at suspicion, probably not well founded, but in a way to be understood as possible to the sound mind. There may be no real change of feeling, but the change of after-circumstances has given rise to a train of ideas which menace the unity of the married life. The case is different, however, when the estrangement happens to concern one of neurotic temperament, in whose family there may have been actual insanity and where exists a tendency to a mental instability from causes which but for this trend would have had comparatively little significance. Here we are face to face with a latent morbid sensitiveness fanned into flame by unfounded suspicions of acts never intended, and productive of conditions which are most serious in their results. It is in this class that we note a distinct change of feeling-Love is turned into Hate, reconciliation becomes impossible, and we are confronted with the spectacle of the home destroyed, the family divided into partisanship of the one side or the other, and ourselves perhaps called in to adjust the balance of parties as best we can. In this change of Feeling without adequate cause and in the face of facts which speak to the contrary, we should suspect the early development of an insanity which in time will be apparent to all. In its early stages the friends and sympathizers can see nothing wrong, they listen to and receive as adequate the explanation and statements made, possibly with all coherence and with an air of truthfulness, and as they are not primed with all the facts they see no ground for treating the indignation of the self-made victim with doubt or disapproval. They see no insanity even though

you may.

It is a curious thing how people generally consider themselves judges of insanity! Just as they think the sun goes around the world because they see it drop in the west, so do they conclude that the evils are real because the aggrieved one says so! And our difficulties in these cases are very real, because much as we may know that temporary seclusion or residence under skilled supervision is absolutely necessary in the interests of the patient and others we cannot enforce it. We cannot sign a certificate for compulsory detention because the patient is not certifiable in the accepted sense of the word-she would probably be returned in a short time because there is so much lay and so-called "common-sense' interference with the detention and treatment of persons who do not come up to the legal definitions of insanity, that even those who know better are handicapped in their knowledge and the patient refuses to submit to place herself under a separation treatment which she regards as a branding extinction prompted by the desire to get rid of her for

self-seeking purposes. A concrete example of what I mean would work out as follows. A married couple have maintained happy relationship for years and have produced a family. In one of these parents there is a history of a decidedly insane progenitor. All goes well until the advent of the climacteric period or the influence of mental strain asserts itself by the production of a change in the emotional tone which leads to bickering and dissatisfaction in the place of contentment and harmony. If the nature of the change is not noticed there ensues a responsive recrimination, relations become strained, and separate sleeping apartments are adopted as a means of escape by the one from the other. This, not unnaturally perhaps, leads to an aggravation of the changed emotional tone, and there follow accusations of unfaithfulness, of cruelty and unkindness, all of which may be absolutely unfounded, though protestations and even proofs to the contrary of the most convincing nature may be to hand.

It may be said that, if the change in emotional tone has gone so far as to set up these unfounded ideas, the case has already become one of pronounced certifiable insanity, but it must be remembered that it is only later that these ideas, prompted by the change of tone, assert themselves; at the first they are not demonstrably present, though they may have an existence in the subconscious area. To the careful observer there are frequently other symptoms present, though in public they are not apparent, such as abstention from proper food and insomnia, due to suspicion, anxiety, and other associations set up by the changed state. Suppose a person of this group of symptoms were to commit a crime, either to injure herself or to inflict damage on others, there would be no difficulty for anyone acquainted with the facts in giving evidence as to mental incapacity, and without doubt such evidence would be gratefully accepted by the friends of the patient, the very people who up to the time of this criminal behavior could see nothing wrong and would have strongly condemned proceedings calculated to prevent such a catastrophe as has happened.

斑病

A school inspector, testing a class in fractions, asked a boy, whether given his choice, he would prefer one-sixth or one-seventh of an orange. The boy promptly replied that he would prefer one-seventh. The inspector more promptly explained that such action would be foolish, because, though the suggested fraction might seem the larger, just the reverse was true.

"I know, sir," said the boy, "that's why I chose it. I don't like oranges."

General Considerations

The problem of mental sanity contemplates both the presentative and the expressive relations between the subjective mind and the objective world. In other words, it inquires how the mind receives and immediately interprets impressions made upon it through the senses, and what it does under the influence of such impressions.

Neither factor is of itself a sufficient basis for determining sanity; both must be considered together. We cannot do without the expressive phases the words and acts of the individualsince these constitute the only available means of ascertaining the state of his mind. On the other hand, words and acts do not, of themselves, afford a trustworthy index to the condition of the mind, because the individual may, either purposely or through accident of education or circumstance, be exhibiting a perfectly conscious discrepancy between them and his thoughts. Only when we are able to establish an abnormality of word and action, flowing out of a corresponding abnormality of cognition, are we justified from a medical standpoint, in diagnosing insanity.

But

To pass upon this dual relationship between the mind and its objectives would be none too easy, even if its outworking were constant and uniform-if persons always spoke and acted alike under similar circumstances or conditions. such is not the case. There is no fixed norm of mentality or conduct. The question of sanity is concerned, not with hypothetical, but with real conditions; and the possible variation of cognition and expression is so wide, and choice is so important a factor in the mental process, that such a poise of mental qualities, and such a uniformity of behavior, if they could be found, would suggest a defective, rather than a normal, mentality. A norm of sanity, therefore, if it exists, is to be sought in other directions than an average of mental faculties and a uniformity of

conduct.

Yet there must be some general standard by which normal and abnormal states of mind can be gauged. And there is. A comparatively simple one in its nature, albeit often so difficult in its

application. It consists essentially in the same factors which furnish the gauge of physical health (sanitas) in the body.

The development and functionation of the body follow two series of biologic progressions, which parallel each other at every point, and whose proper interadjustment constitutes physical normality and health, their interruption and mal-adjustment disease. These two processes are the phylogenic and the ontogenic-the racial and the individual. There are certain underlying typetraits to which the body is normally predestined to conform by virtue of racial evolution. There are certain other characteristics of structure and function to which it conforms in accordance with individual requirements. And the health of the body depends upon a successful inter-adjustment of type and organism for the best welfare of both.

The mind has a precisely similar and parallel duality of development. Its racial traits constitute what are known as the instincts, which determine the basic motives and ends of all human action, from which all conduct springs and towards which it moves. The individual qualities consist of those faculties of cognition and expression which are acquired by individual education. A sane mentality consists in the interadjustment of the two for the best interests of both.

When a body either under or over develops any of the type-stigmata, we look upon it as a freak. When it exhibits an excessive or deficient development of individual structure or function, we call it deformed. When it fails to adjust individual qualities to type forms, i. e., when the organic structures and functions do not properly minister to the racial needs, we say it is diseased. In like manner, when the racial qualities of mind, the instincts, exhibit either excessive or deficient development, we call the individual a degenerate. When we see a mind over-developed or deficient in acquired faculties, we class it as defective. When, from any cause, the adjustment between the two processes is broken, so that the mental faculties do not properly minister to or correct the instincts, we say the person is insane.

The desire to energize is no doubt a phase of the life instinct, hence the list may actually be reduced to the two primal instincts of life and sex. However, energization is such a distinctive impulse, representing the expenditure as against the acquisition of life, that it is convenient to let it stand as a primary instinct, especially for the purpose of alienism, in which it plays so important a part.

All of these instincts co-exist in the normal

act. Only in occasional and exceptional instances, when the sudden and powerful appeal to one or other of the instincts temporarily throws the others into eclipse, does conduct exhibit a singleness of instinctual motive, as in the performance of the sexual act, or when one is confronted with the necessity of defending life.

A conspicuous departure from this rule, also, indicates a perverted mind, where in the exercise of the faculties is continuously and persistently directed toward the satisfaction of a single instinet. Of this, too, more will be said presently A still more important consideration, perhaps, is that in man the instincts themselves, at least in their outworking, manifest themselves in numerous and complex phases. Therein he differs conspicuously from the lower animals, in whom the instincts are simple and elemental in their manifestations. Thus, in the beasts the desire to energize expresses itself in sheer motor activity, often purposeless and inco-ordinated; in man it normally

By this we understand that, while a child's conduct flows jointly out of the instincts of life, sex, and energization, it is the instinct of energization which normally predominates. In the old person's conduct, the instincts of energenization and sex, though still operative, are normally subordinated to that of life, i. e., the preservation and prolongation of life. The child is normally prodigal of life, and practically unconscious of sex, but the desire to energize is strongly marked. The adult has both the desire to energize and the instinct of life well in evidence, but the sexual instinct, with all of its domestic and social phases, is the strongest factor in determining his conduct. By the time old age is reached, both the desire to energize and the sexual instinct have become greatly diminished, and the aged individual, conscious in all his being of the shortness of life, experiences a powerful instinct toward its conservation.

A marked deviation from this natural order of instinctual dominance constitutes, as we shall presently see, a state of perversion; as when a little child is unduly dominated by the sexual instinct, or when an old person evinces an inordinate desire for energization, usually manifested in excessive emotion.

Not only do the instincts, in man, overlap each other in the periods of life; they also overlap in the motive and determination of practically every

moral activities which are usually well ordered and purposeful. In the lower animals, the sexual instinct is a single impulse to sexual congress, or at best to the reproduction of kind; whereas in the normal human being it enlarges itself into a general love for, and interest in, the race. In beasts, again, the thstinct of life is almost wholly a concern for self-preservation, modified, perhaps, by a certain desire for physical comfort; in man the same instinct spreads itself over a wide range of impulses, from the need of food and drink to a love of the beautiful.

This complexity of the normal human instincts is a consideration of great importance in a study of mental states, because it forms the most fre quent point of departure from the normal, and therefore the most frequent field for the exercise of the alienist's judgment. The child, of course, affords the nearest approximation to the elemental in this respect; in the outworking of its dominant instinct (that of energization) we all recognize, and variously express, the resemblance of the child to a young animal. And a singleness of instinct which in a child would be normal, would in an adult be so abnormal as to suggest a suspicion of mental unsoundness.

The Mental Faculties

The mental faculties lend themselves to many and various kinds of classification and definition, depending largely upon the point of view from which one wishes to consider them; and indeed, every branch of science which concerns itself with the mind has its own system of nomenclature and description. For the purposes of this work, which avowedly aims at the minimum of confusion and the maximum of simplification, the simplest

method will be followed which is consistent with clarity and comprehensiveness. We therefore recognize the following faculties and their functional definition:

Cognition. In this term is included all the mental mechanism by which the mind receives cognizance of the objective world, whether it involve a percept, or a concept, or a group of concepts, and without regard to the number of simple elements included therein.

Memory. By this is meant the mental mechanism by which cognitions are made cumulative, without regard to the supposed nature of such mechanism, which is immaterial to this work. It includes, of course, the faculty of recognizing these cumulative cognitions.

Judgment. This faculty, in its simplest intent, and sufficient for our purposes, is the arrangement of accumulated cognitions into groups characterized by similar or dissimilar qualities.

Reason. By this is meant the mental mechanism by which the classifying process of the Judgment is extended to hypothetical groups of cognitions, and general principles of classification are thus deduced.

Imagination. This much misunderstood faculty, in the last analysis, is nothing more or less than the power to rearrange accumulated cognitions into fanciful or hypothetical groupings, much as a child builds all sorts of different objects out of a set of blocks. The workings of imagination are either rational or fantastic, according as they observe, more or less the limits of

reason.

Will By this term is indicated at once the highest and simplest faculty of the mind, namely, the sheer choice between two sets of cognitions accumulated by memory, classified by reason, and rearranged into hypothetical settings by imagination, the choice being exercised with reference to the satisfying of an instinct.

Emotion. This is not properly a faculty at all, but an attitude of mind resulting from an exercise of the faculties, and forming, so to speak, the transition between them and conduct.

Expression. In this term is included all the mental mechanism by which the net results of the other faculties find an outlet and are made to impress themselves again on the objective world.

It must not be supposed that the so-called faculties are to be regarded as in any sense selfsubsistent entities. What was previously said in regard to the overlapping of the instincts in the motivity of conduct applies equally to the influence of the faculties in the process of mentality; in no moment of consciousness does one faculty alone play a part to the exclusion of others.

Of these faculties the one which is peculiar to the human mind is the faculty of Imagination. This is, in reality, the faculty which the ordinary man, and often the philosopher, has in mind when he erroneously refers to the power of Reason as the distinguishing mark between the lower animals and man, although the Reason undoubtedly contributes largely to the process of Imagination. It is capacity to rearrange classified cognitions into hypothetical groupings, for the exercise of the will, which distinguishes the human from the brute mind; and this is Imagination. It is easy to see that this faculty is not needed to minister to the beast instincts, since, as we have seen, their instincts are single and elemental in phase, and therefore never present hypothetical problems to the faculties. In man, on the other hand, the wide range of indirect phases exhibited by the instincts continually make necessary the exercise of the imagination in order to properly minister to these complex instincts.

It is clear, then, that Imagination is above all the other faculties the crux of the problem of sanity, from the presentative standpoint, as it is also the most variable of all the human mental faculties. It is more variable even than the will, for what we popularly call "errors of judgment" are most often not errors of the will at all, but deficiencies of the imagination faculty, depriving the will of adequate data. A lack, or marked deficiency, of imagination, even though all the other faculties be unimpaired, will go further toward reducing a human being to the brute state of mentality than will a large deficiency in all the other faculties together where the imagination is highly developed.

Judgment is really but little in advance of sheer cognition. It marks the first beginning of a mental process, is purely analytical in nature, and depends upon the already-determined attributes of the cognate rather than upon any peculiar power of elaboration residing in the faculty itself. It merely analyzes the cognition into its constituent elements in the form and proportion in which they already exist in the cognate, and classifies them into similars and dissimilars.

Reason may be said to be the synthetic counterpart of Judgment, and marks the beginning of the constructive part of the mind-process, to which extent it is a higher faculty than Judgment. However, neither Judgment nor Reason are, in themselves, particularly high-grade faculties. There is no doubt that both exist in the lower animals. Both are, in their ultimate nature, exceedingly elementary and simple, restricted to one rigidly-defined method of operation, and admitting only of quantitative, not qualitative, variation. That is to say, the process of reasoning, like that of adding

or subtracting, is precisely the same, whether it be carried out by a scholarly logician or by a dog; and whatever superiority the one may exhibit over the other lies merely in the rapidity and accuracy with which he is trained to carry it out, and the number of cognates to which he can apply it. The faculty can be developed by training to a very high degree of proficiency, both in man and also (proportionate to the powers of cognition) in the animal. But such development of the reasoning faculty does not, of itself, make any qualitative improvement in the mentality of either the man or the animal.

We have already seen that the Emotions represent the attitude of the mind in the presence of the data furnished by the faculties and acted upon by the Will. In the lower animals, where the instincts are elemental and imagination is wanting, the emotions are correspondingly single and elemental, bearing directly upon the satisfaction or otherwise of the crude instincts. In man, whose instincts are complex, and in whose mental process the cognitions pass through the crucible of the imagination, the emotions are correspondingly more complex and finely graded. In this, as in other respects, the child is nearer to the elemental state of the animal than is the adult. Thus a child, like an animal, may be angry, or afraid, or pleased, but is never sad, or remorseful, or experiences a sense of humor. Yet a child is popularly supposed to be generously endowed with imagination-a popular error, similar to that which credits a child with a prodigious memory, the real truth being that a child has little else to do than to exercise its memory and its imagination, and we naturally exaggerate the achievements of a child in these directions because it is a child.

It has been further seen that the emotions repreesent the transition between impressions and conduct. They belong, so to speak, to both. They imply, in a general way, both what the impressions have been and what the expression will be. For, in a general way, the emotions shape and determine conduct. The rule is that the more elemental the mind, the more rapidly will conduct follow the emotions and the more directly will it correspond with them. The child, being made angry or afraid, immediately and directly gives motor expression to its feelings. The normal adult, on the other hand, is not only seldom made sheerly angry or afraid, but delays his action and modifies it from the terms of the emotion, through the exercise of Imagination and the Will.

As the Reason and Imagination are, from the standpoint of sanity, the crucial factors in presentative mentality, so must the Will be regarded

as the crux of mentality in its expressive aspects; but in virtue of precisely opposite qualities. Reason and Imagination are crucial elements of mentality because of their complexity and variation; the Will, on the contrary, because of its singleness and constancy. The Will, in effect, translated into action, constitutes the resultant of all the other facultative operations of the mind; and a resultant is always single and direct, and faithfully represents its component elements. As already pointed out (see footnote on page ?), the immediate impressions of the mind are so variously split and diffracted by the mediate faculties of Reason and Imagination as to be impossible of sharp differentiation between normal and abnormal. In the Will and its operation they are, so to speak, reunited at definite focal points, so as to form again a clear image of mentality whose sanity or otherwise can be readily determined.

The relation of Will to conduct is in reality the final determinant of its sanity. And especially is this so in the case of an abnormal act, or course of conduct, such as might raise the presumption of insanity.

The Will acts upon all the data furnished by the subordinate faculties, and if these faculties be working normally the Will is normally exercised, however strange the conduct may appear. Now, if conduct be so abnormal as to attract attention, and thus to raise a presumption of insanity, the crucial question is, whether such conduct be thus abnormally directed by the Will of the individual or not. That is to say, is he pursuing such conduct not knowing it to be abnormal, or, knowing it to be abnormal, does he nevertheless will to pursue it, for reasons which, if known, would make its normality apparent?

If abnormal conduct be so directed by the Will-i. e., if it be willful-it is clear that the actor knows it to be abnormal; and if he knows his conduct to be abnormal, he is clearly not insane, however much he may appear so. But if abnormal conduct be not so directed by the Willi e., if it be not willful-then the actor does not know it to be abnormal, and to that extent is insane. That is to say, the Will, in the latter case, is acting upon defective data furnished by deficient faculties.

†(E. g., if a man puts himself in the way of a bullet, not knowing it to be dangerous, his Will acts upon insufficient facultative data, and to that extent he is a dement. If he knows its danger and puts himself in its way, trusting to a special intervention in his behalf, his Will acts upon perverted data, and he is insane. If, knowing everything he deliberately wills to be shot, then his Will acts upon an adequate data and his act