the annual suicides about the year 1S50 ranged from 213 to 266, while the average for groups of successive years was 240.

Dr. O'Dea in his work quotes Quetelet and states the present annual rate in London at about 260, when esti- mated in a succession of years.

All statistics and all experience show that exceptional years and causes produce exceptional results.

EPIDEMICAL SUICIDE.

There is frequently an epidemic of suicides in a district. Notably, the Egyptian epidemic, caused by Hegesias' orations ; the Milesian ; the epidemic of Manifried, in 16Y9 ; Rouen, in 1806 ; St. Piermont Jean, in 1813 ; Etampes, Lyons and Versailles, the latter of which, in 1793, numbered some 1,300 victims.

A great number of suicides were committed in June, 1697, at Hansfield.-^

* Sydenham Collection, vol. 2.

SUICIDE AND LEGISLATION. 7

It is well known that wherever a suicide is committed by precipitation from a monument or height, it is fre- quently followed by several others, as from Notre Dame, Colonne Vendome or Colonne Bastile. *

Niagara Falls, in our country, is a parallel, though not

MALES— AGES.

o

^."2 5 lo 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90

123

116

"3

98 95

73

65 61

34 33

25

nnn

Compiled from the U. S. Census of 1870.

*Bri«rre de Boismont, ouv-cit , p. 141.

8

SUICIDE AND LEGISLATION.

completely, as it is more difficult of access to the great masses by reason of its distance from our large cities. The pensioner who hung himself on one of the lanterns

FEMALES— AGES.

53 « 5 lo 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90

42

38

33 32

30

26

16

PI

irinHHiiu

nHHHHHHHHHailBBB (■■■■■■■■■■■IIHBSI

Compiled from the U. S. Census of 1870.

of the Hotel des Invalides in Paris, was followed within a few weeks by twelve others, hung at the same place, which was only stopped by removing the lantern.

In Cuba, the negroes committed suicide in large num- bers, under a religious delusion, believing that they

I

AGES.

149

137 136

»35

13a

lie

5 10 15 30 25 30 35 40 45 50 55 60 65 70 75 80 85 90

83 81

69

33

28

Chaut I. — Suicides and Aj?8. Both J^exes. Compiled from tlie U. S. Census of 1870.

AGES.

Population .

Frequency ) of Suicide y

10

SUICIDE AND LEGISLATION.

would be restored to life at the end of three days. It was only suppressed by the Governor- General ordering the heads exposed in public for one month, their bodies burned and their ashes publicly scattered to the winds.*

The foregoing tables show that- the largest number of suicides occur between the ages of twenty-five and fifty- five, f

O'Dea submits an interesting diagram or chart, com- paring suicides at various ages with corresponding totals of living persons.:}:

The following table, quoted by the same author, from the Medico- Chirurgical Review, vol. 27, p. 211, shows the proportion of suicides to the entire number of per- sons at the different periods of life :

YEARS. SUICIDES. POPULATION.

10 to 15 12 50,000

16 " 20 38 71,000

21 " 25 63 73 000

26 " 30 67 70,000

31 " 40 107 117,000

41 '• 50 115 91,000

51 '* 60 85 74,000

61 " 70 41 51,000

71 " 80 14 20,000

81 " 90 2 4.000

From 1858 to 1864 the number of deaths were :

AGES. MALES. FEMALES.

All ages 6,754 ' 2,462

5 years 5 1

10 years 32 19

15 years 545 435

25 years 886 373

35 years 1,294 428

45 years 1,540 532

55 years 1,474 374

65 years 759 222

75 years 198 66

85 years 21 22

* Hevue de Paris, 19 Aoril, 1845. t P. 140, O'Dea on Suicides. X O'Dea on Suicides, p. 141.

SUICIDE AND LEGISLATION. 11

Average annual death Average annual death

rate of males to rate of females to

1858 to 1864. 1,000,000 living 1,000,000 living

at each age. at each age.

AQE8. MALK8. FEMALES.

All ages 98.4 34.1

5 years 0 1

10 years 4.3 2.6

15 years 46.6 32.8

25 years 90.7 33.5

35 years 166. 7 49. 1

45 years 249.1 85.0

55 years 362.3 92.0

65 years 374.5 81.8

75 years 261.1 70.0

85 years 238.4 87-2

From these tables Dr. O'Dea finds the following con- clusions :

1. Suicides increase in number until extreme old age (limited in England after seventy-five years .

2. The increase is in direct ratio to population until the age of thirty, after which it continue^ in inverse ratio to population until the allotted time of life.

3. The number of suicides is very small, both abso- lutely and relatively, to population previous to the age of fifteen.

SEX.

The influence of sex on suicide Dr. O'Dea shows by similar charts based upon the census of 1870, which place the maximum between the twentieth and fortieth year. Women commit suicide earlier in life ; men, later. The proportion of the sexes is in general three men to one woman, except in England and Wales the ratio is two to one, and in Denmark four to one. In large cities tlie proportion is nearer equal. This author quotes two tables computed from ''Lisle, du Suicide,^'' pp. 105, 106,

12

SUICIDE AND LEGISLATION.

which are interesting by way of comparison as to causes of suicide in females, bearing upon the question of pro- portion between the sexes;*

CAUSES OF SUICIDE.

Grief caused by loss of parents, etc

Grief caused by ingratitude of children. . .

Grief caused by departure of children

Grief caused by separation of family. , . . .

Forbidden love

Jealously between married couples and be

tween lovers

Grief at quitting master or a bouse

373

193

173

74

20

20

35

16

938

627

53

118

229

24

566

247

-\0

51

1,565

171 293

The difference between the sexes in indulgence of pro- pensity or passion by the following table :

CAUSES.

MEN.

WOMEN.

TOTAL.

Gambling

Laziness

157

76

1,569

2,761

1

4 223 441

158

80

Debauchery

1,792

Drunkenness

3,202

Upon the question of suicides for the cause of

INSANITY,

the following table, computed from the census of 1870, is made up by Dr. O'Dea :

STATES SHOWING THE LARGEST INSANITY RATES.

California . . . . ,

Maine

Massachusetts.

New Hampshire

Vermont

* O'Dea on Suicide, pp. 158, et seq.

Ratio to 100,000 population, U. S. Census, 1870.

196 9 126.4 182.6 172.1

2181

SUICIDE AND LEGISLATION.

13

Being States showing the largest insanity rates, in which Vermont leads.

The States showing the lesser rates are :

STATES.

Ratio to 100,000 population. U. S. Census, 1870.

SUICIDES.

INSANK.

Delaware

2.399 1.182 3.154 2.063 1.517

52 0

Geoma

53 5

Indiana

89 4

Louisiana

Tennessee

62.0 73.5

A general table from the census of 1870 is given under the head of Table of Suicide and Social Condition in the United States. A close examination of these tables shows no uniform rate or proportion between suicide and insan- ity. The difference is inexplicable by any known law.

Connecticut, with a suicide rate of 3.907, has an insaii ity rate of 143.05, while Rhode Island, with a suicide rate of 2.760, has an insanity rate of 143.0.

Dr. O'Dea thinks that the causes which tend to in- crease insanity also tend to increase suicide.

About 30 per cent, of insane are believed to be melan- cholic*

Dr. John P. Gray thinks that about 35 per cent, of melancholic insane develop suicidal tendencies, t

The relation in Europe of the proportion of insane to the whole number of suicides is about one-third. J

*Penii. Hospital Reports for Insane, 1860 to 1870.

fSxiicide, Journal of Lisanity, July, 1878.

:}:Von Ettingen's Moral Statistics and Christian Manners.

14

SUICIDE AND LEGISLATION.

I am unable to find any American statistics on this subject.

EDUCATION.

MM. Bronc and DeLisle, French writers, who have given this subject careful study, unite in the opinion that the diffusion of education and general intelligence increase the rate of suicides in France. That depart- ment of France which is first in intelligence (Depart- ment du Nord) has the largest proportion of suicides. In this department 50 per cent, of all the suicides of France

SUICIDES NUMEROUS.

Departments.

Seine

Nord

Seine-et-Oise

Seine-et-Inf^rieure. .

Aisne , •

Ois;

Marne

Seine-et-Marne. . . .jr.

806 155 155 151 129 127 125 114

70 29.5

7.9 29.1 19.1 14.4

10.9

SUlCrOES FEW.

Departments.

'3

m

Corse .

Loz^re

Hautes-Pyrenees

Cantal

Hautes-Loire

AriSge ,

Py renees-Orientales . Haute-Savoie

6

7

9

9

9

10

10

11

31.4 32.4 11.8 25.2 43.5 66.6 41.6 15.8

occur. The Department of the East is next with 16 per cent., while of the remaining departments the three, Center, South and West, where education is lowest, the rate is only 34 per cent, between them. The influence of Paris as a city, however, where the rate is so high, weakens the force of M. Bronc's opinion to some extent. The following table from M. Bronc's book will be of in- terest.*

*" L'Europe, Politique and Social." Paris, 1869, p. 206, et seq.

SUICIDE AND LEGISLATION.

15

NATION AND RACE.

The tables of M. Bronc's, bearing on other questions, are equally interesting and valuable. Deaths from sui- cide in 1876, in each of the named countries :

COUNTRIES.

Proportion of

suicides to

1,000,000 pop.

Degree of Education. Percentage of Illiteracy.

Switzerland

England and Wales

Scotland

Ireland

Norway

Finland

Sweden

Prussia

Bavaria

Belgium

Austria

Italy

United States

Nearly free from illiteracy.

33.

21.

46. Nearly free from illiteracy.

7. 30. 49. 73. 20.

These tables of M Bronc do not accord with our experi- ence in the United States respecting ignorance and crime, nor are they in accord with the better opinion in this country as to the relation of illiteracy to crime so far as we can estimate.*

It may be of interest to inquire concerning the causes of suicides, and I submit a few statistical facts concern- ing them.

DOMESTIC TROUBLES.

It will be observed that France and Italy have a higher rate of suicide from domestic troubles than other coun- tries. I quote a table : t

^Prisons and Reformatories, Home and Abroad. London, 1882. Kidder & Scbem, Op. Cit. Arb. Criminal Education. O'Dea on Suicide, 167.

f Compiled by O'Dea from tbe Belgian Statistics published in 1. Europe of Brussels. O'Dea, Suicide. 177.

16

SUICIDE AND LEGISLATION.

COUNTRIES.

Proportion of suicides to sex to 1,000 cases, from domestic troubles.

FEMALES.

Sweden . France. Italy. . . Prussia . Saxony . Norway

38

164

75

76

48

51

26

29

21

18

16

24

DRUNKENNESS.

Different countries show a wide difference in rate as to this cause of suicide. In Denmark it is stated to be nearly forty per cent. Nearly the same proportion is claimed for Norway and Sweden. In Italy, on the con- trary, only six out of every 1,000 can be attributed to this cause. It is estimated that at least seven per cent, of suicides are due to drunkenness, which I think rather too low.^

This author furnishes an interesting table, compiled from the census of 18 TO, contrasting suicides and deaths by alcohol in this country.

SUICIDES— DEATHS BV ALCOHOL IN THE UNITED STATES.

Suicides.

Deaths from Alcohol.

Chinese and Japanese

10 13 1 7 19 10 42

104 22

146 16

Other Soutli of Europe

5

Italians

3

Other North of Europe

3

French ...

12

(Scotch

22

English and Welsh

Irish ... -

57

488

Swedes, Norwegians and Danes

5

Germans

144

All others

12

Total

390

751

Indian

1

18

813

1

Colored

61

White

535

Total

832

597

Unknown

21

62

Affffreerate

1,243

1,410

•O'Dea, Suicide, p 184.

SUICIDE AND LEGISLATION.

17

NATIONALITY.

The difference in rate in different countries is remark- able, and while various writers account for it in various ways, there is really no satisfactory explanation. More- over, different cities in the same country will have a widely different rate. In England the rate is highest in the southeastern counties and lowest on the western coast.* France shows the same phenomena as before stated.

In our own country the proportion of suicides in San Francisco, and in the cities of Nevada, is very largely in excess of New York, Brooklyn or Philadelphia. The following table from the work of Dr. O'Dea gives the general ratio as to race and nationality : t

NATIONS.

No. of suicides in 1.000,000 pop.

1

NATIONS.

No. of suicides in 1,000,000 pop.

Portugal

7 14 16 25 26 80 35 40 68 94 66

Belgium

Austria Cisleithauia

Bavaria

Baden

55

Spain

Ireland

84 73

Russia

109

Italy

France

Prussia

110

Finland

123

Scotland

United States. . . Eng. and Wales . . Norway

Wurtemberg

Switzerland

Denmark

164 206

288

Saxony

251

Sweden

The study of the causes that make the rate so greatly in excess in Switzerland, France and the German -speak- ing countries, is very interesting, but I have not space for it in this paper. The largest numbei' of suicides in

^ *Report of English Register-General for 1873. ' fTable of Dr. O'Dea, Suicide, p. 199.

18

SUICIDE AND LEGISLATION.

London in any one year was in 1846, during the great railroad panic, and the per cent, rose from Y.2 per cent, to 12.8 in the 100,000 population in France in 1847.

The vital statistics of Ireland show an increase of suicides from 7.57 to 8.41 in the decade that witnessed the great famine in that country.^"

The statistics of Quetelet, to which allusion has been made, are analyzed and formulated by O'Dea, pp. 113,

140 and 141.

GENERAL CAUSES.

Brierre de Boismont gives the following table, made from a study of 4,595 cases of suicide (pp. 261 etc.).

Tables of Brierre de Boismont, from authentic docu- ments of the causes of suicide, selected and analyzed from 4,595 cases :

CAUSES OP SUICIDE IN ITALY.

Unhappiness

Loss of employment . . Reverses ot fortune. . . .

Domestic trouble

Hindered love

Disgust of m'lty s'rvce

Disgust of life

Fear of condemnation

Jealousy

False point of honor, . . Ante-nuptial pre<:nacy,

Drunkenness

Physical suffering. . . .

Cerebral fever

Insanity, delirium. . .

Monomania

Pellagra ,

Idiocy, imbecility — Unknown

NUMBER OF SUICIDES.

1876.

187^

Per 1,000 Suicides 1877]

Total

64

7

141

93

47

7

26

21

5

7

6

7

59

5

127

18

55

8

321

Males

F'm'les

Total

Males

F'mTs

Males

58

6

105

92

13

100.55

7

2

2

2.19

136

5

104

102

2

111.47

73

20

88

68

20

74.32

33

14

36

19

17

20.76

7

8

8

8.74

23

3

28

27

1

29.51

21

24

24

26.23

4

1

6

5

1

5 46

7

11

11

12.02

6

4

4

6

1

6

6

6.56

51

8

79

64

15

69.95

4

1

7

4

3

4.37

89

38

136

95

41

103.83

12

6

24

15

9

16.39

38

17

121

77

44

8415

7

1

12

9

3

9.84

278 [ 854

43

338

287 1 915

51

313.66 100,000

170

1,139

244

58.04

8.93 89.29 75.89

4.46

4.46

17.86

66.96

13.39 183.04

40.18 1^)6.43

13.39

227.68

100,000

*0'Dea, Suicide, p. 277.

SUICIDE AND LEGISLATION. 19

FIRST GROUP.

Drunkenness 530

Poverty, Misery 282

Reverses from financial embarrassment 277

Licentiousness 121

Laziness 56

Want of Work 43 1,309

SECOND GROUP.

Insanity 652

Ennui— disgust of life 237

Feebleness — sorro ^ , melancholy 145

Acute delirium , 55 1,089

THIRD GROUP.

Domestic troubles 361

Other troubles 311 672

FOURTH GROUP.

Sickness 405 405

FIFTH GROUP.

Love 306

Jealousy 54 360

SIXTH GROUP

Remorse, dishonor, criminal prosecution 134 134

SEVENTH GROUP.

Gambling 44 44

EIGHTH GROUP.

Priile and vanity 44 44

NINTH GROUP-

Unknown motives 556 556

Total 4,613

And as a further analysis of causes, I give another table from this same author. -

TABLE OF ANALYSIS OF 676 CASES OP SUICIDE.

Bade adieu to parents, friends and the world 278

Gave directions as to funeral and burial 105

Asked pardon for their suicide , . . , 45

Evinced solicitude for parents or children 43

Had confidence in Divine forgiveness 36

Expressed regret at leaving world, friends, etc 38

Avowed belief in a f ut ure state 22

Died in liouses of ill-fame 18

Expiated faults or asked forgiveness 30

Desired the prayers of the Church 11

Prayed friends to shed tears to their memory 11

Ascribed their death to useless motives 11

Expressed horror at their own death 9

Wished their death concealed for sake of family IV

*Brierre de Boismont, Suicides, p. 262.

20 SUICIDE AND LEGISLATION.

2. As to the second proposition or inquiry, viz. : *' What can best be done by society to diminish the increase of suicide, hj legislation or otherwise ? " Whether suicide is on the increase or not, is of sufficient consequence to justify us in studying whether and how far the evil may be avoided, and what legal or punitive measures for its repression or punishment can be adopted. How far can such measures act as a restraint upon mankind to pre- vent suicide ? What restraining influences can be used or adopted, the tendencies of which will be to diminish the volume of suicide ? But little doubt can be enter- tained that the extreme laws of the Eomans, Greeks, and the earlier laws of France and Great Britain, bar- barous as they may now seem, must have operated largely to deter many from the commission of this crime.

It is, of course, quite impossible to know how many have been thus deterred. Those who were thus prevented in the nature of things can neither be counted, nor with certainty be calculated. One means of forming an opinion is by comparing recent suicides, in proportion to the population, with other times ; and the better opinion is that those laws must have exercised a decided and beneficial restraint.

Buckle and Comte both concur in the unwisdom of legal enactments against suicide. *

The verdict of history must, however, be on the other side, and tend decidedly to show the beneficial effects of punitory laws, when strictly enforced. f

^Civilization, vol. 1, pp. 19, 20; Traiie de Legislation, vol. 1, p. 486.

f O'Dea on Suicidr, p. 278, who cites also Tarquiu's proclamation to the Roman army. The edict of the Milesian authorities. The famous order of Napoleon I. to his army, which stopped what might otherwise have been a serious epidemic among the French soldiers.

SUICIDE AND LEGISLATION.

21

It is most reasonable to suppose that the certainty of loss of goods, disgrace to family, and indignities to the remains, would have deterred many weak or vain per- sons, who have committed suicide in the past, with no possibility of such results attaching if punitory laws had existed and been enforced. Besides the cases cited where orders, regulations and laws have clearly operated to arrest suicides in epidemical periods, I have felt it im- portant to cite the effect of legislation in British India to suppress that system of suicide formerly so prevalent there, and known as

SUTTEE.

Following is a copy of the official returns of suttee in India, from 1815 to and including 1828 :

DIVISIONS.

1815.

1816.

1817.

1818.

1819.

1820.

1821.

1822.

1823.

1824.

1825.

1826.

1827.

1828

Calcutta

2.53

289

442

544

421

370

372

328

340

373

398

324

a37

308

Dacca

31

24

52

58

55

51

52

45

40

40

101

65

49

47

Murshedabada.

11

22

42

30

25

21

12

22

13

14

21

8

9

10

Ratna

20

48

29 65

49 103

57 137

40 92

62 103

69 114

70 102

49 121

42 93

47 55

65

48

55

49

55

Benares

33

Barielly

15

13

19

13

17

20

15

16

12

10

17

8

18

10

378

442

707

839

650

627

634

583

575

572

639

518

517

463

This practice was suppressed in Southern India by Lord William Bentwink declaring it a crime punishable by the Criminal Court. ^

All India was freed by similar laws and regulations adopted by the British generals, which have effectually suppressed the practice.

What would be the effects, if the unsuccessful attempt

* Wheeler's History of India, vol. 3, p. 373. O'Dea Suicide, 306.

22 SUICIDE AND LEGISLATION.

at suicide was punished by law as a crime in all cases, and a conspicuous example made of the offender ? Would it not operate as a wholesome restraint, in some cases at least, against the commission of the act^?

LEGISLATION PROPOSED IN FRANCE.

The most striking proposition of recent times is that submitted by M. le Dr. Jeannel, to the International Medico-Legal Congress, at the Paris session of August, 1878, to provide by law, that the corpses of all suicides be furnished to the medical schools for dissection, except in such cases as the victims were insane or irresponsible. By the Penal Code of France, Art. 64, it is provided, that suicide is not a crime when committed by a person who is insane at the time, ' ' en etat de demence au temps de V action.'^ Dr. Jeannel supported his proposition by a strong array of facts, and claimed :

1. That such a law would increase the resources of the medical schools, for careful and valuable anatomical studies, etc.

2. Seriously diminish the number of suicides. He proposed the following points for the consideration of the Congress :

1. Each particular case of suicide should be given to a Medico-Legal determination or Commission (une con- sultation Medico -Legale) to determine as well the fact of the suicide as the sanity of the victim.

2. The passage of a general law requiring that the body of every suicide who was found to be sane and

SUICIDE AND LEGISLA.TION. 28

responsible for his acts should be sent to the medical college (Amphitheatres Anatomique).

Tt was objected by M. Lacassagne that it would be very difficult to execute such a law as Dr. Jeannel pro- posed. He alluded to the difficulty of transporting dead bodies to the anatomical schools, especially from a dis- tance, and also to those persons who from religious scruples oppose the dissection of bodies at all in the hos- pitals or anatomical schools. He also thought that a very strong feeling of opposition would arise on the part of the families and friends of suicides to such a disposi- tion of the remains.

M. Gubler took part in the discussion and opposed the proposition, claiming that such a law would aggravate the situation of families so unfortunate as to have a suicide occur in their midst, and that it would be another evil for them to bear, added to the shame and disgrace of the act itself. He feared also that instead of increas- ing the anatomical subjects, it would create a feeling against the schools, which would in the end operate to diminish the number of subjects to be obtained.

M. Devergie, who pr jsided at the session of the Inter- national Congress, expressed a doubt whether the Legis- lature would consent to deprive a family of its rights to dispose of the remains of one of its members who had committed suicide.

No action was taken by the Congress upon M. Jean- nel's proposition.

The objections thus presented were considered by Dr,

24: SUICIDE AND LEGISLATION.

Jeannelj in a reply submitted as annex No. 2, which forms a part of the pubhshed proceedings of that Con- gress, and in which the questions involved are treated with signal ability.

To the objection as to the transportation of the dead bodies, he submits that the experience of the commission of the French Society of Medical Jurisprudence had demonstrated the entire feasibility of transporting dead bodies, and perfectly retarding putrefaction by the use of phenic acid, and gives the formula which perfectly embalms the body at a cost of five or six francs, which was then in actual use throughout France between the various prisons and medical schools.^

Dr. Jeannel meets the objections raised with powerful arguments. He demonstrates the right of the Legisla- ture to pass such a law, and argues that it would not only have a beneficial result as a restraint upon suicide, but sensibly aid the schools in their labors.

While it must be conceded that families would at first object to such a disposition of the bodies of suicides, it is upon a solid and safe principle that such a law would be founded if the Legislature should pass it. The bodies of murderers or criminals, if furnished for dissection to the medical schools, present quite the same question, whether the criminal is a suicide or a murderer of some one beside himself.

The consequence upon the family is one of the real

* Poudre Antisepiique de Wafflai'd. Acide Phenique brut., 1. Seiure de hois, 4.

SUICIDE AND LEGISLATION. 25

arguments for the passage of such a law, because the suicide, if sane, must consider all the consequences of his act, and this must operate in many cases as an enormously powerful restraint against the commission of the crime.

No valid legal objection could be raised by the family in the case of a suicide, that could not be raised if a member convicted or accused of any other crime should die pending trial, or after conviction while in prison.

No question of this character had force against the ancient punitive la^s.

What is needed is additional force upon the moral sense of the community, to render the crime of suicide more generally odiou'^ and detestable.

There is at present practically no legal restraint against suicide.

The suicide has nothing to fear for his crime, even if unsuccessful. Our laws are not enforced.

Is society doing its whole duty in the matter ? Should not such legislation be considered as would be calculated to arrest the hand of weak persons, who now really encounter no resistance to their suicidal ideas and ten- dencies, by legislation or public sentiment ?

Of course, laws of all countries recognize insanity as a defence to crime. Suicide is within that rule. No insane or irresponsible person can be held responsible for suicide.

Dr. O'Dea admirably suggests the great value and im- portance of religious and moral training, as an important

26 SUICIDE AND LEGISLATION.

factor in preventing suicide. He most ably supports this, as well as the value of medical advice and treat- ment, as a means of prevention, in the closing chapters of his w^ork.

These should not be neglected. They should be studied and made use of to the fullest extent. But can we rely alone upon these means as a preventative ?

The question is one of great importance and worthy serious study. Dr. O'Dea has dedicated his work : '^ To the Medico-Legal Society of New York, whose success- ful efforts at medical, legal and social reform reflect honor on itself and lasting benefit on the community. "

This work has been of great value in the preparation of this article, and while the author only touches lightly on the legal means of prevention, the weight of the book favors sound action, if public opinion would be behind proper remedial legislation, without which no important reform can be accomplished by legal means. If this Society can be useful in awakening public inter- est in sach reaiedial legislation as would save the lives of even a few unfortunates who would otherwise perish by their own hand, it would, I feel quite sure, be doing good work in thus acting. If it can be instrumental in bringing into force and play any elements within the commonwealth that shall so intensify and make odious this growing crime of suicide, it ought not to hesitate long in its action.

The consideration of the feelings and wishes of the family and friends of the suicide, we must all feel

SUICIDE AND LEGISLATION.

27

sensibly ; but higher and broader and nobler than these is the great good to the State, the public conscience and the heart.

I am not aware what action has been taken by the French Society upon this question, or whether any action has been taken, but I have thought it not inconsistent with my duty to bring the subject to the thoughtful attention of the Medico-Legal Society of New York.

APPENDIX.

Suicides in the United States and Territories at the Tenth Census :

STATES ANDTERRITORIKS. SUICIDES.

Alabama 10

Arizona 8

Arkansas. 14

California 188

Colorado 12

Connecticut 40

Dakota 7

Delaware 1

District of Columbia 13

Florida 1

Georgia 28

Idaho 3

Illinois 171

Indiana 115

Iowa 178

Kansas 43

Kentucky <'4

Louisiana 34

Maine 49

Maryland 33

Massachusetts . . 134

Michigan 101

Minnesota 49

Mississippi 15

STATES AND TERRITORIES.

SUICIDES.

Missouri 99

Montana 13

Nebraska 13

Nevada 13

New Hampshire 31

New Jersey 07

New Mexico 3

New York 332

North Carolina 20

Ohio 191

Oregon 20

Pennsylvania 219

Rhode Island. 10

South Carolina 16

Tennessee 39

Texas . . 65

Utah 4

Vermont 22

Virginia 23

Washington Territory 9

West Virginia 14

Wisconsin 7<>

Wyoming 1

Totil— United States 2,517

Saice reading this papei", I have seen some statistics

28 SUICIDE AND LEGISLATION.

prepared by Dr. John T. Nagle, of suicides in the city of New York for the eleven years ending December 31, 1880, also the proportion of suicides to the population of New York City from the year 1804 to 1880, inclusive, from which I make some interesting extracts. Dr. Nagle claims that :

1. There is a marked difference in the number of suicides, based on nationality, the Germans especially exceeding the Irish in number.

2. That as to sex, the males exceed the females in number, during past eleven years, by males, 1193 ; females, 328. The proportion being 3.64 males to one female.

3. The highest rates of suicides in New York City dur- ing the past seventy-seven years was in 1805, when there was one to every 3,017 inhabitants; and the lowest in 1864, when the rate was 1 suicide to 23,827. In 1874 the rate was one to 5,515, and was the largest year since 1834, when the proportion was 1 to 3,474.

The maximum among males was between the ages of 35 and 40 years, and of females between 30 and 35 years.

4. The age and sex of suicides in New York for the eleven years ending December 31, 1880, was :

Males 1,193

Females 328

Total for eleven years 1,521

Average for each year 138.i^oo

Dr. Nagle has classified these deaths, to see whether time of year influences suicide, into four quarters of

SUICIDE AND LEGISLATION. 29

the year and for the eleven years, with the following result :

First quarter 341

Secoud quarter 417

Third quarter 412

Fourth quarter 351

He states that these relations vary in different years. He states that the average annual rate of suicide for the eleven years was 16.7-1: to every 100,000 of the native population.

During the same period the rate was for foreign born population 26.24 to every 100,000. It was less frequent among the colored than the white population.

The table of nationalities is interesting, the Belgian heading the list and the Irish of foreigners being the lowest, viz. :

Austria 20.54

Britisli America 27.28

Bohemia 29.C5

China 57.82

Denmark 56.39

England 27.68

France 45.27

Germany 34 49

Holland 47.13

Italy 13.98

Norway , 51.23

Poland 1876

Portugal 96.77

Russia 12.86

Scotland 23.84

South America 92. 15

Sweden 39.04

Switzerland 77.09

Spain 56.92

Wales 13.49

Cuba 43.53

Belgium 115.06

Ireland 9.71

United States 5.61

The data as to Belgium is more curious than reliable, as the total Belgian population for the eleven years was only 478, and the number of suicides six.

In the table of causes, 503, or really one-third of the whole number, was by poison^ of which Paris green was the favorite, causing 200 deaths, and various forms of opium, 139 deaths Pistol, gun-shot wounds caused 399

30 SUICIDE AND LEGISLATION.

deaths, hanging 239, cutting throats or arteries with razors and knives, 175, leaping from heights 82, and drowning 101.

There are interesting tables in Dr. Nagle's paper, in regard to foreign cities and American cities, for which I regret that I have no space. Dr. Nagle's tables are especially valuable, for the reason that he has the benefit of the State Census of 1875 ; while all the tables I have hitherto seen were based upon the U. S. Census of 1870. I am indebted to the Commissioner of Patents for the first table in appendix, based on the census of 1880, which his courtesy has enabled me to furnish since my paper was read.

SUICIDE AND LEGISLATION.

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THE MENOPAUSE: ITS RELATION TO

INSANITY.

By T. R. Buckham, A.M., M.D.

I have just read with Hvely interest the ''paper" by Mr. Chamberlain, the discussion had thereon, and the editorial comments as they appeared in the Medico- Legal Journal of last month.

Without specially referring to the '^ Druse Case" (of which there is not sufficient evidence in the Journal to enable any reader to form an intelligent opinion), an examination of the general medico-legal question of the relation of the menopause to insanity, may not be wholly without interest or profit.

To properly study this question, the natural method would appear to be, to first interrogate nature, as to the uses of the function of menstruation, and thereby try to discover the intention of the Creator in making that most marvellous and beneficent provision for women.

From the general natural organization of woman, it is obviously intended, that from a certain age to a certain age she shall bear and nurse children, as before the ova are developed, and after they are all gone, there is no menstruation.

During pregnancy the woman is subjected to the

* Read before the Medico-Legal Society, April Meeting, 1888.

THE MENOPAUSE : ITS RELATION TO INSANITY. 33

annoyance and inconvenience of displaced pelvic viscera ; subjected to the additional load of increased weight and bulk, causing more or less nervous irritation ; be- sides there is a draft upon her vital force for the sup- port and growth of another being, and, added to these, the exhaustion consequent upon parturition and lacta- tion. Under such an accumulation of burdens, were it not for the wonderful compensation of the menstrue, a large percentage of our delicate ladies would inevitably succumb under the grievous superimposed load conse- quent upon pregnancy, and even the strongest of the sex would in time have their constitution sadly debili- tated, if not utterly shattered.

The design of nature is, to utilize all her vital forces in the growing girl, that her body may develop into vigor- ous womanhood ; but when that condition has been attained, when it is possible, nay, probable, that new and exhausting demands may soon be made upon her strength, nature has generously arranged for the gen- eration of more vital force than is necessary for her ordinary maintenance, which excess will be periodically thrown away, until the extraordinary demand caused by pregnancy shall arise, then the catamenial excess will cease to be thrown away, will be retained in the ex- pectant mother's person, and, so admirable and com- plete is the compensation afforded, that pregnant women during their full term are often stronger and more healthful then, than they are at other times, and they are in like manner compensated during lactation. The same

34 THE MENOPAUSE : ITS RELATION TO INSANITY.

compensation is often observed when a woman is the sabject of any wasting disease, e.(/., it is well known that the cessation of the menses is often the first indication of tubercular consumption. As the strength and vitality have begun to fail when the age of forty-five or fifty has been reached (the ova being all gone, there can be no further extraordinary demands made on account of pregnancy), then conservative nature permanently stops the waste, and utilizes all the vitality the mother gener- ates in building up her partially worn out body.

From the foregoing, would any person, a priori, expect from this most marvellously benign provision of nature, the dire results which are by many claimed for the menopause ? Reason would assuredly answer no, and we do not think that facts can be found to seriously conflict with reason in the premises.

It will possibly be a matter of surprise to those who are not familiar with that department of literature, *' Diseases of Women," that in the elaborate works of those who have made '^ woman, and her diseases," their special study, with all their advantages for prosecuting that study, the menopause is not mentioned at all by many of the most eminent of those writers and observers, and by others it receives only a brief passing notice, as of little importance. Among these authors are the cele- brated names of Sir J. Y. Simpson, Churchill, Leishman, Thomas, etc., while Cazeaux and Tarnier (p. 114, 8th Am. Ed.) say: '^In the majority of cases, all these troubles are quite slight and disappear promptly ; but,

THE MENOPAUSE : ITS RELATION TO INSANITY. 35

in some instances, diseases, before latent, then declare themselves. It is this fact which, though much rarer than is commonly supposed, has obtained for this time of life, the name of the critical period. Its dangers have been wonderfully exaggerated, and modern researches prove, in opposition to the opinion of physicians who have preceded us, that the organic affections of the breasts, of the uterus, and of the ovaries, begin much more frequently before, than after the cessation of the menses." They do not mention insanity as one of the sequelae. Ziemssen, in his Cyclopaedia of Medicine, takes substantially the same view, and my own obser- vation fully coincides with the authorities quoted. The weight of authorities unquestionably indicate more men- tal disturbance at the beginning than at the eyiding of menstruation. When the function begins there is generally considerable nervous excitement, which is also usually the case at every return of the period, and it could not be expected that a natural habit of thirty years' standing, together with the retention of vitality in the system, which during that period had been thrown away, would take place without some physical disturb- ance. Occasionally there is some cerebral congestion, which, unrelieved, might resuli in organic disease of the brain, as might any cerebral congestion ; but if such a case should occur from that cause, it would simply prove neglect ; the insanity would not arise ex necessi- tate rei, as a little depletion affords speedy and perma- nent relief.

36 THE MENOPAUSE : ITS RELATION TO INSANITY.

It is possible that a latent strong predisposition to in- sanity might be developed into activity by the nervous irritability and excitement incident to either menstrua- tion or the menopause ; but if there be no evidence of such insanity other than the commission of an atrocious crime, the perpetration of the heinous wickedness would not of itself be any evidence of insanity, especially when an adequate motive, such as revenge for cruelties and injuries endured, were shown. As insanity is the result of physical disease, brooding over long -continued, unmerited wrongs and cruelties would naturally lead to perversion of the moral nature, but such brooding could not produce pathological changes in the brain tissue.

Were the atrocity of crime regarded as evidence of insanity, then Catherine de Medici, the instigator of St. Bartholomew's Massacre, must have been very insane.

When a woman becomes insane at the age of forty- five or fitty, we believe the time is simply a coincidence. As there is no adequate cause in the menopause to pro- duce an organic lesion of the brain, the conclusion appears to be inevitable that it cannot, de nova, cause insanity, ex nihilo nihil fit.

THE MEDICAL JURISPRUDENCE OF INEBRIETY.''

By Joseph Parrish, M.D,, Burlington, N. J.

Before entering upon the discussions of the subject we have in hand, it is essential to an intelhgent view of it, that we agree upon the meaning and appHcation of terms. The words, Drunkenness, Intoxication, AlcohoHsm, In- ebriety, etc. , are so carelessly and interchangeably used, that I shall confine myself to Inebriety, the Disease, as distinguished from other forms of alcoholic effects, and especially from the daily drunkenness of the saloon and the street. The typical ineberiate comes into the world with the ^'mark of the beast upon his forehead," or it may be with a vestige only of an ancestral taint, which inclines him to seek indulgence in intoxicants of some kind. In other words, he is born with a decided alcoholic diathesis, or with a positive tendency to form one. That is to say, that where the hereditary impulse is not sufficiently potential to impart a complete dia- thesis, it leaves only an inclination or tendency to free indulgence, which, if continued in excess, mil grow into a constitutional demand, as imperious and exacting as in the other case.

* Read before the Medico-Legal Society of New York, at its Annual Meeting, bel4 Pecember 14, 1887,

38 THE MEDICAL JURISPRUDENCE OF INEBRIETY.

Such persons are moved at times by a passion for indulgence, which is beyond their control. It comes at intervals, it may be weeks, or months, during which periods of time they not only have no desire for alcohol in any of its forms, but a loathing and disgust for them. It is not the taste or appetite for them that is to be satisfied, but the effect. They long for a condition of oblivion, of forgetfulness of self, and of all selfish and annoying cares and troubles and moods. Neither have they any desire for convivial companionship. The glitter and glow of public resorts, where liquor is the prime factor of wrong and ruin, have no attractions for them. They are not tempted by such displays. The tempta- tion, with which they are tempted, is within. It is sub- jective. It circles in the stream that gives them life. It may be likened to a battery that is hidden somewhere in the cerebral substance — connected by continuous fiery wires, with a coil in every ganglion, from whence they continue to extend — attenuating and distributing, as they go, reaching after the minutest neive fibrils, which need only a throb from the inborn impulse, to transmit a force that quivers in every muscle, and burns in every nerve, till the victim is suddenly driven from himself, into the ways of unconscious debauchery. Technically, it is a brain or nerve storm, which dominates all other conditions, and leaves the patient, for the time, without any power to control his own acts.

Dr. J. M. Howie, of Liverpool, England, says, that such a man possesses no power of resistance, ^Hhat he

THE MEDICAL JURISPRUDENCE OF INEBRIETY. 39

drinks as naturally as a fish swims, or a dog barks ! " Dr. I. B. Hurry, also of England, describes the craving for drink as ' ' coming in the form of a paroxysm, which runs a more or less cyclical course." He calls it '^uncon- trollable drunkenness ! " and quotes Dr. Hutcheson as saying, ''That this sort of mania differs entirely from drunkenness, the diagnostic sign of the disease being an irresistible propensity to swallow stimulants in enormous doses, whenever and wherever they can be procured. This form of inebriation is often, if not usually, found in our most useful professions — men of letters and culture, of refined tastes and manners, who scorn the low-lived friendships of the groggery, and who vainly strive for liberty.''

Dr. Norman Kerr, of London, the faithful friend of the inebriate, and eloquent advocate for legislative aid in his behalf, has used the following most impressive language : " The struggle of the intemperate for freedom, is a com- bat more terrible than any other fight on earth. It is more arduous than the most celebrated of those, the praises of which have been from remotest ages immor- talized by undying verse." It remains yet to notice a most important and prominent symptom of inebriety, which, together with periodicy, constitutes its real pathognomonic sign, namely, loss, or suspension of con- sciousness and memory, without sleep or stupor, during which the patient acts automatically, being without knowledge of his actual condition, at the same time ap- pearing to be, ani to act. naturally. I have had numer-

4:0 THE MEDICAL JURISPRUDENCE OF INEBRIETY.

ous cases of the kind, of which the following are ex- amples.

G. A., a young gentleman who resided about four- teen miles from the city, left home to visit friends, and to attend to a few errands, agreeing to return by an early evening train. He called on his friends, attended to his business, accomplishing all that he intended to do on leaving home, but did not take the early evening train to return. Instead of doing so, he unfastened a fine look- ing horse and vehicle from a hitching post on the side- walk, mounted the carriage, and drove safely to his home, fourteen miles away. He crossed the river by a bridge, avoided collision with vehicles of all sorts on a crowded thoroughfare, paid toll at all the turnpike gates through which he passed, and reached home in safety and in good season, with the horse in good condition, showing that he had not been abused by fast driving. He was taken to the stable, and the young man retired to his room. In the morning, having slept off the effects of a few potations of whiskey, he met his family in the breakfast- room, having no knowledge of having reached home in the way he did, and was surprised to find in a morning paper an advertisement for the horse and wagon Ashamed and humiliated by the discovery, he proceeded at once with an attendant to answer the advertisement. The owner, being a physician and tak- ing in the situation, was thankful to find his favorite horse unabused. The two gentlemen, shaking hands and congratulating each other upon the safe and satisfactory

THE MEDICAL JURISPRUDENCE OF INEBRIETY. 41

issue of a bold and reckless experiment, with abundant apologies on one side, and full forgiveness on the other, separated, having left for you and me a record of an interesting case of cerebral automatism, to become a part of the proceedings of this society.

Another, Professor W , a Christian gentleman and

scholar, a popular and successful teacher. The passion comes to him unbidden, and even without previous thought on the subject, and sometimes suddenly. He may be engaged in his study preparing to meet his class, and there comes over him a seeming cloudiness which darkens his mind, and he seems lost to things about him. Without seeming to know why, he leaves his study and his home, seeks the village near which he lives, takes a few drinks of whiskey, casts aside all sense of self-respect, all care for the opinion of others, resists all appeals to stop and stay, and with a recklessness unknown to him in a state of sobriety, abandons himself to his cups and their consequences. During his carouse, he hires a horse and buggy, drives into the country, visits friends, dines or sups with them, remains till the next day, returns to the village, pays for his horse and carriage, settles his saloon bills, and when quite himself again, goes to his home, seatshimself in his study, resumes his preparation for his classes, without remembering anything that was done during his absence. The interval between the cloudy feeling in his study and his return, sobered, mor tified, and overcome with self-reproach and remorse, is a complete blank.

42 THE MEDICAL JURISPRUDENCE OF INEBRIETY.

My friend and colleague, Dr. Crothers, of Hartford, Conn., has brought to light a number of similar cases, and published them in a valuable brochure which every student of this subject should read; it is called '^Cere- bral Trance, or Loss of Consciousness and Memory in Inebriety."

The phenomenon of unconscious cerebration, of which I have produced two examples, is seen, and sometimes in a more marked degree, in the disorder known as Som- nambulism, which has no connection with alcohol as a factor, and yet its exhibition of amnesia under remark- able conditions leads to the suspicion that both disorders may be traced to a want of equilibrium in the same nerve centres, or in those that are closely allied to each other, by which, in both, there is impaired consciousness. Dr. Clouston tells us of one, Simon Fraser, a highly neurotic subject, who had been a sleep-walker all his life, and did all sorts of things in accordance with his illusions and false beliefs, during his somnambulistic state. He once went up to his neck in the sea of Norway, and did not awake. At last one night, while in a somnambulistic state, he seized his child, to whom he was much attached, thinking it was a white animal, and dashed it against the wall and killed it.*

From Dr. Crother's pamphlet we learn of a record made by Dr. Forbes Winslow, " Of a somnambulist who, while walking about, his night dress caught fire, and with

*A full account of the case and the trial, is given in The. Journal of Mental Science, Vol. XXIV., p. 451.

THE MEDICAL JURISPRUDENCE OF INEBRIETY. 43

excellent judgment and coolness, he threw himself on the bed and extinguished the flames, resumed his walk, and next morning had no knowledge or memory of the event, and wondered greatly how his dress became so charred.

Another exhibit of cerebral automatism, whose con- sciousness was either obliterated or suspended, is the most remarkable case of the Massachusetts farmer. His rye harvest had been carefully stored ; and when the threshing season came, he arose from his bed, went to the barn, climbed to the mow, and threw down a floor- ing of sheaves ; threshed them, raked the straw away, and deposited it in a place provided for it, swept into a heap the rye, and after repeating this act four times, returned to his house and bed, and in the morning was surprised to find that he had threshed several bushels of rye while in the state of automatism.

THE SCIENTIFIC STUDY OF INEBRIATE

CRIMINALS^

By T. D. Crothers, M.D. Superintendent Walnut Lodge, Hartford, Conn.

The question of the sanity or insanity of an inebriate criminal in court has so far been decided on theory, law and precedent. Medical testimony is made to conform to legal theories and court-rulings, irrespective of all other conclusions. Courts have dictated to science what the test of responsibility should be, and given definitions and explanations of abnormal conduct, requiring the medical witness to bend his views to such theories Not only has the law laid down arbitrary lines, as if they were fixed principles of nature, but it has assumed to decide all questions of brain health on the same basis, accepting scientific evidence only so far as it sustains such theories- Medical testimony in courts indicating insanity, that is not sustained by overwhelming evidence, comes under the suspicion of prejudice in the prisoner's favor, or incompetency of the witness. The practical result from such errors is a degree of confusion, injustice, and great wrong, that is a sad reflection on the intelligence of both

Read before the Medico-Legal Society, New York, Dec. 14, 1887.

THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS. 45

the medical and legal professions. My object is to call attention to the inebriate criminal^ and to indicate the scientific methods by which such cases are to be studied, and to show some errors which have followed from the failure to understand the facts in these cases.

The inebriate appears in court as a criminal, the crime is admitted, and the question is raised of his mental soundness. It is asked : Did the prisoner at the time of committing the crime realize the nature and conse- quences of his acts and conduct ? Had he the power of self-control to have done otherwise had he so willed? Was the inebriety and crime voluntary and with motive ? or involuntary and without motive ? From the answers to these inquiries, the mental health and condition of the prisoner is determined.

The scientific expert who is called to answer these in- quiries should approach the problem without any knowl- edge of the legal rulings and questions of responsibility of such cases, held by courts. His province is simply to examine the facts, and the conclusions which they seem to indicate , which are in harmony with the laws of nature.

As a scientific expert of the phenomena of the mind and its morbid manifestations, he is not called to deter- mine questions of legal responsibility, but must point out the facts, show their accuracy and meaning, no matter what the consequences or conclusions may be This cannot be ascertained from newspaper reports, statements of counsel, or slight examination of the pris-

46 THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS.

oner. Such a study, to be accurate, should begin and follow a general order of facts, as follows :

1. Legally the crime is first studied, but medically this order is reversed. First, study the history of the crimi- nal, then the crime. Often a history of the criminal distinctly indicates the nature and character of the crime. The heredity of the inebriate criminal should be the first object of study. From a knowledge of the defects and diseases of the parents, of their strength, conduct and character, a general conception can be had of their de - scendants.

2. A study of the prisoner's early growth, culture, training, nutrition, surroundings and occupation, reveals many facts indicating the brain capacity or incapacity to act normally.

3. The inebriety of the prisoner still further points out his mental condition. The origin, duration and character of the drink impulse, are most important facts for minute

study.

4. The nature and character of the crime, the associate circumstances, including the inebriety, all bring ad- ditional evidence pointing out the actual mental state of the prisoner. From a systematic study of this kind, the prisoner and his crime will appear clear and distinct. Not as an outburst of vice and wickedness, but as the natural sequence of a long, progressive march of physical events. Inebriety and criminality are not accidents, but the products of causes, the outcome of conditions, which have grown up in obedience to laws that move

THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS. 47

on with progressive uniformity. This is illustrated in the history of every case which can be f ollov/ed along a continuous chain of events, dating perhaj^s from hered- ity, degenerate growths, up to inebriety, then to crime. Both the crime and inebriety are but symptoms of dis- ease and degeneration, culminations of events whose foot- prints can be traced back from stage to stage. Attempts to apply dogmas of free-will, and show at what point powers of control existed or were lost, where conscious- ness and unconsciousness of events joined, or where sanity or insanity united, is to attempt the impossible. To the scientific man, the knowledge required to deter- mine these facts extends far beyond the widest range of human intellect.

In the efforts to determine the mental soundness and brain health of a prisoner in court, there are certain gen- eral facts already established that will serve as a founda- tion from which to date more minute and accurate studies.

1 . The inebriety of any person is in itself evidence of more or less mental unsoundness. Alcohol, used to ex- cess and to intoxication, is always followed by changes of brain circulation and nutrition. Degrees of mental impairment and paralysis always follow, whether recog- nized or not.

2. In a large proportion of cases inebriety is only a symptom of slow, insidious brain disease, particularly general paralysis, also of many forms of mania, dementia, and other brain degenerations.

48 THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS.

Here, notwithstanding all appearances, the inebriate is diseased and unsound mentally.

3. When crime is committed by inebriates, growing out ot the inebriety or associated with it, the probability of mental disease and some form of insanity is very strong. Inebriety always favors and prepares the way for the commission of crime.

4. Whenever it appears that persons have used spirits to intoxication, for the purpose of committing crime, this is evidence of a most dangerous form of reasoning mania, requiring the most careful study.

From these general facts, which should govern the expert in such cases, I turn to indicate the great in- justice which has followed in some late prominent trials, from the failure to realize and apply these principles.

Peter Otto, a chronic inebriate, shot his wife in a drink paroxysm. On the trial, the insanity of the prisoner was raised. Several medical experts testified to his sanity, and explained his unusual conduct as that of a simulator. He was found guilty and sentenced to death. An appeal was taken, and a year later I examined this case. Begin- ning with heredity, the prisoner's grandfather, on his father's side, and grandmother, on his mother's side, were both insane ; the former died in an asylum. His father was a paroxysmal inebriate, and a morose, irritable man, who died in Andersonville prison. His mother, still living, is a passionate, half insane woman, being irritable and suspicious, and drinks beer. One of her sisters died insane. The prisoner's early life was one of great

THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS. 49

wretchedness and neglect — in the street and saloon. He was ill-nourished, and drank beer at home and wherever he coald get it. At ten he was injured on the head, and was treated in a hospital for several weeks. At puberty he drank to intoxication and gave way to great sexual excess. Later, he was married in a state of great intoxi- cation and unconscious of it at the time. For ten years before the crime he drank to excess as often as he could procure money to pay for spirits. He grew quarrel- some, suspicious and very irritable, and at times acted wildly. He had the common suspicion of his wife's infidelity, without any reasonable basis. He had tried to kill himself on two different occasions, by the most childish means. He was injured again on the head and complained of bad feelings ever after. He was arrested on six different times on complaint of his wife and mother for violence when intoxicated, and was confined in jail from ten to sixty days. Two months be- fore the murder he was placed in jail, suffering from mania. The jail physician called his condition alcoholic insanity. The murder followed, while drinking to great excess, and grew out of a quarrel with his wife. He made no effort to run away or conceal himself. In jail he developed religious delusions of frequent personal con- versations with God. Heard voices and saw lights which he interpreted as God's messages to him. His appear- ance and conduct indicated great mental enfeeblement. My conclusion of insanity was sustained by the history of the heredity, growth, surroundings, inebriety, general

50 THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS.

conduct and delusions. A special commission of phy- sicians decided that he was sane and fully responsible, and on this conclusion he was executed.

The second case was that of Charles Hermann, a chronic inebriate, who, while under the influence of spirits, threw his wife down on the floor, cut her throat, and placed the body on the bed. That and the two following nights he slept in the bed with the dead body, going out in the morning and returning at night, acting as usual, drinking and manifesting no excitement or con- sciousness of what he had done. Three days later the body was discovered ; he described all the circumstances of the homicide, gave no reason or explanation, except that she would not stay in when he wished her.

The defense was insanity from spirits, and alcoholic trance. This was denied by the medical witnesses for the people. From my study of the case the following facts were undisputed :

1 . Hermann was a German, forty-two years of age, a butcher by trade. No hereditary history was obtained. He was very reticent, and could give no clear history of his past.

2. About twenty years ago he began to drink to excess. When under the influence of spirits he was sullen, irrit- able and suspicious of every one, his character and con- duct were changed ; he had suspicions of his wife's infi- delity. When sober no reference to this delusion was made ; he seemed to be a kindhearted man.

3. For the past five years he has greatly changed in

THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS. 51

every way. He did not work much, tramped to Chicago and back, drank at times to excess, was very quarrel- some with his wife and others, when under the influence of spirits. Was rarely stupid when intoxicated, but was heavy and dull. A week before the murder he drank more than usual.

4. The crime was committed automatically and in the same way he had been accustomed to kill animals. He seemed oblivious of the nature and character of the crime, and made no efforts to conceal it, or escape, but went about as usual, apparently unconcerned. This same indifference continued up to his execution. As in the former case, a commission decided that he was not insane, and was responsible. Both his inebriety and the peculiarities of the crime were ignored in this con- • elusion.

Case three was Patrick Lynch, a periodical inebriate, who killed his wife in a similar indifferent manner. The defense of insanity was urged, and opposed by the same confused medical testimony. A marked history of heredity, embracing insanity, inebriety, and idiocy, was traced back two generations. The prisoner grew up in bad surroundings, was an inebriate early in life. At the age of thirty he was a periodical inebriate, with a drink period of twelve or fifteen days, during which his conduct was markedly insane. He killed his wife by striking her on the head with a board, under no excite- ment and perfectly cool, then went to the station and gave himself up, giving no reason for the act. He had

62 THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS.

not quarrelled with her or exhibited any anger. He had delirium tremens three times at intervals before the crime was committed, and had manifested marked changes of character and conduct. When sober he was very kind ; when drinking he was treacherous, violent and dangerous. He was found guilty, but finally sent for life to prison.

The fourth case was that of William Enders, an ine- briate, who rushed out of his house and shot a passing stranger, without a word or provocation. The history of epileptic and alcoholic heredity was in the family in both parents. His early life was in a poorhouse, and later an errand boy in a hotel. At twenty he was an inebriate, with distinct drink paroxysms. These were attended with intense delusion of persecution.

The crime was committed during one of these attacks. The defense was insanity, but the jury decided him guilty, on the testimony of the medical witnesses for the prosecution, and he was executed.

These four cases are not uncommon or different from many others appearing in court every week. I have pre- sented them to show both the failure of medical testi- mony, and a correct legal conception of such cases. The medical testimony in such cases fails in not making an independent research in each instance, to ascertain the facts, no matter what the conclusions are. The physician goes into the court-room with the expectation of giving a semi -legal opinion, along some line of theory and law ; he attempts to mark out conditions of responsibility and fails, hence his testimony is confusing and worthless.

THE SCIENTIFIC STUDY OF INEBRIATE CRIMINALS. 53

In each of these four cases the medical evidence was founded on theory and not on the facts of the case. The legal treatment was also imperfect and unjust for the same reason.

The teachings of all scientific research are in unison to-day concerning the disease of inebriety, and also that this disease of inebriety may merge into criminality. It is obvious, then, when they are found associated, only a full, exhaustive inquiry and study of the facts can de- termine the sanity of the case.

The question of the sanity and insanity of inebriate criminals must be decided by an appeal to the facts, gathered by scientific experts, and not from any theo- logical or judicial theory, however ancient in history or universally accepted by lawyers and scientists.

The question of responsibility in any given case must be answered exclusively from its scientific side, apart from all legal conceptions and tests in such cases. The inebriate criminal belongs to that obscure class of border line cases who must be studied, both legally and medi- cally, from the facts in their history.

From every point of view it is apparent that the pres- ent treatment of the inebriate criminal is far behind the scientific teachings of to-day. The time has come to put to one side all mediaeval theories of the vice and vol- untary nature of inebriety, and study each case more thoroughly and from a wider range of facts, estimating the degree of sanity and responsibility by physiological, pathological and psychological methods,

PERSONAL RESIONSIBILITV AS AFFECTED BY ALCOHOLIC INFLUENCE.''

By T. L. Wright, M.D., Bellefontaine, Ohio.

I will speak of the responsibility for crime committed when alcohol enters as a factor in its inception — as well as a common incitement to crime — from two points of view only : First, when nerve function is impressed and embarrassed by alcoholic influence ; and, second, when nerve structure is affected through alcoholic influence.

1st. As to nerve function, I am not assuming any- thing when I say that it is the universal verdict of sci- ence, that accurate knowledge is wholly dependent upon accurate consciousness ; that is, consciousness healthy, not morbid in kind ; and complete, not fragmentary or deflcient, in degree.

Now, what is consciousness, and what are its condi- tions ?

'^Consciousness," says Wundt {see Ribot, German Psychology, p. 247, et. seq.), ^^psychologically, is a uni- fication, although itself a unit." There is no organ or '^ center" of consciousness. The entire organism is es- sential to its completeness. ^^Thus, perception, represen- tation, idea, feeling, volition, form the continuity called consciousness, of which only tautological definitions can

* Read before the Medico-Legal Society, at January Meeting, 1838,

PERSONAL RESPONSIBILITY, ETC. 55

be formulated .... Taken as a whole, the act which physiological psychology seeks to interpret " — and upon which the question of responsibility is pending — ^'em- braces the following moments : First, impression ; sec- ond, transmission to a nerve centre ; third, entrance into the field of consciousness (large but vague '' perception "); fourth, passage to the particular point of '^ appercep- tion " (definite, no longer vague) ; fifth, voluntary reac- tion ; sixth, transmission by the motor nerves."*

Careful authorities ?gree that alcohol is a poison, the most obvious effect of which is to induce paralysis. This was pointed out by Dr. T. W. Poole, of Ontario, in a work published in 18Y9. Prof. A. B. Palmer, of Ann Arbor, Mich., discusses the same thing in the Journal of Inebriety, July, 1884. Doctor Sidney Ringer, of England, declares that alcohol is not a stimulant as comparable with its radically depressant properties. He says that the ultimate effect of any considerable quantity of alco- hol is paralyzing. Doctor C. H. Hughes, of St. Louis, in a letter to the writer, upholds the same doctrine, and be- lieves it to be of very great import.

But it is not necessary to rely upon authorities in this part of our discussion . Everybody is familiar with th'^ stag- gering gait and the distorted countenance of the drunken man — evincing partial paralysis of the niuscular system. Everybody is aware of the confusion and incoherence of thought Avhich demonstrates the repression in functional power of the nerve centres of rational movement. Every-

• Ribot, pp. 246-248.

56 PERSONAL RESPONSIBILITY AS AFFECTED

body is cognizant of the lying and treacherous propensi- ties of the drunkard — showing a partial paralysis of the nerve centres which preside over the manifestations of the moral nature : and falsehood is the corner-stone of the whole edifice of crime.

Universal paralysis, when complete, is death. But universal paralysis, when incomplete, is disorganization of function. It is absence of perfection, in the essential details of all the departments of a sound individuality. How can a man, handicapped by deficiency and inca- pacity of nerve throughout his whole organism, cor- rectly judge and discriminate in difficult and involved questions ? The consciousness of sound, for instance, is one of the most simple and plain of all. And yet the mind must be alive to the distinctions and quali- ties of pitch, intensity and timhre, in order to determine the quality of sound with accuracy. These several prop- erties depend upon the ^' number, amplitude, and form of certain atmospheric vibrations."

In regard to the capacity of a drunken man, by an act of volition, to raise himself above the level of his drunken state — and upon the possession of which capacity the question of his responsibility turns, it is only necessary to say this : Since the beginning of the world no exam- ple has been known of a drunken man improving upon the condition and phenomena of his drunkenness. In every other possible relation, the same mind steadily im- proves and advances upward ; but the " drunk " of three- score jrears and ten is^ in all its essential features and

BY ALCOHOLIC INFLUENCE. 5Y

exhibitions, the ^^same old drunk" that was character- istic of the individual at the age of twenty or thirty years. In other words, the drunken man is not his own master. Alcohol dominates him, and guides him in its own way.

^nd. As to nerve structure, alcohol interferes with the co-ordinate or co-equal nutrition of the physical tissues which enter into the composition of the human body. Substantial growth in certain directions is mor- bidly increased ; and the result is, that a relationship is established amongst the several bodily parts which is not symmetrical. The particular structure which mainly takes on inordinate and unhealthy growth, is the fibrous or fibro-cellular substance ; or, as it is called in medical parlance, tissue. It is therefore proper to inquire specifi- cally, what is the fibro-cellular tissue, and what is its office ? As I wish to be plain, rather than technical, I will say in general terms : It is the gray, dense struct- ure in the body which holds and binds the entire organ- ism together, giving to it shape, tenacity, and elasticity. It enters into the substance of the liver, giving it strength and form. It enters into the mechanism of the kidneys, giving them strength and form. It enters into the texture of the brain, giving it strength, tenacity and form. And so likewise, it enters into the substance of every organ and structure of the body — of the muscles, bones, lungs, heart, skin, and so on, giving all of them strength, protection, tenacity and form. And besides, this same fibro-cellular tissue binds — through its modifica-

58 PERSONAL RESPONSIBILITY AS AFFECTED

fcions in shape and position, as by ligaments, bands, lead- ers, etc., — the various portions of the body into one grand and harmonious whole. In every organ of the body, the fibrous tissue is liable to be substantially modified and permanently changed in form through the toxic power of alcohol.

It is not surprising, therefore, that Dr. Bartholow de- clares that ^^few structures escape the deformabive in- fluence of alcohol when it is habitually taken into the system. The kidneys, the stomach, the liver, and the brain, all exhibit," the doctor continues, ''an increase in the substance of the fibro-cellular tissue which is found within them." And Dr. Sieveking, of London, in his work on Life Assurance, says : *' There is scarcely a de- generative condition of the body that may not result from the habitual use of ardent spirits." I economize space by declaring that the authorities are a unit on this point.

When, therefore, the complexion becomes muddy, and the eyes tinged with a greenish hue ; when the appetite and spirits fail, and an incessantly recurring jaundice colors the skin of the habitual tippler, we know that the liver is becoming structurally injured through the mischievous effects of alcohol upon the cellular tissue which enters into its structure.

When we perceive the habitual drinker — previously of good report in most respects — beginning to steal ; or when we perceive in him some surprising lapse in decency and public morality, we know that the fibrous tissue

BY ALCOHOLIC INFLUENCE. 59

within the brain is being injured by alcohoUsm. We know that nerve cells are being squeezed and oppressed by the intrusion of a foreign substance ; and at a later stage we know that nerve corpuscles are being trans- formed into fat, or are absorbed altogether ; that brain fibres are torn in sunder, and that the blood-vessels of the brain are strangled and obliterated. We know that in a few months the scene will close upon a paralytic de- ment—imbecile and driveling.

Such is a partial description of the power of alcohol carried to its logical conclusions. While a portion of habitual inebriates, only, reach this woeful end, it is yet proper to understand its occasional reality ; for the tend- ency of habitual di inking, even though called moderate in degree, is always, to some extent, greater or less, in this direction.

But in impairing the constitution, the worst effects of alcohol must take place within the brain. The cellular structure within the brain, at first morbidly and inordi- nately increased in volume, at length begins, by httle and little, to contract. To illustrate : After a severe burn is healed, the scars are apt to appear prominent in the form of unsightly welts and ridges. These scars are one form of cellular tissue. But in time these prominences Avill dis- appear. The scJtrs shrink, very considerably, becoming, at the same time, very hard and tense ; and not infre- quently, by drawing portions of the body out of their natural relationships with each other, they produce se- rious inconvenience and deformity. A similar contrac-

60 PERSONAL RESPONSIBILITY AS AFFECTED

tion in the overgrown fibrous tissue of the Hver produces the ^^ hob-nail" Hver of the habitual drunkard.

In a manner exactly parallel, the redundant fibrous substance in the drunkard's brain shrinks, and it in- volves and strangles some of the brain's blood-vessels. Thus, nerve cells and nerve centres perish through lack of nutrition — their blood supply being cut off. This con- traction of the fibrous structure within the brain may even tear nerve fibres apart. And in many other ways it imposes modifications, and, of course, degradations, on the mental and moral activities.

Usually, these lapses and defects in mental and moral action are referred to a v^illful disregard for the princi- ples of good sense and good morals. But the microscope will dispel that misapprehension. It will disclose physi- cal degeneration in nerve cells, nerve fibres, and nerve centres, sufficient to explain some misconduct as the child of disease, rather than of criminal will.

After a time the damage to the central nervous tissue (when not excessive) becomes assimilated, or adopted, by the constitution. That is, the human constitution becomes modified. It takes on new and inferior char- acteristics, and occupies a plane of existence lower than belonged to its original nature. The important point is, this bad constitution is liable to be reproduced in pos- terity. Quite likely the newly-transmitted constitution will differ in the forms of its exhibition from its parent. It may take on some of its kindred forms. There may be, for example, defective intelligence, as imbecility, or

BY ALCOHOLIC INFLUENCE. 61

defective physical structure, as hare-lip, or club-foot ; or a defect in one or more of the senses, as deafness, and, of course, dumbness ; or there may be defect in the brain centres of co-ordination, through which the moral nature and the sense of personal identity, and the ideas of duties and responsibilites are exemplified. Through de- fects in the physical instruments of the moral nature within the brain, there is apt to be developed, through heredity, the criminal constitution.

The property of alcohol, of inflicting physical unfit- ness upon body and brain, opens a field of disaster, whose extent is absolutely unlimited.

I have stated a few of the effects of alcohol upon the human body and human mind. It is for others to make specific deductions, and draw conclusions from them, with reference to their bearing upon the personal responsibility of the inebriate.

PROHIBITION AND INEBRIETY.

By Mary Weeks Burnett, M,D.

Member Medico-Legal Society, President National Temi^erance Hospital, etc.

In the many problems which have arisen through the inter minghng of labor, in law and medicine, satisfactory solutions have been most readily secured when the under- lying causes have been made the basis of study. In view of the fact, that there now exist many and great differ- ences of opinion, in the Medical Jurisprudence of Ine- briety, we need to keep prominently before us the causes of, as well as the remedies for, inebriation.

Inebriety, or drunkenness, is a condition of mental unsoundness or derangement, induced by the use of intoxicating liquors. The law assumes, that he who, while of sound mind, puts himself voluntarily into a con- dition in which he knows he cannot control his actions, may be considered to have contemplated the perpetra- tion of his crime, and should suffer the legal conse- quences of his acts. Drunkenness being apparently a deliberative or voluntary act, of a presumably sound mind, the law does not admit that it is a disease.

It is a rule in medicine that a mentally diseased or dis- abled person is incapable of responsible motive or intent, and should not be held respoDsible for acts committed

PROHIBITION AND INEBRIETY. 63

whil'j SO diseased or disabled. Medicine assumes that, as inebriety or drunkenness is manifestly a condi- tion of unstable or diseased mind, it is, therefore, a disease, and the inebriate should be shielded from the legal consequences of his acts. Each view contains much truth, yet it is evident that the differences of opin- ion, based as they are upon a study of results alone, are irreconcilable. Into each case the elements of disease or of crime may both or singly enter. The complica- tions will forever present new opportunities for disa- greement, and no conclusions can be reached except by the yielding of one side or the other.

It is truly said, that inebriety and criminality are not accidents nor causes, but the products, the results, of causes.

What is the cause of inebriety ? Undoubtedly, hered- ity and surroundings have a large predisposing influ- en:e, but all medical authorities agree that the imme- diate cause of the disease of inebriety is intoxicating liquors.

Legal authorities agree that the immediate cause of the crime of inebriety is intoxicating liquors.

Medicine and law, then, are in complete accord upon the cause of the disease and crime of inebriety. May we not hope to agree upon the remedy ? The highest judicial power in the land, the power of which Washing- ton said, '^ it is the chief pillar upon which our govern- ment must rest," has clearly emphasized a remedy.

The Supreme Court of the United States, in its recent

64 PROHIBITION AND INEBRIETY.

decision based upon the 14th amendment, has declared that ' ' the pubhc health, the public morals and the pub- lic safety is endangered by the general use of intoxicat- iny drinks, and that it is a fact established by statistics accessible to every one, that the disorder, pauperism and crime prevalent in this country, are in some degree at least traceable to this evil. "

And it further states, in an opinion from which there can be no appeal, that "the people of a State have a right, under the 14th amendment to the Constitution, to absolutely prohibit the manufacture and sale of intoxi- cating liquors for other than medical, scientific and manufacturing purposes." Here, then, seems to be out- lined a medico-legal remedy for inebreism : the sup- pression of intoxicating liquors as a beverage — in a word, prohibition.

Three prominent objections have been raised against prohibition as a remedy for inebreism :

1st. That prohibition is impracticable.

2d. That other measures present a more satisfactory basis for the Medical Jurisprudence of Inebriety.

3d. That prohibition is not necessary.

Are these objections sustained by facts ?

1st. The Supreme Court of the United States has declared that prohibition is entirely practicable. In cer- tain places, where high State officials vie with each other in violations of the law, it is true that the law may not be enforced, but there is abundant evidence that where- ever there is harmonious action, among the educated

PROHIBITION AND INEBRIETY. 65

forces of any community where prohibitory law has been secured, the law is a success.

2d. That other measures present a more satisfactory basis for the medical jurisprudence of inebriety.

Among the n.ost popular of the measures now being tested are moral suasion, high license, local option, jails, penitentiaries, inebriate and insane asylums. What real promise is there in these ?

Moral suasion has little effect upon minds and bodies writhing in the clutches of the drink power. Taking the pledge will not redeem a drunkard, nor will it pre- vent a man from becoming one.

License, high or low, makes intoxicating drink lawful, and the drinking places are by it made the fashionable and legal breeding-ground, of disease and vice and crime. Local option can be voted in as a law one year, and voted out the next, and in its very instabihty there is great danger. We can name one of many instances. A. R., a man of talent, with inherited narcotic suscepti- bility, remained for years in a local option county, at a great pecuniary disadvantage, for the sake of the safety it afforded him from his appetite. But the liquor traffic eventually prevailed over this temporary local option law, and the man is now in prison for life as a result of crime committed because liquor was not kept away from him.

Asylums for the cure of inebriates are necessary now. They serve a needed end in shutting the patients away from liquor. But suppose we could shut the liquor

^6 PROHIBITION AND INEBRIETY.

away from the patients. The very large proportion of the now victims of inebreism would, under careful non- alcoholic medical supervision, be enabled to take their places with the wage-earners and producers, instead of, as now, being helpless dependents upon public and private charity.

Our jails and penitentiaries are full of men, women, boys and girls, committed for the crime of inebriety. There is no assurance from past experience that they will not, the moment they are free and again under the influence of liquor, commit as grievous, if not greater crime. More than this. Great numbers of those of neu- rotic and narcotic susceptibilities, of hereditary and acquired hyper-sensitive organisms, are daily and hourly swelling the ranks of this great multitude, before which the world already stands appalled.

Temporizing measures give no promise of a true solu- tion of the problem.

3d. May not, then, the prohibition of intoxicating liquors as a beverage be necessary ?

An authority says that ninety-five per cent, of those who leave the Concord (Mass. J Eeformatory, go out with a firm resolve to do right, and if they backslide it is because of the evil influences and drink habits to which they return. Other institutions of a like nature fur- nish practically the same statement. Did space permit, I could cite a large number of cases which have come under my immediate observation, of men and women leaving our hospitals, asylums or jails with firm hope in

PROHIBITION AND INEBRIETY. 67

a better future, who, within twenty-four hours, have again become hopelessly overcome by the temptations to drink which have met them at every step.

The will of the inebriate is helpless and imbecile in the presence of temptation and opportunity. In the presence of liquor the inebriate is uncontrollable, except by lock and key.

Which is the greater wisdom, prevention or cure ? Wliich should he under ban, the liquor or the man ?

Prohibition will remove from the inebriate both the temptation and the opportunity.

Under the ruling of the Supreme Court, it is now in our power to speedily make it impossible to obtain intoxi- cating liquors as a beverage. Suppose the neurotic and the narcotic susceptibles, the highly-endowed psychical hyper- sensitives, the strong in animal forces, but weak in will cases, could not have the taste for liquors aroused. We would still have the insane and the criminal to deal with, but in fewer numbers, and the disease and crime due to inebriety would no longer be a perplexing com- plication.

Shall we, who hold the wealth and the health of the people in our hands, foolishly waste our forces strug- gling in such a mire of bewildering phraseology as the inebriety of insanity, the insanity of inebriety, volun- tary and involuntary intoxication, delirium tremens and other alcoholic seizures, when so simple and absolute a remedy is at hand ?

These neurotic cases which so easily drift into disease

68 PROHIBITION AND INEBRIETY.

and crime, cannot be the subjects of the disease and crime of inebriety until they have come under the influ- ence of intoxicating hquors. There may be brain inca- pacity or mental unsoundness, but the disease of ine- briety cannot be grafted upon these conditions without intoxicating hquors. Tliey cannot have the disease if they cannot get the liquor.

Inebreism, whether manifested in disease or crime, or both, can be wholly extirpated from the great catalogue of medico -legal problems. Is there any valid excuse for its continuance ?

THE POSSIBILITY OF AIR IN THE HEART IN CERTAIN CASES OF INFANTICIDE,

BY P. w. HiGGiNS, M.D,, Cortland, N. Y.

In February, 1888, Maurice B. Congdon was tried in the Court of Oyer and Terminer, in Cortland County, for the crime of infanticide. On February 10th the jury brought in a verdict of manslaughter in the second degree, and he is now serving a sentence of twelve years' imprisonment at Auburn.

There is little serious difference of opinion in regard to the main facts of the case. The mother of the infant was Nora Congdon, seventeen years of age, daughter of the defendant. The defendant was probably the father of the infant by his own daughter. One child had been born of the same parent ige, two years before, and buried immediately. This last infant was born April 30, 188Y, while the girl was alone in a room ; she called to her father, who came up into the room and cut the umbilical cord close to the body, as appears by the girl's testimony before the Grand Jury ; he then grasped the child's neck by the thumb and finger of one hand, retaining his hold until life was extinct. With the other hand he laid a cloth in the bottom of a tight tin pail, laid the child in the pail on its right side, still retaining his hold upon the child's neck^ threw the cloth

To THE POSSIBILITY OF AIR IN THE HEART

over it, took the pail by the edge and carried it out of the house. Within an hour he buried the pail and its con- tents in a field two feet below the surface.

On May 2 1st, twenty-one days after its burial, it was exhumed, and the writer assisted the Coroner, George D. Bradford, in the post mortem examination. It was evidently a full term male child, 19f inches in length ; the weight and measurements, and the appearance of the nails, testicles, hair and skin corresponding. It had been born alive, as shown by the evidences of complete respiration. The lungs were light in color, completely filling the enlarged chest. The anterior bor- ders were rounded, that of the right lung within one- quarter of an inch of the median line, the left three- quarters of an inch ; crepitant in every part, and every part floating high above the water. The pressure of 150 pounds applied twice to a portion from the base of the lungs, did not destroy its capacity to float. In short, if the hydrostatic test can ever prove anything, complete respiration had occurred. An additional sign of live birth was ihe congestion and extravasations which had occurred above a line about the neck. Also, if the opinion of the writer be allowed, the appearance of air in the heart.

The main blood vessels of the heart had been ligatured in floating the heart and thymus gland, with the lungs, for the hydrostatic test. On cutting into the cavities of the heart, the auricles were found nearly empty. Both ventricles were found filled with dark fluid blood mixed wth an abundance of air bubbles or bubbles of gas. The

IN CERTAIN CASES OF INFANTICIDE. 71

significance of these was debated at the time, but not clearly understood until it was too late to make some observations which would render this paper more com- plete.

Upon reflection, for there seems to be little literature bearing upon this subject, there suggest themselves but three possible sources for this appearance of air mixed with the blood of the heart.

Perhaps the most natural theory is that the appearance was due to gas, the result of decomposition. In answer to a letter of inquiry, Professor A, L. Loomis, of the New York University, writes that he has seen gas in the heart, as the result of putrefactive changes, quite early. This infant had been dead for twenty-one days. But it lay in a tin pail buried in the clay subsoil, two feet below the surface. The weather had been dry and the ground was yet cold. In Wharton and Stille the statement is found that the changes which would occur in one day from exposure to the air, would require eight days in ordinary burial. Considering the circumstances of burial in this case, we should expect to find about the same evi- dences of putrefaction that would occur from two days' ordinary exposure. The signs of putrefaction actually found were simply small spots of greenish discoloration along the right side and on the outer side of that arm and leg. The epidermis was loose and easily rubbed off over the suggillation on the right side. There was no odor of decomposition discoverable — there were no se- rous or gas blebs anywhere in the interior Qt the body ;

{

72 THE POSSIBILITY OF AIR IN THE HEART

there was no softening of any organ except the brain, which would not retain its shape when the membranes were removed. At the base of the brain was an extrav- asation of blood estimated at one ounce. The exact loca- tion of this was in the sub-arachnoid space in the left middle and posterior fossae of the cranium and also fill- ing the upper part of the spinal canal. This blood was dark and fluid, but not mixed with air or gas, although the brain contiguous to it was softened. It is possible that putrefactive germs may have gained entrance at the cut end of the umbilical cord, and induced a change in the blood even as far as the heart.

The cut end of the cord, however, showed no evidence of decomposition ; a little dark fluid blood was noticed upon it. A few experiments, made by exposing beef blood to the action of the air, seemed to indicate that gas is not developed easily from it ; at least, until the odor becomes unbearable.

A second barely possible origin for the air found in the heart, is suggested by the following case reported in Beck's Medical Jurisprudence, Vol. II., page 213. It reads as follows :

'^ In the case of a woman who had been strangled per manum by two men, Littre found the tympanum of the left ear lacerated, and from it flowed about an ounce of blood ; the vessels of the brain were unusually turgid ; red blood was extravasated in the ventricles, and also on the base of the cranium ; the lungs were greatly dis- tended, and their niembranes very vascular. Not more

IN CERTAIN OASES OF INFANTICIDE. Y3

than an ounce of blood, however, was contained in the right ventricle of the heart, and it was fluid and frothy, like that of the lungs."

In this case the air must have found its way through the parenchyma of the lungs, into the pulmonary veins, and so into the heart. If this were possible in any case, it did not occur in this one. There was no sign of rup- ture of the lung substance. The lungs were not even engorged with blood. The absence of overfilling of the internal organs ol the chest and abdomen is accounted for in this case by the open umbilical arteries, affording an outlet for a certain portion, and by the large amount extravasated at the base of the brain, and filling the veins of the brain and head. Also the less relative amount of blood in the infant must be taken into consid- eration.

The only theory remaining to account for the appear- ance of air in the heart, would be that it was drawn in through the cut end of the umbilical vein during the res- piratory efforts while strangling.

That air may enter a vein, reach the heart, and cause alarming symptoms or sudden death, is well known to surgeons. The circumstances necessary for its occur- rence are the opening of a large vein near the heart, some reason for the cut end not closing from its natural flaccidity, and a deep, gasping respiration to exercise suc- tion. For this latter reason this accident was more com- mon before the days of anaesthesia.

In the case under consideration all the elements neces-

74 THE POSSIBILITY OF AIR IN THE HEART

sary to the occurrence of this accident are present. But one-quarter of an inch of the cord was left attached to the body, unHgaiured. The violent, spasmodic move- ments of the abdomen during strangulation would open the umbilical vein intermittently at least. In through this vessel, but a moment before, the whole of the infant's blood had been coursing ; a distance of about two and one- half inches would reach the vena cava, from which the course is broad and direct to the heart. The suction power exerted was the greatest possible. The return of blood from the head — disproportionately large in the infant — was entirely cut off from the heart. The heart was beating wildly, with the tenacity to life belonging to the new-born. This, vis-a-fronte, would tend to draw in air through the open channel to supply the place of the blood imprisoned in the head, and lost by the umbilical arteries. Still more powerful would be the suction force exerted by the respiratory efforts. With the trachea compressed by the strangulation at the neck, none, or very little air enters the lungs. This sense, of want of air causes these efforts to become more severe. It is easy to understand, that air will rush into such a vacuum, if there be any avenue.

The explanation of these air bubbles being found in both sides of the heart easily suggests itself. By the foramen ovale, as yet partially open, the entering cur- rent from the ascending vencava would still enter the left auricle and so the left ventricle. The descending current of blood being almost entirely shut off, the

IN CERTAIN CASES OF INFANTICIDE. 75

irregular action of the heart would naturally force the blood into either side of the heart.

On removing the liver, the large blood vessels were cut off just below the diaphragm. From these frothy blood escaped. It is impossible now to say whether this was from the aorta or vena cava.

If further research or observation in cases where no suspicion of putrefactive origin be possible, shall show that air is drawn into the heart in cases similar to the one related, we may see that this sign will be an import- ant one.

By a strange freak of the law, the killing of a foetus in utero is criminal, and the killing of an infant fully born is murder, while the destruction of a child during deliv- ery is not a legal offence. The evidences of complete live birth are remarkably few and unsatisfactory. If, upon j90S^-morf em examination, this sign should be found, it will be positive proof that death had not occurred until after birth was complete. Nor could it have been pro- duced until the cord — the last bond to the mother — had been severed.

THE PROGNOSIS OF PELVIC CELLULITIS.''

By W. Thornton Parker, M.D. (Munich). Medical Examiner Third District, Newport, R. I.

K. McW., a servant in the family of a wealthy sum- mer resident at Newport, was ordered by her employer to go to the stable and open the sliding door, so that the coachman could drive into the barn. This occurred on the afternoon of October 11, 1886. In her endeavor to obey this order, the heavy door would not shde, but fell on the girl, crushing her down. The girl was assisted to her feet and returned to the house. She pluckily endeavored to do her work, and said, as she then thought, that she did not consider herself seriously hurt. The morning after the accident she spat blood, and complained of pain in her side. There was considerable physical dis- turbance ; menses increased, with tenderness in left side and in spinal dorsal lumbar region. Tuesday night she had a smart vaginal hemorrhage. Quantity of water (urine) increased. For two days following, symptoms of prolapse were complained of. An attempt to make vag- inal examination reveals an almost imperforate hymen. The examination was concluded with great difficulty, owing to pain. Pelvic cellulitis was diagnosed.

The general condition of the patient continued to be

* Read at the January meeting of the Medico-Legal Society of Rhode Island, and before the Medico- Legal Society of New York.

I

THE PROGNOSIS OP PELVIC CELLULITIS. 77

very unsatisfactory. She was confined to her bed under treatment for a week or ten days, after which she seemed to be gaining slowly. On the 30th of October she went on to New York City, to be with her relatives for the winter. The journey was a severe one for her, and she lost ground by the pain and weariness of travel.

May Yth she returned again to Newport. Pelvic cellu- litis still present, and a large swelling in the left inguinal region is still evident — there is great tenderness, general feebleness and depression of spirits. As already stated, upon vaginal examination, the girl was found to be a virgin, the hymen being present and unruptured. Vaginal examination is still very painful, and causes symptoms of fainting. The local and constitutional treatment is still continued, but anodynes are less fre- quently employed. The fact of her being a respectable and virtuous woman is proved quite clearly by the pres- ence of a well-defined hymen ; but if this be denied on account of one or two cases where the membrane has been said to have been found in prostitutes, we can cer- tainly assume that, generally speaking, the hymen is proof of virginity, if we can claim to have any medico- legal proof whatever.

The strength and general intactness of the hymen sat- isfied me, however, that no speculum had been intro- duced, and that the pelvic cellulitis was not due to severe and unreasonable treatment by some medical attendant . I have had under my care a young woman who suffered

78 THE PROGNOSIS OF PELVIC CELLULITIS.

for weeks with pelvic cellulitis, after rough and so-called heroic treatment of a female physician, but in this case no medical man had attended the girl for some years, if I have been correctly informed ; for up to the time of the accident she was strong and healthy, and of cheerful spirit, willing to make herself useful and to earn her wages by honest toil.

All of our medical authorities agree as to the danger- ous character of pelvic cellulitis and the permanence of the injuries usually induced, and the possibility of a rapidly fatal termination in a large number of cases.

In this case we must decide that pelvic cellulitis could have no other cause than the external injury which the poor woman received, and for which she sought our relief.

Pelvic cellulitis follows :

1. Paiturition (labor).

2. Abortion.

3. Accidents in labor, such as the use of instruments. It is doubtful if the disease can at all originate with- out violence.

4. Strong vaginal injections can cause it, also syring- ing with cold water after coitus, to prevent conception.

5. Immoderate coitus, hard pessaries. Y. Mechanical injuries from accidents.

All except the last are ruled out of this case, because the woman was positively and without doubt a virgin, and no entrance had ever been made into the vagina by anything whatever until examined for this very injury.

THE I'ROGNOSlS OF PELVIC CELLULITIS. 79

The case^ then, is one of pelvic celluHtis following external causes, inflicting internal injuries.

Pelvic cellulitis is an inflammation of the cellular tissue surrounding the uterus and other pelvic organs, and extending up betv^een the folds of the peritoneum, which form the broad ligaments of the uterus — at least this is wiiere pelvic cellulitis is most common. We have first a condition of congestion, the cellulitis gradually extending, but it was during the stage of formation that the poor woman hoped that she was all right. Gradually the injury asserted itself, until, worn out by her brave and patient efforts, she succumbed to the now established physical ailment, and sought professional relief.

From the moment the accident occurred until to-day, the development of the case has been complete and the diagnosis of the disorder verified by its course. We are striving in the treatment of such cases to avert the most serious results. The usual results of pelvic cellulitis are these :

Health impaired for at least many months. Conva- lescence, if at all possible, tedious and prolonged. Ster- ility almost certain. Adhesions interfering with the growth of the uterus. The reproductive organs seriously and probably permanently damaged by destruction of the ovaries. Septicaemia, thrombosis and pulmonary embolism liable to occur and to cause death. The patient, in point of fact, becomes a permanent invalid, and finally succumbs to some form of tuberculosis.

We must admit the severity and serious danger of this

80 THE PROGNOSIS OB" PELVIC CELLULITIS.

accident. I have tried to explain the special features of this case. It may be claimed that there is no proof that the woman did not overestimate her injuries, when in point of fact the poor woman did not and cannot realize the full extent of the hurt she has received. First, we have positive proof that the woman sustained an injury. Certainly the evidence shows that she was in a position to have sustained all and every injury her counsel claimed for her. Certainly the burden of proof should rest with the defense. Secondly, we have proof that a serious internal injury developed shortly after the acci- dent and in regular course ; and, thirdly, we have proof that the only chances by which this case could have developed from any other cause are wanting, because physicians have testified that the woman, when exam- ined, was found to be a virgin, and that consequently these injuries did not arise from any examination, appli- cation or erroneous treatment, but only by what did actually occasion them, the accident.

Dr. H. R. Storer, whose great experience and admir- able judgment is generally admitted by the medical pro- fession of all lands, was early in attendance upon this case, and yet against his opinion, and that of the other medical attendant, and without any professional defense, the counsel for the defendant did succeed in obtaining a disagreement of the jury.

Now the medico-legal interest in this case is in the query whether I have rightly or wrongly assumed that pelvic cellulitis is the sequence of violence. Is it at aU

THE PROGNOSIS OF PELVIC CELLULITIS. 81

likely, or is it even possible for pelvic cellulitis to develop idiopathically ? T think the medical profession will sus- tain me in my position, and at least allow that med- ical literature does not afford cases where pelvic cellulitis has originated without some marked and noticeable exciting cause. The general history of the case is inter- esting, and I believe it is one which is not likely to be rare in medical annals.

Are we not justified in claiming for our patients pecu- niary compensation for such injuries on the theory that they have been seriously, and even permanently injured ? In this particular case we had a poor young woman pen- niless, struggling for what she deemed a legal right to compensation against one of Newport's wealthiest sum- mer visitors — a gentleman of not only large means and considerable influence, but defended by one of the most learned and eloquent lawyers in New England. Consid- ering the fa?ts as stated to be correct, did^ the poor girl receive justice ? I for one am sure that she did not.

At the second trial, the case was won by the plaintiff*, with $1,000.00 damages.

Newport, R. I., June 20, '8Y.

TRANSACTIONS.

MEDICO-LEGAL SOCIETY, APRIL SESSION. Presidency of Clark Bell, Esq.

April meeting was held on the 11th day, at Bucking- ham Hotel. Minutes of March meeting were read and approved. In absence of Secretary and Assistant Secre- tary, M. EUinger acted as Recording Secretary.

The following active members, proposed by Clark Bell, Esq., were, on recommendation of the Executive Com- mitte, duly elected :

Arthur S. Wolff, M.D., Brownsville, Texas ; Dr. R. E. Young, Sup't. State Asylum, No. 3, Nevada, Mo. ; George B. Twitchell, M.D., Sup't., Keene, N. H.; S. Preston Jones, M.D., Sup't. Stockton Sanitarium, Mer- chantville, N. J.; Morris H. Stratton, Esq., Salem, N. J.; J. B. Gaston, M.D., Montgomer}^, Ala.; Dr. J. S. Dor- sett, Sup't. State Asylum, Austin, Texas ; Henry Palmer, M. D., Surgeon- General , Janesville, Wis.; Dr. Granville P. Conn, Concord, N. H., Sec'y State Board of Health ; John W. Ward, M.D., Sup't. N.J. State Asylum, Trenton, N. J.; Hon. Gustave Cook, Houston, Texas, Judge Criminal Court ; F. H. Clarke, M.D., Sup't. East- ern Kentucky Lunatic Asylum, Lexington, Ky. ; Hon. Daniel Barnard, Attorney-General of N. H., Franklin, N. H. ; Cyrus K. Bartlett, M.D., Sup't. Minnesota Hos-

'

I

TRANSACTIONS. 83

pital for Insane, St. Peter, Minn. ; James D. Moncure, M.D., Eastern Lunatic Asylum, Williamsburgh, Ya. ; Dr. C. A. Rice, Sup't., etc., Meridian, Miss.; Dr. B. F. Eads, Marshall, Texas ; Dr. A. N . Denton, Austin, Tex. ; Drs. M. B. Sullivan, Jas. W. Bartlett, Paul A. Stackpole and Carl H. Horsch, of Dover, N. H.; Dr. R. Rutherford, State officer, Houston, Texas ; Dr. Michael Campbell, Sup't. Eastern Hospital for Insane, Knoxville, Tenn.

The following active members, proposed by Dr. W. J. Lewis, of Hartford, were also duly elected :

Professor Frank L. James, editor St. Louts Medical and Surgical Journal, of St. Louis, Mo.

Dr. Geo. W. Brown, of St. Louis, Mo.

Bradley W. Lee, Esq., of the St. Louis Bar, 417 Pine street, St. Louis ; Dr. I. P. Kligensmith, of Blairsville, Pa., proposed by Dr. E. P. Thwing; Dr. Henry B. Baker, Secretary State Board of Health, Lansing, Mich., pro- posed by Dr. W. G. Stevenson, were also elected active members.

Dr. L. Th. Pompe, Superintendent of the Asylum for Insane called ^^Coude water," at Rosmalen, Holland, was, on motion of Clark Bell, Esq., and on recommenda- tion of the Executive Committee, duly elected a corre- sponding member. The following papers were read :

The Menopause in Relation to Insanity, by T. R^ BuCKHAM, M.D., Flint, Mich.; The Prognosis of Pelvic Cellulitis, by W. Thornton Parker, M.D., Medical Examiner, Newport, R. I. ; The Medical Jurisprudence of Inebriety, by Mary Weeks Burnett, M.D.

84 TRANSACTIONS.

The paper by Dr. Burnett was discussed by M. Ellin- ger and others.

President Bell announced the death of our late member, Hon. W. A. DoRSHEiMER, and made remarks as to his character, official position and life. Mr. Bell said he had known Mr. Dorsheimer for twenty years. He alluded to his position as Lieut. -Governor, as member of Con- gress, as United States District Attorney for this District, his literary tastes and his position latterly as editor of one of the leading daily newspapers, and the esteem in which he was held by a large circle of friends. A letter from his late law partner, Hon. David Dudley Field, was read expiessing regret at not being able to be present, and extolling the character of the deceased. Eemarks were made by Albert Bach, M. Ellinger and others.

Mr. Bell then announced the death of Hon. Charles Hughes of Sandy Hill, N. Y., our late active member, and paid a tribute to his memory, reading the resolutions adopted at the Washington County Bar, on the occasion of his death.

The death of Cornelius A. Eunkle of the New York Bar was announced by the chair, who spoke feelingly of Mr. Eunkle's character and merits, and to the general expression of regret that his death had occasioned among the Bar and the Press of the city. M. Ellinger and Mr. Bach also spoke.

Mr. Bell then announced the death of our late corre- sponding member, Dr. J. N. Eam^r, Inspector of the Insane Asylums of Holland. Mr. BeU said Dr. Eamaer

TRANSACTIONS. 85

was the foremost of the ahenists of Holland. Born in 1817, a graduate of the University of Groningen, a pupil of Vander KoLK, he was, on the latter's recommendation, made superintendent of the Insane Asylum at Zutphen, in January, 1842, where he remained till 1863, when he was appointed superintendent of the asylum at Delft, where he remained till 1861), when he removed to the Hague, in medical practice, till his appointment, in 1872, as General Inspector of the Dutch Asylums by the gov- ernment.

Dr. Ram^r was largely influential in the amendments adopted in Holland in October, 1884, amending the lunacy laws of that country. He was the founder and ex-President of the Dutch Society of Psychological Medicine, and an honorary and corresponding member of various societies in Europe, beside our own.

Mr. Bell read a letter from Dr. L. Th. Pompe, accepting the honor of corresponding member of the Society, enclosing a portrait of Dr. Ram.^r, and donating a copy of his report on *' Coude water " to the Medico-Legal Society of New York.

The chair laid before the Society the form of the record of post-mortem examinations adopted by the Massachusetts Medico-Legal Society, and in force among the Medical Examiners of that State, which specifies the manner of conducting autopsies, and schedules the detailed report in writing to be made and signed by the physician, making the autopsy, and characterized it as the fullest and most complete that had hitherto received official endorsement in this country.

86 TRANSACTIONS.

He felt, that in view of the careless manner of con- ducting autopsies in coroners' cases, that there was a public necessity for concerted action, and perhaps legis- lation on the subject.

1. Should autopsy be made in all such cases by law ?

2. What should such an autopsy be, and what should it show ? And should not some provision be made to have such post-moi^tem examinations so conducted and officially reported as to answer any question that might arise after the decomposition of the remains ?

He suggested that the Massachusetts form, which, if he correctly understood the matter, was substantially that of ViRCHOw, and the subject, be referred to a select committee.

On motion, the recommendation was approved unani- mously, and the chair directed to name a committee of five. The chair named as such committee. Dr. Frank L. Ingram, Dr. Peterson, Prof. E. 0. Doremus, Dr. Mat- thew D. Field and Dr. W. G. Stevenson.

The Society then adjourned.

MoRiTz Ellinger, Secretary pro. tern.

MAY SESSION, 1888. Presidency of Clark Bell, Esq.

May meeting, 9th May, 1888, was held at Buckingham Hotel.

The following gentlemen were, upon the recommen- dation of the Executive Committee, elected members ;

TRANSACTIONS. 87

Corresponding — Proposed by Clark Bell, Esq. :

Dr. Semal, Medical Superintendent of the Insane Asylum at MoNS, Belgium, and President of the Society of Mental Medicine, of Belgium.

Dr. KuYSCH, of the Hague, Holland, Inspector-General of the Insane Asylums of Holland.

Dr. Prius, Inspector- General, of the Prisons of Bel gium.

ACTIVE MEMBERS.

Daniel L. Brinton, Esq., 227 St. Paul street, Baltimore, Md.; 0. Wellington Archibald, M.D., Superintendent Insane Asylum, Jamestown, Dakota ; Dr. W. C. Mc- Farland, 54 W. 26th street, New York ; Eugene Grissom, M.D., Sup't. Insane Asylum Kaleigh, N. C. ; W. W. MacFarlane, M.D., Sup't. Insane Asylum Agnew, Cal. ; Dr. H. K. Pussey, Sup't. Kentucky State Asylum, Anchorage, Ky. ; Dr. E. P. Sale, President State Board of Health, Aberdeen, Miss.; W. W Godding, M. D., Sup't. Government Hospital for Insane, Washington, D. C, Dr. T. R. Chew, San Antonio, Texas ; Dr. D. M. Clay, Shreveport, La.

Proposed by M. Ellinger, Esq.: Morris Goodhart, Esq., 45 William street; Sigismund Waterman, M.D., 131 East 59th street.

Proposed by N. S. Giberson, M.D.: Professor J. 0. Hirschfelder, of Cooper Medical College, San Francisco, Cal.

Proposed by E. W. Chamberlain, Esq. ; Dr, Thomag Cleland, 354 West 22d street.

88 TRANSACTIONS.

Professor Thwing, Chairman of Committee on Hyp notism, reported, that the committee, as organized, desired to be discharged from the further consideration of the subject, which, on motion, was ordered.

It was moved and carried that the President name a new committee on Hypnotism.

The Chair laid before the Society communications from Society of Mental Medicine of Belgium, embracing publications made in the Bulletin of that Society for 1888, No. 4:S.—

1. The Classification of Mental Diseases, adopted by the Society of Psychiatry, of St. Petersburg, Russia, through the International delegate. Professor Meirzejewski.

2. The action of a commission upon the same subject named by the Societe Phreniatrique Italienne, in Sep- tember, 1886, composed of Professor Verga, President ; Signor Biffi, Vice-President of that Society ; Signer BoNiFiGLi, Superintendent of Asylum at Ferrane ; Funa- lOLi Paola, Professor and Director of Asylum at Sienne ; Signor Morselli, Professor University at Turin ; Signor Raggi, Director Asylum at Voghera, and Professor of the University at Padua ; and Signor Tamburini, Direc- tor of Asylum at Reggio-Emilio, and Professor of the University at Modena, Secretary.

3. The classification for the United States of America, adopted at the Congress of Alienists, held in Saratoga, in Sept., 1880, and transmitted by the international dele- gate, Clark Bell, Esq., to the Belgian Society, with an enumeration of the various societies and associations

TRANSACTIONS. 89

represented at that Congress, a list of its officers, and a resume of its transactions.

4. The report of Dr. Ram^k, the international dele- gate from Holland, enclosing the basis of classification proposed by him, with his views upon the whole subject.

This report was received and ordered placed on file.

Professor Thwing then read a paper on Inebriety, which was discussed by Dr. Isaac Leavis Peet, Mr. Albert Bach and others.*

Dr. Isaac Lewis Peet: — "I wish to say that Dr. Thwing's argument seems to me a very strong one, that there are reasons in the life of the citizens of this country which make it of special importance that the view expressed by him receive attention. I am glad he has given this paper, in which I concur."

Albert Bach : — "Mr. President, I cannot assent to the broad statement of Dr. Thwing, that total abstinence is necessary for all persons living in our city. I do not believe that his assertion in that direction is borne out by statistics. It is true, that owing to a sharp, active competition in mercantile and other pursuits, a largo number of our citizens evidence a certain restlessness, impetuosity and nervous excitability in their movements, but to claim that therefore they should abstain from all use of stimulants of any kind, in my opinion, is going

*The paper by Dr. Thwing will be found in the book, on the Medical Jurisprudence of Inebriety, just published by the Medico-Legal Society of New York, unavoidably crowded out of our columns.

90 TRANSACTIONS.

too far. I accept and advocate the doctrine of modera- tion for every one, irrespective of the atmosphere in which we hve, but look upon the theory of total absti- nence not only as impracticable, but unnecessary of universal application. The use of stimulants is often essential to build up an overstrained physical system. Dipsomaniacs are the exceptions among the masses of our community, and it is, I submit, absurd to argue that moderate indulgence leads, even in a majority of cases, to alcoholism. Inebriety has been considered, in most of the papers read before this Society, as a disease ; when it is, I concede it should be medically treated as such, but the effect of constant, excessive use of stimulants is not to be generally predicated, of occasional use of the same. I consider the extremists on the subject of ptohibition, fanatical ir their desire for an indiscriminate application of their rule. Abstemiousness should be our banner word, not prohibition. Heredity has much to do with a love of liquor, and natural inclinations and disinclina- tions of individuals should be taken into consideration when discussing the propriety of prohibitory laws. The lateness of the hour prevents my saying more on this subject."

In the absence of the author, Mr. E. W. Chamberlain read a paper by Daniel Brinton, Esq. , of the Baltimore Bar, entitled ^^Eapeby Boys."

The Treasurer read a paper by W. Thornton Parker, Medical Examiner at Newport, R. I., on a ''Case of Supposed Abortion,"

TRANSACTIONS. 91

The President then made a report in detail on the prog- ress of the work of Nationahzing the Society.

President Bell. — After the action of the Society rec- ognizing formally the recommendation of the President in his '' Inaugural Address," in regard to extending the lines of influence of this Society throughout the Union, this circular letter was prepared, to be sent to prominent men, throughout the Union and the Canadas, in both professions :

Medico-Legal Society, Office of the President, 57 Broadway,

New York, February, 1888. (Dictated.)

My Dear Sir :

It is proposed to nationalize the Medico-Legal Society by extending its membership into each State and Territory of the Union, where members do not now reside, and to elect at least ten names in each.

We have at present members in all the States except eight, and in all the Territories except four, and steps will at once be taken to address distin- guished and representative men in those States and Territories,

We wish to be on more intimate r<'lation with those men in each State who take an interest in Medical Jurisprudence, and w^e shall ask judges, and prominent men in both professions, in each of the States and Territories to unite, with a view of placing the Science in Ameiica upon a higher and more important basis, which, if successful, cannot fail to be of the greatest possible advantage, and add to the dignity and usefulness of both professions in America.

The plan proposed is —

First — To reduce our annual dues to members residing outside of the State of New York to $2.00 per annum. Initiation fee, $5.00.

Second— We shall send the Jouknal free to active members, the sub- scription price of which alone is $3.00 per annum.

Third — We now vote by mail (by ballot) at our annual elections, and the presence of members at meetings is not iudispeusable. The Journal contains full accounts of our transactions and the papers read.

Fourth. — We propose to elect a Vice-President of the Society from each State and Territory, and to ask members from each to report all cases of

92 TRANSACTIONS.

interest to the Editor, or the President of the Society, with a view of bringing the study of the science and of all questions arising within this country, at once to the attention of the Society. This plan has met the approval of distinguished men in various sections of the Union. Judge Somerville of the Supreme Court of Alabama, and Dr. P. Bryce, Superintendent of the Scate Lunatic Asylum at Tuscaloosa, will lead the movement in that State, and have consented to favor it actively in the Southeastern States.

Governor Robert S. Green and Judge C. G. Garrison, of New Jersey, will lead in that State. Dr. Joseph Jones in Louisiana ; Professor J. J. Elwell, Rev. William Tucker, of Mt. Gillead, C. H. Blackburn of Cincinnati, in Ohio ; Dr. McClelland, of Kuoxville ; Dr. Horace Wardner, Superintendent at Anna, Dr. E. J. Kilbourne, Superintendent at Elgin, Dr. D. W. Aldrich, Mayor of Galesburgh, and some friends in Chicago, will lead in Illinois ; Dr. J. Draper, Superintendent of State Asylum at Brattleboro, in Vermont ; Dr. Thomas O. Powell, of State Asylum, Milledgeville, in Georgia; Dr. D. W. Yandell in Kentucky ; S. Hepburn, Jr., of Carlisle, Pennsylvania ; ex-Governor Hoyt, of Philadelphia, Dr. George B. Miller, Dr. Alice Bennett, Mrs. M. Louise Thomas, in Pennsylvania ; Dr. W. B. Fletcher, Dr. O. H. Kellogg, in Indiana ; Dr. Jennie McCowen, of Davenport, Dr. Gershom B. Hill, Dr. F. E. Crittendon, in Iowa ; William M. Taylor, Vice-President of the Connecticut Mutual Life Insurance Company, and Dr. Gieb, of Stamford, Dr. J. S. Butler and Dr. W. B. Lewis, of Hartford, will lead in Connecticut ; Judge J. C. Normile, of the Criminal Court in St. Louis, and Dr. R. E. Young, Sup't of the State Asylum, at Nevada, will lead in Missouri, aided by distinguished members of both professions ; Dr. Middleton Michel, of Charleston, S. C, in that State ; Dr. T. R. Buckham and Professor V. C. Vaughan, in Michigan ; Dr. Ira Russell, Dr. Ed. J. Cowles, Dr. Frank K. Paddock, in Massachusetts, while prominent gentle- men in various other States have consented to aid the movement.

I send herewith current number of the Medico-Legal Journal, or copy transactions, which contains a list of our active and corresponding members at the end of last year. As this movement will be addressed largely to the judiciary and upon the legal side, it may be proper to mention the following judges and ex- judges in this State who are now members of this body;

Ex-Chief Justice Noah Davis, Judge Miles Beach, of the Supreme Court, ex-Judge Richard W. Busteed, ex-Surrogate D. C .Calvin, ex-Judge John R. Dillon, ex-Judge A. J. Dittenhoefer, ex-Judge Charles Donohue, District Attorney John R. Fellows, ex-Judge S. Burdett Hyatt, ex-Judge M. S. Isaacs, Judge George L. Ingraham, ex-Judge J. P. Joachimson, ex-Judge J. II. McCarthy, (/hief-Justice David McAdam, ex-Judge Marcus Otter- berg, Judge Calvin E. Pratt, Chief- Justice Sedgwick and ex- Judge G. M. Speir.

TRANSACTIONS- 93

Your name has been banded me by with a request that I write to you and ask you to lend your name to the movement in your State.

If this meets your approval, sign enclosed consent and I will propose your name for membership.

I will thank you to send me the names and addresses of such leading men of both professions, in your State and the States adjoining your own, as you think will be likely to unite with this body in the proposed movement.

I remain, sir, with great respect,

Very respectfully yours,

Clakk Bell.

That letter has been sent to about five hun- dred gentlemen, asking them to send them to per- sons interested in the subject in their States. Some members of the Society also have been furnished with a

few copies of the circular, which they have sent to friends. Enclosed in this letter has been sent a copy of

the committees which were named in the various States, additions to which have been made to-night, where they did not exist at the time this circular was prepared. The responses which have been made to this proposition have been, to my mind, something extraordinary. These circulars have been sent to men most prominent in the various States, men occupying prominent positions in each profession, and I have to announce to you that commencing with the January meeting, which is hardly within the scope of the movement, up to the present meeting, one hundred and fourteen active members, and seven corresponding members, have united with this body, making in all one hundred and twenty-one new members.

94

TRANSACTIONS.

The medical members will be surprised and pleased to know how splendidly this movement has been aided by the medical superintendents of insane asylums.

I have not written them all, because it requires, besides the circular, an additional letter, and the pres- sure of my private business has been so great that I have not had the time to devote to it. I wish I had. But we have elected twenty-seven superintendents of asylums, since the January meeting, to this body. I enclose a list of these gentlemen, who are the leading representative alienists of the Union, with some of the leading officials who have united :

Superintendents of Asylums.

T. Bryce, Tuscaloosa, Ala.

Emmett C. Dent, Blackwell's Island,

New York, Ed. E. Wliitehorne, Batavia, 111. Thos. O. Powell, M.D., Milledgeville,

Georgia. Dr. J. Draper, Brattleboro, Vt. Dr. E. J. Kilbourne, Elgin, 111. Dr. H. Wardner, Anna, 111. Dr. R. E. Young, Nevada, Mo. Dr. Fred. Peterson, Asst. Physician. Dr. D. R. Wallace, Terrell, Texas. Dr. E. R. Burrell, Canandaigua, N. Y. Dr. S. B. Buckmaster, Mendota, Wis. Dr. G, B. Twitchell, Keene, N.H. Dr. S. Preston Jones, Merchantville,

New Jersey. Dr. J. S. Dorsett, Austin, Texas. Dr. J. M. Ward, Trenton, N. J. Dr. F. H. Clarke, Lexington, Ky. Dr. C. K. Bartlett, St. Peter, Minn. Dr. J. D. Moncure, Williamsburgh,

Virginia.

Judges, District Attorneys and Officials.

Judge H. M. Somerville, Mont- gomery, Alabama,

Ex-Governor Hoyt of Pennsylvania.

Prof. Vaughan, of Ann Arbor, Mich.

Judge M. B. Montgomery, Wash- ington, D. C.

Dr. D. W. Aldrich, Mayor Gales burgh, 111.

Hon. Henry Robinson, Concord, New Hampshire.

Judge Normile, St. Louis, Mo.

Judge Erlich, New York.

Hon. H. C. Tompkins, Alabama.

Dr. Arthur S. Wolff, Texas.

Dr. H. Palmer, Surgeon-General, Wisconsin.

Dr. Henry B. Baker, Secretary State Board of Health, Michigan.

Judge Gustave Cook, Texas.

Hon. Daniel Barnard, Attorney- General of New Hampshire.

Dr. R. Rutherford, Health Officer, Texas.

TRANSACTIONS. 95

Superintendents of Asylums. Judges, District Attorneys and Officials.

Dr. C. A, Rice, Meridian, Miss. Prof. Frank L. James, St. Louis

Dr. Michael Campbell, Knoxville, Medical Journal.

Tennessee. Daniel L. Brinton, Esq., Baltimore

O. Wellington Archibald, Jamestown, Bar.

Dakota. Dr. E. P. Sale, President Missis-

Dr. E. Grissom, Raleigh, N C. si ppi State Board. of Health.

Dr. W. W. Godding, Washington, D. C. Prof. J. O. Hirschfelder, of Cali-

Dr. H. K. Pusey, Kentucky. fornia.

Dr. W. W. MacFarlane, California. Prof. C. H. Boardman, State Uni-

Twenty-six in number. versity of Minnesota.

John M. Taylor, Vice-President of Frank H. Howard, Esq., Los

Connecticut Mutual Life Ins. Co. Angeles, California. Governor R. S. Green, New Jersey.

This is a most cheering and gratifying result. You can hardly measure or estimate, the extended influence this is to bring to the usefulness of this Society through- out the United States, and indeed North America. I hold in my hand many letters from gentlemen through- out the States, who express the warmest sympathy.

We have elected twelve from New Hampshii'e, eight from Texas, twenty-three from New York, four each from Pennsylvania, Wisconsin, Georgia and Michigan, eight from Missouri, nine from New Jersey, five each from Alabama and Illinois, three each from Connecticut, Kansas, Kentucky, Louisiana, Mississippi, Massachu- setts, Minnesota and Virginia, with several additions from other States, so that West Virginia, Maine, Delaware and Arkansas are the only States in which we have not members at this moment.

It has occurred to me, that this would be the most grat- ifying announcement I could possibly make to the Society. To my mind, this is one of the most extraordinary

9G TRANSACTIONS.

sfcatements that any official of this Society has ever been called upon to make. We have, as you are aware, called an International Congress of Medical Jurisprudence, and have issued circulars to the scientific world, and fixed the time for the Congress to commence on the first Tuesday in June, 1889, and decided that it be held for four days.

I have already received many letters from men who desire to be present. Men from all parts of the world will be invited. Those who come will be entertained by members of the Society at their homes, and at that Con- gress members of the Society residing outside New York City will find it a good time to visit us. A preliminary sub- committee of arrangements has been appointed; the full committee of arrangements will be made later on, when it becomes necessary to take hold of the work. Dr. Charles H. Hughes, the talented editor of the Alienist and Neurologist, has notified mo that he will read a paper. W. W. Godding, Superintendent of Government Asylum of the Insane at Washington, announced that he would also read a paper on that occasion.

I desire to allow the Society to be aware of the steps taken. I have no doubt that we shall increase the mem- bership very largely by the early autumn. There is only one more meeting of the Society before the summer vacation. I have no doubt that these figures which have been given will be more than doubled, and that the usefulness and interest in this body, and its lines of influence, will be extended far beyond anything we have ever hoped or expected."

TRANSACTIONS. 97

The resignation of Clark B. Augustine as Assistant Secretary, being presented, who was unable to give the necessary time to the discharge of the duties of that office, it was, on motion, accepted. By unanimous con- sent the by-law was suspended requiring one month's previous notice of nomination of candidates, and the Society, on motion, proceeded to elect an Assistant Sec- retary. Dr. Frank H. Ingram, having received the unanimous vote of the Society, was declared elected.

On recommendation of the Executive Committee, the date of the International Congress was fixed for the first Tuesday in June, 1^89, to continue four days, in the City of New York.

The Secretary laid before the Society a contract dated May 8, 1888, between the Medico-Legal Journal Asso- ciation and this Society, by which this body subscribed for the Medico-Legal Journal, Vols. 6 and 7, for all its members, and for one hundred copies for its exchanges, which had been executed by the Presidents and Secre- taries of both bodies ; which was read and ordered filed.

On motion, the contract was duly approved in form, and the action of President and Secretary in signing tlie same duly approved.

The paper of Dr. W. Thornton Parker was discussed and criticised by Dr. Peterson, who said : ' ^ It seems to me that the method of post-mortem examinations has been made too cursory, because any medical exam- iner who is called to investigate a suspected criminal case, should examine the organs of the chest and head.

^S TRANSACTIONS.

I think, where a person is found dead, a thorough exam- ination should be made in all medico-legal cases.''

Mr. Edward Chamberlain : — '' I would like to ask the gentleman if he suggests the examination of the chest and head, as bearing upon this possible crime of infanti- cide or abortion in any way, or merely as a matter of ordinary precaution, with no relation to this paper. If so, is it possible that this examination may be omit- ted by the author of this paper, who did not consider it necessary.

Dr. Patterson : — ^^The writer of the paper was called in to ascertain the reason of death. He examined the body as it is done in other medico-legal cases in this country, but he ought to have examined the os, as well as the stomach."

Dr. Matthew Field : — ^^ I would say just one thing, which is important to ascertain, whether the woman was married before ? He does not make any statement dealing on this subject."

President Bell : — ^' The Chair has had no correspond- ence with Dr. Parker, and the only knowledge he has on the subject is the paper contributed."

The Chair announced the addition of the following names on the Committee on Nationalization, viz.:

Dr. D. M. Clay, of Shreveport, La., in place of Dr. Joseph Jones, whose state of health forbids his serving. Hon. Daniel Barnard, Attorney- General of New Hamp- shire, in place of Dr. C. P. Frost, resigned. Dr. C. A. Rice, Sup't. of the State Asylum at Meriden, for Mississippi.

TRANSACTIONS. 99

Dr. Michael Campbell Supt. State Asylum, of Knoxville, for the State of Temiessee. Dr. D. R. Wallace, Sup't. State Asylum of Terrell, for Texas. Dr. W. W. Godding, Sup't. Government Hospital for Insane, at Washington, for District of Columbia, and Dr. 0. Wellington Archi- bald, Sup't. Insane Asylum at Jamestown, for Dakota Territory.

The Chair stated that he would hereafter announce the Committee on Hypnotism.

The Society then adjourned.

Albert Bach, Secretary.

MASSACHUSETTS MEDICO-LEGAL SOCIETY.

Rooms of the Boston Medical Library Association.

June 12, 1S88.

The eleventh annual meeting was called to order at 12:15 p. M., by President Winsor.

Present, sixteen members.

Reading of the record of last meeting was postponed.

The Treasurer made his report, showing a balance of $26.85 in the treasury at date.

The report was adopted, and an assessment of three dollars was declared.

The President appointed a Committee of three to nominate a list of officers for the ensuing year.

The Committee reported the following list, wiiich was unanimously adopted : President — Medical Examiner J. G. Pinkham, Lynn.

100 TRANSACTIONS.

Vice-President — Medical Examiner A. F. Holt, Cam- bridge. Corresponding Secretary — Medical Examiner B. H. Hart- well, Ayer. Treasurer — Medical Examiner C. C. Tower, South Wey- mouth. Recording Secretary — Medical Examiner W. H. Taylor, New Bedford.

President Pinkham thanked the Society for the honor conferred on him, and made a few remarks concerning the best ways of forwarding the Society's interests.

The President appointed the following gentlemen Standing Committee for the ensuing year : Medical Examiners, Draper, Presbrey and Winsor.

Voted, On motion of Medical Examiner Draper, to empower the Standing Committee to bind the Trans- actions of the Society in a suitable manner.

Medical Examiner Holt deplored the inactivity of members in the matter of presenting papers, and hoped that members will feel it their duty to the Society to make efforts to increase the interest of the meetings.

Voted, On motion of Medical Examiner Winsor, that the subject for discussion at the October meeting be ^^ Poisoning by Arsenic," and that members be notified of this vote as early as convenient.

Medical Examiner Winsor made some remarks regard- ing his term of office as President, and read an inter- esting account of a Disputed Case of Accidental Drowning. The death was due to an epileptic attack

TRANSACTIONS. 101

while bathing. Certain questions of violence arose in the minds of the public, and an autopsy was made by private parties, without definite result as to cause of death. A prominent question in Dr. Winsor's mind was, whether he should have made an autopsy to satisfy public sentiment, believing, as he did, that the case was purely one of accidental drowning.

In the discussion which ensued, Medical Examiner Morse reported a case of an epileptic who met his death by drowning while in an attack.

Medical Examiner Holmes reported a case of drown- ing in a tub, the subject being a child of twenty- one months, and the water but one and three-quarter inches deep.

Medical Examiner Presbrey reported a case of drown- ing in a little rill of water from melting snow, the locality being dry when the body was found.

Medical Examiner Taylor reported a case of drowning in a little water contained in the imprint of a horse's hoof in mud, which subsequently became frozen.

Medical Examiner Wright reported a case of a man who vomited the contents of his stomach, and, lying face downward, was literally drowned in the fluid.

Medical Examiner Holt believed that the office of Medical Examiner was created in the interest of the public and not that of the official, and he would make an autopsy in any case where public sentiment demanded it.

102 TRANSACTIONS.

Medical Examiner Paine reported a case of drowning showing the necessity of an autopsy.

The subject was further discussed by members Holmes and Morse. Voted to adjourn.

W. H. Taylor, Recording Secretary.

I

EDITORIAL.

Definitions of Insanity and Tests of Legal Re- sponsibility OF the Insane :

Burton : —

'* Madness is therefore defined to be a vehement dotage, or raving with- out a fever, far more violent than melancholy, full of anger and clamor, horrible looks, actions, gestures, troubling the patients with far greater vehemency, both of body and mind, without all fear and sorrow, with such impetuous force and boldness, that sometimes threo or four men cannot hold them.

*' Differing only in this from phrensy, that it is without a fever, and their memory is in most part better. It hath the same causes as the other, as choler adust and blood incensed, brains inflamed, etc."

(Burton's Anatomy of Melancholy, p. 91.) Phrensy :

'* Phrenitis, which the Greeks derive from the word (pf>'/i', is a disease of the mind, with a continual madness or Idotage, which hath an acute fever annexed, or else an inflammation of the brain, or the membranes, or kels of it, with an acute fever, which causes madness and dotage.

' ' It differs from melancholy and madness, because their dotage is without an ague; this continued with waking or memory decayed, etc. Melancholy is most part silent, this clamorous, and many such like differences are assigned by physicians."

(Ibid.)

" Madness, phrensy and melancholy are confounded by Celsus and many writers, others leave out phrensy and make madness and melancholy but one disease, which Jason Prateusis especially labors, and that they differ only secundum niagis or minus in quantity alone, the one being a degree to the other and both proceeding from one cause. They differ intenso et remisso (jradu, saith Gordonius, as the humor is intended or remitted.

'' Of the same mind is Aretus Alexander Tertullianus, Guianerius, Savarcasola, Heumius, and Galen himself writes promiscuously of them both, by reason of their affinity, but most of our Neoterics do handle them, apart, whom I will follow in this treatise."

(Ibid.)

104 EDITORIAL.

Fracastorius : —

Adds to the defiuition of Burton " a due time and full age to distinguish it from children, and will have it confirmed impotency, to separate it from such as accidentally come and go again, as by taking henbane, nightshade, wine, etc.

" Insams est qui aetate debita, et temj)ore debite per se nom momen- taneam et fugacem, ut vini, solani. Hyosciami sed contirmatam habet impotentiam, bene operandi circa intellectum." (Lib. 2 de Litellictione.) (Burton's Anatomy of Melancholy.)

English Sympathy with Physicians.

Drs. Marshall and Shaw, of Clifton, were sued for damages by a lady whom they certified to be insane. They succeeded in the action, but the impecunious plaintiff was irresponsible for costs.

The British Medical Journal of the IJrth of April, 1888, publishes the subscription list of sympathizers who con- tribute over £160 to them to defray the legal and other expenses.

Phenomena of Droavning.

Dr. Paul Loye, at the Congress for the Ada^ance- ment of Science, held lately at Osam (Algeria), contrib- uted the following, as the results of his observation, regarding death by drowning :

^' The first stage of deep inspirations lasts about ten sec- onds, followed by a reaction caused by the resistance to the entrance of water into the bronchioles — this lasts for a minute, and is succeeded by arrest of respiration, and loss of consciousness — finally the scene closes with four or five respiratory efforts — the last." Immersion causes

EDITORIAL. 105

an immediate rise in the blood pressure, with slowing of the heart-beats.

The action of the heart remains slow l)ut strong, till death ensues. The pressure gradually lessens, but rises just before death, to fall to zero immediately afterward. The heart sometimes continues to beat feebly, for about twenty minutes.

The result is the same in animals which have been tracheotomized. The period of respiratory resistance is therefore due to the respiratory muscles, and not to spasm of the glottis.

(British Med. Journal.)

Chair of Medical Jurisprudence in Dublin.

Mr. Robert Travis, who has had this chair in Trinity College, Dublin, and who lectured on Medical Juris- prudence in the Ledwich School of Medicine, died on March 27, 1888. He has been Professor since 1864.

Dr. A. Bewley has been elected lecturer on Medical Jurisprudence at Trinity for the present session, and Dr. C. H. Robinson has been appointed lecturer^ on Medical Jurisprudence in the Ledwich School of Medicine.

Personal.

Dr. Droineau has been appointed Inspector-General of the French Charitable Institutions, in place of Dr. AcH FoviLLE, deceased.

Dr RuYSCH has been nominated to the position of

106 EDITORIAL.

Inspector-General of the Insane Asylums of Holland, to fill the vacancy occasioned by the death of Dr. Ram^r.

Electricity vs. the Hangman. New York says:

' ' Adieu to the hangman and the gallows, The scaffold and the rope."

Science removes from our civilization the ghastly struggles of the condemned, with the executioner, and the revolting scene of men strangled by bungling in adjusting the rope.

Despite the clamor of the voices that saw beauties in hanging men for crime, the labors of the Medico-Legal Society, after years of debate, are C2^owned with success. The Governor has signed the bill to which he called attention in his message.

The le3Son taught is, that needed legislative reforms, against evils, long existing, come best; through properly selected commissions.

The New York Press and Medical Jurisprudence.

The New York Herald has lent the great weight, of its influence as a journal, to a notice of the work of the Medico-Legal Society of New York. In its issue of 20 th June there appeared a resume of its work, which will arrest the attention of both professions, throughout the world.

We give it space in this Journal.

EDITORIAL. 107

MEDICINE AND THE LAW.

Organizing an International Congress and a National Society.

CLOSER combination DESIRED.

Progress in Biology, Neurology, Psychiatry, Physiology, Psychology

and Toxicology.

The Medico-Legal Society, of this city, is apparently awakening to a state of considerable activity, and the effect of its exertions is being felt throughout the country and in Europe.

It has been decided to undertake two important steps. In the first place, efforts aie being made to gather together in this country in June, 18^9, an international congress of medical jurisprudence, to which representatives of all countries have been invited to at end, or at least contribute papers on the subjects to be discussed.

In the second place, an apparently successful attempt is being made to nationalize the Medico-Legal Society, by extending its membership into each State and Territory of the Union where members do not now reside, and to elect at least ten representatives in each section.

THE coming congress.

Regarding the proposed international congress, a circular letter was recently sent by the Medico-Legal Society, to all kindred societies in Europe and to a large number of prominent lawyers and physicians throughout America. This circular set forth the fact, that the progress made in this century, in the sciences of biology, neurology, psychiatry, physiology, psychology and toxicology, have enhanced our knowledge of the functions of brain and nervous organization, and have elevated medico-legal science to a higher rank than it ever occupied before.

Th>i conviction, it is said, has therefore gained ground, that medicine and jurisprudence must combine closer for a clearer definition and the better understanding of the principles that are rooted in both branches of learning, in the exercise of functions which reciuire [)ractical application in the gov- ernment of society. This is claimed to be the special fiekl of medico-legal science, and calls for the most intimate relationship between the faculties of medicine and of the law.

In most of the Euro-wan countries, say the advocates of medical juris- prudence, forensic medicine is taught by great specialists, attached to the universities, and the same is don" in some of our own colleges, though there is no uniform practice, in the application ^f these principles to tiic aihniuis-

108 EDITORIAL.

tratiou of justice. The courts in Germany obtain the opinions of experts- officially attached to those institutions, but they are often disregarded, and neither in this country, or in Europe, are the courts bound by the professional opinions of the medical expert.

ACTIVELY ORGANIZING.

As to the efforts being made b}'^ the Medico-Legal Society, to nationalize its organization, it is stated that the society has members in all the States except eight, and in all the Territories except four, and steps are being taken to enter into communication with representative men, who take an interest in medical jurisprudence, in the unrepresented States and Territories. As the Society votes by mail (by ballot) at the annual elections, the presence of non-resident members at the meetings is not considered indispensable.

According to the plan adopted, it is proposed to elect a Vice-President of the Society, from each State and Territory, and to ask members from each* to report all cases of interest to the President of the Society, with a view of bringing the study of the science,'and of all questions arising from it, within this country, at once to the attention of the Society. This plan is said to have met with the approval of distinguished men, in various sections of the Union.

Judge Somerville. of the Supreme Court of Alabama, and Dr. P. Bryce, Superintendent of the State Lunatic Asylum at Tuscaloosa, will lead the movement in that State, and will favor it actively in the Southeastern States.

Governor Robert S. Green and Judge C. G. Garrison, of New Jersey, are announced to be willing to lead in that State. Dr. Joseph Jones will do the same in Louisiana. Professor J. J Elwell, Rev. William Tucker, of Mt. Gilead ; C. H. Blackburn, of Cincinnati, lead in Ohio ; Dr. McClelland, of Knoxville ; Dr. Horace Wardner, Superintendent at Anna ; Dr. E. J. Kil- bourne, Superintendent at Elgin; Dr. D, W. Aldrich, Mayor of Galesburgh, and some friends in Chicago, lead in Illinois. Dr. J. Draper, Superintend- ent of the State Asylum atBrattleboro', Vt,; Dr. Thomas O. Powell, of the State Asylum, Milledgeville, Ga.; and Dr. D. W. Yandell, in Kentucky.

In Pennsylvania the Society is represented by S. Hepburn, Jr., of Car- lisle, ex-Governor Hoyt, Dr. George B. Miller, Dr. Alice Bennett and Mrs. M. Louise Thomas, of Philadelphia. Dr. W. B. Fletcher and Dr. O. H. Kellogg hold up the flag in Indiana. Dr. Jennie McCowen, of Davenport, Dr. Gershom B. Hill and Dr. F. E. Crittenden do the same in Iowa. Will- iam M. Taylor, Vice-President of the Connecticut Mutual Life Insurance Company, and Dr. Geib, of Stamford ; Dr. J. S. Butler and Dr. W. B. Lewis, of Hartford, will lead in Connecticut. Judge J. C. Normile, of the Criminal Court, heads the list in St. Louis, and will lead in that Slate,

EDITORIAL

100

aided by distinguished members of both professions. Dr. Middleton Michel, of Charleston, S. C, is foremost in that State ; Er. T. R. Buck- ham and Dr. V. 0. Vaughan lead in Michigan ; Dr. Ira Russell, Dr. Ed. J. Cowles and Dr. Frank K. Paddock are in the front rank in Massachu- setts, while prominent gentlemen in various other States have consented to aid the movement.

NEW YORKERS INTERESTED.

The following j'ldges and ex-judges in this State are members of the Medico-Legal Society : — Ex-Chief Justice Noah Davis, Judge Miles Beach, of the Supreme Court ; ex- Judge Richard W. Busteed, Ex-Surrogate I). C. Calvin, ex-Judge John F. Dillon, ex-Judge A. J. Dittenhoffer, ex- Judge Charles Donohue, District Attorney John R. Fellows, ex- Judge S. Burdett Hyatt, ex-Judge M. S. Isaacs, Judge George L. lugraham, ex-Judge J. P. Joachimssn, ex-Judge J. H. McCarthy, Chief-Justice David McAdam, ex-Judge Marcus Otterburg, Judge Calvin E. Pratt, Chief-Justice Sedg- wick and ex-Judge G. M. Speir.

According to the statistics furnished by Clark Bell, President of the Med- ico-Legal Society, the movement for nationalization has been successful in several States, and over one hundred members have recently united, with that body, some twenty-five of whom are superintendents of insane asylums outside of New York,

Much increase of interest seems to be taken in medico-legal science. The Medical Jurisprudence Society, of Philadelphia, is in a flourishing con dition, 'Live Birth in Medico-Legal Relations,' 'Will Contests,' 'The Handwriting of the Insane,' 'The Claim of Moral Insanity.' 'A Strange Homicide Case,' 'Criminal Psychology' and 'Suicide in Its Relations to Insanity,' being some of the interesting papers recently read before that body.

The Massachusetts Medico-Legal Society is also doing good work, being organized under the action of the Medical Examiners of that State, who take the place of the coroners, who have been abolished, in that section of the country.

In France, the position of forensic medicine is considered to be in a satis fying condition, and the labors of the Medico-Legal Society of France have borne good fruit. But, strange as it may seem, Italy has led, in the race for knowledge in this direction, and the Italian journals are considered to be in the front rank of the world, in the various departments of neurology, psychiatry, forensic and State medicine.

IN OTHER COUNTRIES.

Forensic medicine receives careful attention in the German universities, and there is a chair of forensic medicine in each. Belgium has no Medico-

110

EDITORIAL.

Legal Society, the students of the science being chiefly medical men. The leading Belgian society is the Society of Mental Medicine, which includes the leading alienists of Belgium. Holland is in a similar condition, the Netherland Society of Psychiatry at present being the foremost society in Holland, so far as mental medicine is concerned.

Russia's leading society is the Society of Psychiatry, of St. Petersburg, but that countrj' has no Medico-Legal Society. In the Scandinavian couu tries, Professor Alexander Key, of Copenhagen, Denmark, is the leading advocate of forensic medicine. There is as yet no national or local society of medical jurisprudence in Great Britain, but the English and Scotch alien- ists and neurologists keep abreast with the advance of science in other countries.

Some time since, the Medico-Legal Society of New York announced that the following prizes for original essays, on any subject within the domain of medical jurisprudence or forensic m.edicine, would be awarded for the first time this year, the papers to be sent to the President of the Medico-Legal Society of New York, no later than June 1st, 1888 :

1. For the best essay, $100, to be known as the ' Elliott F. Shepard prize.'

2. For the second best essay, $75.

3. For the third best essay, $50.

Though the time was originally limited to April 1st, it is understood that any essays arriving up to June 1st, will be considered and receive due recognition. It was intended to make these prizes open to all students of forensic medicine, throughout the world.

A sample of the work covered by the Medico-Legal Society may be judged from the following questions recently sent to gentlemen who were compe- tent to answer them, by the President, Mr. Clark Bell : —

' Please give me your idea of the best definition of insanity under our present knowledge of that subject ? '

* Also what in your judgment should be the legal test of criminal respon- sibility for acts committed by persons suffering from any form of mental disease ? '

'In conclusion it may be stated, that therewas no section of medical juris- prudence, at the late International Medical Congress at Washington, and many people complain of the fact, that the science is almost wholly neg- lected in the American Bar Association."

When a great journal like the New York Herald pays this tribute to a scientific society in America, and gives such a recognition to the character and value of its labor,

EDITORIAL. Ill

it is entitled to the thanks of every officer and member of tlie body.

THE NEW YORK TRIBUNE.

This influential journal, which has ever been alive to the advance of scientific thought, notices with approval the labor attempted by the Society.

The public are aware of the interest taken by the Tribune in the question of intemperance, and the rela- tion of alcoholic liquors before the law, and it has made and published, from a great variety of sources, the opion- ions of competent judges, as to the effect of inebriety in the various States.

We give the substance of the Tribune's article, and take this occasion to thank the Tribune for the interest it has taken in the Society and its projected en- deavor :

A NATIONAL MEDICO-LEGAL SOCIETY.

PUSHING TIIR WORK OP ORGANIZATION IN EVERY STATE AND TERRITORY,

The Medico-Legal Society, of which Clark Bell is president, will soon be organized in a more thorough manner, consolidating in this country its dilTerent branches under the name of the Medico-Legal Society. Already there are members in all but eight S tates and four Terriories, more or less organized in a systematic manner, and it is proposed to further carry forward the work of organization, to acquire better facil- ities for the study and collection of facts regarding the sciences of biology, neurology, physiology, psychology and toxicology, by convening an inter- national congress early next spring.

A circular has already been sent to the leading kindred societies in Europe, and to prominent professional men throughout America. It is also proposed to elect in each State and Territory a vice-president, through whom all facts, gathered in his dist'ict relating to the sciences named, shall

112 EDITORIAL.

be forwarded to the central body iu New York. A subject which is receiving great attention from the Society, is insanity from drunkenness, and a great many facts relative to that phase of the human mind and appe- tite have been carefully compiled and commented upon in a book which is now in proof, but will soon be published under the name of "The Medical Jurisprudence of Inebriety," by the Medico-Legal Society.

One of the papers recently read at a meeting of the Societj', was the report of a committee on the best methods of executing criminals. Judge Noah Davis has submitted a long article to the Society on the disease of drunkenness, and its relation to the law. He says : " Whether drunkenness be or be not a disease, was not the point to be determined, but the point was then, as now, whether drunkenness, if it be a disease, is or is not to be treated like other diseases in the commission of crime. No disease excuses any man for the commission of crime."

Among the prominent men interested in the work of the Society, are Judge Somerville, of Alabama ; Dr. P. Bryce, superintendent of the State Lunatic Asylum at Tuscaloosa; Governor Robert S. Green and Judge C. G. Garrison, of New Jersey ; Dr. Joseph Jones, of Louisiana ; Professor J. J. El well and the Rev. William Tucker, of Ohio; Dr. McClelland, of Ten- nessee ; ex-Governor Hoyt, Dr. George B. Miller, and Dr. Alice Bennett, of Pennsylvania and Pliny Earle, of Massachusetts.

The following judges and ex-judges in this State are members of the Medico-Legal Society : Ex-Chief Justice Noah Davis, Judge Calvin E. Pratt, .Tudge Miles Beach, of the Supreme Coui t ; ex-Judge Richard W. Busteed, ex -Surrogate D. C. Calvin, ex-Judge John R. Dillon, ex-Judge A. .J. Dittenhoefer, ex- Judge Charles Donohue, District-Attorney John R. Fellows, ex-Judge S. Burdett Hyatt, ex-Judge M. S. Isaacs, Judge George L. Ingraham, ex- Judge J. P. Joachimssen, ex- Judge J. H. McCarthy, Chief Justice David McAdain, ex-Judge Marcus Otterbourg, Chief Justice Sedgwick and ex-Judge G. M. Speir.

It may not be amiss in this connection to give a list of distinguished Superintendents of Asylums in the State of New York and outside that State who have recently united with the body since January 1, 1888.

We can say that a still larger number have united since the date given by the Herald duiing 1888, including names in the front rank of the legal and medical pro- fessions, as well as scientists and professors in the colleges

EDITORIAL. llo

and universities who take an interest in these studies. The forthcoming congress will be a notable occasion, and members, active, honorary and corresponding, with all persons interested in the progress of forensic medicine, are invited to not only unite with the Society, but to submit papers, for the approaching congress in June, 1889.

Prize Essays.

An essay was submitted in competition for the prizes, that had been published by a leading London house, over the author's name in the year 18S(), and which had attracted attention in various countries.

The question was referred by the President, to the Executive Committee of the Medico-Legal Society, whether this essay should be allowed to compete. That Committee instructed the President to refer the question to a select committee, to be named by the chair.

Dr. Stephen Smith, ex-Commissioner in Lunacy, ex-Chief -Justice Noah Davis and E. W. Chamberlain, Esq., Treasurer of the Society, were named tliat Com- mittee.

On July 2d that Committee submitted the following

report :

2 Wall Street, New Yokk, July 2, 188S.

To ITou, Clark Bell, President, etc.

The undersigned, a Conimittee appointed by the Executive Committ^-e of the Medico-Legal Society, to consider the question, whether apapersuh- mitted for competition for prl/,e essiys in our list, should be received and entitled to compete, that had been published and issued to the public, respectfully report as follows :

1 1 4 EDITORIAL.

"We are of opinion that such a paper should not be received, and allowed to compete.

The purpose of offering such prizjs, is to call new effort into the field, by invoking new and original productions.

To allow competition by articles already given to the public, is, or might be, to put into the scale against new and unpublished efforts, the public opinion which m ly have been already secured by the publica- tion made.

It is not the intention, in determining the merits of essays, to allow any such prejudgment to aff*^ct the minds of the judges.

Each paper submitted is to come before the Committee on an equal footing in all respects, and that would not be the case if one or more had already been published, and bad thereby secured favorable criticism, or con- demnation. The intention is doubtless to require novelty in the essay, to the extent that it shall be original, and not previously made public.

The essay mentioned by the chairman in his note appointing this Com- mittee, should not, we think, be allowed to compete- Very respectfully,

Stephen Smith, Chairman

Noah Davis,

E. W. Chamberlain,

Committee.

The President thereupon appointed the following Committee to pass upon the merits of the various essays submitted:

Chairman— Ex-Chief -Justice Noah Davis.

Secretary— E. W. Chambeklaix, Esq., Treasurer M(Klico-Legal Society.

Ex-Judge John F. Dillon.

Stephen Smith, M. D., ex-State Commissioner of Lunacy of New York.

^^/, G. Stevenson, M. D., Vice-President Medico-Legal Society.

The action of this Committee will be announced at the September meeting of the Society, and we trust in time for the next i^sue of this Journal,

EDlTOlilAL. 115

The Medico-Legal Journal.

We enter upon our sixth volume, by the present num- ber, with some feehng of pride, at the advances made in the recent past, in the science of medical jurisi)rudence in this country, and the world, as well as the work and influence of the Medico -Legal Society, in accomplishing these results.

L The past year has marked the introduction of a series of prizes for essays, which have just closed on June 1st, ult., which will, we have no doubt, be a feature of the Society in the future.

2. The call for an International Congress, in this city, under the auspices of this body, for four days, com- mencing on first Tuesday of June, 18S1), will bring invalu- able contributions to the literature of this science, from scientists of all countries.

3. The movement to nationalize the Society, com- menced only in January, 1888, has already assumed such proportions as to insure a success beyond our most sanguine expectations. We are enlisting the cream of the three professions. Law, Medicine and Chemistry, in the various States and territories, which cannot fail to make the International Congress of June, 1889, the most notable event that has hitherto occurred in the progress of the science in this country.

Large numbers of the newly elected members will attend and contribute papers, while the savans of other countries, who cannot attend, will be heard by their contributions.

116 EDITORIAL.

4. We feel, therefore, justified in asking our sub- scribers, and especially any member of the Medico -Legal Society, and friend of the science, to personally and actively aid us, by extending our subscriptions to mem- bers of all professions, who are not members of the body.

This Journal will give all lawyers, physicians and public officials, the latest news germane to these topics, and will enable any medical expert, or legal gentleman, to meet the questions constantly arising in their practice.

Miscarriages of Justice. — Mr. Justice Barrett, of the New York Supreme Court, contributes a thoughtful article to The Formn, for May. We notice some of his suggestions, which are worthy the attention of the legal profession and the public.

1. "A constitutional amendment consolidating, in New York City, the three highest Courts into one great Tribunal, with an appellate branch of five judges sitting permanently throughout the legal year."

This would be a great saving, would dispense with two out of the three present General Terms, and would enormously increase the capacity of our present judicial force to dispatch the public business. We think the profession would favor it.

2. A plan to abrogate or modify the present system of calendar delays — under the existing rules — which con- fessedly works badly.

8. Judge Barrett explains why the general criticism

\

EDITORIAL. 117

as to the number of reversals is unfair, as it relates, not to a percentage of all the decisions, but only to the small relative number of those that actually come up for review.

4. As to Juries, that, by constitutional amendment, nine out of twelve should control a verdict, if approved by the Court, a suggestion of Mr. Chief-Justice Van Brunt.

He concludes a very able paper with these words, speaking of " the machinery of justice ": —

" Behind the machinery there must be power — power adecfuate to its efficient working.

"That power can be supplied only by an enlightened public opinion, finding its expression in an able, upright and vigilant press."

The press can hardly be relied upon, especially in exciting public trials, as reflecting an enlightened public opinion.

Its attitude on recent great public trials, in which Mr. Justice Barrett took a conspicuous part, hardly entitles it to be called '' upright," whatever might be said of its ''vigilance."

There is as wide a gul between " popular clamor," as reflected in the press — especially in prejudging and attempting to influence judicial action, in cases before trial — and '^ali enlightened public opinion," as that which divided Lazarus and the rich man, in our Lord's Parable.

It will be a sad day for the city, for the profession, for the administration of justice, when a judge on the

llB EDITORIAL.

bench is influenced, much less intimidated or deterred, by the assaults, menaces or threats of the press, from giving accused persons that fair and impartial trial which has been the glory of English-speaking races.

In no country in the world, and in no city save New York, is it tolerated, nor has the press ever usurped the license to pass upon the guilt or innocence of accused persons, before and during their trial, or openly sought to intimidate judges in the discharge of their duties, not sparing the Chief -Justice of the highest court of the State.

There can be no greater danger to our judicial system than the daring and unlawful encroachments of the press, upon the rights of accused persons, and no sadder reflection than the growing public sentiment, that our judges are in danger of being, either intimidated, or im- properly influenced, by that " popular clamor" of the press which it is so easy to designate as, or mistake for, ' ' enlightened public opinion. "

Notice to Honorary, Corresponding and Active Members, Medico-Legal Society : — The President will feel obliged, if all who are willing to prepare papers foi' the International Congress of June, iSSii, will notify him as early as possible, and also give the title of the paper, so that preliminary announcements may be made in September number of Journal.

Papers are desired as well from those who are unable to attend as from those who can.

The movement to Nationalize the Medico-Legal

EDITORIAL. 1 19

Society has been so successful that it only needs a little effort on the part of every member to aid the Committee- men in the several States and Territories.

Blanks will be furnished each member, on application, and more than double could be added to the one hun- dred and thirty new members elected already the pres- ent year, before its close.

JOURNALS AND BOOKS.

De L'Examen Medtcat> dans i-es Assurances sue la Vte. (F. B. Bat>- LTERE et pils. Patits (1887). —By f;ir the most complete and sci«'nt,iTic treatise on this subject that vve have seen.

The name of the author and of his co-!aborators is withheld, although the publishers assure us that he has for a long time been the physician of one of the great life insurance companies of Paris.

The work contains 571 pp., and is elaborate, giving each branch of the subject thorough examination and care. It is divided into three parts. Tlie first relates to the etiology of applicants for life insurance, and gives great stress to heredity. The second to the pathological questions, and the third to the clinical examination.

Reiiarding as we do the great importance of the medical examination to the future of life insurance, we should be glad to see this work translated into English. Its value is greater here than in France, because America leads the world in life insurance, and must do so for some time.

The American Journal of Psychology. Edited by Prof. G. Stan- ley Hall, Johns Hopkins University, Baltimore.

We are glad to welcome this journal, which must wield a prominent influence in the study of psychology. Prof. Hall is well equipped for such a labor, and the three numbers of the first volume published sliow tliat the subject is not only in able editorial hands, but that the best names are aid- ing in making it a first-class journal.

Dr. William Noyes, of Bloomingdalc Asylum, N. Y., contributes an interesting paper, entitled " Paranoia," with illustrations, to the last number* and Dr. Edward Cowles, of McLean Asylum, Massachusetts, an able paper on "Insistent and Fixed Ideas "' to the February number. We shall notice this journal again, and we hope have more space to give it.

The Religion op Philosophy. By Raymond S. Perrin. G P. Put- nam's Sons. 1885.

Whether we agree with this author in his religious opinions, or in his want of them, we can say without hesitation, that we recall no recent work which so succinctl3% briefly and fairly epitomizes the various types of what

wc may call the philosophical schools, of ancient and modern faiths, as this.

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JOURNALS AND BOOKS. J 21

We have a chapter devoted to the dawn of pliilosophic thought, one 1o the pre-Sooratic period, the schools of Athens, of various types, the Alex- andrian school, and the various scepticisms which have marked the free- thinking pliilosophers of the last and present century. He gives ua the cream of the German transcendentalists, and the modern positive schools of France and of Scotland, in the first part of his work.

The second part is devoted to a careful and friendly analysis of the views of Herbert Spencer on the one hand, and of George Henry Lewes on the other, while the third part of the work is an attempt to outline the author's veiws under the cognomen of the Religion of Philosophy, by a search into the great popular beliefs of the world for reasons to justify his own. The ancient faith of the Egyptians, the doctrine of Buddha, the faiths of Greece, Rome, the religion of Mahomet, of Moses, of Christ, of Pantheism — all are reviewed ; and the work concludes with an appeal to American women in behalf of the religion of philosophy.

We could never see value, or strength, in the views of the agnostics. They may, and will, interest and occupy thoughtful minds of educated men, but for women, we do not see that they have any, or but little, attraction.

It emasculates a woman, to lose her hold on faith. A woman without faiih, is as a dead tree, over which the sirocco of the desert of unbelief has swept, and left it sere and withered. Who would dare take out of the history of mankind the influence of the mother's hand on the head of her child, as he knelt at her knee in childhood ?

Any religion which lifts the soul to higher aspirations, purer life and nobler ideals, even if error, does not injure or degrade its devotees.

The faith of the Christian woman sustains her through life, lifts her soul to clearer, lovelier hopes of the hei eafter, shields and befriends her in temp- tation, and in every ill, and sheds around her, as wife and mother, a lustre which gives to womanhood its loveliest type and form.

Before we tear down and shatter the faith of the mother whose hand rests on the head of her child in prayer, so long as he remains under her charge, let us be sure we put in its place something on which she can lean securely, in the hour of trial, temptation, the ills of life and the pains of death. The iconoclasts should be compelled to furnish us with newer and better idols before they destroy the old ones.

For men it is bad enough, but for women, who are to be our wivee and the mothers of our children, one soul guided by a pure faith Is worth a wilderness of doubts and unbeliefs.

DiAGNosia AND TREATMENT OF ILemoiitiiioids. By Chas. B. Kelsey, MD. (Geo. S. Davis, Detroit, Mich.). 1880. This brochure is a thoughtful contribution to tl^e medical profession of

122 JOURNALS AND BOOKS.

the results and experience of one of our abler physicians, upon a subject best known to those who, like Dr. Kelsey, have made it the subject of special study. It has lesc value in its medico-legal than in Its medical and surgical aspects. Dr. Kelsey advises how to correctly diagnose the disease, treats of the various forms which it assumes, the best treatment, and gives his views as to the ligature, treatment by injections, and the use of the clamp. It is well worth a place on the library shelf of the physician in general practice.

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Books, Journals & Pamphlets Received.

Austin Abbott.— Physiology of the Rogue (1888). Burr PrintlDg House.

Dr. Tiieo. S. Armstron({. — Ninth Annual Report Binghamton Asylum for Chronic Insane (1887).

H. M. Jones, Supt. — Twenty-seventh Annual Report of Cincinnati Hospital (1887).

Edwai.d Cowles, M.D.— Nursing — Reform for the Insane (1887).

Woman's Publtshing Co.— April No. " Woman " (1888).

Dr. W. W. Ireland.— Weak-Minded Children (1888).

Wm.^BeTn' mT- ""' [ ^^^^^ «^ ^««^ Preservatives (1888).

Doctor Frank. — Boston Journal of Health, Vol. I., No. 8.

Dr. C. H. Hughes. — The Neural and Psycho-Neural Factor in Gyn.Tic Disease (1888).

Milton Jostati Roberts, M.D. — International Journal of Surgery, Vol. I., No. 2.

L. W. Baker, M.D.— The Alcohol Habit (1888).

Horace Wardner, M.D. — Occupation in Treatment of Insanity (1888).

Prof. M. D. Ewi-.lf.. — Cornell University School of Law Announcement (1888-89).

Henry IIazlkeiukst, Esq — The Handwriting of the Insane (1888).

Sterling Efxiott. — Novel Advertising (1888).

CiiAS. B. Kei,s";y, M.D. — Tlie Diagnosis and Treatment of Hnemorrhoids (1888).

CoMMTSSioNEKS OK LowER AUSTRIA. — Auuual Rcport on Condition of Lunatic Asylums for Lower Austria (188(5, 1887).

C. A. TiiNDSLEY, M.D. — Tenth Report Commissioners State Board Health

(1887).

124- BOOKS, JOURNALS AND PAMPHLETS RECEIVED.

Dr. O. W. Akchibald. — Biennial Report North Dakota Insane Hospital

(1886).

Dr. James D. Munson. — Reports of the Board of Commissioners and Trustees for the Northern Michigan Asyhim (1886).

Norman Kerr, M.D. — Report of the Homes for Inebriates' Association, and the Fourth Annual Report of the Dalrymple Home at Riekmansworth (1887-88), England.

Eugene Grtssom, M.D., LL.D. — Reports of the North Carolina Insane Asylum, at Raleigh, N. C. (187i, 1880, 1881, 1883, 1883, 1884, 1885, 1886, 1887), and digest of laws relating to North Carolina Insane Asylum, 1867.

Dr. W. W, Godding. — Reports of the Government Hospital for the Insane (1855 to 1887), complete.

Dr. O. R. Long. — Report of the Michigan Asylum for Insane Crimi- nals (1886).

Dr. Henry J. Garriguks. — The Improved Csesarean Section. (1888.)

Dr. Andrew J. Ourt. — Fifth Report Pennsylvania State Committee on Lunacy (1887).

R. H. Chase, M.D — Reports State Hospital for Insane, Southern Dis- trict of Pennsylvania (1881, 1882, 18.-3, 1884, 1885, 1886), and the Various Points Involved in a Course Examination of the Braki and Spinal Cord.

Henry F. Carriel, M.D — Report of the Central Illinois Asylum for Insane (1886).

Dr. A. E. Prince. — The Extraction of Cataract as Influenced by Myco- logical Development (1887). The Pulley Method of Advancing the Rectus (1888).

David Prince, M.D. — An Aseptic Atmosphere — Club-Foot — A Rectral Obturator— Palatoplasty (1888).

A. Reeves Jack«on, A.M., M.D. — The Intra- Uterine Stem in the Treatment Flexions (1887). Conservatism in Gymecology (1888).

Henry J. Reynolds, M.D. — Stricture of the Urethra (1888). A New Method in the Treatment of the Vegetable Parasitic Diseases of the Skin (1887).

C. W. Moore, M.D. — Water, its Impurities Gathered from the Air and Earth (1888),

Dr. Benjamin Lee. — Proceedings of the Pennsylvania Sanitary Conven- tion in May, 1888. •MaHy PtTTNAM Jacobi, M.D. — Thirty-ninth Annual Announcement Women's Medical College of Pennsylvania (l.'^88-80)

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BOOKS, JOURNALS AND PAMPHLETS RECEIVED. 125

Nicholas Senn, M.D., Ph.D. — Experimental Contribution to Intes- tinal Surgery. Special Kefercucc to Treatment of Inti^rnal Obatruc- tions (1888).

J. B. Mattison, M.D. — Cocaine Dosage and Cocaine Addictions (1888).

Hampton L. Cakson, Esq,— The Weaver Case at Philadelphia (188 -).

John B. Ciiapin, M.D.~The Case of John Dalj. at Washington (1888). Annual Report of the Department for the Insane, Pennsylvania Hospital, (1888).

Ephraim Cutter, M.D. — Partial Syllabic Lists of the Clinical Morphol ogies of the Blood, Skin, etc. (1888).

Fredrick Peterson, M.D. — Some of the Principles of Craniometry

(1888).

James T. Crawford, D.D.S. — Fourteenth Annual Announcement of the Medical Department of the University of Tennessee (1888).

MAGAZINES.

The Theatre. — Deshler Welsh makes his midsummer number very charming. The illustrations are exceedingly good.

London Medical Recohdeu. — The May number gives an interesting account of the trial and conviction of Surgeon-Major Cros3 for poisoning his wife, taken from the paper read by Dr. C. Yelveiton Pearson on the Medico-Legal aspects of the case, before the Irish Academy of Medicine.

International. Journal of Surgery. — An able new journal, edited by Dr. Melton J. Roberts, published quarterly, is an aspirant for new favor. Its second number appeared April, 1888.

The Forum, edited by Lorettus S. Metcalf , is out for July, with an attractive table. Dr. Meredith Clymer writes on " The Stuff that Dreams are Made of," Senators Wm. E. Chandler and Geo. F. ^^dmuuds write on '' Our Southern Masters" and " The Political Situation," respectively. It is an attractive number.

The Eclectic for July has a fine engraving of Leghorn, and its usual well-selected articles from current literature.

Littell's Living Age grows better and better.

The Journal op Nervous and Mpjntal Disease. — We have not been able to see a copy since this journal changed hands, which we greatly regret.

The Sanitary Record (London). — The May number contains a resume of the Report of the Medico-Legal Society on " Best Method of Executing Criminals."

Denver Leg\l News says that Senator Lansbicn has crowded Mr. Evarts off the post of honor, as constructer of long sentences, by propound- ing a hypothetical question to Dr. James H. Forman in the case of Seligman vs. Seligman, containing in a single sentence 872 words.

Chicago Law Times. — The July number has an engraving of ex-Chief- Justice Waite, a sketch of Judge Melville W. Fuller,