QJnrn^U Ham ^rl^nnl ^jibrary 
 
The original of tiiis book is in 
 tine Cornell University Library. 
 
 There are no known copyright restrictions in 
 the United States on the use of the text. 
 
 http://www.archive.org/details/cu31924024903704 
 
THE 
 
 TRANCE STATE IN INEBRIETY: 
 
 MEDICO-LEGAL RELATIONS. 
 
 T, D.'^ROTHEte, M,l>.,.. ., 
 
 SuPERJNTENpHNT WALNUT LoDGE, HARTI^OBD, GoNN,^ 
 
 IntroduGtion on the- Nature and' Ctiaraeter.of ttle Tranee State, 
 
 BY 
 
 GEORGE M. BEARD, M.D, 
 
 New York City. 
 
 ■ - A Paper READ BEFORE THE New York M&dico-Legal. Society, 
 
 NOVEJtBER 2, iSSl. 
 
 HARTFORD,' CONN, ; 
 
 The Ca.se, Lockwood & Brainard Company, Printers, 
 
 1882. 
 
THE 
 
 TRANCE STATE IN INEBRIETY: 
 
 MEDICO-LEGAL RELATIONS. 
 
 T. D. CROTHERS, M.D„ 
 
 Superintendent Walnut Lodge, Hartford, Conn. 
 
 IntroduGtion on the Nature and Charaeter of the Tranee State, 
 
 GEORGE M. BEARD, M.D., 
 
 New York City. 
 
 A Paper read before the New York Medico-Legal Society, 
 November 2, 1881. 
 
 HARTFORD, CONN.; 
 
 The Case,' Lockwood & Brainard Company, Printers. 
 
 1882. 
 
INTRODUCTION. 
 
 It has long been known to students of the nervous system 
 that various morbid states may induce conditions like those, 
 described in this paper ; but that inebriety (dipsomania) was 
 a special, distinct, positive, and sole cause of these conditions 
 was, a few years ago, a new discovery. 
 
 As long ago as 1879, Dr. Crpthers called my attention to 
 some of these cases, and aSjcad^e' to^^xplain them. The 
 explanation I gave was, that, the conditions were analogous 
 of the double consciousness, of some of the forms of natural 
 trance ; and that the term " alcoholic trance " might very 
 properly be applied to them, just as the term "epileptic 
 trance" is applied to the same condition when resulting from 
 epilepsy. 
 
 Since that time I have frequently referred to these cases in 
 my writings and lectures during the last two years, and in 
 my private practice have seen a number of cases precisely 
 similar. 
 
 Although so much has been written on this subject by Dr. 
 Crothers and myself, but little attention has been attracted 
 to it in any country, and at the last meeting of the Interna- 
 tional Medical Congress, in London, a paper was read before 
 the Mental Section by Dr. Motet, of Paris, on the same sub- 
 ject, although under a different title. ' 
 
 The following report is taken from " The Journal of Men- 
 tal Science," October, 1881 : 
 
 " Dr. Motet read an important medico-legal paper bearing on intem- 
 perance and moral shocks, of which we have no abstract. 
 
 DISCUSSION. 
 " Dr. Ashe said that he could cite some nearly analogous cases which 
 had occurred in his own experience ; cases in which people had dissi- 
 pated constantly, but without becoming actually intoxicated. The pa- 
 tient would have an absolute explosion of insanity, from which he would 
 
afterwards completely recover. He quoted one case which he had seen 
 immediately after the attack. There was total dementia, with appre- 
 hensions that people were coming to kill him, and so forth. This con- 
 tinued for some time, after which the patient made a very slow but per- 
 fect recovery. 
 
 " Dr. Mercier said that the importance of Dr. Motet's paper was 
 great, especially from the medico-legal point of view. He remembered 
 a case in which a man had been discovered in an empty and unoccupied 
 house, breakinst up the kitchen range with a crowbar. He (Dr. Mercier) 
 was not surprised to hear that the man had been in and out of asylums. 
 He was at that time in a stupid condition, answering questions in a silly 
 and incoherent way. He (Dr. Mercier) certified the man was insane, 
 but to his great astonishment the man subjected the witnesses, includ- 
 ing the doctor, to a cross-examination so acute that it was very un- 
 pleasant indeed. The magistrates, however, were satisfied that the man 
 was not insane, and sentenced him to a month's imprisonment. It 
 transpired that he, being a man of unstable brain, and being moreover a 
 teetotaler, had taken a considerable dose of beer on the evening he was 
 found. Alcoholic mania, although very transitory, might be very differ- 
 ent from delirium tremens. Another case was that of a man who was 
 crying out in the_streets that people were taking his life by means of the _ 
 telegraph wires. He was then in a state of acute mania, with delusions, 
 and on the following morning he was completely well. In this case also 
 the man, being a teetotaler, had suddenly taken a considerable dose of 
 alcoholic liquor. 
 
 '■ Dr. Maudsley suggested whether, in these cases of moral traumat- 
 ism, there might not have been a strong hereditary epileptic tendency. 
 It occurred to him that in these cases of genuine acute mania of a tran- 
 sient kind, during which the person was unconscious, or would forget 
 afterwards what he was doing, that kind of a mania might be a sudden 
 outbreak in consequence, perhaps, of the patient's having drank too 
 much. 
 
 " Dr. Clouston drew attention to a correct description of this particu- 
 lar variety of disease which had been given by Dr. Hayes Newiogton, 
 who called it mania a potu, and desired that the term should be restrict- 
 ed to this kind of disease. He (Dr. Clouston) quite agreed with Dr. 
 Maudsley as to there having actually been a very strong hereditary 
 tendency. 
 
 " Dr. Bucknill said that he rose to thank Dr. Motet for his paper and 
 to assure him that so far as he (Dr. Bucknill) was concerned (and he had 
 given much time and thought to the study of the relations of insanity 
 and drunkenness), the idea advanced in this paper was perfectly new. 
 He had read the paper to which Dr. Clouston had referred, and was 
 fully aware of the value of the pamphlet ; but it seemed to him to refer 
 to quite a different kind of case, namely, mania following the habitual 
 use of drink, and not alcoholism, or any form of delirium tremens. The 
 
cases described by Mr. Motet were, he thought, quite different. There 
 was an interval between the habitual drunlcenness and the development 
 of the mental symptoms which he himself had seen, and which he fully 
 believed had been faithfully depicted and rightly explained in the inter- 
 esting, and to him quite novel, views put before them that day." 
 
 From this abstract we learn : first, that, in spite of all 
 that had been written on this subject in America, this con- 
 dition was not understood in Europe, and was regarded 
 there, by some at least, as something entirely new ; and, 
 secondly, that the terms used are but of little importance, 
 provided that we really understand the condition. The 
 speakers at the congress used various terms and phrases, 
 but it was clear that they all meant substantially the same 
 thing. 
 
 We might, if we chose, call this state inebriate automa- 
 tism, analogous to epileptic automatism ; we might call it 
 inebriate insanity, or inebriate unconsciousness. Scores of 
 phrases or terms would answer our purpose. The fact to 
 be made clear is simply this, that the nervous disease, ine- 
 briety (dipsomania) is, especially in this country, frequently 
 the cause of these automatic acts, during which the subjects 
 are more or less irresponsible; and they may commit crimes 
 for which they ought not to be punished any more than the 
 irresponsible insane of other classes. The first suspicion 
 that would strike a student of the nervous system would be 
 that these cases were masked epilepsy, or epilepsy without 
 convulsions; and it is a very natural view to those who have 
 not thoroughly examined the ca;ses, because epilepsy devel- 
 opes these same phenomena. But taking the extreme view 
 of non-convulsive epilepsy, these patients are not epileptic 
 in any sense of the teirm, or by any just theory or conception 
 of epilepsy. 
 
 It might be suspected that they are insane, and, in truth, 
 they are insane during these attacks ; but it is a special and 
 peculiar form of insanity, just as progressive paresis or 
 dementia are special forms of insanity. There is not in any of 
 these cases that I have seen any of the physical signs of 
 general paresis, — in the pupils, in the walk, or in the speech, . 
 
or in the intellectual or moral phenomena exhibited by them, 
 or in their subsequent history. Hysteria results in phenom- 
 ena like these, sometimes ; but these cases are very far 
 indeed from being hysterica] . Other drugs besides alcohol 
 will produce these effects ; the bromides, for example, and 
 possibly, in some cases, chloral and opium. 
 
 I have a letter written by a very intelligent literary man, 
 who took bromide of sodium to prevent sea-sickness, and 
 who, as it seems, had an idiosyncrasy in reference to that 
 remedy. It entirely prevented sea-sickness, but, instead of 
 producing sleep, it acted more like champagne, causing 
 excitement and various phenomena of insanity. This letter 
 is badly written and badly spelled. It contains untruths, as 
 well as nonsense. It reminds one of letters sometimes read 
 by general paretics, and it is also quite illegible, as is some- 
 times true of the writing of paretics. The letter was writ- 
 ten off the coast of Ireland, when the steamer had nearly 
 reached Glasgow, and was sent to the writer's wife, who was 
 very much alarmed by it, fancying her husband was becom- 
 ing insane. It was the first letter she received after he left 
 America for Europe. I have since seen the author of the 
 letter, and he stated that he had no recollection of having 
 written it. He has shown me another letter, which he found 
 among his documents on his return, directed to " Dear 
 Friend." It is even worse than the first for bad spelling 
 and great illegibility. The gentleman has no idea to whom 
 the " Dear Friend " refers, and has no recollection of hav- 
 ing written the letter. Tiiis man soon recovered from this 
 abnormal condition, which was perfectly analogous to the 
 cases Dr. Crothers describes as having been produced by 
 inebriety. 
 
 Wilkie Colhns, in his novel, " Moonstone," makes the plot 
 depend mainly on conditions of this kind artificially pro- 
 duced. A character in the novel, who, in a state of somnambu- 
 listic trance, carried away and secreted a very valuable dia- 
 mond, was afterwards put into a somnambulistic condition 
 artificially, and, while in this state, went directly to the place 
 where the diamond was hidden, and found it. 
 
This same condition can be produced artificially by acting 
 on the emotion of expectation in sensitive subjects, and has 
 been so produced before the New York Medico-Legal Soci- 
 ety, by Dr. Hammond and myself. 
 
 There is no possible crime which subjects in that state 
 may not commit, or try to commit, and without any recollec- 
 tion after they came out of what they have done. They will 
 kill each other or any one else, and do anything evil that 
 was possible, just as in a dream. 
 
 A remarkable illustration of the. natural induction of states 
 of this kind was witnessed in Switzerland while I was trav- 
 eling there this year. There was a tremendous land-slide, 
 a mountain falling on a village and killing large numbers of 
 people. 
 
 Those who were near and in peril, but managed to escape, 
 were many of them frightened into a state like that in which 
 these inebriates are, so that they walked about in a kind of 
 natural somnambulism, and were unable to give and never 
 will be able to give any. trustworthy account of what trans- 
 pired. The emotion of fear had produced the same effect as 
 the emotion of expectation in the artificial induction of these 
 states, or as alcohol or bromide might produce. It is known 
 that there were at least two or three separate land-slides, 
 but whether they were a minute or an hour apart had not 
 been determined, for this reason only : that the inhabitants 
 who survived had their rememberable consciousness de- 
 stroyed or impaired by the emotion of fear. 
 
 By looking through these side lights we get a clear, dis- 
 tinct view of the philosophy of these niorbid, automatic 
 states. We see that they can be produced naturally as well 
 as artificially ; we see that they can be produced naturally by 
 an immense variety of causes ; we see, in short, that mental 
 and physical influences, acting singly or together, injuries of 
 the brain, powerful drugs, diseases of the brain, like epilepsy, 
 hysteria, or insanity, or simple neurasthenia — in som.e in- 
 stances, powerful emotions, as of expectation, fear, and especi? 
 ally wonder — may produce these automatic phenomena just as 
 well as alcohol, which is the great excitant in these cases which 
 
Dr. Crothers has described ; and when we understand the 
 philosophy of this complex causation we can call the special 
 results by any name we choose. 
 
 The fact that the nervous disease, inebriety, may be the 
 cause of phenomena of this kind is important, both in a sci- 
 entific and medico-legal sense, and is a new and original dis- 
 covery in science of the highest conceivable interest, and 
 will soon be so recognized. 
 
 On one point I vs^ould suggest a correction of the philoso- 
 phy of the paper. I do not believe that these persons were, 
 correctly speaking, unconscious at the time of what they did ; 
 they knew what they were about, to a greater or less degree, 
 just as we at this moment know what we are about, but not 
 to the same degree or in the same way that we do ; but the 
 point in their cases is that they knew, but did not remember 
 that they knew ; the period is a blank in their lives — cut 
 clean out of their minds, just as if they had never been. 
 
 I believe that this distinction between consciousness and 
 rememberable consciousness is of vital import in relation to 
 a great many psychological questions. Consciousness is one 
 thing. Remembering past consciousness is quite atiother thing. 
 There is a plane of consciousness below which it is unre- 
 memberable, and above which it is more or less remember- 
 able ; although this whole matter is one of degree, and we 
 all forget much of our past lives, sooner or later. The pecu- 
 liarity of cases like these is, that events of great importance, 
 like crimes, which in their full senses they could not have 
 forgotten, or serious business matters, were forgotten within 
 two or three days, after they had been done. This is true, as 
 is well known, of very many acts of the insane, although not 
 all ; but it is especially true of crimes of very many kinds 
 committed by persons in somnambulistic trance or in arti- 
 ficial trance. 
 
 One of the best illustrations conceivable of this difference 
 between consciousness and rememberable consciousness has 
 been reported during the past year in the famous case of 
 trance-lethargy which excited so much discussion in this coun- 
 
try, and which I had opportunity to study in detail ; an 
 account of which was published by me in the " Medical 
 Record," p. 513, 1881 : 
 
 John Gyumbere the Hungarian, as he was called, but who 
 is now known to be a Pole, was in a condition of trance-lethargy 
 169 days, in the alms-house in Lehigh county, Pennsylvania. 
 I have heard from the physician who had him in charge (Dr. 
 Erdman) since my return from Europe, and he tells me that 
 he is now somewhat flighty, or out of his head, with a ten- 
 dency to dementia ; is no longer in the hospital, but is at 
 work, and has no recollection of his former condition ; yet I 
 am certain that while he was in that state he had a certain 
 degree of consciousness, though not of rememberable con- 
 sciousness. My own experiments with him convinced me 
 that though an automaton, like a baby, yet he was conscious 
 just as a baby is conscious, and knew that some one was 
 talking to him ; for he followed me about like a dog when I 
 spoke loudly to him ; he swallowed food when it was placed 
 in his mouth, and in many ways showed a low grade of con- 
 sciousness ; and more than that, he improved the opportu- 
 nity, when his attendants were absent, to jump out of 
 the window. All this shows consciousness, but not re- 
 memberable consciousness. All those months were blank to 
 •him; his experiences did not make sufficient impression on 
 him to be recalled, and there was no responsibility at the 
 time for what he did ; and, so far forth, it was a parallel to 
 these cases of inebriety. 
 
 Anaesthesia illustrates the same important principle. Pa- 
 tients, even when perfectly anaesthetized, cry out under severe 
 operations, and we say they do not feel the pain ; which is 
 probably a mistake, for they do feel it slightly, dimly, tran- 
 siently, at the time, and the cry is the sign that they do feel 
 it ; but the consciousness is not rememberable consciousness, 
 and so, when they come out of the state, they do not remem- 
 ber what has happened. 
 
 The application of the word Trance to these automatic 
 states, when resulting from epilepsy, hysteria, inebriety, 
 or hypochondria may perhaps be questioned, for the reason 
 2 
 
lO 
 
 that it cannot always be proved that in these states there is 
 any concentration of the nerve force, in any special direction. 
 
 The suspension of nervous activity in certain directions 
 will be admitted by all, and all will admit that the subject be- 
 comes an automaton ; the only doubt that remains is whether 
 there is any real concentration in these cases, or in the cases 
 of trance coma, trance lethargy and the like. The concen- 
 tration theory of trance does not require that the concentra- 
 tion of the nerve force must be in the full degree correspond- 
 ing to the suspension, although it is probable or possible that 
 such may be the case in very many instances ; all that it im- 
 plies is, that the nervous activity is limited in its range, and 
 that there is at the same time a suspension of activity in di- 
 rections in which it is active when in the normal state. It 
 is possible, however, that even in these cases of epileptic 
 trance and alcoholic trance, as here described, there is more 
 or less concentration of nervous force as well as suspension ; 
 that the mind is abnormally active in certain directions as 
 well as suspended in others. 
 
 The following case of alcoholic trance, which lately con- 
 sulted me, illustrates this in a most interesting manner. A 
 physician of ability and energy inherited a tendency to ine- 
 briety, and is now a periodical inebriate. He tells me that, 
 after an important operation, or after the death of one of his 
 patients, he sometimes feels unusually weak and nervous and 
 rushes off to drink. Sometimes he shuts himself up for a 
 whole day. While in the trance state which follows these 
 drinking experiences, he says and does things which he for- 
 gets all about on resuming his normal condition. The most 
 interesting feature of all these phenomena is that, while in 
 this state he collects bills, gives receipts, pays bills, giving 
 and receiving checks ; that he can do business of this kind 
 very much better than in his normal condition ; but when he 
 resumes his natural state he forgets all he has done, and 
 has no evidence of it other than the checks and receipts ; in 
 other words, his nervous force is concentrated in this direc- 
 tion — receiving and paying bills. While in this state, patients 
 come to him or send for him for treatment ; he will promise 
 
II 
 
 to go to see them, but does not go ; indeed, he never prac- 
 tices medicine while in this condition. In addition to these 
 trance states, this physician was troubled with uncertain sleep 
 with headaches, with great sensitiveness to ether and chlo- 
 roform, and there was every evidence of cerebral conges- 
 tion at times. 
 
 Other cases of this kind that I have seen, and that Dr. 
 Crothers has reported, certainly show nervous exaltation of 
 nervous activity in certain directions, compensating for the 
 suspension of activity in other directions. 
 
 In regard to the pathology of these cases, I may suggest 
 that it is probably a cerebral exhaustion, which causes a low- 
 ering of the consciousness below the plane of rememberabil- 
 ity. The knowledge of a common electric ' battery helps us 
 here. If the resistance outside of the cells be diminished 
 by putting metals into the fluid, or by using warm water 
 instead of cold, putting salt into the water in which the poles 
 lie, or bringing the poles together, or by using large wires, 
 we increase the action in the cell, and the cell wastes more 
 rapidly. 
 
 A nerve cell and fiber, though not exactly a battery, may 
 be compared to a battery. Alcohol and other poisons, and 
 various other disturbing influences, tend to diminish the resist- 
 ance and to increase the action of the cell, as the German 
 philosopher Wundt and others have suggested ; and the 
 activity of the cells may be positively and independently in- 
 creased by disease, just as the activity of battery may be 
 increased through a change in the acid. Thus nerve-force 
 becomes exhausted in the cells through a double process, pos- 
 itive and negative, and, as a consequence, mental activity 
 takes place below the plane of rememberable conscious- 
 ness. In a shorter or longer time, varying in different 
 persons, the force returns, and with it diminished cell activ- 
 ity and rememberable consciousness. The same philosophy 
 applies to neurasthenia and epilepsy. 
 
 There will probably be some difficulty in getting a general 
 acceptance of all the doctrines here taught; but it should be 
 remembered that all diseases — even insanity itself — had to 
 
12 
 
 fight for acceptance against both scientific men and the peo- 
 ple. The recognition of all the special varieties of insanity 
 was only attained after long and severe campaigns. This 
 special variety, introduced for the first time, must expect, 
 and is now receiving, the same opposition that has been 
 received and is now overcome, in whole or in part, by gen- 
 eral paresis, epilepsy, and very many of the special varieties 
 of mental disease. 
 
 For climatic and other reasons that cannot be dis- 
 cussed here, there is very much more of the nervous disease 
 inebriety, inherited and acquired, in America than in any 
 other country, although there is less drinking among the bet- 
 ter classes here than in any European country. The oppor- 
 tunity for studying the disease inebriety is therefore greater 
 here than elsewhere, and I am glad that it is being im- 
 proved. For those who occupy the advantages for the study 
 of this subject, either in inebriate homes, as Dr. Crothers 
 has done, or in private practice, there is as much evidence 
 of the existence of the functional nervous disease inebriety, 
 characterized, (i) by its irresistibility, (2) by its hereditary 
 character and association with other nervous diseases, (3) 
 by the suddenness of the attacks, and (4) by its periodicity, 
 as there is of general paresis, or dementia, or melancholia, 
 or masked epilepsy, or neurasthenia, or acute mania, or hys- 
 teria, or chorea, or locomotor ataxy ; and those who study 
 these cases thoroughly will, in time, find just such phenom- 
 ena as are described in this remarkable essay. 
 
 GEORGE M. BEARD. 
 
 New York, 52 West 34th St., January 20, 1882. 
 
THE TRANCE STATE IN INEBRIETY— ITS MED- 
 ICO-LEGAL RELATIONS. 
 
 BY T. D. CROTHERS, M.D., SUPT. OF WALNUT LODGE, 
 HARTFORD, CONN. 
 
 In 1879, I read a paper before the American Association 
 for the cure of Inebriates, at their annual meeting, entitled 
 CJerebral Trance or loss of consciousness following inebriety, 
 based on a clinical study of cases. The following are some 
 of the conclusions which were drawn from this study. 
 
 1. Loss of memory and consciousness may come on in 
 inebriety and be accompanied by little or no evidence of the 
 actual state. 
 
 2. This condition of the brain arises from complex causes, 
 which require careful study, and particularly when crime is 
 associated with inebriety. If the trance state is present, its 
 medico-legal relations are of the greatest practical impor- 
 tance. 
 
 Up to that time no study had been made of this phase of 
 disease associated with inebriety. Then I supposed that 
 this peculiar psychological state was ra,re, and seldom seen 
 in this disorder ; also that it was some obscure form of epi- 
 lepsy, the result of causes that were more or less accidental, 
 and seldom developed in this way. Later studies in this 
 direction indicate clearly that these cases are very common, 
 and are distinct from epilepsy. This state, noted by a loss 
 of cgnscioysness and memory, without stupor, during which 
 
14 The Trance State of Inebtiety. 
 
 the patient acts and appears rational, and yet is a mere autom- 
 aton, without memory or realization of his actual condi- 
 tion, is present more or less in all cases of inebriety. To 
 test this clinically, I made a special study of sixty-two cases 
 which came under my personal care. Cases of inebriety that 
 were of long standing, representing the middle and better 
 classes of society, and studied as they came, without selection. 
 Of this number, in ten cases the trance state was so promi- 
 nent as to be recognized by friends, and considered a form of 
 insanity. In twenty-eight cases these blanks of memory had 
 been noted less prominently, and of shorter duration, and 
 were termed drunken fits. In the remaining twenty-four 
 cases these blanks were more or less indistinct following 
 stupor and intoxication, and only ascertained by a study of 
 the symptoms. All of them gave evidence of acts which 
 were unaccountable to themselves or friends, of which they 
 had no recollection. I propose in this paper to give some of 
 the general conclusions which have been indicated from these 
 and other clinical studies I have made, illustrated by the 
 history of some very prominent cases, whose physiological 
 and medico-legal significance can not be over-estimated. 
 At the beginning it is important to recognize clearly the dis- 
 tinction between alcoholism and inebriety. 
 
 The term alcoholism does not correctly describe all the 
 cases which suffer from excessive use of alcohol or its com- 
 pounds, but denotes merely such cases which come directly 
 from the toxic action of alcohol. Inebriety represents a 
 special disease of the central nervous system not caused by 
 alcohol alone, but due to conditions of nerve degeneration, 
 of which alcohol may be only an exciting cause, or symptom 
 of the neurotic condition. As understood at present, inebriety 
 is the disease, and alcoholism is only a group of symptoms 
 noted in the latent stages of the disease. All my studies of 
 these cases are based on the fact that inebriety is a disease, 
 originating in certain definite or complex causes, and pro- 
 gressing through regular stages of development on to recov- 
 ery, chronicity, or death. Inebriety is a positive physiolog- 
 ical disorder, and not a combination of habit, vice, and sin. 
 
Its Medico-Legal Relations. 15 
 
 The trance state is only a phase or particular symptom of 
 inebriety in which certain brain functions are arrested. Un- 
 like some other forms of trance, nervous activity is not par- 
 ticularly concentrated in one direction, but is absolutely cut* 
 off in others. The combined action of a defective mental 
 state, with the effects of alcohol, in certain unknown stages, 
 cause not only a suspension of the memory, but of conscious- 
 ness, a literal paralysis of certain brain functions. It may 
 appear at almost any stage of inebriety, notably in chronic 
 cases, or in those recently attacked. The nature and phe- 
 nomena of trance in general, have been fully described by 
 my friend Dr. Geo. M. Beard, and many of the vast fields of 
 medico-legal, and physiological interest outlined by him. This 
 is the same physiological state coming from certain specific 
 causes. In this special form of trance following inebriety 
 the following facts may be considered, established, and con- 
 firmed by clinical studies. 
 
 1 . The trance state is a common symptom in inebriety, 
 in which the patient is without consciousness and recollection 
 of present events, and gives no general evidence of his real 
 condition. This may last from a few moments to several 
 days. 
 
 2. This state is clear evidence of profound disturbance 
 of the higher brain centers, and is of necessity followed by 
 impaired judgment, and lessened responsibility. 
 
 3. This trance state will always be found associated with 
 a particular neurotic condition, either induced by alcohol or 
 existing before alcohol was used. In all chronic states of 
 inebriety it will be found present in a greater or less degree. 
 The first fact is supported by the evidence found in the 
 history of every case of inebriety. The second will be clear 
 from the history of the cases which will follow ; and the 
 third can also be established from the clinical histories. The 
 cases presented are selected as typical, and also for the pur- 
 pose of bringing out prominently the symptoms and medico- 
 legal interest growing out of them. I shall confine myself 
 to some of the most general clinical facts, without entering 
 into any discussions of the pathology or nature of this 
 
1 6 The Trance State of Inebriety. 
 
 state. The plan I have followed is to give first, cases in 
 which the mind acted along certain accustomed lines of 
 thought and action in the trance condition ; second, cases in 
 which the mind displays unusual ranges of thought and 
 action, referable to varied mental conditions ; and third, cases 
 in which the criminal impulse was prominent. 
 
 CASE I. 
 
 Trance Following Inebriety — Automatic Recovery. 
 
 A railroad conductor, aged 45. Parents farmers, and healthy ; no 
 evidence of inherited disease. He grew up a strong, robust boy, and 
 at twenty-two went on the railroad as baggage-master. Ten years later 
 he married and was promoted to a conductor. He was up to this time, 
 temperate and regular in all his habits, using no spirits except beer at 
 long intervals. A few months after his promotion to conductor, his 
 train ran down an embankment, and was wrecked. Many lives were 
 lost, and he was greatly excited, fearing the censure of the company and 
 public, remaining at the scene of the accident over twenty hours with- 
 out rest or food. He then went home and drank spirits to profound 
 intoxication, remaining in bed two days before he went to work again. " 
 From this time he began to use brandy, and occasionally was intoxica- 
 ted at home at night. Two years after he complained of restlessness 
 and inability .to sleep at night ; for this, bitters were prescribed, which 
 brought relief. His disposition began to change, and he became more 
 excitable and impatient of opposition. A year or more after he began 
 to drink regularly when the work of the day was over, and by nine or 
 ten in the evening, was heavy and stupid from the effects of spirits. 
 He was very exact and methodical in all his habits, drinking beer 
 through the day, and never varying the routine of his life or work from 
 any cause. When thirty-six years old, he complained of blanks of 
 memory, or periods in which he could not remember, terminating sud- 
 denly, leaving him in some strange position with all the past a blank. 
 His usual habit was to drink in the evening, either at home or at the club, 
 come home always at ten o'clock, and retire, get up next morning at 4 
 A.M., and take his train a little later. These blanks would come on in 
 the evening and break up at some point on the road the next day ; or they 
 would last until late in the afternoon, on his return trip. He would 
 then show much anxiety to know what had taken place, in meantime, 
 fearing he had made some mistake, and inquiring minutely of his wife 
 and some intimate friends. These blanks increased, and were noted 
 by his brother-in-law, a physician, as follows: He would come home at 
 night heavy and stupid, not unconscious, apparently, but still and quiet; 
 sleep soundly until morning, get up at the regular hour, talk but little. 
 
Its Medico-Legal Relations. 17 
 
 take breakfast as usual, go out on his train, read the paper, attend to 
 all the duties of his business, in a quiet mechanical way. If any thing 
 unusual happened he seemed to be more indifferent, aiid acted with 
 judgment and caution. All at onct he would seem to awaken, his man- 
 ner would be nervous, and his eyes would indicate alarm, he would look 
 over his change and tickets, and inquire of any one who was intimate 
 with him as to what had taken place, having no idea of anything from 
 some time in the evening before. He would remember some question 
 or topic of conversation that occurred in the company in the past eve- 
 ning, and be ready to go on with the conversation, only the circum- 
 stances had changed, and the interval was a blank. This state would 
 alarm him, and he would drinkless for a few weeks. He never was deliri- 
 ous, but complained of heaviness and desire to sleep. When he was 
 sober he would bu nervous and irritable, and then use spirits to steady 
 his nerves. 
 
 The treasurer of the road noted this condition, in his inabihty to make 
 out the returns, when his trip was over. He would count and recount 
 his money, then give it up saying his head ached, and he could not get 
 it correct ; the next day it would be satisfactorily settled. The blanks 
 increased in length, and would last from the evening until the return 
 from his daily trip, the next day, twenty hours or more. During this 
 time he would not seem to be in any way different to the train men. 
 Once, when an accident had occurred, he recovered his senses, and was 
 unusually excited ; on other occasions he would have men put off the 
 the train, and pass through exciting scenes, yet have no memory of 
 them, and be unable to make up a report, except from the assistance of 
 a brakeman. He tried to break up the use of stimulants, but failed, 
 saying he would become insane if he stopped ; then he diminished the 
 quantity, but always came back to the usual amount, which was followed 
 by more or less stupor at night. Both his wife and brother-in-law, 
 noted these trance states, and fully verified his statements of no recol- 
 lection of events. He seemed to be more suspicious as he grew older, 
 and urged that everything be put in writing. On the road in this state, 
 if he was asked for a favor he put it down on paper, and urged that 
 others do the same to him. When not in this condition, he was quite 
 careless about little things, but when he became exact and very particu- 
 lar his friends knew that he was not able to comprehend his state. He 
 rarely drank except when at home, and whenever he felt that he had 
 used more than he could bear, went quietly to bed ; always seeming to 
 have an inner consciousness of his situation, seen in the caution which 
 he displayed to keep from observation. For over three years these 
 blanks continued, sometimes every week, then at longer intervals, but 
 steadily increasing in duration, and becoming more prominent in the 
 heavy stupid air and manner of doing business. He resigned and 
 
1 8 The Trance State of Inebriety. 
 
 spent a year on the farm, using less alcohol, and recovering rapidly. 
 He is now in business, and has had no blanks for two years, but at times 
 after he has drank two or more glasses of beer his memory is confused 
 for an hour or more. 
 
 COMMENTS. 
 
 The character of the trance-state in this case was mar- 
 kedly automatic, the patient doing that which he had been 
 accustomed to day after day. The inebriety dated from the 
 profound excitement of the accident where he supposed he 
 would be blamed ; for what reason he became intoxicated at 
 this time was probably unknown to himself. In the trance- 
 state his mind acted along the usual channels, without any 
 evidence of its suspended condition ; but when this paralysis 
 lifted, he manifested weakness, embarrassment, and alarm at 
 the danger he was in. His fears of doing some extraordinary 
 act, or committing violence in this state, was founded on a 
 knowledge of some inner impulses, which he did not reveal. 
 When free from alcohol his mind exhibited evidence of fail- 
 ure in the irritability and changed dispositon. These trance- 
 states were purely automatic, and yet they indicated a half- 
 conscious realization of his uncertain state, in the little cau- 
 tions manifested. His inclination to begin the conversation 
 or answer some question, which had occurred many hours 
 before, showed the reality of the blank, although his manner 
 gave but little evidence of it. I am convinced that many 
 similar cases will be found among those who are pursuing 
 an exhausting, monotonous work. A steamboat pilot in- 
 formed me that when worn out from loss of sleep, if he drank 
 a glass or more of brandy, all memory of the time and place 
 would vanish ; and some hours after he would recover, finding 
 that he had remained at his post, but could not tell what had 
 happened in this blank. The captain of the boat doubted 
 this for the reason that he seemed in no way different, only 
 less talkative. A skilled mechanic consulted me for similar 
 blanks which followed excess in the use of spirits, during 
 which he attended a certain dangerous machine, performing 
 all the duties requiring skill and judgment, and yet he could 
 not remember anything which ha4 taken place for hours. 
 
Its Medico-Legal Relations. 19 
 
 He would awake when the machine stopped for the night. 
 When the machine wa^ kept in motion late one night, his 
 blank continued until it stopped. These blanks were trance- 
 states following periods of severe drinking, and in many re- 
 spects like the case we have detailed at length. A house 
 painter, who is an inebriate, will paint for hours in the most 
 dangerous positions while in these trance-states, then come 
 down, recover his senses, and wonder how he could have 
 done it without falling. 
 
 I have gathered the histories of a number of similar cases, 
 in which, during the trance-state, the mind acted as before, 
 with the same discretion and judgment. They are all of 
 them following some methodical work, without change or va- 
 riation from day to day. Also the alcohol is taken with regu- 
 larity and is unattended with any symptoms of intoxication. 
 One of these cases is a grocer, who for hours has a perfect 
 blank in his work, but keeps everything on paper, and thus 
 is able to know what he has done. A second is a clergyman, 
 who, after a few glasses of beer on Sunday morning, has no 
 recollection until night of anything which may have followed. 
 A third is a traveling man for a boot and shoe house, who 
 drinks with every customer ; at certain times in his trip he 
 has blanks of one or two days, during which he does busi- 
 ness, and has no memory of what has happened. An engi- 
 neer would attend to his duties in this trance-state for hours 
 without giving any evidence of his condition, except general 
 abstractedness of manner. He would show coolness and 
 judgment the same as if he fully realized his surroundings, and 
 have no memory after. In all these cases there is a similar 
 condition in the automatic state, showing that the mind may 
 go on, irrespective of the memory, in certain directions, un- 
 der the influence of inebriate-blanks of many hours, and yet 
 the person attend to his work without knowing what he is 
 doing. 
 
20 , The Trance State of hrebriety. 
 
 CASE II. 
 Trance following Inebriety of Emotional Character. 
 A physician came under my care, fifty-one years old, with a history 
 of insanity and phthisis in several members of his family for two gen- 
 erations back. He was educated at Harvard, in both the literary and 
 medical departinents, married at twenty-four, and settled in a large 
 manufacturing town. He soon built up an extensive practice, and 
 worked incessantly for many years. When about forty years of age, 
 he suffered from depression and continuous melancholy, following the 
 death of his parents and two of his children. At this time he began 
 to use alcohol as a stimulant when worn out and after a hard day's 
 work. This increased with his labor, and at times he drank regularly, 
 then the amount would be diminished. He was never intoxicated, 
 and yet for weeks he would be under the influence of alcohol all 
 the time. After prolonged over-work and want of rest he would fall 
 into a paroxysm of crying before retiring, condemn himself for drink- 
 ing, saying he would soon die, and then fall asleep, waking up next 
 morning with no memory of it. These emotional paroxysms would 
 occur every week, and only disappear when he became less exhausted 
 or was rested. All his life he had been a noted skeptic and doubter, 
 never entering a church, but continuously sneering at all religious 
 truth and church organizations. On one occasion, during a season of 
 over-work, followed by the usual excessive use of alcohol, while pass- 
 ing a church where a revival was in progress, he went in, and was soon 
 interested, going forward for prayers, then began to pray and exhort, 
 manifesting great eloquence and enthusiasm. The church people were 
 overjoyed at the sudden conversion and change of life, but did not dis- 
 cover anything unusual in his manner or words. He went home in a 
 happy frame of mind, singing and praying, went to sleep, and the next 
 morning had no memory or recollection of any of these scenes. When 
 informed was mortified and avoided all contact with church people, 
 going away for a week for fear his disgrace would be known. Two 
 months later, he entered another church, late at night, where a prayer- 
 meeting was in progress, taking part as before, and displaying both 
 eloquence and great earnestness, then going home, and next morning 
 he had no consciousness of where he had been beyond a certain point. 
 Within a year, on several occasions he appeared at religious meetings 
 and took an active part, to the astonishment of his friends and the 
 alarm of himself when informed of it after. At these times he seemed 
 perfectly sober, but was nervous and excitable in his actions and man- 
 ners. He would not see any of the church people after these events, 
 and when obliged to meet them was cold and silent. He protested 
 stoutly that he had no memory of it, which was confirmed by the failure 
 to fulfill some promises made at these times. The sound of church 
 bells and music at night, when he was driving out after having drank 
 
Its Medico-Legal Relations. 2 1 
 
 freely of alcohol, seemed to throw him into a trance state, dtiring 
 which this strange impulse came on. Finally he became alarmed and 
 went abroad ; but as he used wine freely, these trance states continued 
 at long intervals, and were indicated by paroxysms of prayer and sor- 
 row that he was not better, and resolves to live as he should. After a 
 year of traveling he returned and resumed business, taking a partner, 
 who went with him at night and watched over him continuously ; but 
 still the trance states appeared. He still used alcohol, but could not 
 stop, fearing that he would die without it. He then retired and con- 
 sulted me. These trance states were, in his opinion, drunken fits, 
 which he wished to be free from. But, like nearly every inebriate, he 
 was confident he could be a moderate drinker, and never be the worse 
 for the use of alcohol. He talked rationally on other matters, and was 
 suffering from "rheumatism and general debility. A few weeks' treat- 
 ment was followed by restoration, after which he went West to live on 
 a farm. A year after, he had recovered in a great measure. 
 
 COMMENTS. 
 
 The marked neurotic inheritance was the favoring soil 
 from which inebriety would naturally follow, depending on 
 any exciting cause that was brought to bear upon it. In 
 this case, the exhaustion of over-work and the mental shock 
 from grief reacted readily into inebriety. This continued 
 for a long time, until the trance state came on. This was at 
 first a mere emotional outburst, manifest in religious feel- 
 ings ; then, from circumstances, developed into the strange 
 religious interest of short duration which was utterly a blank 
 to him. The emotional fear of death was present in all these 
 cases, but on no occasion di4 his friends at the churches 
 have .any suspicion of his real state. The knowledge of 
 these scenes from the statements of friends plunged him 
 into deeper melancholy and remorse. His mind was full of 
 alarm at the prospect of insanity, and yet he could not stop. 
 These trances pointed clearly to the failure of the mind and 
 a degree of mental irresponsibility which was not clearly 
 recognized. The line of action was that to which the brain 
 was unaccustomed, and required the play of a new set of fac- 
 ulties. In the first case, the brain in the trance state sim- 
 ply acted along its usual course. In this case a new path 
 was followed. In both, an automatic condition was present, 
 one guided by the experience of the past, the other acting 
 
22 The Trance State of Inebriety. 
 
 from inner impulses in new channels. The same condition 
 is often noted in chronic inebriates, who, after a certain stage 
 of excess in the use of spirit, will exhibit a remarkable spirit 
 of emotional excitement to reform bthers or protect them 
 from injury or wrong. The strange mental acts and desires 
 at this time are nothing but trance states, in which some of 
 the faculties are suspended, and others are alive and active. 
 The gospel temperance meetings, where the excitement is 
 intense, are excellent places to study this trance state. Men 
 in different stages of alcoholic excess will come forward and 
 sign the pledge and manifest great earnestness, and yet next 
 morning be utterly oblivious to everything done. I have 
 seen many inebriates just this side of stupor and muscular 
 paralysis be attracted to these gospel meetings by some 
 means, and become the most enthusiastic temperance men, 
 sign the pledge, and describe their past degradation with 
 evident satisfaction, and close with the wildest assertions and 
 promises for the future. The meetings of Moody and Mur- 
 phy brought out many very curious illustrations of this 
 phase of inebriety. Thoughtful men often wondered why 
 the same men who were so enthusiastic did not appear more 
 than once or twice at these gatherings. On inquiry, it was 
 found that they had fallen, or gone back, when, in reality, 
 this was a trance state, from which, on recovering, they did 
 not return, because they could not realize the position which 
 had been taken. A United States senator, who was an ine- 
 briate, appeared at one of these meetings, and made .a sol- 
 emn pledge not to drink again ; the next day he denied it, 
 and never believed or acknowledged that it was true. I 
 have found many persons who join the temperance ranks in 
 this state, when on finding what they have done, make an 
 honest effort to carry it out. Others are ashamed, and avoid 
 all such influences in the future. The temperance leader 
 never stops to question the strange inconsistency of men 
 who are so positive and earnest in their reformation, then 
 suddenly grow indifferent. To him this is only an evil heart; 
 but to the closer observer it is simply the trance state indi- 
 cating a degree of degeneracy needing medical rather than 
 
Its Medico-Legal Relations. ' 23 
 
 spiritual care. I conclude from this that inebriates brought 
 suddenly into conditions of much excitement fall into this 
 state and are moved by circumstances and surroundings to 
 which they are really oblivious. This state may appear as a 
 simple impulse, or glrow into a fixed delusion ; as in the case 
 of an inebriate who signed the pledge, went home, and 
 because his brother did not approve of this action, assaulted 
 him with great violence, attempting to force him to believe 
 in it. Often men who signed the pledge in this state sud- 
 denly manifest a mania for public speaking in the temperance 
 ranks, and go on for weeks, always drinking in secret, and 
 more or less oblivious to their real condition. In one case, a 
 man who had signed the pledge was for many weeks both 
 drinking and speaking, creating intense excitement every- 
 where, then recovered, with no connected memory of it. I 
 am confident in believing that this trance state is not only 
 full of danger from impulses of all kinds, but is the fertile 
 soil for delusions which linger long after the origin of them 
 is forgotten. Two patients of mine, who had been sober for 
 four months, both drank freely, and then went to a gospel 
 temperance meeting. Both went forward, and soon became 
 very warm in their religious feelings. The next day they 
 had no recollection of what had happened or that they had 
 attended such a meeting ■; but both affirmed that only prayer 
 could save inebriates, and when asked where they received 
 this impression could not tell. Their history before this 
 event showed that they did not entertain it then, and that it 
 was impressed on them during this trance state, but all the 
 other circumstances were forgotten. It may be stated as a 
 fact that in all cases where religious emotion is constantly 
 appealed to as an element of cure, the patient is on the bor- 
 der of the trance state ; and, furthermore, any system of 
 treatment which depends exclusively on the religious element 
 cannot build up healthy tissue or restore defective brain 
 
 force. 
 
 CASE III. 
 
 Is presented to show the prominence of the sexual instinct during the 
 trance state. 
 
 A farmer, age forty-eight, whose parents were eccentric and feeble 
 
24 The Trance State of Inebriety. 
 
 * 
 minded and had lived away from society, and worked hard a long life 
 time. When about twenty-six years old the lady to whom he was en- 
 gaged to be married died suddenly, causing great grief and gloom. Both 
 parents dying soon after, a deep melancholy followed, during which he 
 became more secluded, never leaving the farm unless on business. For 
 many years he lived very retired ; when any one called on him he was 
 pleased, and talked cheerfully, but never returned such calls. He seemed 
 to take pleasure in history and spent his leisure reading, never visiting 
 or attending lectures or meetings of any kind. At thirty-nine his sister 
 who kept house for him died, and soon after he was noticed to visit a 
 neighboring town, and buy a jug of whiskey. , This was repeated regu- 
 larly every few weeks at first, then at shorter intervals. No one saw 
 him use stimulants, and he never seemed different from the effects, 
 only more solitary and reserved in his manner. At this time he worked 
 hard, was prosperous, and apparently in good health, manifested ex- 
 cellent judgment, would go to his room at dark and would not be seen 
 until next morning. The amount of spirits consumed reached a gal- 
 lon a week, and in the harvest nearly double ; when one day he broke 
 off work abruptly, dressed up and drove away to a neighbor's, asking to 
 see an unmarried lady. He explained his presence as a mere social 
 call, that he had been secluded but now he was going to be social and 
 visit his friends often. His manner was reserved but polite, and his 
 conversation was clear and sensible. The next week he made other 
 calls on young ladies in the neighborhood, talking very pleasantly a few 
 moments then going away thanking them for the invitation to call again. 
 These visits were perfect blanks to him ; he would awake next morn- 
 ing and remember nothing of what had taken place after a certain mo- 
 ment in the field or at the house, and wonder greatly how he had em- 
 ployed his time. One day he loaded up the wagon to go to the flour 
 mill, went to the house and evidently drank some whisky, returned, 
 hitched up his horse, and went calling about the neighborhood. The 
 next morning he could not understand why he had not gone to mill. 
 These visits excited much interest in the neighborhood, and among his 
 friends. He seemed fully conscious of all the surroundings in this state, 
 was polite, and rarely called twice, but if the lady was supposed to be 
 anxious for marriage he seemed very guarded, and inquired for some 
 male friend to be present, holding only the most general conversation, 
 and always declining invitations to ride out with any one. He was never 
 childish or embarrassed, but seemed in earnest and really enjoying him- 
 self. He would return soon after dark, put up his horse, give very strict 
 injunctions about fire, then retire, and have no memory of what had hap- 
 pened. These blanks continued for several years and were all substan- 
 tially the same, hmited to short calls on different ladies for miles about. 
 He was more secluded than ever, in the intervals, refusing to see per- 
 sons who returned these calls. Coming under my notice I found him 
 
Its Medico-Legal Relations, 25 
 
 suffering from dyspepsia and many of the usual symptoms following the 
 use of alcohol. He thought he was intoxicated during these blanks, 
 and claimed that he used alcohol to prevent consumption. He was 
 reserved but seemed to have no fixed opinions about his case, or desire 
 to diminish the use of alcohol. His memory was defective, and he 
 could not work regularly on the farm. He would not consent to any- 
 thing being done, and two years later he died from gangrene following 
 a broken leg. 
 
 COMMENTS. 
 
 The neurotic inheritance and depression following the loss 
 of friends found a natural relief in alcohol, and he became a 
 secret inebriate. The trance state was manifest after a pe- 
 riod of prolonged excess and hard work, in amorous impulses 
 to seek the society of ladies. An extreme caution seemed 
 to be present holding him from making more than a formal 
 call, and not to visit the same place more than once. Noth- 
 ing but the unusual character of the call was in any way no- 
 ticeable. At home, the abruptness of leaving business, and 
 other important duties, was a hint of the change of mind and 
 loss of consciousness. When informed what he had done he 
 seemed more dejected than ever, and became more adverse 
 to society or meeting any one. This trance state gave vent 
 to his latent sexual impulses, which for a time guided his 
 mind. Had he committed an assault at this time, no general 
 evidence in defence relating to his conduct would have indi- 
 cated more than unusual acts, for which he gave general 
 good reasons at the time in his desire to change his life, and 
 when this trance state had passed away all knowledge of 
 these events would have been denied. No ordinary observa- 
 tion of persons who saw him in this state would have indi- 
 cated his real condition. I think it will be found that many 
 of the unusual sexual crimes committed by inebriates were 
 done in this trance state, where the higher faculties were ar- 
 rested, and the animal instincts were left free to guide and 
 suggest. The extraordinary conduct of previously moral 
 men who are inebriates can only be explained by this trance 
 state. When sexual crime follows inebriety it may be either 
 a mere automatic action of a low moral condition, built up 
 and fostered by low thoughts and actions, or the expression 
 
 4 
 
26 The Trance State of Inebriety. 
 
 of a disturbed function which bursts out into an impulse that 
 is dominant, for a time. In the former case some plan or 
 premeditation may seem to be present, because the line of con- 
 duct has been outlined in actions and thoughts that have left 
 an impression on the brain. In the latter it is often paroxys- 
 mal without plan or purpose, — simply the explosion of an im- 
 pulse which the disorganized brain is powerless to resist. 
 The following cases are given to indicate the prevalence of ' 
 these trance states in inebriety. I have gathered the history 
 of each one, but merely give an outline for want of space. 
 An inebriate clergyman committed a rape in the most extra- 
 ordinary circumstances and asserted that he had no memory 
 of it ; the circumstances bore out his statement. A middle-aged 
 business man of excellent character assaulted an old woman. 
 A lawyer of reputation planned the abduction of a lady he 
 was going to marry ; a man of standing and happy in his do- 
 mestic relations, married a notorious woman, although having 
 a wife and large family. Each of these cases had no memory 
 whatever of the occurrence, and all the circumstances were so 
 unusual, and at variance with previous conduct, as to con- 
 firm their statements ; and yet they were all punished, and 
 the defence of unconsciousness and irresponsibility was con- 
 sidered weak. No medical study was made of these cases, 
 and the excess in the use of spirits was mentioned as only 
 incidental to the case. The apparent realization of all the 
 circumstances was the point insisted upon in the measure of 
 
 punishment. 
 
 CASE IV. 
 
 Was a lawyer of eminence, whose ancestors and family had all died 
 of consumption. He was a nervous, passionate man, wealthy, of bril- 
 liant talents, ambitious and industrious ; also a devout, conscientious 
 man, and very temperate in all things but eating. After a severe attack 
 of typhoid fever, he began to use whisky at meals. Three years later 
 he used it both at the table and at night before sleeping. His life was 
 more or less irregular and he complained of exhaustion, and inability 
 to sleep. After a long campaign of speaking and great irregularity of 
 living, during which he drank constantly large quantities of whisky, 
 he suddenly called for paper, wrote a will, affirmed that he was going to 
 die, made a full disposition of his property, and after a night's rest, awoke 
 with no memory of anything which had occurred. A week after he had 
 
Its Medico-Legal Relations. 27 
 
 another paroxysm of melancholy, wrote another will and arranged for 
 death, and awoke a few .hours after, with all these scenes a blank. 
 During; the time of this trance, he was perfectly calm and seemed in no 
 way different, reasoned clearly on all matters, and by no word or action 
 betrayed his real state. For two years he remained about the same, 
 having many of these blanks, always attended with the same mental 
 phases, and apparent full consciousness ; then they changed into suici- 
 dal impulses in which he wished to .have his wife die with him. He 
 reasoned very calmly and correctly on this matter, but followed the 
 advise of his friends. The next day he was greatly alarmed when 
 informed of what had happened. Another trance state followed, in 
 which the suicidal impulse took on the form of intense suspicion of the 
 unfaithfulness of his wife. A friend of his took down an elaborate 
 statement of his wrongs, he then made another will, left an explanatory 
 note to be printed in the papers, and finally was persuaded to sleep, 
 after which he awoke and all the past, as before, was a blank. The 
 friend who wrote this statement was a lawyer, who said that beyond the 
 extraordinary nature of these papers nothing could be noted of the real 
 condition of the patient. He could not in any way detect mental 
 unsoundness. On another occasion he purchased pistols and a knife, 
 when his friends put hira in the care of a lunacy specialist, who called 
 this epilepsy." Two months later he came under my care, and was 
 deb'rious from the removal of the spirits for two days, then made a slow 
 recovery, and is to-day at a water cure, improving. The trance states 
 have disappeared, but his mind and body are both feeble. 
 
 COMMENTS. 
 
 The inebriety began with use of spirits 'after the fever, 
 and the trance state was marked by emotional disturbance 
 and conviction of speedy death. This was but the sugges- 
 tion of the general exhaustion of the system, and the desire 
 to arrange his property was the usual caution of a business 
 man. The fact of having written his will never remained on 
 his memory, and he always urged to have it written when in 
 this state, even when other copies were exhibited to him. 
 When speaking these blanks came on, but excepting that he 
 had no recollection of anything after a certain time, no one 
 could have realized it. As he grew more exhausted, suicidal 
 impressions started up. These were checked by the inter- 
 position of friends. Had he kept these impulses to himself, or 
 not been influenced by friends, they would have developed 
 into a tragedy. He was drifting into a dangerous mental 
 
28 The Trance State of Inebriety. 
 
 condition, in which impulses of every description were likely 
 to take possession and control his actions. Had he killed 
 his wife at this time, or any one, no reasonable defense could 
 have been urged that would have been intelligent to a judge 
 or jury, and yet he was in a condition of irresponsibility, 
 without doubt. I have verified this condition in the follow- 
 ing cases : A retired merchant, while drinking, assaulted a 
 stranger, who was attending to other business ; he had no 
 consciousness of the act, and at the time said that this man 
 was an enemy who had deceived him long ago. The assault 
 was cool and devoid of all excitement, and justified at the 
 time by the above reasons, urged with a great show of 
 candor. An inebriate, in large business, made the most 
 extraordinary purchases of goods, which he could not remem- 
 ber the next day. A cautious banker, after a season of 
 drinking, invested a large trust furid in Wall street and lost 
 it all, without any memory of it after. A very kind, affec- 
 tionate husband, who was an inebriate, began divorce proceed- 
 ings while drinking ; two days later he was astonished to 
 realize what he had done, all the past being a blank to him. 
 George D. Prentice, the poet and orator, was advertised and 
 had prepared to deliver a lecture on a certain subject. When 
 the time came he repeated an entirely different lecture, with- 
 out any knowledge of it ; he could not believe it until he read 
 a full report in the next morning's paper. This was a trance 
 state, in which the mind swung into an accustomed channel, 
 and could not be brought back to subject intended. 
 
 CRIMINAL CASES. 
 
 The following cases are noted for the prominence of the 
 criminal impulse. I have studied them to bring out the 
 trance condition and the character of the criminal impulse, 
 with some of the varied possibiHties of crime which may 
 spring from it. 
 
 CASE I. 
 
 I .was called to determine the condition of a man repeatedly con- 
 victed and punished for horse-stealing. He was fifty-one years old, a 
 hackman by occupation. His father was a weak-minded man, and his 
 mother died in an insane asylum. At tw§nty he entered the army, and 
 
Its Medico-Legal Relations. 29 
 
 suffered great hardship as a prisoner. He was an invalid for two 
 years after the war, from malaria, chronic diarrhoea, and rheumatism. 
 At thirty he was employed in a livery stable, and was a moderate beer 
 drinker. A few years after he was a partner in the business, and was 
 considered honest and a very correct business man. His habits were 
 regular, and he was very fond of horses and driving. About this time 
 he married, and a few months later was noticed to be using spirits to 
 excess at night. No special effects were noticed, except stupor and 
 heaviness, and sometimes extravagant conversation ; all his business 
 matters were carefully carried on as usual. One day he walked out, 
 after drinking large quantities of spirits, and unhitched a fine horse in 
 front of a strange residence, and drove about for an hour, bringing the 
 horse to his own stable ; and the next day he had no recollection of it. 
 A few weeks later he drove off another horse which he found standing 
 in the street, and put it up in his stable, without any memory of the 
 event. This was with difficulty explained to the owner, and was a 
 great mystery to the man why he should do it. The third event of this 
 kind was driving away a team of horses which had been left in a shed, 
 and after going about for an hour or more offered to sell them at his 
 stable. He was in no way different, talked and acted as usual, said he 
 had bought the team from a stranger and given his check for it, and 
 went into a detailed statement of its merits and excellencies. Except 
 a strong odor of whisky he could not be supposed to be under the influ- 
 ence of alcohol. The next day all this was a blank. When told what 
 he had said he could not believe it. Later he was arrested, and the 
 act was only settled after much trouble. A year after another similar 
 event, only more aggravated, happened, during which he sold the horse, 
 and appeared to be guilty from his actions ; but when arrested his mind 
 returned, and all was a perfect blank. Another event occurred the 
 same year, in which he went about with the owner, showing great inter- 
 est to discover the horse, when he had placed him in a stable in a 
 neighboring town. He was arrested, and after a long legal contest 
 barely escaped punishment. He was ruined financially, and from this 
 time drank more. Within a few months he was found driving a valuable 
 horse up and down before the owner's house, testing its speed, and 
 asserting it was his own. For this he served one year in prison ; the 
 defense of want of memory or knowledge of these scenes was treated 
 with contempt by the court. On another occasion he took a horse, 
 sold it, and went about with the owner for two days, trying to find it. He 
 had no memory of anything which had taken place, and was sincere 
 and anxious to help the owner get his property. When it appeared 
 that he was the guilty one he was astonished beyond measure. From 
 this time he went repeatedly to prison, having stolen horses on many 
 occasions, and always after drinking, and in a condition in which he 
 claimed to have no memory of it whatever. Sometimes he showed 
 
30 The Trance State of Inebriety. . 
 
 some degree of cunning in the concealment of horses ; at other times 
 he was bold and reckless as to the consequences of being seen. In 
 every case there was a certain purposeless character and absence of 
 motive, other than the mere pleasure of riding behind or driving a good 
 horse. I found him full of delusions of persecutions, and intensely 
 suspicious of others. His memory of events was defective, and he 
 could give no reason for stealing, having no memory of such acts. He 
 drank spirits whenever he could get it, but was never stupid or wild 
 from the effects of excess ; but would, after a day's excess, awake, 
 and have no memory of what had happened. To his friends who had 
 watched him carefully during these trance states, he was more reserved 
 and silent, or impulsive, and laughing loudly at times ; otherwise he 
 was rational, and seemed fully aware of what he was doing. I pro- 
 nounced him an inebriate, and irresponsible as to the nature and char- 
 acter of his acts; but he was found guilty and sentenced to prison, 
 where he died a few months later of phthisis. 
 
 COMMENTS. 
 
 The inebriety in this case coming from physical causes 
 was marked by a long prodroma before the trance state 
 appeared. The purposeless character of the crime, and the 
 want of the usual caution manifested by this class of thieves, 
 confirmed the statement of no recollection of it. He could 
 have no special motive to steal when he had so many horses 
 of his own, and when he had stolen he did not seem to use 
 the money he received, or regard it as a gain. He seemed 
 governed by a mere impulse to drive a good horse, never 
 stealing a poor one, and always doing it in an automatic 
 manner, which varied but little from time to time. His 
 previous good conduct and the unusual character of the 
 crime made no difference in the judgment of the court, and 
 he was sentenced over and over again. No one ever thought 
 it possible that he should not realize the real nature of his 
 acts. The following are similar cases which have come 
 under my notice: A teller in a bank, who was a secret ine- 
 briate, after a paroxysm of drinking forged a note and put 
 the money in his pocket. The next day he was amazed at 
 the presence of this money, not knowing where it came from. 
 When his guilt was discovered he had no recollection of cir- 
 cumstance, or reason for this act. He was punished, notwith- 
 
Its Medico-Legal Relations. 3 1 
 
 standing the unusual character of the act and his defense of 
 no memory of it. 
 
 A rich brewer, after a periodical paroxysm of drinlcing, 
 would alter his signatures on checks, and refuse to pay drafts. 
 He would have no recollection of these events the next 
 day, and after being convinced of their genuineness would pay 
 readily. 
 
 Another brewer in these trance states, after drinking, 
 would diminish the wages fifty per cent, of all his workmen ; 
 and if the trance continued long enough a strike would fol- 
 low. Then he would recover, and all would be reinstated 
 again — he all, the time wondering why he had done this, not 
 recollecting anything of it. This has happened a num- 
 ber of times, and is now distinguished by the sudden im- 
 pulses to cut down the wages. 
 
 A farmer of the highest respectability is now serving a 
 life sentence for manslaughter, committed (after drinking 
 spirits to excess) on a man unknown to him, and for no rea- 
 son or motive. The judge charged that his reasonable con- 
 duct up to the time of the homicide, and his appearance of 
 full knowledge of all the surroundings and the consequence 
 of his acts, was strong evidence of his sanityj and that no 
 proof of his inebriety or want of recollection of the homi- 
 cide should be considered any defense, or by any possible 
 way lessen the responsibility of his crime. 
 
 An inebriate of wealth suddenly fired his buildings, and 
 awoke when they were burned down, offering a large reward 
 for the incendiary. When it was traced to him he was 
 amazed, and reformed from this time. 
 
 All these cases were that of trance, with the impulse to 
 crime, that developed in different ways. I am inclined to 
 believe that some crimes have begun in this state, then, 
 from fear or other conditions, suddenly checked, with the 
 mind partially conscious of the nature and results of the 
 act. Undoubtedly there may be present a strong element 
 of insanity associated with this trance state in crime ; still, 
 not distinct enough to be recognized by court or jury. Epi- 
 lepsy may appear along this line, and be so mixed up with 
 
32 The Trance State of Inebriety. 
 
 both insanity and inebriety as to make recognition still more 
 difficult. The practical point to be observed is that all such 
 cases must be measured by the facts of their own personal 
 history, thoroughly studied and justly understood. 
 
 CASE II. 
 
 Was a manufacturer forty-nine years old, who had used alcohol freely 
 at meals for five years. His ancestors were inebriates and he had be- 
 gan to use spirits from some supposed debility, until he was obliged to 
 continue them every day. He was very affectionate and generous to 
 his wife and family, and never betrayed any anger or displeasure at her 
 conduct. Suddenly, after using more than usual of spirits, he became 
 very passionate and offered violence to his wife ; her tears roused him 
 from his condition, and he was greatly distressed at his conduct, which 
 was unaccountable to him. He consulted physicians and was treated 
 for months for some brain malady. Then another blank of memory, 
 in which he started the most slanderous stories about his wife staying 
 at a hotel. His conduct was consistent with his stories, and his manner 
 was in no way unusual. On recovery he was again chagrined and did 
 not believe he had said what was represented to him by others. He 
 would return from a long absence on business, and break up parlor 
 furniture in a perfectly cool way, and in two hours after have no knowl- 
 edge of what had taken place from a certain time. Sometimes he 
 would affirm that he wished to punish his wife for some negligence ; 
 she would keepkaway from him at such times, and after an outburst of 
 anger in which he would sometimes break up the furniture, all would 
 be quiet again and the trance state would disappear as suddenly as it 
 came on. The surprise and grief at what had taken place would alarm 
 him, so he would abstain for a few weeks from alcohol. One day he 
 assaulted his wife in the street, and walked into the police office asking 
 to be arrested for some crime. When he recovered he had no concep- 
 tion of any part of the event. These blanks always attended by vio- 
 lence to his f-urniture or his wife increased, and were not noticeable for 
 any other unusual insane conduct, which he fully justified at the time, 
 and always appeared cool and calculating. When friends called during 
 these periods, he would reason with great calmness, and be perfectly 
 self-possessed, saying that his head was heavy and he was not well, 
 but would be so next day. He went to Europe, and visited the hot 
 springs with no benefit. Finally he went to an insane asylum, and re- 
 lapsed there, injuring an attendant, but in a way and manner so per- 
 fectly cool and free from excitement that the superintendent thought it 
 evidence of a sane mind, and doubted all his statements, discharging 
 him as malicious. I advised him to go under the special care of a physi- 
 cian, and he is now free from these trances, and has taken no spirits 
 for many months. 
 
Its Medico-Legal Relations. 33 
 
 COMMENTS. 
 
 The general history of this case is exceedingly suggestive. 
 The inebriety was followed by a distinct trance condition, 
 with an unusual course of action, utterly at variance with 
 his previous character and habits. The suspicion and vio- 
 lence grew into a dangerous impulse. This always followed 
 after an excessive use of alcohol, and vjas not attended by 
 any symptoms except the delusion of wrong in his wife, and 
 the desire to right them by violent measures. The passion- 
 ate violence at these times was of short duration, and the 
 blanks lasted from a few hours to two or more days. His 
 appearance gave no hint of his unconscious condition, and 
 his reasons for violent acts were in a measure sane. He 
 would have committed a fatal assault had a favorable oppor- 
 tunity occurred, and only by the caution of his wife and 
 friends was this avoided. Only a minute study of all the 
 circumstances and history of the case would have indicated 
 the mental instability which was present, and yet he would 
 have received the full measure of punishment in the hands 
 of any court or jury without such study. This case illustrates 
 what in all probability takes place every day in this country 
 especially in the sudden purposeless crime committed by in- 
 ebriates. These cases fill the newspapers, and astonish both 
 courts and juries, who are puzzled to find a motive for the 
 crime, or to attribute it to insanity as described by the text 
 books, or defined by experts. Sometimes these cases, 
 (where the suspicion of irresponsibility is present) are de- 
 fended on some strained theory of insanity, whose obscurity 
 confuses the courts, and is criticised and ridiculed by non- 
 experts and ignorant lawyers. These cases are not studied 
 intelligently, and the true theory of their condition is un- 
 known. Two cases will illustrate the every day's experience 
 of courts all over the country. Some man, an inebriate, of 
 low moral nature, (which is al.ways an evidence of defective 
 brain organization,) comes home, after excess from alcohol, 
 not intoxicated, and in an altercation kills his wife, or some 
 one who may be drawn into the circle accidentally. He is 
 arrested and has no memory of the event, no study is made 
 S 
 
34 The Trance State of Inebriety. 
 
 of his case, only a few facts of the crime come out promi- 
 nent. If he has money the defense is technically unnatural, 
 and of course fails ; he is punished. The second case is 
 one where previous good character, except excess in the use 
 of spirits, is prominent. He commits a homicide or some 
 strange crime under circumstances that are inadequate to 
 explain or account for it ; denies all recollection of it after- 
 ward, and the defence must resort to some specious reason- 
 ing and theories, or work on the sympathies of the jury. 
 The judge is indignant at what seems to him efforts to de- 
 feat justice, and charges strongly against the prisoner ; con- 
 viction follows, his counsel are. sure of some mental defect 
 and yet they can not make it clear to either court or jury. 
 If the crime is of petty character the punishment precipi- 
 tates him into incurable conditions, and the object of legal 
 measures to prevent and check crime is defeated. The 
 theological notions of the nature and character of inebriety, 
 upon which legal decisions are based, are active causes in 
 developing incurables of this class. One third of the busi- 
 ness of the courts in all our large cities consists of adminis- 
 tering what is termed justice to inebriates, but what is liter- 
 ally means which make their recovery more and more im- 
 possible. Thus crime following inebriety and inebriety it- 
 self are punished, with no effort to study the causes or reach 
 down to understand the physical conditions present. The 
 result is that both church and state, in their ignorant measures 
 to check inebriety, are not only increasing its growth, but 
 preparing the soil for its more rapid development. 
 
 Hundreds of cases may be selected from the records of 
 courts and prisons equally as, prominent as these I have pre- 
 sented. All conspicuous for crime committed after and 
 during excess in the use of alcohol ; all denying any recol- 
 lection of the event ; and all the circumstances of want of 
 motive and purpose confirming their statements. Yet in all 
 these cases there has been no medical study to understand 
 the mental condition which would develop into such acts. 
 Assumptions of perfect sanity and capacity to reason clearly 
 have governed the decisions in these cases. As long as the 
 
Its Medico-Legal Relations. 3 5 
 
 inebriate was not stupid or wildly delirious he is supposed to 
 be fully cognizant of all his acts ; it is considered a vice and 
 punishable up to a certain line, and beyond that, a doubt 
 might be entertained. This is the same spirit of supersti- 
 tion which punished witches and believed in demoniacal pos- 
 sessions, ignoring all physical causes, and is clearly outlined 
 in the late charge of an eminent judge as follows : 
 
 Intoxication from excess of alcohol is no defense for crime 
 and can not in any way lessen the measure of responsibility. 
 
 If inebriety is only a voluntary spiritual state, this is good 
 law, probably, but if it is an involuntary physical condition, 
 a reform is demanded in both theory and practice. 
 
 C O N C UU S I O N . 
 
 I pause at this point to arrange some of the conclusions 
 which stand out prominently from the facts stated. The 
 great obstacle apparent in the medico-legal recognition of 
 this trance state is the confusion of opinion as to the dis- 
 ease of inebriety. It is a remarkable fact that, notwithstand- 
 ing the great advances madfe in the field of mental sciences, 
 and the increasing prominence of inebriety in its effects in 
 every community, the same opinions prevail to-day which 
 were taught centuries ago. Insanity has emerged from the 
 superstitions of religious teachers, but inebriety is still invested 
 with murky theories of vice, sin, and punishment. All 
 studies of its nature and causation have been made from the 
 moral side alone. As a natural result the application of 
 means and measures for the care and control of inebriety, 
 based on such views, have utterly failed. Practically no other 
 result can be expected until the entire subject is studied 
 from a scientific standpoint, above the dogmas of theologians- 
 and reformed inebriates. The world moves, and no measures 
 for the benefit of society or the elevation of the race will 
 succeed, unless founded on the truths of nature, and along 
 the line of its eternal laws. The inebriate in this trance 
 state is a mere automaton in motion, either moving along 
 certain fixed lines of conduct, or acting in obedience to un- 
 known forces, which may change or vary any moment. Some 
 
36 The Trance State of Inebriety. 
 
 governing center has suspended, and all consciousness of 
 time and the relation of events has stopped. Changing 
 thoughts and impulses, the suggestion of a disturbed organ, 
 or the impression of a thought or desire coming from the 
 past, may suddenly concentrate into action, irrespective of 
 consequences. Both subjective and objective states, influ- 
 enced by conditions of health ^nd brain power, may develop 
 into deeds that are practically unknown and unrecorded by 
 the higher brain centers. 
 
 The phenomena of this state divides into two forms. One, 
 probably the most common, in which the mind moves along 
 certain familiar lines of action, and follows some purpose 
 which has been previously fixed, all of which appears natural 
 and reasonable ; as, for instance, the conductor pursuing his 
 every-day work, or the banker who attends to all his usual 
 business, unconscious of what takes place. Second, a new 
 line of thought and action appears, unusual and foreign to 
 his every-day life. Often impulsive, inconsistent, and yet 
 seemingly one that he is fully conscious of, and if questioned 
 may give reasons that seem to justify his conduct. As, for 
 instance, the physician who attended the prayer-meeting, or 
 the lawyer who wrote a will, in every trance state, etc. In both 
 of these forms sudden changes from one state to another 
 may follow. Emotional disturbances may precede this state, 
 or may appear coincidently with it. The senses are blunted 
 or enfeebled, or they may be intensified in certain directions. ' 
 Except this, perhaps, there is little evidence of unconscious- 
 ness, and if the impulse is criminal it may appear without 
 premonition, like a flash of light, and disappear equally sud- 
 den. Legally the 'first question is the inebriety of the 
 patient. On this point the inference will be clear if the per- 
 son has used alcohol at intervals or continuously to intoxica- 
 tion. The degree of this excess need not be stupor or 
 delirium, but whenever it is marked by changes of intellect, 
 manner, temper, disposition, habits, and character, inebriety 
 is present. Next, the presence of the trance state, which 
 may be shown from the statement of the patient, and all the 
 circumstances of this state, with a history of the case. 
 
Its Medico-Legal Relations. 37 
 
 First, the statement of the patient that he did not remember 
 the act may be made to shield him from its legal conse- 
 quences, or save his reputation. The general principle here 
 is that the use of alcohol invariably impairs the memory, and 
 that confusion of rflind and disturbed will-power is a patho- 
 logical result from the same cause; hence there is always a 
 physiological possibility of the correctness of the statement. 
 
 Second., the general character of his conduct during this 
 state will bear out his claim of trance. His general abstract- 
 ness of manner, or his strange, inconsistent actions, unusual 
 in motive and object, united with an apparent recognition 
 of the surroundings, may be taken as evidence. The farmer 
 who went about visiting was strangely inconsistent in con- 
 duct. The engineer was very abstract and reserved in his 
 manners, etc. 
 
 Third, the range of the mind, and the general vigor and 
 health displayed, will give some indications of the conscious- 
 ness of his acts in this state. The sudden change from 
 frankness to reserve, or from confidence to suspicion, or the 
 presence of emotional excitement in little things, melancholy 
 or hilarity, the rapid change of the mind from one extreme 
 to another, are also evidences. The physician, from a skeptic, 
 became a pious man in this state ; the manufacturer be- 
 came violent to his wife, whom he loved very dearly, etc., etc. 
 
 Fourth, if crime is committed, or any conduct which perils 
 the good order of the community, a careful study will bring 
 out the evidence of the mental state present. 
 
 As in the case of the hackman, a full history of his stealing 
 was clearly that of a man not realizing the consequences of 
 his acts. Or in the lawyer 'who wrote his will, and had sui- 
 cidal impressions, the entire history of these acts pointed to 
 the trance state. Lastly, a general history, which will in- 
 clude inheritance, education, mental capacity, and health, 
 will bring out many factors to determine the case. The 
 patient's acts after coming out of the trance state will also 
 determine its presence. He will manifest an indifference 
 and a change of conduct from that noted in this state. An 
 illustrative case recently under my care was that of a dentist 
 
38 The Trance State of Inebriety. 
 
 who in this state was very anxious to make money, although 
 wealthy, but when this condition passed away all his money 
 schemes were forgotten. In another case a man murdered 
 his wife in a trance state, and went about for hours, not real- 
 izing what he had done, or making arfy effort to escape. 
 From these and other studies the trance state may be rea- 
 sonably proven to any court or jury. Then comes the ques- 
 tion of responsibility. Clinical facts within the observation 
 of any one will indicate unmistakably that in all cases of 
 inebriety there is a defective brain power and general per- 
 versions of healthy activity. Also, when inebriety is pres- 
 ent, the door is open for many and complex nervous dis- 
 orders, which often complicate and make the inebriety more 
 uncertain and doubtful. Hence when inebriety is proven to 
 exist, the responsibility of the patient for his acts is lessened ; 
 he is not of sound mind. When the trance state is deter- 
 mined the actual responsibility or cognizance of right and 
 wrong is suspended, and the patient is a mental waif, with- 
 out compass or chart. No evidence of premeditation or 
 apparent judgment in his actions can alter this fact. Any 
 course of action marked by this may come from some impres- 
 sion laid up in the past, which, when conscious reason is 
 withdrawn, takes on form and semblance. The real condition 
 of the mind in this state is more or less concealed. Nothing 
 less than a thorough medical study of every case, by com- 
 petent men, can determine the measure of responsibility. 
 Such a study must be made from a physical point, based on 
 the facts, for nothing can be a greater injustice to both the 
 patient and the community than to condemn and punish 
 without a knowledge of all the conditions and circumstances. 
 The object of the law to protect the rights and interests of 
 individuals is defeated where its enforcement precipitates 
 the victims into more hopeless conditions. Inebriety in any 
 of its forms may be no excuse for crime, in law, but it can 
 never,' in any case, be an excuse for punishment which 
 destroys the victim. The time has come to lay aside the 
 legal barbarisms, relating to inebriety, of the past, founded 
 on superstition and ignorance. The border lines of sanity 
 
Its Medico-Legal Relations. 39 
 
 and responsibility in inebriety, as laid down by courts, are 
 unsupported by facts and the teachings of science. 
 
 Inebriety in all cases must be regarded as a disease, and 
 the patient forced to use the means for recovery. Like the 
 victim of an infectious disease his personal responsibility is 
 increased, and the community with him are bound to make 
 the treatment a necessity. 
 
 The following propositions sum up many of the facts 
 mentioned : 
 
 1. Inebriety must be recognized as a condition of legal 
 irresponsibility to a certain extent, depending on the char- 
 acter and circumstances of the case, and the general mental 
 integrity displayed. 
 
 2. All unusual acts or crime committed by inebriates, 
 either in a state of partial coma or alleged amnesia, which 
 come under legal recognition, should receive thorough 
 study by competent physicians before the legal responsibility 
 can be determined. 
 
 3. When the trance state is established beyond doubt, he 
 is both legally and practically irresponsible for his acts dur- 
 ing this period. And each case should be measured by the 
 facts of its individual history. 
 
 4. Inelriety is a disease requiring physical means in the 
 treatment. Society demands of the patient that he use dil- 
 igence to recover, and so far as he may neglect this, both 
 himself and community are responsible. 
 
 5. It is the duty of the State to provide asylums and en- 
 courage private enterprise to furnish the means and appli- 
 ances for restoration. 
 
 6. Lastly, standing on this border-land, and looking back 
 at the monstrous injustice and legal crime that is daily com- 
 mitted in the punishment of inebriates, who are practically 
 insane, I am convinced that the time has come for a revolu- 
 tion of sentiment and practice, in which both the inebriate 
 and the community must be held responsible, not alone for 
 his acts, or the consequences of them, but the causes and 
 conditions which have developed in this way ; then the victim 
 will be forced to avail himself of every means for prevention, 
 restoration, and recovery. 
 
FOR THE SPECIAL TREATMENT 0F_ 
 
 IlSlEBRIATES AND OPIUM CASES. 
 
 This institution provides medical care, witli thorough 
 seclusion from all exciting causes in the best surroundings 
 and conditions of living. Some of the general principles of 
 treatment may be stated as foljows : 
 
 1. The patient is recognized as a sick man requiring 
 absolute removal from all temptation, with perfect rest, 
 change of thought, and building up into healthy activity all 
 the functions of 'i^e- 
 
 2. For this purpose every means and appliance ate used 
 which science and skill have indicated to permanently restore 
 the weakened nervous system and the general organism to 
 health again. . - . - ^ 
 
 3. To this is combined the atmosphere and surroundings 
 of a true Christian Home, in its widest and best sense— full 
 of sympathy, and charity; rousing up new thoughts, new 
 motives, and new purposes of life. ,;^' 
 
 With special legal powers of control, and delightfully 
 situated in the suburbs of the city, and with all the comforts 
 and luxuries of an elegant home, the possibility of permanent 
 recovery is very promising in nearly all cases. 
 
 The number of patients. is limited, and each one comes 
 under the direct personal care and attention of the physician. 
 
 All inquries should be addressed 
 
 T. D. CROTHERS, ^}A.D., 
 
 Supcriutcndent, 
 
 FRED. S. HILL, Hartford, Conn. 
 
 Business Manager. ' '• 
 
HV 5053 C95 
 
 Author 
 
 Vol. 
 
 Crothers, T.D. 
 
 Title 
 
 Copy 
 
 The Trance State in Inebriety 
 
 Date 
 
 Borrower's Name 
 
/^■nan 
 
 <_^