New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1915-07-17
D;sonosticians "of Large Experience.

In declaring MS COlCuI lNilNN - 49,
dict provided him "by way Of advice ana
aid" in determining the present mentaI
STATE of Harry Thaw Justice HendrlcK
took occasion to deprecate the manifest
! evils attending the use Of medical testl-
Imonv in cases involving questions oil san
itv and responsibility. There are few VINO
do not agree with him in deploring these
evils and share his hopes that by JOINT
action of the legal and medical professions
thew NAV speedily be abolished. But II
they are to be abolished 1t is TO ne hopeu
that they will not be replaced by worse
evils. =,
The trial that has just been concluded
was unioue in the annals of the state.
Never before, as Justice Hendrlck OBJ
served. had the question of mans sanity
been submitted under these conditions to
the Judgment of jury. Let us hope that
| it will never happen again. For days wit
nesses. without the least pretence to any
extraordinary understanding of mental
disorders. were allowed to offer their dag
noses on the strength of casual acqualnt-
ance with the relator, to say whether or
not they thought he was of sound mind.
Their testimony, Justice HendI1ck says,
impressed him deeply, because they were
"women of undoubted high repute' and
"mon of large experience who know the
difference between a sane and insane
man
Here is a begging Of the whole question
at issue Are men of large experience IN
the common affairs of life really carable
Of detecting by casual observation the
signs of an unsound mind? If so, they
must have more skill than those who have
devoted their lives to the study Of mental
disease. for nothing is more generally
q. acknowledged by psychiatrists than the
difficulty often encountered in discovering
evidence of insanity, even in elicitlng the
decisions Of patients who are known TO
be subject to them. One of the medical
witnesses admitted on the stand that Thaw
during the present trial had shown no
sign of mental arrangement This admis-
sion evidently made a great impression on
u the Jury. But what does it amount to?
/ Absolutely nothing as far as the question
of sanity is concerned. There is a classic
example of an inmate Of an asylum in
Paris who completely deceived the govern
lment commissioner during a long and eX-
Ihaustive mental examination. At last 1t
was decided that the man was absolutely
sane; the discharge papers were brought
to him to sign, and it was only then that
his delusion was revealed. lie signed aim-
self Jesus Christ"
Gross delusions of this kind are some
times concealed for long periods. If Thaw
is a paranoac there is nothing wonderful
in his apparently sane behavior. Spltzka
speaks of a patient of his who harbored
the widest decisions, yet to one unac-
Iduainted with the facts their delusional
mature would not have been apparent, for
his manner and address were simply such
as would be expected Of a courtly and
prosperous man of business" Nor is it
always easy even for medical men of con-
siderable experience to detect the signs Of
insanity. Some years ago a lawyer asked
physician and well known psychiatrist
to examine a patient who had been com
Imitted as insane. Both reported in favor
Of his release, basing their decision on
"the calm and rational behavior of the
patient" and the testimony Of an assistant
asylum physician who had observed moth
ing wrong about him" Six weeks later
the man was recommitted on the certificate
of the very. two who had pronounced him
sane.
This is a common experience. A few
years ago there was a great clamor in
London over a paranoiac who was sup
posed to be unlawfully confined. The
Home Secretary made inquiries and
learned that during three or four years
detention the mans behavior had been
exemplary. He was released, relapsed in
stantly, repeated the offence for which he
had been originally committed, and was
recommitted the very next day. Examples
Of this kind might be multiplied indefinite
! ly. That such patients can often conceal
I their decisions for long time, that they
are frequently quite orderly that their
consciousness may be unclouded, and that
they may live for years without any
marked mental deterioration-these are
circumstances not always understood by
men "of large experience" and the ques-
ton is whether large experience of a gen
eral kind qualities a man to diagnose
disease.
A circumstance which made manifest
impression on the judge was a disagree
ment between two Of the medical witnesses