Homicidal Insanity, 1800-1985

6. Homicidal Insanity and the Unstable Nervous System, 1870-1910

Homicidal Insanity and the Unstable Nervous System 1870-1910 The change to a strictly neurophysiological view of insanity fostered the theoretical modification of several diagnostic concepts. Rudolf Virchow's cell theory supported the concept of inflammation and renewed interest in the role that the circulation of blood, by now at the capillary level, played in producing mental symptoms. Alienists reevaluated the static states of partial insanity in this new light. The existence of such pathological events as moral insanity and monomania were rejected outright by some physicians and reinterpreted by others. I Intellectual Insanity: Dementia Praecox and Paranoia During the I88os, the concept of monomania or homicidal insanity underwent theoretical change, but the beliefthat the lunatic laboring under delusions and command hallucinations was dangerous prevailed. Because the idea ofpartial insanity, that a person__ could be insane on one point and sane on all others, had been challenged by Gray, Bucknill and Tuke, Maudsley, and others, the finding of delusions in the course of a mental examination came to be diagnostic of far-reaching brain disorder. Some physicians continued to place the delusion in a position of diagnostic primacy , but others, conceding its global significance, maintained 74 The Unstable Nervous System 75 nevertheless that insanity of an equally serious nature could occur without delusions. But it was generally agreed that the use of the term monomania to designate all sorts ofmorbid symptoms would result in the indefinite multiplication ofmonomanias, far removed fJ;'om the original conception.2 By 1884 the term monomania was falling into disuse and was being replaced by a new idea. Although the term paranoia had been used in many ways since Hippocrates, its application to persecutory delusions originated in the psychiatric textbook ofRichard Krafft-Ebing. The Germans used the term Primiire Verrucktheit. The essential characteristic of paranoia was delusions of persecution arising out of an antecedent emotional disturbance, yet not progressing to dementia. 3 Although the nomenclature changed, the relationship between delusions and homicidal insanity remained constant in the minds ofphysicians.4 The Freeman Case In certain states, the lunatic who committed homicide was designated as permanently dangerous. Under some of these laws, no provision was made for discharge from the asylum after recovery. For example, in Massachusetts in 1879 Charles F. Freeman murdered his child under the delusion that the Lord had commanded the sacrifice. The governor sent him directly to the Danvers Lunatic Hospital without trial. By 1883 Freeman had recovered and was brought before the supreme court for a sanity hearing. The alienists gave no conflicting testimony in describing his recovery from the delusion. The result was that he was declared "not guilty by reason ofinsanity. " Under the 1873 Massachusetts law, "when a person is acquitted of murder or manslaughter on the ground of insanity he must, regardless of his condition at the time of his acquittal , be committed to one of the lunatic hospitals for life." Alienist Charles F. Folsom, who reported the case, interpreted the spirit of the law as punitive rather than for the protection of the public: "Has any sane man escaped punishment by the Massachusetts law, so far as is known?"5 76 Homicidal Insanity, 1800-1985 The Webber Case Public opinion overrode psychiatric theory in some cases, even when the existence of delusions and their direct connection with the homicide was unequivocal. Since the Guiteau trial, public sentiment favored executing offenders who were not flagrantly deranged .6 The neurologist William A. Hammond lent substantial support to this position. Since 1873 he had publicly advocated executing the homicidal insane both as an example to other lunatics and to protect the public.7 The Webber murder case in Philadelphia in 1887 illustrates the way in which lay sentiment overpowered expert testimony. Testimony by physicians and by Webber's family and friends established the history of a previously sane man, free of criminal influences and associations, who in the autumn of 1885 began to show a change of character as well as disposition and the growing presence ofirrational beliefs. He was convinced that his wife chloroformed him and received visits from her lovers. He believed that he was pursued and persecuted by members ofhis family, friends, and fellow workmen. On December 6, 1886, he shot and killed William H. Martin, a jeweler, in his shop. No motive or connection between the two men could be found. 8 The only witnesses called to rebut the testimony of Webber's intimates...