homicide. This psychosis is essentially characterized by terrors, by panophobia, by hallucinations and optical illusions, and by troubles of sensibility in general. I omit the enumeration of physical symptoms. The attack begins quite suddenly, but it is ordinarily preceded by prodromes, which announce it, as insomnia, nightmares (nocturnal hallucinations), tremblings of the extremities, etc. The accesses once established, the patient trembling and terrified, sees disgusting animals, which climb upon him; he sees phantoms, people who threaten him, pursue him, dagger in hand. It may happen, and it happens often, that he does not remain passive, and that he reacts against the phantoms that threaten him. Then he becomes a murderer. He kills to defend himself and to save his life, which he thinks is endangered. The murder in this case is not the result of fury; it is the result of fear or terror; it is in fact, the consequence of an intellectual and sensorial error, or rather, the result of delirium and hallucination.

In the same way suicide, which is not rare, in this form of alcoholism, is not the result of impulse, or of a desire to be done with life, or of destroying one's self, but it is solely the consequence of an error. The patient precipitates himself through the window, which he mistakes for the door, or he throws himself into the river to escape from the fantastic beings which pursue him, in order to extinguish the imaginary flames which surround him.

It is but incidentally that I am led to speak of suicide in alcoholism to show a similarity which presents itself here. Suicide is really the end in certain cases of alcoholism, of the pathologic process, which I mention, but in other moments of alcoholic madness; it has an entirely different genesis. Thus it may result from a true obsession of the necessity of disappearing; it can also effectuate itself under the reign of fury, of remorse, etc. When the access of delirium is over, the remembrance of the accomplished murder persists, but often in a confused

manner.

The patient has sometimes an impression as if he had dreamed it. In all cases there is never real unconsciousness as in epileptic mania.

This is the pathologic, cerebral process, which ends with homicide in the alcoholized, in half the cases very likely, but these patients may become murderers according to another mode. In regard to them, we could establish a division analogous to the one indicated a moment ago, in mentioning epileptic homicides.

Under the influence of chronic poisoning through alcohol the mental faculties progressively weaken; the last stage of this weakening is the so-called alcoholic dementia. In the course of this intoxication there are supervening with many patients, but not with all, divers accidents, as fits of insanity, such as have just been described, febrile attacks of delirium tremens, convulsive epileptiform fits, sometimes real epileptic attacks; apoplectic fits, etc. There results from these oft-repeated shocks to the nervous system, as well as from the anatomical lesions of this same system, due also to alcoholic mania, certain morbid modifications of the cerebral functioning. The alcoholized subject, who, before he was intoxicated, was of a gentle and quiet disposition, and possessed a clear and sound judgment, has since become irascible, revengeful, and incoherent in his undertakings. He used to be good and kind, but now he is wicked, mischievous and perverse. On all occasions he is wrathful and violent; discussions with him degenerate quickly to quarrels. Finally, when he has caught a new and fleeting excitation in some recent excess, he is led by anger to commit homicide.

Most of those narrations which fill our daily papers, in which some drunkards have beaten, wounded, or even killed, refer to chronic alcoholics, who have acted under the influence of a blind and irrational ire. A fact interesting enough to be mentioned in legal medicine is that in large cities, especially among the laboring classes, the startingpoint of those dramas is very often jealousy; jealousy of

"a husband in respect to his wife, jealousy which renews itself at every new excess and is really of a morbid nature, often without any serious foundation.

In a word, it is certain that homicide in alcoholism is in a great number of cases the result not of a true delirium, but of a peculiar pathological condition due to chronic poisoning. You understand without insisting upon it, how it is difficult to agree upon the legal responsibility of individuals belonging to this class. Have they possession of their free will, or have they not? or do they have it only in a restricted measure ? Then they discuss upon the intensity of the fit of anger, the immediate cause of the catastrophe. The fit of anger (insania brevis), as the defendant of the accused never fails to call it, has it been violent enough, so as to allow that the will has been in fact momentarily annihilated? They weigh also the gravity of the motive which has occasioned the ire. It must not be forgotten that if someone's drunkenness is an attenuating circumstance, it is viewed by others as an aggravating circumstance. In truth, these problems will never be solved in a satisfactory manner; a time will come when they will not be put any more.

The question will not be whether the alcoholic homicide did or did not have liberty of will. It will be sufficient to establish at the first instance that he is a nuisance of the first class, and an endeavor will be made to put him out of the possibility of committing any more nuisance. The aim will be to render similar cases as rare as possible.

We have just passed in review a certain number of mental maladies, which present as a more or less frequent symptom, the tendency to homicide. In each of them we have tried to establish the psychologic process which had this aim for its tendency; but there exist yet other psychopathic conditions which can, at a given moment, complicate themselves with impulse to homicide. I say, which can complicate themselves, because in these

cases homicide is a complication rather than a symptom of the malady.

Manias may be divided into two great classes; those which before the invasion of the mental affection were normal from a psychological point of view; and those which already presented some irregularities, or some troubles in the physical functioning. The Germans say, lunatics with a healthy brain, and lunatics with an unhealthy brain. In France we say of the latter that they are stained with intellectual degeneracy. In all psychiatric schools, whatsoever may be the divergence of opinions upon certain points, we always find this same fundamental idea, the distinction of lunatics in two great classes.

Without entering into any dogmatic discussion we must admit how well established this motion is, and that the subjects who are affected with intellectual degeneracy do not react under influence of lunacy in the same manner as the others. Irregularity and the unforeseen are the characteristics of most of the mental maladies with which they are afflicted.

It is useless to call to mind that intellectual degeneracy is not a synonym with mental debility. The imbeciles and the mentally weak may well enter into this class of the degenerated, but we find in this class some men with normal and sometimes with superior intelligence. Men of genius are not rare herein, and there are some who say that such men are only found in this class. It is the state of disequilibration of mental faculties that is the criterion of intellectual degeneracy and not imperfection in the whole of their develop

ment.

In France we especially attach degeneracy to neuropathic heredity. This is exact, but we may be inclined to make this morbid heredity the unique cause of degeneracy. This is exaggerated. It is against this exaggeration that Cotard has spoken. He has demonstrated that degeneracy is often acquired, and that it may establish itself at the moment of conception, during intrauterine life, during

infancy, and even during adolescence. In reality some hereditaries with a heavy degree of inheritance are not always degenerate, and some individuals clearly degenerated do not count among their ancestors any lunatics or neuropaths. The two terms degenerated and hereditary must be confounded, the one with the other, as it happens often.

One of the principal characters which intellectual degeneracy imprints to lunacy (the only one which is to occupy us) consists in the manifestation of obsessions and of divers impulses. It is under their influence that tendency to murder complicates too often in the degenerated, certain fits of mental alienation. But with these, the circumstances which precede, accompany and follow the murder, are not the same as in the cases above mentioned. We have also observed some persecutes who have reached a determinate period of their affection, kill after mature deliberation. We have seen alcoholics become homicides in trying to escape from their imaginary enemies. With the degenerate deliriants the impulse to homicide is not produced in similar manner. It bursts forth suddenly at different stages of the affection without precise rule, with or without hallucinations or previous delirious ideas.

Melancholy of the degenerated takes one of the first places in the conditions of madness, which are susceptible of complicating themselves with homicide. However, the melancholics are more prone to suicide than to homicide. But suicide or homicide, the act with these individuals is so to say, reflex, whether it is accompanied with consciousness or not. It is during the paroxysms of anguish, while the sufferings are unbearable that the patient, in order to escape from them, kills himself, or some one of his surroundings. Often the being most dear to him becomes the victim. The despair which he feels on account of the accomplished deed adds still more to the sufferings he experienced before. At other times it is under the strain of an hallucination, or of a delirious