Medical Jurisprudence And Toxicology

CHAPTER XIX

INSANITY" AND ITS MEDICO-LEGAL ASPECTS

Definition.—It is not easy to give a succinct definition of insanity and a
medical witness should never venture to do so in a court of law, ^even though
pressed for it by counsel, inasmuch as the law requires of him to affirm
whether a particular individual, by reason of unsoundness of mind, is either
incapable of looking after himself and managing his own affairs, or is
dangerous to himself or to others. It appears that the law givers have used
the term " unsoundness of mind " (non compos mentis) in the Indian Penal
Code with a view to avoiding the necessity of defining insanity. Unsound-
ness of mind covers a wider range3 and is synonymous with insanity, lunacy,
madness, mental derangement, mental disorder and mental aberration or
alienation. All these terms are used for ^he disordered state of the mind
in which an individual loses the power of regulating his actions and conduct
according to the rules of society in which he is moving^

In cases of insanity brought before courts the following terms are often
used in giving evidence; hence the medical jurist should be well acquainted
with the distinguishing points between them : —

1. Delusion-—A delusion is a false or erroneous belief in something
which is not a fact. It is not always a sign of insanity. A normal man may
have a delusion, but he corrects it by reasoning power, by applying his past
experience, and by listening to the arguments of other people. A delusion
in an insane person is a symptom of brain disease, is not in harmony with
his education and surroundings, and cannot be corrected by any amount of
logic, reasoning or argument. An insane person is guided by his own
feelings and sensations, and does not care to listen to any arguments.

Delusions may be of grandeur or exaltation, of persecution, of depres-
sion, of reference, of jealousy, of infidelity, etc. Delusions of grandeur and
delusions of persecution are often found together in the same person. For
instance, a man who imagines himself to be very rich may also imagine that
his enemies are conspiring to ruin him financially.

Delusions are very important from a medico-legal point of view, as they
often affect the conduct and actions of the sufferer, and may lead him to
commit suicide, murder or some other crime. The judge and the lawyer
attach great importance to the presence of delusions as a sign of insanity.
It is, therefore, necessary that a medical man, when called upon to examine
the mental condition of a person, should carefully make a note of any insane
cfelusions he has been able to elicit during the examination. It must be
reoaembered that the delusions may not be evident in the beginning of the
(Jioease or in a form of insanity which is not characterized by delusions. In
some cases the patient successfully conceals them, even though he be
suffering from delusions.

2. Hallucination,—A hallucination is an erroneous sense perception
without any external object or stimulus to produce it. It is due to some
abnormal excitation in the brain cells, and may affect any or all the special
senses, as also the cutaneous sensations. Hallucinations of sight and hearing
are the most common. For instance, a man may imagine rats and mice
crawling into his bed, when there are none, or may suspect a tiger coining
to devour him, when there is no tiger. He may also hear the voices of
persons in his room^ when there is absolute silence.

Hallueinatkms ocetcr in fevers and intoxications, as well as in insanity.
They may be pleasant, "but more often they are unpleasant. A person
suffering from unpleasajxt and disagreeable hallucinations, should be classed