INSANITY, a more or less impaired condition of any or all of the mental functions involving the intellect, emotion, or will. There can be no absolute test of insanity—or of sanity for that mat ter. Sanity is proved by normal self control, and insanity by the loss of it from disease.
The most common mental symptoms are morbid emotional depression and mental pain. In many cases of insanity to energize mentally is to suffer pain. Another symptom in other cases is an undue emotional exaltation; this is com monly associated with a loss of the great controlling or inhibitory functions of the brain, and occurs in mania. There is morbid brain excitement, commonly ex hibited in restless motions or shouting. Such cases may go on to complete loss of any consciousness of all the former brain impressions and mental life. The patient remembers nothing and does not know his nearest friends. Another com mon symptom is a diminution or loss in the power of attention. This is common to nearly all forms of insanity. Then we have perversion of the reasoning power, as seen more frequently in insane delusions, which are common in most cases and varieties of insanity. They are divided into fixed delusions and changing delusions, the former being the more serious and incurable. Hallucina tion is sensation without an object. The hearing of voices, when none exist, is a good illustration. Hallucinations are usually subjective and psychical in their origin, though unquestionably both a psychical and a sensorial element may enter into their genesis. Hallucinations may be of hearing, which are the most common and the most serious, as a symp tom of incurability if long continued; of sight, the next most common and more likely to be recovered from; of smell and taste, which are rare, and not favorable. Another mental symptom of insanity very common is impulsiveness of action in an automatic, unreasoning way some times without any conscious intention on the patient's part, and without power of control by the will. A man sees a
large plate glass window and he impul sively hurls a stone through it, Another cannot resist the impulse to tear his clothes, a third cannot resist the impulse to set a haystack on fire. Uncontrollable impulse naturally goes with diminished volition in insanity.
One of the most common and most painful symptoms of insanity IS Et change of natural affection toward relatives. This is not universal, but in nearly half the cases of insanity the affective condi tion is thus perverted or reversed. The memory is not necessarily affected in in sanity. In many patients it is exagger ated; thing-s come back with unnatural vividness.
One of the chief bodily symptoms in insanity is sleeplessness. Almost every kind of insanity is sleeplessness in its early stages. Another is morbidness of speech; it may be incoherent or par tially coherent; it may be over-rapid, slow, or entirely absent. Often the con ventionalities of speech are lost or dropped in insanity. The articulation of words may be changed. Next in im portance to speech is the expression of the face and eyes. This is given by the most delicate combined muscular and nervous apparatus that exists in nature, being in the most intimate connection with the mental part of the brain, and acting as its chief expositor and inter preter. In the depressed and demented cases the eye loses its luster and bril liancy; in maniacal cases it has abnormal feverish brilliancy; the pupil enlarging and the eye-lids being drawn too far apart produce staring, by exposing not only the cornea, but much of the sclerotic as well. Irregularity of the pupil is sug gestive of organic brain disturbance. The natural expression of the face is greatly changed, and little beauty of fea ture survives during acute attacks. The conventional control over the outward expression of the emotions is lost, and the face accurately shows the state of the melancholic, the maniacal, or the de mented patient.