I replied that, before answering, I would want to know what was considered "a strong hereditary taint of insanity"; also the qualifications which the prisoner's friends had for forming their opinion in relation to his insanity; also what interpretation was put upon the word inspiration as used by Mr. Scoville in this connection. Mr. Scoville refused either to explain, to modify the form of his question, or to permit any answer except sane or insane; and upon my declining to stultify myself, excused me from the stand. (See also Dr. John P. Gray's comments upon this hypothetical case as given later.)

This hypothetical question was, however, so badly shattered by the rebutting testimony introduced later, that Mr. Scoville was forced to reconstruct it himself.

With the exception of Dr. Kiernan, the prosecution waived the cross-examination of the expert witnesses for the defence, but we were directed to remain in the city.

On Dec. 8, the following note was handed me:—

"Dr. WORCESTER :

"Dear Sir,-As the government desires your testimony as an expert in the case of the United States vs. Guiteau, you are requested to remain in the city until your testimony is taken.

"GEO. B. CORKHILL, U. S. District Attorney, D. C."*

The reasons for my declining to answer Mr. Scoville's question will be given as in my testimony when placed upon the stand by the government on Dec. 21.

Before leaving Salem, I formed my opinion that the prisoner was insane, from statements that he was actuated at the time he shot the President by an insane delusion, and that he did the act under the influence of an irresistible impulse, which was the outgrowth of that insane delusion. My views were changed by his own testimony and appearance on the witness-stand, and my interview with him at the jail.

"Q. (by Mr. DAVIDGE). At that meeting you communicated your change of views to Mr. Reed?-A. I gave my views to Mr. Reed at that meeting.

* When placed upon the stand on Dec. 21, I said, "I would like to state that I appear here as an expert summoned by the government, and not to testify on behalf of the defence or of the prosecution, but simply to state my opinion on the facts, or on the condition of the prisoner as presented to me.

"The COURT. Of course.

"The DISTRICT ATTORNEY.—I think it is due to Dr. Worcester to state, and your Honor will recollect, when he left the stand that I directed him to remain on subpoena, holding him for the government. I had never seen the gentleman or knew anything about his opinion. The doctor has been very persistent and earnest to get away. I deem it due to say that he has been held here by me a very reluctant witness."

"Q. Then after that you were put upon the stand to testify in relation to a hypothetical case put by Mr. Scoville, were you not? A. I was asked a hypothetical question the next morning.

"Q. And you refused to give any opinion in relation to that case now tell me what induced you to decline to give your opinion upon that hypothetical case?-A. I did not decline to give an opinion, I simply declined to answer without explanation. "Q. Well, state why you desired the explanation. A. In the first place, I considered the hypothetical case an ambiguous one, and if answered categorically, as was required, it would not express what I considered a true answer. Second, simply that I was put on the stand and sworn to tell the truth and the whole truth, and if I answered that question, unexplained, either yes or no, I should not have told the truth nor the whole truth; and so I declined to answer.

"Q. You then thought that in answering that hypothetical statement you would not be giving an honest opinion to the jury as to the sanity or insanity of the prisoner? A. Not so far as I was concerned.

'Q. (by Mr. ScoVILLE). Will you state what there was ambiguous about that question that was asked? A. If certain things here stated were done under the influence of inspiration or fancied inspiration, as an insane delusion, the man was insane. If they were done under the influence of inspiration, using the word as it has been repeatedly used by the prisoner, there is not the slightest evidence to my mind of insanity.*

*That Judge Cox makes a similar distinction is shown from the.following extract taken from No. 2 of his instructions to the jury:·

"If the jury find that the defendant committed the act charged, and, at the time thereof, knew what he was doing, and that what he was doing was contrary to the law of the land, it constitutes no excuse, even if it were true that when he committed the act he really believed that he was producing a great public benefit, and that the death of the President was required for the good of the American people.

"Nor would such excuse be afforded by the fact that in the commission of the act he was controlled by a depraved moral sense, whether innate or acquired, or by evil passions, or indifference to moral obligations.

"And even if the jury find that the defendant, as a result of his own reasoning and reflection, arrived at the determination to kill the President, and, as a further result of his own reasoning and reflection, believed that his said purpose was approved or sug gested or inspired by the Deity, such belief would afford no excuse.

"But it would be different, and he would not be responsible, criminally, if the act was done under the influence and as the product of an insane mental delusion that the Deity had commanded him to do the act which had taken possession of his mind, not as the result of his own reflections, but independently of his will and reason, and with such force as to deprive him of the degree of reason necessary to distinguish between right and wrong as to the particular act.

"If there was no insanity, but a mere fanatical opinion or belief, such as before described, the only impulse that could have actuated the defendant must have been a sane one, such as, in the most favorable view of it, a mistaken and fanatical sense of duty, which the law requires him to resist and control."

"Q. What is the meaning of ambiguity? A. Of doubtful purport.

Q. Will you explain how it applies to the word 'inspiration in that question? A. Because the word 'inspiration' may be any sense that you choose to give it.

used in

་

"Q. Read the sentence. - A. (reading).

During the month of June, 1881, at about the expiration of said term of five years, he honestly became dominated with the idea that he was inspired of God to remove by death the President of the United States also that he acted upon what he believed to be such inspiration.' "Q. Will you please explain the two meanings which can be attached to that expression, and which render it, as you say, ambiguous? Take it in that connection, just as it is used there. - A. That is where we differed, as to how it might be used there. That was the point. If you attach the prisoner's signification to the word 'inspiration,' there is no symptom of insanity about it.

"Mr. DAVIDGE. - Then the hypothetical case is a truism? "The WITNESS.

delusion, it is a truism.

If you take inspiration in the sense of a

"Mr. DAVIDGE. - Undoubtedly.

"The WITNESS. -But if you take it in a sense of inspiration as the prisoner has explained it to us, in that case there is not the slightest evidence of insanity.

"Mr. DAVIDGE. That is what I mean.

-

"The DISTRICT ATTORNEY. - Doctor, in the question propounded to you by Mr. Scoville, reference was made to a divine pressure: what do you understand by a divine pressure as used by these inspired men?

66 The WITNESS. - As I understand the word 'pressure' as used in this Court, if I understand it correctly, it is simply another term for the conflict going on in a man who is subject to temptation to do evil."

Among the authorities on insanity in this country, Dr. John P. Gray, of Utica, N. Y., stands undeniably as the chief; but he too refused to answer the hypothetical question for the following reasons, which may be compared with those given by me.

On Dec. 31 he testified as follows: "The DISTRICT ATTORNEY. I will ask you to answer that hypothetical question (Mr. Scoville's).-A. In my judgment, that question cannot be answered yes or no.

66

Q. For what reason? A. First, it refers to the prisoner at the bar as representing the imaginary person in the question. I would not be willing to answer that question if it applied in any way to the case of the prisoner, with the knowledge I have of him from a personal examination. I should feel that it would be mis

leading, assuming that it is entirely an imaginary case, and that there is no reference whatever to the prisoner. I should not be willing to give an opinion that it really represented an insane man. The element in regard to heredity does not state whether it was heredity in the direct line or simply collateral. A man may have parents or other relatives insane, and not be insane. himself. Such transmission may not go to him at all. In regard to the second proposition, as the question is stated, there is no foundation except the opinion of other persons that he was insane; and I should not be willing under oath to give an opinion as to the possible insanity of a person on the opinion of others, · especially without knowing whether the observers who made that opinion were competent persons to observe. In regard to the third element which this question presents, of the possibility of an insane delusion in the case as inferred from the word 'inspiration introduced, there is no statement in connection with it as to any disease. The motive given is a love of country, and, taken in its literal sense or reasonable sense, together with the conclusion as to the conduct of the person after the act, my judgment would be that it would not represent an insane person. It suggests a person who is dominated by his own idea that he is inspired by God to remove the President for the love of his country. If inspiration is an insane delusion then the person would be insane without reference to anything else; but if it is only inspiration and interpreted as such, it is then, as I understand, only an illumination of his mind by God as the source of all truth, so that he sees it to be his duty to remove a ruler; and in the further development it states that this amounted to a belief that it would be in accordance with the divine will to have this done. In the further development of the question, though it is stated as in the nature of a command of God, it is qualified by the expression afterward to the extent that it was a conviction, not to the extent that it was a command, because the command is qualified by the statement that it was a conviction overriding the force of his conscience and will. Finally it is stated that he was unable to withstand the mental pressure, not any divine pressure, but mental pressure. If mental pressure means anything, it means reflection, thought, judgment.

66

'Then if you take into consideration the fact that at the conclusion he simply felt like one who had discharged a duty to his country, you have, as I conceive, no possible indication of insanity; but it may be fanaticism. On the other hand, if it was inspiration, which is to be taken in this case as an insane delusion, then the conclusion that he had felt as though he had performed a duty when he was acting under the command of God, and that was the end of it, that it really arose with the occasion of the

idea, and closed with the accomplishment of the act, is entirely inconsistent with any idea of insanity."

The question will naturally arise, Why was I especially singled out as the target for Mr. Scoville's abuse? and the answer is simple: I was the only one of the experts summoned for the defence, who, believing in the sanity of the prisoner, and placed on the witness-stand by Mr. Scoville, who was cognizant of that belief, refused to stultify myself or prove false to my oath, and was then retained as expert by the government. Those gentlemen who answered the question as desired were not detained any further.

I will now consider the leading events in the life of Guiteau, including the incidents attending the murder, and show how inadequately they bear out the theory of insanity.

(To be continued.)

OCCIPITO-SACRAL POSITION: CASE IN PRACTICE.

BY PERRY MARSHALL, M. D., WEST ADDISON, VT.

It is said that of 20,517 deliveries, this position occurred but twice, and some accoucheurs doubt its existence. [Boivin.] (King.)

I was summoned March 2, about 1 o'clock, P. M., to the bedside of Mrs. S―, aged thirty-three years. Found her in her first labor, first stage; the os-uteri somewhat rigid and undilated, the diameter of the orifice being not more than two lines. I retired until daylight, when examination revealed dilatation enough to admit the point of the finger, the pains continuing at somewhat regular intervals. Gave Tinct. Belladonna gtt. v. At noon, the os would admit two fingers, and I was sure of a vertex presentation. Applied Unguentum Belladonna to the os, and cloths saturated with lobelia water over the abdomen. Dilatation was complete about six o'clock, P. M. Examination proved the head to be in the occipito-sacral position; the sagittal suture running antero-posteriorly; the flat surface of the top of the head forming a floor across the upper strait. The forehead could be felt distinctly above the pubis. The pains were quite regular and natural; but effected nothing except to turn the head to the right occipito-posterior position, with partial flexion and very little descent in two hours. I assured myself positively of the position by introducing my hand so far as to reach the fingers around the occiput, which lay at the right of the sacrum.

Introducing one blade of the forceps to the mother's left, and lifting gently but firmly, the rotation toward the right occipitoanterior position was partly accomplished. Being a stranger