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few, and is thereby to receive a certain enlightenment. The institution is to save a certain other few when the disease is of more persistent type.
With the highly complex nervous organization which we have, our little insight into its proper management and the wonderful variety of calls upon it under circumstances confusing and trying, the only wonder is that we are not all subject to other fits than those of annoyance and anger. It seems to be the belief that, a fit having once manifested itself, succeeding circumstances which prove a tax upon the nerves are more liable to produce a similar attack. This many parents fail to appreciate, but continue in hopefulness for years, leaning first on one prop and then on another, until a final and severe shock knocks them all from under them.
Finally, we may ask ourselves what offspring we may expect from epileptic persons who have had all these cares and attentions given them, and have recovered from the convulsive seizures, and even the more serious, but associated, query as to whether such children are worth saving at all; and by these unanswered queries we are led to the interesting and unsolved problem of the exact use which such classes of sick and dependent serve in the general discipline of mankind.
In commenting on the papers of Dr. Spratling and Dr. Flood, Mr. Sanborn said it was very gratifying to hear of such success as the former had with the striking case of the young man from St. Lawrence County, whom he had heard described by Dr. Hoyt, of the New York State Board of Charities, and by others.
He now appears to be recovered, but it is seldom such patients are permanently restored. Dr. Flood also has had marked success with many of his youthful cases of epilepsy. “I have often visited his establishment,” said Mr. Sanborn, 6 and have seen the kindly and sensible means there taken for the training and treatment of Dr. Flood's hundred inmates, two-thirds of whom are epileptic children. It was the first in order of time of any State institution for this class, although not exclusively for epileptics, as the Craig Colony is, which I have also visited, and as the new Massachusetts hospital at Monson (to be opened early in 1898) also is. Much
good will be done at both, but it would not be reasonable to expect many recoveries after epilepsy has become fully established.”
The need of seclusion for epileptics with homicidal impulses, after a seizure (by no means so rare as is sometimes supposed), was illustrated by Mr. Sanborn in the case of Richard Barber, a worthy and amiable young English farm-laborer, who was tried for murder at Ithaca, N.Y., in October, 1888, and is now in the Auburn State Prison on a life sentence.
“In the spring of 1888, while I was beginning my annual lectures at Cornell University, the village people were talking of a shocking murder committed the previous winter near Trumansburg, in the next town. Two old English persons, Mr. and Mrs. Mason, good friends of Richard Barber, had been attacked by him in their own house, at night, after a friendly call. The old woman had been killed, her husband badly wounded, and the house, either by accident or design, set on fire, and destroyed. Richard was known to have done the deed, though he denied all knowledge of it; and he narrowly escaped lynching on the night of the crime, when arrested a mile or so from the fire, at which he was gazing in a confused way. He had been committed to the Ithaca jail, which I was in the habit of visiting each year; and I determined to see him, imagining from the account of his deed that there must have been some mental disturbance, since no motive for the crime appeared. I therefore called on him at the jail, and endeavored to engage him in conversation on indifferent matters, and with very indifferent success. He would hardly speak, and answered my questions, if at all, by nods and signs. As I stood by him, watching him closely, there passed over his face that significant, indescribable look which I had learned to associate with epilepsy, having seen in my official inspection of insane asylums, etc., several thousand epileptics, and talked with hundreds of them. As I left the prison, the jailer said to me, ' Do you find Richard insane?' 'No: there are no indications of insanity; but I think he is an epileptic.' That evening Mr. George Davis, of Ithaca, who had been assigned as counsel for culprit, called on me, and said he heard I suspected Richard Barber to be an epileptic. I replied yes; that, if I were his counsel, I would get a stay of proceedings until evidence could be taken at his English birthplace (Billingboro, in Lincolnshire), and I thought it would show that his was a case of epilepsy, and that he had killed his friend in the 'homicidal fury' that sometimes follows a seizure, even in cases of petit mal. Mr. Davis, who had become interested in the youth and simplicity of his client, caught at the suggestion, procured delay in the capital trial, and wrote to Lincolnshire for evidence as to the personal and family history of Richard.
“In a month's time there came back from England, from the resident medical man of the little village where Richard was born, the most startling family record of insanity and epilepsy I had
ever seen. Richard himself had been epileptic from infancy, almost, until some nine years old, having several seizures a day, and falling in the street or wherever he might be. After that age the disease mitigated; and when he came to America, at the age of nineteen (he was now twenty-six), no sign of epilepsy was noted during the daytime. Nor could we find at the trial in October (at which I testified as an expert, along with Drs. P. M. Wise, G. A. Blumer, Allison, and other physicians) any witness who could say that he had seen Richard in a 'fit.' Evidence was offered tending to show that he might have had nocturnal seizures. But this had little weight with the jury; and our expert theory that he had been thrown by the heat of the kitchen, where he was sitting with the old couple, into an attack by night, in which unconscious state he had done the homicide, could not be accepted even by the intelligent young judge who held the court. Richard was found guilty of wilful murder, and sentenced (or would have been but for his counsel's exceptions) to execution. Yet no motive had been shown, and the testimony to his gentleness and good conduct in all the relations of his humble life was very striking.
“When the exceptions (very well founded, as experts in such cases knew) were presented to the Court of Appeals, the verdict was promptly set aside, and a new trial ordered. But the county authorities, who had incurred great expense in the first trial, were unwilling to proceed, and gladly accepted from Richard's counsel a plea of guilty in the second degree. He was therefore sentenced to the Auburn Penitentiary; and there, not having seen him for more than eight years, I called to learn what had happened to him, in November, 1896. I found him in good health. He recognized me, and told me very intelligently of his fortune in prison,- a story which the warden confirmed. He had been an exemplary prisoner; had learned the art of wood-carving and wood-working, which he carried on in his cell, as well as in the shop; and had become extremely proficient and skilful, so that he was the best workman at it in the prison. I inquired if he had been known to have epileptic seizures; and the officer told me that several times at night he had disturbed the corridor where he slept by shouting and turbulence in his cell, of which the next morning he was wholly unconscious, except as his cell showed the disorder of his violence. I therefore inferred that his nocturnal seizures still recur, at long intervals; and probably this may always be so. But he has won the confidence and affection of his officers, as he did of his employers and associates before his awful deed; and it was evident ihat the basis of his character is not depravity, but ingenuity and goodness. The virtues had been thrown off their guard by his insidious disease, and he had unconsciously committed his offence. It might never be safe to allow him liberty ; but, on the other hand, he had shown himself in prison a good and useful person, and the State had been spared the mistake of putting him to death for an act to which moral responsibility could not attach.”
The narration of this incident by Mr. Sanborn led Mr. Kingsbury to inquire if the once famous case of the negro homicide, Freeman (saved from the gallows by Governor Seward, who defended him), was not similar to that of Barber. Dr. Smith replied that it was not, pointing out the distinction, and then added this singular incident:
I happened to be present in Auburn as a lad at that trial, and sat among the audience, in a sort of amphitheatre, with the court and bar below, when an extraordinary event occurred. John Van Buren, son of the President, was the attorney-general, and was prosecuting the case against Freeman, whom Governor Seward was defending on a plea of insanity. A chief witness for the defence was Dr. Brigham, of the Utica Asylum, then at the height of his reputation as an expert in lunacy. He had seen and examined Freeman, and testified that he was insane; and Van Buren was seeking to break down his evidence by cross-examination. “How did you decide that he was insane, doctor? Was it by looking at his face?” “That was one thing,” said Dr. Brigham. “Did you think him insane by looking at his nose?" "No." "At his mouth?” “Not entirely.” “At his eyes?” “The eye is a very expressive feature, indicative of the mind; but I did not judge altogether by that. I took all the features into consideration.” “Do you mean to tell this jury that you can decide whether a man is crazy by looking at him?” “I have sometimes done so.” “Will you then look through this large audience, and pick out some one as insane, from the looks of his face?” “That would be difficult." "From your testimony it would not be difficult for you; and I insist that you shall make the test.” “Very well,” said Dr. Brigham, quite composed, erect, and impressive; and he began to point his hand toward the benches, moving it as he passed from one section to another, and searching all our faces with his keen eye. My own heart beat fast as he came near me with his search, for fear he should pronounce me crazy; but he passed my section by, and had gone past the middle of the benches, when he suddenly stopped, raised his long arm, pointed his long finger at a man in one of the upper seats, and said, very gravely, “That man is insane.” Instantly the man sprang from his seat, angry and swearing, and rushed down toward the bench and bar, crying: “You lie ! I am not crazy," with other manifestations of mania. The ge rose from the bench, Mr. Van Buren jumped on a chair, Dr. Brigham stood still, fixing his eye on the madman. The sheriffs rushed in, seized the shouting maniac, and the court adjourned in great agitation. The cross-examination of Dr. Brigham broke down, and Mr. Seward won his case. But Van Buren insinuated next day that Governor Seward had placed a madman in the audience for the purpose of having such a scene.
BY J. C. CARSON, M.D., SUPERINTENDENT OF THE “SYRACUSE STATE
INSTITUTION FOR FEEBLE-MINDED CHILDREN,” NEW YORK.
[Read Wednesday morning.]
In entering upon a consideration of the influences of sound physical health upon the right development as regards the feebleminded, it will not only help to elucidate the question, but will also emphasize the importance of these influences, if we stop at the outset to refer briefly to the classification of the feeble-minded, and to recall exactly what the so-called state of feeble-mindedness is.
In England the mentally deficient are recognized as idiots and imbeciles, no attempt being made to draw an arbitrary line of distinction between the two, it being understood that the imbecile is of a higher order of intelligence than the idiot. In this country all the mentally defective are now more acceptably spoken of as feeble-minded, this term including all grades and shades from the high-grade imbecile to the low-grade idiot, carrying with it less of the repugnance that has become associated with the terms idiot and imbecile. A convenient line of distinction, although a not always strictly correct one, is that of grouping as idiotic those who have no use of language, and as imbecile or feeble-minded those who have. It is of this latter class that we are invited to speak.
Feeble-mindedness is a mental state, and yet one would form a very erroneous conception of this condition to consider it merely from the standpoint of a state of intellect. To arrive at a correct comprehension of the full meaning and scope of the term, one must know something of the etiology of this condition; and it is here that we at once see the intimacy existing between this mental state and certain physical influences. Without going deeply into the causation of feeble-mindedness, we find that it is a condition of mental defect dependent upon soine mal-nutrition or disease of the nervous centres taking place either anterior to birth or during the developmental years of childhood, the cause of this mal-nutri