|
Addressing an audience of medical students in 1810, the Philadelphia
physician Benjamin Rush1 recounted a recent call he had made,
in consultation with a Dr. Physick,2 to the residence of
"a lady in this city, equally admired for her amiable virtues and
elegant accomplishments." As they were seated in the parlor, she
related her medical complaint: "I am blessed with one of the best
of husbands, and a family of promising children, whom I love most
affectionately," she began, "and yet, in the paroxysms of my disease,
and with the perfect exercise of my reason, I wish for an ax, that
I might split open their heads, and lay them all dead at my feet."
Upon hearing this terrible confession, Rush was convinced that he
was faced with a case of "moral derangement." By this, he meant
"that state of mind in which the passions act involuntarily through
the instrumentality of the will," a condition he linked to an underlying
physical disorder. Since this form of derangement was most clearly
manifest in the commission of crime, Rush explained, it was invariably
mistaken for ordinary depravity in courts of law, with tragic results.
In fact, he reckoned that if his patient were to succumb to her
morbid impulses, her fate would be sealed: all her virtues and accomplishments
would prove insufficient to save her "from expiating her disease
by an ignominious death." Rush further observed that there was cause
for concern on the civil side of the docket as well, for it appeared
that the morally deranged were left free to make wholly unnatural
dispositions of their estates, to the great injury of their unoffending
families. In light of this state of affairs, he charged his students
with broader "objects and duties" than simply caring for their patients.
It was, he insisted, a physician's civic obligation to extend the
benefits of his science "to the protection of property and life"
through the cultivation of a distinctly "medical jurisprudence."3
Following his own prescription,
Rush published Medical Inquiries and Observations, upon the
Diseases of the Mind, constituting the first such study produced
by an American physician. Directed to the general public as well
as medical students, the treatise provided a systematic analysis
of the "cause, forms, and symptoms" of mental disorders, by means
of which the author sought "to rescue persons affected with them
from the arm of the law, and to render them subjects of the kind
and lenient hand of medicine." In thus defining the province
of medical jurisprudence, Rush was quite clearly attempting to
advance the interests of his profession, though there is no reason
to doubt that he proceeded in earnest, with the ultimate aim of
serving "the cause of humanity."4 His Medical Inquiries
enjoyed wide circulation in the early republic, going through
five editions between 1812 and 1835, and inspiring others—lawyers
as well as doctors—to build upon the foundations of this
pioneering work.5 This article examines the accumulating
mass of medico-legal literature, drawing particular attention
to a profusion of treatises and tracts at mid-century, which addressed
the central problem presented by Rush in his treatise—the
attribution of responsibility. Historians who have approached
this body of discourse have tended to portray medical and legal
participants as engaged in an ill-fated venture, destined to fail
on account of their fundamentally incompatible ways of conceptualizing
the human subject. As the conventional story is told, nineteenth-century
lawyers remained beholden to traditional notions of "free will"
and "individual responsibility," while their colleagues in medicine
subscribed to a "deterministic discourse" which explained human
behavior in physiological terms that seemingly left little space
for moral agency.6 In casting doctors and lawyers in these
terms, historians have captured important strains and tensions
in the inter-professional dialogue sustained over the course of
the nineteenth century, but their approach has nonetheless worked
to obscure the common philosophical and religious commitments
that the two professions shared. In addition, it has left us with
the false impression that American jurists were only superficially
influenced by medical writers—that the jurists tended, on
the whole, to discount or dismiss professional medical advice.
However, a closer reading of the major works produced by doctors
and lawyers in the heyday of medical jurisprudence—from
1800 to 1860—tells a different story, one of far greater
mutual influence. More particularly, I will argue that the legal
construction of responsible agency in the nineteenth century grew
directly out of the dialogue between doctors and lawyers, and
that it was largely in response to medical critics that lawyers
were forced to clarify what they meant when they determined that
any given individual was liable for his acts.
The story this article tells begins
in the post-revolutionary era and situates lawyers and doctors
within a common intellectual framework. Part I examines the Common
Sense philosophy of the Scottish Enlightenment, in which most
college-educated Americans of the era were schooled. Writers within
this liberal Protestant tradition primarily relied upon introspection
as they proceeded to elaborate universal "laws of the mind" that
dictated how human beings ought to act. By this method, they were
able to scientifically confirm that God benevolently had endowed
all of his creatures with a set of cognitive, volitional, and
moral faculties that enabled them to understand and conform to
the dictates of divine and human laws. These indubitable "facts
of consciousness," in turn, constituted the grounds of human responsibility,
according to the philosophers. It was with this basic model of
the "moral and accountable agent" in mind that many antebellum
lawyers and doctors went about their professional work. As the
Scottish philosophy was transposed into nineteenth-century American
jurisprudence, we see in Part II that it generated certain perplexities
about legal responsibility. For the Common Sense way of thinking
about human agency and accountability encouraged the identification
of freedom with conventional rationality and morality, pointing
jurists toward the paradoxical conclusion that irrational and
immoral actors were less than entirely free and (therefore) accountable
for their actions—that the only persons who could be held
fully responsible were those who were constitutionally incapable
of violating the laws of God and man.
Part III examines the various
attempts of medical men to address this attributive dilemma. The
analysis focuses on a group of American physicians who specialized
in the diagnosis and treatment of "mental alienation." These self-styled
"alienists" served as superintendents of the growing number of
insane asylums and hospitals that dotted the early republican
American landscape.7 Working from Enlightenment premises,
they tended to conceive of mental disease in far broader terms
than doctors in previous centuries. Deviant behavior that had
traditionally been attributed to the innate and universal depravity
of humankind would be recast by American alienists as the product
of some sort of "derangement" of one or more of the mind's mental
faculties. They further observed that the conditions of life in
the young republic were especially conducive to the incidence
of mental disorder, suggesting there was a direct correlation
between the freedoms enjoyed by their countrymen and the maladies
they suffered as they over-indulged in them. Aiming to redress
this public health problem (and enhance their own professional
stature), the alienists began to publicize their findings in works
of medical jurisprudence, which were unabashedly intended to advertise
the curative effects of their scientific approach, and also designed
to promote legal reform in two main directions. First, they called
for the modernization of the traditional legal category of non
compos mentis, urging judges to recognize the existence of
a host of partial and non-intellectual disorders—classed
under the heading of "moral insanity." And second, they exposed
what they regarded as lamentable inconsistencies between the civil
and criminal rules of responsibility, regarding it to be especially
problematic that an individual might be declared a lunatic and
deprived of his property in one proceeding, only to be found criminally
liable and punished in another.
Part IV considers the legal response
to this burgeoning literature on medical jurisprudence. It concentrates
on those American jurists who worked most strenuously to incorporate
the alienists' clinical findings into the common law of insanity.
As might be expected, there is abundant evidence of frustration
and ambivalence on the part of legal writers as they undertook
this task. But it would be a mistake to conclude that they were
primarily engaged in fending off the incursions of medical science.
The concept of a moral derangement might well have seemed
too deterministic to be assimilated into their legal science,
but American jurists found other ways to make allowances for those
who had lost command of their will. Indeed, by the last quarter
of the nineteenth century, these jurists had secured a place for
a quite robust notion of "insane delusion" among the bases for
excuse from criminal and civil liability, and some also put forward
schemes of graduated responsibility, which took greater account
of the "myriad phases of mental unsoundness." The architects of
these schemes aimed to calibrate punishment to more accurately
reflect a given defendant's "distinct degree of moral culpability"
for his unlawful acts, presuming all the while that his mental
debility was in some measure attributable to a "prior vicious
indulgence" on his own part.8 In thus reformulating the
grounds of legal responsibility, American jurists communicated
a more chastened perspective on the moral capacities of humankind,
but they still seemed to retain a measure of hope that these capacities
might be nurtured and even recovered through the discipline of
the law.
Thus we will find that a fully
articulated legal model of the accountable agent was in place
by 1870—one that premised liability on the fact of self-neglect,
the failure to develop one's own God-given mental faculties. To
be sure, there were obvious problems with this particular way
of thinking about consciousness and culpability, for its expositors
never quite explained why they did not allocate at least some
of the blame to parents, teachers, society, or the Divine Parent.
But still the model would prove extraordinarily resilient as it
was deployed in the rough and tumble world of nineteenth-century
litigation.9 And, for better or worse, it is arguably the
way we continue to think about the basis of legal—if not
human—responsibility.
I. The Metaphysics of Moral Government
Reflecting upon the state of the union in an 1812 letter to John
Adams, a rueful Benjamin Rush was reminded of a sermon he had
heard as a child, entitled "The Madness of Mankind." The sermon
was delivered in 1754 by Rush's uncle and preceptor, the revivalist
minister Samuel Finley, who compared "this World to a great Bedlam,
filled with Persons strangely and variously distracted." The minister
associated these afflictions with the fallen condition of human
nature and implied that a cure could only come through "earnest
Pursuit of a saving Wisdom."10 Although these words clearly
left a lasting impression upon Rush, he ultimately elected not
to follow his uncle into the ministry, as he felt called "to save
bodies rather than souls." Medical study took the aspiring physician
to Edinburgh, London, and Paris, where he was broadly exposed
to liberal Enlightenment currents of thought and introduced to
many of the leading republican figures of the day. Rush returned
to his native Philadelphia an ardent revolutionary, convinced
that America was "destined by heaven to exhibit to the world the
perfection which the mind of man is capable of receiving from
the combined operation of liberty, learning, and gospel upon it."
To hasten this process along, he synthesized principles of physiology,
metaphysics, and Christianity, which were intended to guide the
administration of schools, prisons, and hospitals in the new polity,
with the broader aim of converting his fellow citizens into "republican
machines."11 The physician's confidence in his scientific
method would, however, be severely tested in the decades surrounding
1800, as he perceived the dangerous spread among his countrymen
of a form of insanity he called "anarchia," and his own
son fell victim to a baffling mental illness from which he would
never recover. It was perhaps no wonder that Rush circled back
to his uncle's sermon late in life, even as he put the finishing
touches on his seminal treatise concerning the diseases of the
mind. However bold the claims it made for medical science, still
the volume closed with the pious proviso that no doctor could
hope to succeed "without the aid of that supernatural and mysterious
remedy which it hath pleased God to unite with them in his moral
government of his creatures": his forgiveness of their sins.12
The peculiar melding of evangelical
Calvinism, republican politics, and Enlightenment medicine forged
by Rush marks him as a transitional figure, one who vividly illustrates
the sorts of challenges faced by revolutionary Americans as they
struggled to reconcile the new scientific findings about man's
moral nature with the orthodox doctrines of innate depravity and
divine determinism that still enjoyed a certain predominance in
the colonies.13 To the end of his life, the Philadelphia
physician maintained his faith in these religious tenets and steadfastly
insisted that the true principles of metaphysics and physiology
could never conflict with Scripture. And yet even Rush was moved
to modify his Calvinism in one critical respect: he ultimately
adopted the doctrine of universal salvation, as he firmly concluded
it could be no part of God's purpose to call some men into existence
only "to endure the pains of eternal misery."14 By the
time he was laid to rest in 1813, the intellectual forces of liberal
humanism appeared to be penetrating ever deeper into Calvinist
strongholds, prompting more thoroughgoing reconsideration of the
metaphysics of moral government—not only on the part of
ministers and theologians, but politicians, lawyers, physicians,
and other "men of affairs" as well. Given the range of participants
in this early republican discourse, it is rather striking to find
that religious and secular leaders across denominational and occupational
lines tended to converge upon the conceptions of human nature
and divide judgment elaborated by the Common Sense philosophers
of the Scottish Enlightenment. With the Scots, they figured God
as a benevolent father who had endowed his creatures with the
"moral ability" to live in accordance with his will—one
who would visit the pains of eternal misery only upon those who
elected to squander this divine gift.
Calvinism and the Specter of "Necessity"
As the "New Learning" of the Enlightenment philosophers increasingly
circulated over the course of the eighteenth century, Americans
were presented with a vision of the universe as governed by fixed,
impersonal laws of cause and effect—one in which "occult"
or "accidental" powers had little, if any, role to play. To be
sure, God's absolute sovereignty was formally preserved in the
philosophers' schemes: "In him all things are contained and moved."15
But divine superintendence of the universe was now said to be
accomplished largely by way of secondary causes, which were operative
in human as well as physical nature, and comprehensible
through unassisted reason. This was, indeed, the guiding assumption
behind most of the published studies in the newly invigorated
field of philosophical psychology, including Ren˙ Descartes's
Les Passions de l'˙me (1649), Thomas Hobbes's Leviathan
(1651), John Locke's Essay Concerning Human Understanding (1690),
George Berkeley's Treatise Concerning the Principles of Human
Knowledge (1710), Francis Hutcheson's Essay on the Nature
and Conduct of the Passions (1728), David Hume's Treatise
of Human Nature (1739–40), and Adam Smith's Theory
of Moral Sentiments (1759), all of which gained notoriety
in the colonies, sometimes mainly by way of their detractors.16
Although these writers viewed the subject from a variety of perspectives,
they commonly assumed that knowledge about "human nature" could
be obtained through use of the same experiential and critical
method that was deployed to understand the natural world. Most
went on to suggest that such an inquiry could also yield prescriptive
rules of conduct—that the laws of morality by which God
expected men to govern themselves were discoverable through self-analysis
and without any need to consult traditional religious authorities.17
At the core of this scientific
discourse about human nature was a certain ambiguity about the
meaning of the term "nature." In some instances, it was used to
denote a "human essence, understood by and in relation to the
divine," but in others it was meant to imply that human beings
were, in a sense, continuous with—or even dependent upon—the
natural world. The latter meaning would become the more common
one in the eighteenth century, marking the gradual secularization
of theories about the human condition. That is to say, there was
a tendency among Enlightenment writers to recast "an essential
Christian nature, originally represented in Adam and Eve," in
terms that owed more to the natural sciences, conveying a sense
that individual identity was most immediately shaped by history
and experience, with divine influence figuring only in the more
remote background. And yet the writers differed widely among themselves
as to the "relative contribution of physical and moral causes
in man's constitution," and in their estimates of the capacity
for knowledge and virtue inhering in humankind.18 At one
end of the spectrum, there was the famously pessimistic Hobbes,
who portrayed humankind as hopelessly corrupt and chiefly animated
by an egoistic "desire of ease, and sensual delight," while at
the other end one finds the far more flattering renderings of
the "sentimentalist" British philosophers, who found a set of
innate "affections" within the human mind, including a "moral
sense," which naturally—and, on some accounts, "irresistibly"—directed
men toward other-regarding, righteous conduct. There was also,
situated between these two perspectives, a neutral position momentously
staked out by Locke, who seemed to deny the existence of an innate
moral character as well as innate ideas, observing: "Of all men
we are to meet with, nine parts out of ten are what they are,
good or evil, useful or not, by their education."19
Taken together, this body of literature
introduced colonial readers to unsettling new strains of materialism,
idealism, and skepticism, many of which were construed as potential
threats to the Calvinist orthodoxy, as well as the social order
more broadly. Something of a pamphlet war ensued as divines sounded
alarms about the "atheistical" implications of "Mr. Hobbes's necessity"
and the hazards of Hume's metaphysics, which seemed to reduce
the self to a "bundle of perceptions." Still other tracts took
issue with the naturalistic mental models of such writers as Locke
and Hutcheson, protesting that they effectively denied original
sin and vastly overestimated the moral capacities of unregenerate
man.20 The stridency of the divines' critiques indicated
the extent to which they were truly placed on the defensive by
the secular moralists; it was, more and more, the divines who
felt pressed to answer for their beliefs, to show that the "blessed
necessity" of Calvinism left plenty of room for human responsibility
and did not render God the author of sin.21 The most comprehensive
and sophisticated such defense was provided by the theologian
Jonathan Edwards in his imposing treatise on the Freedom of
the Will (1754). Appealing to "common sense" as well as scriptural
authority, Edwards sought to convince his audience that a self-determined
will was nothing more than a "confusion of mind," and that a deterministic
metaphysics was not incompatible with the assignment of praise
or blame. "Let the person come by his volition how he will," Edwards
declared, "yet, if he is able, and there is nothing in the way
to hinder his pursuing and executing his will, the man is fully
and perfectly free, according to the primary and common notion
of freedom." Though he labored under a "moral necessity" to act
in accordance with his inclination or disposition, this did not
render him any less susceptible to moral judgment. To the contrary,
Edwards submitted that it was the strength of an individual's
propensity toward good or evil that determined the degree to which
he was to be "esteemed or abhorred," emphasizing as he did that
no human being could be truly virtuous without the saving grace
of God.22
This rendering of divine government
would appear increasingly implausible to succeeding generations
of readers, for such a vision of "the parent of the universe"
hardly comported with "every man's natural sense." In fact, introspection
seemed to yield conclusions diametrically opposed to those announced
in Freedom of the Will—even within the ranks of the
orthodox. "Let a man look into his own breast," averred Calvinist
minister James Dana in1770, "and he cannot but perceive inward
freedom," adding that "liberty in the mind implies self-determination."23
This declaration of independence may be read as a sign of the
times, marking the extent to which the sovereignty of God was
subtly diminished as Americans expanded the bounds of man's "moral
liberty" on the eve of their Revolution. Indeed, as evangelicals
and liberals made the passage from colony to nation, they would
gradually forge a new consensus about the constitution of the
human mind and moral government—one grounded in the Common
Sense realism of the Scottish Enlightenment.
The Consciousness of Freedom
In a society that was energetically casting aside many of the
traditional props upon which virtue and order rested, even the
staunchest Calvinists would ultimately come to see the virtue
of Common Sense realism, as articulated by Scottish Enlightenment
philosophers.24 Bracketing all sorts of ultimate questions,
the Scots focused on the "theatre of life," assuring their audiences
all the while that there was a benevolent Director behind the
scenes.25 Their philosophy spread rapidly from the 1770s,
winning American adherents across not only occupational, political,
and regional lines, but denominational ones as well. In accounting
for its widespread appeal, historians have shown that Common Sense
was especially well suited to meet the practical challenges Americans
confronted in the half century after independence, as they worked
out the concrete implications of their revolutionary ideals. Faced
with the task of stabilizing the new republic, post-revolutionary
elites recognized the need for "moral and political guidelines
that were available equally and reliably to all."26 The
Scottish philosophy delivered on this score, for it proved to
be "immensely useful as an intellectually respectable way for
political leaders to reestablish virtue and for religious leaders
to defend Christian truth on the basis of a science unencumbered
by tradition."27 But what truly ensured the success of
the philosophy was its flexibility: it could be (and was) selectively
appropriated to a variety of ends not entirely compatible with
one another.28 So it might be said that Common Sense in
the American context was not so much a theoretical system as an
"attitude" or "mood," providing "broader habits of mind or reassuring
conventions of thought."29
The Scottish philosophy was disseminated
in America primarily through the works of Thomas Reid and his
popularizers, Dugald Stewart and James Beattie.30 They
defined their system of thought against the "dogmatic metaphysics
and arrant theorizing" of the day, promising to illuminate the
passages of human thought that had been lamentably darkened by
Locke, Berkeley, and Hume. To a significant degree, the Common
Sense philosophy can be read as an effort to overcome the problems
of skepticism and determinism that had proved so vexing to eighteenth-century
theologians and secular moralists. The Common Sense philosophers
proceeded on the basis of certain "first principles" derived from
the "original constitution of the human mind itself" and distinguished
by their self-evidence, universality, and unavoidability. These
were the sorts of propositions that "we are under a necessity
to take for granted in the common concerns of life, without being
able to give a reason for them." Among the most important, according
to Reid, were the principles that our mental faculties are not
"fallacious" and that "we have some degree of power over our actions,
and the determinations of our will." The truth of such propositions
was more or less established by the fact that "no man ever pretended
to prove [them] . . . yet no man in his wits calls [them]
into question." In fact, Reid implied that the denial of common
sense principles could only result from "a disorder in the constitution
. . . which we call lunacy"—a diagnosis
he freely extended to his philosophical opponents, as he routinely
used ridicule rather than argument to answer them. So he made
light of their anxious speculations about the limits of human
knowledge and liberty in remarking that he had "never heard that
any skeptic [had] run his head against a post . . .
because he didn't believe his eyes," and in further observing
that free will's detractors "find themselves under a necessity
of being governed by it in their practice."31
The Common Sense philosophers
thus sought to replace what they saw as the patent absurdities
of the "speculative" philosophers with an intuitive realism. Proceeding
largely by way of introspection and empirical observation, they
confirmed the broad outlines of the traditional faculty psychology
that had long informed the writing of Protestant theologians.
Through such methods, the Scots purported to be able to demonstrate
that all human beings were endowed by God with a set of innate
faculties, which the philosophers conventionally divided into
"intellectual" and "active" powers of the mind, even as they acknowledged
complex interconnections between the two. The intellectual powers
included those of judgment, perception, reflection, attention,
imagination, and memory, while the active powers typically denoted
the will as well as the sensibilities, passions, affections, and
appetites. The "moral sense" or "conscience" often straddled these
two categories, for it was described as a faculty enabling its
possessor to accurately perceive the moral law and make reasoned
judgments with respect to it, but such judgments were invariably
accompanied by feelings of approbation or disapprobation. As they
delineated these various powers, the Common Sense philosophers
tended to arrange them in hierarchical order, placing the "rational"
faculties of intellect, will, and "moral sense" over and above
the "animal" emotions, desires, and appetites, as well as the
"mechanical" habits and instincts.32 This model was meant
to be descriptive and prescriptive, establishing that it was both
possible and desirable for reason to rule "the commonwealth of
the mind."33
In these schemes, the will was
typically figured as a relatively autonomous faculty, operating
independently of the other powers of mind. Although the intellectual,
moral, and emotional faculties might provide "motives" or "incitements"
to action, they did not determine the direction of the will. Casting
aside the "vain theories" of volition espoused by Hobbes, Edwards,
and other "defenders of necessity," Reid insisted that it was
simply a fact of consciousness that "we may desire what we do
not will, and will what we do not desire; nay what we have a great
aversion to." Indeed, introspection provided abundant proof that
these other thinkers had grossly underestimated the moral ability
of humankind. All it took was a look inward, Reid implied, to
see that each individual had the capacity not only to know the
difference between good and evil, but also to choose the former
over the latter.34
This "power over the determinations
of the will" was, for the Common Sense philosophers, the essence
of moral agency and the basis of individual responsibility. They
described "moral liberty" as a "gift from God" exclusively extended
to human beings, who were, in turn, bound to make "right use"
of this divine offering. The individual who did so was worthy
of praise while he who acted "contrary to what he knows or suspects
to be his duty and his wisdom" was deserving of blame. From the
perspective of Common Sense, a person "necessarily determined"
to do well or ill was not, in fact, a moral agent. The man who
was necessarily good "would surely be innocent and inculpable,"
Reid allowed, but "he would not be entitled to the esteem and
moral approbation of those who knew and believed this necessity."
By the same token, one who was ill "because he could not be otherwise"
might well inspire "pity, but not disapprobation." In Reid's estimation,
"[t]he blame is not in him, but in his constitution. If he be
charged by his Maker with doing wrong, may he not expostulate
with him, and say—Why has thou made me thus? . . .
[F]or thou knowest that what I am charged with is thy work, and
not mine."35
As he imagined this interchange
between God and man, Reid marked the extent of the Scots' departure
from the orthodox Calvinist worldview. Their Common Sense philosophy
was built upon the presumption that God observed human norms of
justice in his creation and superintendence of the universe. Accordingly,
they found it difficult to sustain the traditional doctrines of
divine determinism and innate depravity, for these doctrines seemed
to place God in the role of a perverse puppeteer, whose human
creations "do not move, but are moved by an impulse secretly conveyed,
which they cannot resist." To promulgate laws to beings that "have
not the power to obey, or to require a service beyond their power,
would be tyranny and injustice in the highest degree." In the
light of Reason, the Scots reconsidered the relation between divine
and human agency, coming to believe that man was "not merely a
tool in the hand of the master, but a servant, in the proper sense,
who has a certain trust, and is accountable for the discharge
of it. . . . And he must finally render an account of
the talent committed to him, to the Supreme Governor and righteous
Judge."36
Thus as the Common Sense philosophers
viewed the universe, God remained sovereign, but he exercised
his rule over human beings in a manner distinct from the rest
of his creation. The character of God's rule over the non-human
world was "mechanical"; he was "the sole cause and the sole agent"
within it, shaping everything according to his will. Because every
aspect of this world was entirely his doing, it contained no "moral
attributes"—there was "no vice to be punished or abhorred,
no virtue . . . to be rewarded." Human beings were,
of course, the work of God as well, but they were specially endowed
with free will, intelligence, moral sense, and therefore subject
to categorically different, "moral" laws. These laws were inscribed
in the mind of every individual, rendering them naturally capable
of living in accordance with God's will. Nonetheless, it was repeatedly
emphasized that the faculties of the human mind required cultivation.
Both intellectual and moral development were said to proceed "by
insensible degrees," and the mind remained susceptible to improvement
or corruption "by education, instruction, example, exercise, and
by the society and conversation of men." As Reid explained, "the
seed of virtue in the mind of man, like that of a tender plant
in an unkindly soil, requires care and culture in the first period
of life, as well as our own exertion when we come to maturity."
This being the human condition, moral virtue would only be assured
through "struggle and effort" to resist the ardent solicitations
of passion, which threatened always to "blind" the understanding
and "pervert" the will.37
The Scots were not much troubled
by the apparent differences in mental development and ability
from one individual to the next, confidently asserting that they
would ultimately be taken into account by the benevolent Father
in the meting out of rewards and punishments. By implication,
all earthly tribunals were to endeavor to do the same, as far
as humanly possible. For justice required that allowances be made
with respect to those temporarily or permanently deprived of moral
agency, as in cases involving children, madmen, and even sane
adults under the influence of "absolutely irresistible" forces.
And the same held true in cases involving other sorts of natural
differences in individual mental endowments. As a general rule
"in criminal courts as well as private judgment" a man's responsibility
extended no further than his mental and physical capacity; ideally,
there would be a "perfect correspondence" between "his power over
himself" and his "accountableness" under the law.38
Still, the Scots always hastened
to add that no release from liability was warranted where the
individual misconduct was the result of self-neglect, for even
the offender's "own heart" condemned him for "having done what
he ought not, and might not have done." Such an individual was
said to be "guilty to himself" because he knew his descent into
wrongdoing was no more irresistible than that of "our first parents."
Why God had not made human beings more perfect in the first place,
Common Sense philosophers thought an insoluble mystery, refusing
to speculate beyond the bounds of understanding. Instead, they
underscored the potential of "human wisdom and power" to improve
individuals and nations, aiming to "rouse the ambition of parents,
of instructors, of lawgivers, of magistrates, of every man in
his station, to contribute his part towards the accomplishment
of so glorious an end[.]" Reid even entertained the possibility
that unassisted human exertions might bring about a "paradise"
on earth.39
The enthusiastic reception of
this philosophy in post-revolutionary America may be considered
the culmination of a rather dramatic shift in ideas about individual
agency and accountability.40 As Enlightenment conceptions
of moral freedom supplanted orthodox Calvinist doctrines, human
responsibility was placed upon a new basis: it was premised upon
the power of self-determination. By the first quarter of the nineteenth
century, Common Sense models of mental power had been adopted
by Calvinists as well as more liberal theologians and ministers.
Across denominational lines it had become an article of faith
that human beings had the innate capacity and (therefore) the
duty to strive for self-improvement and social betterment "on
the whole." Moral ability, for evangelicals and liberals alike,
was now conceived as a divine endowment and essential precondition
for the imposition of praise and blame within His (and any other)
scheme of "moral government." But it was nonetheless recognized
that man's moral faculties were highly susceptible to corruption,
especially in the stressful environment of a newly liberated society,
where the exercise of voluntary choice—in religion, politics,
the marketplace, and countless other spheres of culture—was
fraught with as much peril as promise. For the freedom that came
with independence could be easily lost through negligence, and
might never be fully realized in the first place without proper
cultivation.41
In this exhilarating yet bewildering
environment, a host of religious, medical, and lay educators and
reformers took it as their self-appointed role to provide moral
guidance. Believing that the very fate of America's democratic
experiment hinged on the "virtue and intelligence" of its citizenry,
they drew upon Common Sense in their descriptions of the mind
as well as their prescriptions for its proper development and
discipline.42 The most systematic self-help theorists were
the academic moralists who occupied chairs in mental and moral
philosophy at the Protestant denominational colleges, educating
not only the next generation of clerics, but also those who would
choose vocations in commerce, medicine, and law.43 In their
textbooks, these moralists articulated a "science of duty," exhibiting
broad consensus about the "facts of human consciousness" as well
as the moral obligations that flowed from them. In doing so, they
displayed a clear debt to Reid's philosophical system, using introspection
to discover the nature of man's moral constitution. Their scientific
inquiries invariably revealed that each individual was born with
sufficient moral, intellectual, and volitional powers to discern
right from wrong and conform to the moral law prescribed by God.44
Following the Scots in their hierarchical
ordering of the mental powers, the moralists situated rational
faculties (moral and intellectual) above the affections and passions,
with the instincts and mechanical reflexes occupying the lowest
rung. They observed that the strength of these various powers
tended to vary "inversely with their position," but emphasized
that it was possible to cultivate and control the passions through
conscious choice, thereby ensuring a properly balanced character.45
Without denying that there were differences in native mental and
physical endowments that might affect the ease with which this
ideal could be attained, they maintained it was well within the
grasp of all of God's creatures, save perhaps the idiot and lunatic,
who received scant attention in most of these works. More often
than not, their philosophizing about the "laws of the mind" tended
toward exhortation, sounding not unlike the tracts and manuals
intended to instruct a more popular audience in the processes
of mental and moral development.46 Ultimately the message
was the same, regardless of the medium: Individuals not only have
the power to form and shape their own character, but also the
duty to do so in conformity with the dictates of conscience. And
with each repetition, academic and popular writers aimed to promote
voluntary observance of God's moral law, so that it would truly
constitute "the common law of the country."47
Still, it was one thing to exhort
everyone to improve themselves, and yet quite another to hold
all individuals to the same standard, as a matter of law. Was
it just to punish those who were less morally capable than others?
Were they wholly to blame for their moral failings? Common
Sense philosophers (and their American expositors) had remarkably
little to say about the genesis and significance of individual
variations in physical and mental capacity, and they had even
less to say about the phenomenon of insanity, with most tending
to treat it as a disorder of the imagination, to the extent that
it was mentioned at all.48 In their depictions of the mind's
operations, they typically deployed an overabundance of organic,
mechanical, and animalistic metaphors, which obscured more than
they revealed about the nature and extent of individual agency
in the process of character formation. Moreover, lunatics were
treated as categorically different from the rest of humanity;
in a self-evident sort of way, they were placed on the margins
along with idiots, brutes, and children, where they served as
foils against which human abilities and duties could be defined.49
For the rest of mankind, Common
Sense philosophy left would-be "moral managers" with a puzzle.
If rational and moral faculties were innate and universal, what
explained the great conflicts among men concerning matters of
belief, manners, and morals (slavery was to provide a prominent
example of this), leading some to commit acts that were, to others
(or even the vast majority of men), patently irrational or downright
evil? And to the extent that there was a common sense about
the dictates of reason, propriety, and moral sense, why did some
individuals act in defiance of them?
In so closely identifying freedom
with conventional rationality and morality, the Common Sense philosophy
seemed to point to the paradoxical conclusion that the irrational
or immoral actor could never be held fully responsible for his
behavior—that the only truly free and responsible agents
were those who had sufficient power to act in conformity with
reason and morality. To contend, as moralists were wont to do,
that irrationality and immorality stemmed from failures in mental
cultivation really only begged the question of responsibility.
For how could such failure be viewed as anything more than evidence
of an individual's lack of power over his or her will? Was there
not—almost by definition—something wrong with the
deviant individual's mind? By the last decades of the eighteenth
century, doctors like Rush were cautiously moving toward such
a position as they introduced the concept of "moral," as distinct
from "intellectual" derangement. As they did, it might be said
that they were only following the logical implications of Common
Sense, which encouraged the relocation of the sources of human
perversity outside the conscious self. And yet, to some these
diagnoses would conjure up the frightening specter of materialism,
threatening to eliminate the metaphysical basis for assigning
praise or blame to individual actors. This prospect would
prove especially troubling to the American jurists who were steeped
in the Common Sense philosophy and yet daily forced to reckon
with the fact that depravity was not easily distinguished from
disease within this optimistic world view.50
II. Common Sense and Common Law
The image of the human subject projected by lawyers, judges,
and jurists in early republican America bore the unmistakable
imprints of the culture they inhabited. As has been suggested,
it was a culture in which Calvinist doctrines of innate depravity
and divine determinism had largely given way to liberal forms
of Protestantism, which affirmed human potency and consequentiality—regarding
man as something of an "un-caused cause."51 With this expansive
view of human agency, we have seen, came a new conception of the
basis of individual accountability. While a causally unbounded
will was hardly required to establish personal responsibility
within the Calvinist scheme, liberal Protestantism expressly premised
responsibility upon "moral ability," specifically the human power
of self-determination. It is thus not surprising to find that
questions of capacity and liability within American legal culture
were increasingly thought to turn on states of mind rather than
"feudal" status distinctions. This "enlightened" way of framing
the subject of responsibility was set out clearly in the treatises
and tracts published by American jurists in the first decades
of the nineteenth century. In and through these works, jurists
forged an indigenous legal tradition, built on the universalistic
premises of Common Sense.
Within the American legal profession,
the most notable exponent of this Enlightenment philosophy was
the Scottish-born James Wilson. He transmitted this accumulation
of wisdom to his colleagues and the wider public during the course
of a series of Law Lectures, delivered at Philadelphia
College and published in 1804.52 In them, he proposed to
outline the distinctive features of American jurisprudence, associating
the laws and government of the United States with the venerable
common law tradition, which he deemed to be based in consent,
while correcting the errors of the English commentators, particularly
those of Blackstone. By Wilson's lights, the "learned author of
the Commentaries" had wrongly supposed that human laws implied
the existence of a superior and inferiors, failing to trace the
source of sovereignty back to its "ultimate and genuine source"
in the "free and independent man." This figure, regarded as both
author and subject of the law, stood at the center of Wilson's
educational enterprise. In pursuing this topic, he favored the
"enlightened and candid Dr. Reid" over "Mr. Locke," warning that
the "artful use of ´ideas' in metaphysicks" was no less "destructive
of liberty" than the "artful use of ´superiority' in politicks."53
Wilson's reliance on the Common
Sense philosophy was most clearly displayed in a series of lectures
on "man, as an individual, as a member of a society, as a member
of a confederation, and as a part of the great commonwealth of
nations." These lectures essentially restated Reid's mental and
moral philosophy, often word for word. Wilson was a bit more inclined
to speak of "Nature" than God in his rendering of the universe,
but he was just as sure as Reid that man had a benevolent Creator,
who governed the universe with "infallible correctness," investing
human beings with the capacity for "perfection and happiness."54
Proceeding in accordance with the philosopher's intuitive realism,
Wilson affirmed that man did not reside in an "enchanted castle,
imposed upon by spectres and apparitions." It was surely not Nature's
"pastime . . . to put such tricks upon a silly creature
and then take off the mask, and show him how he has been befooled."
Wilson also took the same swipes at skeptical writers such as
Hume, who had erroneously reduced human nature to "impressions
and ideas." Moreover, he underscored the absurdity of such theories
when applied in a legal context: "If one set of ideas make a covenant;
if another successive set . . . break the covenant;
and if a third successive set are punished for breaking it; how
can we discover justice to form any part of the system?"55
As Wilson went on to offer a corrective view of "our nature,"
he essentially reproduced the Common Sense philosophers' hierarchy
of intellectual and active powers, placing the moral sense in
a commanding position. Where the moral sense was supported by
other rational faculties of understanding and will, the individual
subject was capable not only of distinguishing right from wrong,
but also of conforming his conduct to the former over the latter.56
Persons fitting this description were properly considered "moral
and accountable beings" according to Wilson, and he implied this
was universally true of the "human species." All the same, he
recognized that mental powers—both natural and acquired—might
vary considerably from person to person, even making passing mention
of the extreme deprivations of the idiot. Yet the existence of
such variations did not appear to unsettle the most basic presumption
underlying Wilson's lectures: that most men and women were endowed
with sufficient intellectual and moral capabilities to be deemed
accountable agents susceptible to judgment under all forms of
law.57
Although elite lawyers of other
political and religious persuasions were certainly far more selective
in their appropriations of Common Sense than Wilson, they nonetheless
tended to adopt the same basic mental model and associated ideas
about the cultivation of character, and they specially commended
this school of thought to those who aspired to join their ranks.58
Like other educated Americans, they would find room for substantial
disagreement within this capacious philosophy, particularly with
respect to the role of the government in the process of character
formation.59 As a general matter, those in the (dominant)
Federalist-Whig camp envisioned a more activist state than did
the Jeffersonian-Jacksonians. But as Daniel Walker Howe has argued,
this was ultimately more a matter of emphasis within a broader
consensus about the importance of mental culture and self-discipline.
Each party, he explains "put primary emphasis on one half of the
idea of self-improvement": the Jeffersonian emphasizing self,
the Federalist emphasizing improvement. In the end, those in both
parties agreed that the essence of freedom lay in the capacity
for self-government, which was now understood as a state of mind
which might be proved or disproved in court.60
Further evidence of the influence
of this liberal Enlightenment view of the self may be found in
antebellum legal literature, through which it is possible to trace
the gradual replacement of the traditional common law of persons
with a generic model of the legal subject, whose civil capacity
and criminal responsibility rested upon his possession of a certain
set of mental attributes.61 The most elaborate discussions
of this model were presented in treatises and tracts that generally
addressed the subject of jurisprudence.62 Such works typically
began with consideration of man "as a single individual," offering
a detailed examination of his "physical, moral and intellectual
constitution." Most were resolutely dualistic, as a matter of
metaphysics, portraying man as "a being composed of a growing,
vital, and sentient substance, denominated body,
and of a subtile or immaterial something, called soul,"
or "mind." Following the introspective method of the Common Sense
philosophers, they elaborated a theory of the mind largely in
line with the Scots, identifying four key attributes presumptively
possessed by the prototypical legal person. First, he was said
to have the capacity for self-knowledge, implying the transparency
of the self to the self. He could observe the workings of his
own mind and obtain reliable information about his true thoughts
and feelings. His second attribute was the power of self-determination,
enabling him to control and direct his thoughts, feelings, and
actions, effectively forming his own character. He had, in other
words, the power to choose the motives that would, in turn,
determine his behavior. Third, he was possessed of and (ideally)
actuated by an innate moral sense, which allowed him to distinguish
right from wrong and, at the very least, regret those actions
of his which partook of the latter rather than the former. And
finally, the faculties of his mind were thought to be organized
in a hierarchical order, with the rational principles of action
reigning over the animal and mechanical ones. Thus in the healthy
human mind, as they defined it, the intellect provided motives
to the will, encouraging action in conformity with the moral sense.63
In setting out this model, antebellum
jurists did not deny the existence of individual differences in
physical and mental capacities, nor the possibility of disease,
but they tended to minimize the significance of these differences,
straining to show that the apparent diversity of humankind did
not compromise the "unity of the moral law." David Hoffman was
especially thorough in his treatment of the subject, going on
at considerable length about "the origins and nature of man" in
his Legal Outlines (1829). Though he acknowledged arguments
in favor of polygenesis, Hoffman remained convinced that man was
a single "unit in the creation," forming "a class by himself,
in which, though there are varieties, there are neither different
orders nor genera, nor species." As far as he (or anyone else)
could see, the variations across the "human family" appeared to
be physical in nature, owing to hereditary and environmental factors,
and there was no reason to believe that they implied any fundamental
differences in "moral constitution." With these various considerations
in view, Hoffman concluded that "we cannot but regard all minds
as essentially the same," from which it followed that all men
were rightly regarded as "moral and responsible beings" equally
subject to divine and human laws. "God may have given to one man
a greater talent than to another," he allowed, "but he has created
the difference by giving him the ability to display advantageously
his mind, through organs more perfectly adapted for that purpose."
And he insisted it was every man's pre-eminent duty to
"cultivate with assiduity all the functions of his mind, and to
preserve in health and vigour all the powers of the body, since
it is by their united action that man becomes useful in every
condition of life."64
As the imposition of liability
was now more squarely premised upon the moral ability of humankind,
an increasing degree of scrutiny was trained upon individuals
whose powers of reason and self-government seemed deficient. The
philosophers' arsenal of explanations for departures from the
law's norms—citing failures in mental cultivation and self-discipline,
or pointing to corrupting influences in the surrounding environment—seemed
insufficient, especially in the most extreme cases. What were
judges and lawyers to make of the individual of proper religious
and moral upbringing who murdered without apparent motive, or
could not be reasoned out of believing "I am the Christ"? Were
their thoughts and actions to be regarded as instances of self-determination,
however eccentric, perverse, or deluded, or as signs of disease,
rendering them unaccountable under the law? Answers to these questions
would be eagerly supplied by a new band of medical men, who effected
dramatic changes in the conceptualization and treatment of madness
in the early decades of the nineteenth century. These new medical
models emphasized the natural as opposed to the supernatural agencies
involved in the production of mental disease, inspiring belief
in "man's power over himself to prevent and control insanity."
In doing so, the doctors also raised new questions about the bounds
of human freedom and the basis of individual responsibility, implying
that the existing rules of law often expected too much of human
nature. Their critiques gradually came to form a new genre of
literature as well as a broader field of study—the "medical
jurisprudence of insanity"—which was intended to promote
more scientific and humane treatment of the "deranged specimens
of our race" under the laws of the land.65
III. "To Give Rules to Folly"
The emergence of the new psychological medicine marked the growing
interest in comparing and relating "normal" and "disordered" mental
operations. To be sure, American alienists fully recognized the
importance of becoming "acquainted with the human mind in its
sane state," drawing liberally on "our British Psychologists,"
especially Locke, Reid, and Stewart. And with them, most of these
doctors would likewise affirm that every individual was "endowed
by the Deity with an equal gift of mind," and that the "exactness"
of its operations essentially depended upon "physical organization,"
mental cultivation, and self-discipline. Yet it was the very fact
of this original equality that spurred mental pathologists to
explore the "diversity of different natures," confident that their
inquiries would yield new insights into disease processes and
methods of cure. As they traversed the expansive and largely unexplored
territory between "perfect mental health" and "total insanity,"
alienists took pains to distinguish their scientific approach
from that of the "metaphysician," who was "directed in his course
solely by his own self-consciousness." If the powers and limitations
of the human mind were to be fully comprehended, they insisted,
it was necessary to quit the "narrow circle" of one's own reflections
and become "conversant" with the subject of mental disorder, ideally
through clinical observation and treatment of afflicted individuals.66
Proceeding in this fashion, American
alienists would accordingly claim a peculiar ability to pronounce
upon the "laws of mind and body," and they would seek with an
almost missionary zeal to dispel superstitions about the nature
of insanity. In the burgeoning medical literature on the subject—directed
to general practitioners as well as the broader public—madness
was cast as a disease of the brain rather than the "soul" or "mind,"
and it was said to be caused by a host of physical, hereditary,
environmental, and "moral" causes, including mental overexertion
and unregulated passion. As this last category more than implies,
American alienists firmly believed that men and women were entirely
capable of going mad on their own, with little help from God and
none from the devil.67
American alienists were especially
keen to extend the benefits of their new science to the legislatures
and courtrooms of the new nation, seeking to enlighten legislators,
lawyers, and judges, as well as potential medical witnesses, so
that all "might thereby become enabled to adapt the facts
in nature" to the "scale of justice." The fruits of their professional
labors were exhibited in a profusion of tracts, manuals, and sprawling
multi-volume treatises, which began to circulate at the turn of
the nineteenth century under the broad banner of medical jurisprudence.
Many were penned by practicing alienists, and most displayed at
least some familiarity with recent advances in European medical
psychology.68 In the earliest published works, medical
writers tended to assume a deferential posture toward members
of the legal profession, assuring readers that they did not presume
to "dictate to that constituted authority denominated law." They
aimed only to provide judges, lawyers, jurors, and potential witnesses
with the pathological, physiological, and behavioral information
needed to determine the questions of legal capacity and responsibility
which seemed to be arising with ever greater frequency, along
with mental disorder itself. Along the way, medical writers offered
some cautionary words about the ease with which insanity could
be both feigned and concealed, and they also catalogued a variety
of "inferior" forms of mental disease, including hypochondriasis,
epilepsy, old age, drunkenness, delirium, and even "nostalgia."69
The legal implications of these
conditions were typically left ambiguous, though the liability
of these maladies to eventually "terminate" in full-blown insanity
was invariably noted. Most often, writers simply concluded that
mental capacity had to be assessed on a case-by-case basis, conveying
the impression that medical specialists were instrumental, if
not indispensable, to the proper administration of the legal system.
To proceed without such medical assistance was to run the risk
that a lunatic would "receive his cure at the gallows," or that
the insanity plea might be used as a "cloak for crime," or
that a mere eccentric might be condemned to live indefinitely
"among the idiotic and the mad." This last image was a recurring
one in the early decades of the century, as medical writers strategically
appealed to the self-interest of sane persons, warning that "no
man can confidently reckon on the continuance of his perfect reason."70
In taking up the task of reform,
however, physicians were immediately beset with a vexing problem
of definition—one that had long been cast as insurmountable
by lawyers, judges, and jurists. "Who can mark precisely the frontier,
which separate insanity from sanity," went the common courtroom
refrain, "who can number the degrees by which reason declines
and falls into annihilation?" To make such an attempt was, in
effect, "to prescribe limits to that which is illimitable, to
give rules to folly, to be bewildered with order, to be lost with
wisdom." For this reason, it was often said, the common law had
always defined insanity in the narrowest possible terms, recognizing
only those cases where the individual had wholly and indisputably
lost "the use of his reason."71 Medical writers did not
deny the difficulties inhering in their project, with some even
admitting that "the varied and mutable phenomena of insanity will
ever mock the grasp of the nosologist." But if no "infallible
definition" could be formulated, alienists might nonetheless offer
more accurate illustrations of the various "species" of insanity,
drawn from asylums and hospital wards, ones that surely improved
upon the "crude" portraits of the afflicted found in common law
commentaries and those "caricatures of disease which the stage
represents or romances propagate." Through such illustrations,
medical writers attempted to correct popular misconceptions about
madness, quite literally seeking to promote new ways of seeing
mental disease. Yet it bears emphasis that they proceeded with
their campaign well aware of the perils of requiring a "perfect
sanity," apprehending that "too nice an investigation of eccentricities
and imperfections may lead to oppression and injustice."72
Medical critiques of the common
law generally focused on the need for modernization of the traditional
rules of capacity and responsibility. They all tended to take
issue with the same array of sources: Lord Coke's categories of
persons non compos mentis were said to be under-inclusive
in focusing exclusively on cognitive disorders, and it was further
observed that Sir Matthew Hale's "total deprivation of reason"
test of insanity set a standard that even the most debilitated
asylum inmate could not meet. General complaints were also made
about the "looseness" and "inconsistency" with which the law was
administered in contemporary courtrooms. In particular, it was
difficult for medical writers to fathom why a "glimmering of reason"
was routinely deemed sufficient to establish the guilt of the
accused, while a single note "sounding to folly" might work to
wholly invalidate a testator's will. At the most fundamental level,
however, their works collectively presented a challenge to the
"philosophy of the intellect" that animated the Anglo-American
legal system as a whole. In the doctors' estimation, this philosophy
was built upon the "groundless and gratuitous" premise that "reason
is the directress of human actions"—"that where the rudder
is attached, the ship must be steered—and that he who reasons
must be rational: and so he is, as long as he does reason."
More experienced observers knew better. Through the "toil of induction,"
they had come to see that the "occasional gleams" of the "reasoning
faculty" were seldom, if ever, reliable signs of the mind's integrity.73
In presenting these criticisms,
however, medical writers were hardly proposing a wholesale revision
of the model of mind they found undergirding the common law. Indeed,
most remained within the faculty psychology tradition as they
wrote about the operations of the mind, simply modifying the accounts
of Enlightenment mental philosophers where they conflicted with
clinical experience. What most distinguished medical models was
the powerful role they tended to accord to the emotional faculties,
in both normal and abnormal mental processes, which served to
underscore reason's precarious hold over human thought and action.74
With these psychological facts in view, medical writers proceeded
to suggest alternative disease classification schemes to replace
the older common law varieties. In the main, they followed the
French alienist Jean-Etienne-Dominique Esquirol as they divided
mental disease into four basic categories: mania, monomania, dementia,
and idiotism.
The most innovative aspect of
this scheme lay in its introduction of the second term, monomania.
This referred to a circumscribed derangement, where the "delusion"
related to a single idea or topic, such as religion or politics.
The behavioral signs of this disorder could vary dramatically,
depending upon the subject of the underlying delusion, but it
was nonetheless possible to identify two distinctive characteristics
exhibited by afflicted individuals. First, their delusions were
discrete enough to leave them capable of reasoning properly on
all other subjects, and second, they exhibited "a high level of
excitation and even audacity" when laboring under the influence
of the delusive ideas. As it was vividly put by one writer, "Sufferers
are pursued day and night by the same ideas and affections, and
they give themselves up to these with profound ardour and devotion.
They often appear reasonable, when conversing on subjects beyond
the sphere of their delirium, until some external impression suddenly
arouses the diseased train." In those moments, alienists explained,
the delusion quite literally took hold of the mind, impelling
the individual to perform unintended acts, for which he could
not justly be held accountable, either as a matter of civil or
criminal law.75
The concept of monomania was soon
expanded to include forms of derangement principally affecting
the nonintellectual faculties of the mind, all of which
came to be rather indiscriminately comprehended under the head
of "moral insanity." Though anticipations of this disease entity
can be found in the tracts and treatises produced by Benjamin
Rush, it was only in the 1830s that other medical writers began
to address the subject in any depth, acknowledging as they did
its controversial character. As an initial matter, readers were
presented with Phillipe Pinel's notion of manie sans d˙lire,
denoting a condition in which patients displayed no discernible
intellectual defects, but "appeared to be governed by a sort of
instinctive madness, as if the affections alone suffered injury."
Other leading French alienists, most notably Georget and Esquirol,
were credited with further distinguishing intellectual monomania
from instinctive and affective forms of the disorder, such as
monomanie homicide, kleptomania, and pyromania, which impelled
patients to commit specific and often seemingly motiveless crimes.
In addition, mention was often made of the phrenological models
of Gall, Spurzheim, and Combe, which were thought to lend further
support to the hypothesis of a circumscribed, moral disease. For
the phrenologists held that the mind was composed of dozens of
determinate faculties, each of which was connected with a specific
organ of the brain, which could be separately deranged. This,
in turn, meant that any form of human perversity was at least
potentially traceable back to some sort of physical disorder,
such as an overdeveloped organ of "destructiveness" or "combativeness,"
or perhaps an underdeveloped organ of "compassion" or "moral sense."
In rounding out their discussions of moral insanity, medical writers
typically gave the last word to English alienist James Cowles
Prichard, who was responsible for coining the term in the first
place. His rendering of the disorder, which was generally recognized
as the most comprehensive and serviceable of all, depicted it
as "a morbid perversion of the natural feelings, affections, inclinations,
temper, habits and moral dispositions, without any notable lesion
of the intellect, or knowing and reasoning faculties, and particularly
without any maniacal hallucination."76
As medical writers delineated
the contours of moral insanity, they conceded that its supposed
symptoms could easily be confused with signs of moral depravity
or mere eccentricity, and they also admitted that moral irregularities
were among the causes of the disease. Still they attempted—rather
unconvincingly—to offer readers a basis for distinguishing
vice from disease. In one breath, moral insanity was said to be
marked by an abrupt and inexplicable change in affections, conduct,
and physical appearance, and yet in the next it was allowed that
gradual alterations of character and ingrained behavioral oddities
might also signal the onset of this disease. Moreover, there was
no denying that many of its supposed symptoms were simply indistinguishable
from crime: the first and only indicator that a patient was afflicted
with monomanie homicide was often the act of murder itself.
With these ambiguities in view,
most legal tribunals in the Anglo-American world stopped short
of recognizing nonintellectual forms of mental disease, and many
medical writers betrayed doubts of their own as they considered
the issue. Certainly it would not do to deny a fact of nature
(disease) simply because it was liable to be mistaken for another
fact (sin). Yet some medical writers found the clinical evidence
inconclusive, suspecting that those diagnosed with moral insanity
more than likely suffered from some related intellectual disturbance,
however slight. And even those who did not share this skepticism
might nonetheless be persuaded that "safety of civil society"
required that the offenses of the morally insane be considered
as crimes—at least until the outlines of the disorder could
be more definitively drawn. But there was also a rather vocal
minority of medical writers who displayed no such ambivalence,
claiming to represent "the cause of truth and justice" as they
ardently pled the case for moral insanity before other medical
and legal professionals and the public at large.77
Perhaps the most outspoken and
unrelenting such advocate was the American physician Isaac Ray,
best known for penning the influential treatise The Medical
Jurisprudence of Insanity, first published in 1838 and going
through four editions before his death in 1881. This work enjoyed
a wide, transatlantic audience, cementing the author's reputation
as one of the leading experts in the field of legal medicine and
the most formidable critic of the prevailing common law rules
of capacity and responsibility. This reputation was well deserved,
for Ray's treatise provided an unusually systematic and pointed
analysis of the "legal consequences" of mental disease, as contemplated
from a medical viewpoint. Within the confines of a single work
it not only offered a comprehensive overview of the "various forms
and degrees of mental derangement," but also went on to consider
them "in reference to their effect on the rights and duties of
man." The doctor pulled no punches in undertaking this task, indulging
in a bit of exaggeration as he cast contemporary judges, lawyers,
and jurists in the role of benighted traditionalists who obstinately
adhering to the "metaphysical dogmas" encrusted in the common
law, even where they so obviously clashed with the "dictates of
true science." The targets of his critiques quickly responded
in kind, suggesting in no uncertain terms that the doctor's doctrines—especially
that of moral insanity—verged upon an atheistic materialism.
This was, however, even farther from the truth than Ray's critical
barbs. For not only was the doctor a confirmed dualist, but his
medical psychology flowed from Common Sense assumptions about
the constitution of the healthy mind.78
Like many of his peers, Ray had
a Calvinist upbringing, but he went on to receive a liberal education
at Bowdoin College before taking up his medical studies at the
Medical School of Maine, and he would gradually drift toward Unitarianism
over the course of his adult life. These educational experiences
left him supremely confident that the universe stood entirely
open to human understanding. Indeed, he echoed the Common Sense
philosophers as he affirmed that "nature played no tricks" on
mankind. This, in turn, inspired him to believe that it was possible
to penetrate the heretofore mysterious relations between mind
and body. Even as he moved into private practice, Ray continued
to read intensively on the subject of mental pathology, becoming
convinced that insanity was invariably rooted in some sort of
physiological disorder, likely situated in the brain.
The Medical Jurisprudence of
Insanity was, in many respects, an extended lament about the
extent to which contemporary judicial opinions and practices lagged
behind "the present state of our knowledge" concerning mental
disease. As Ray saw it, this "sad and melancholy" state of affairs
resulted from the fact that so many members of the medical and
legal professions remained largely ignorant of the stunning advances
in psychological medicine, continuing to derive their knowledge
of the mind primarily through introspective means, following the
example of the "metaphysical writers." However, the doctor hardly
meant to deny the relevance of mental philosophy, for his jurisprudence
of insanity was plainly built upon a model of "our moral and intellectual
constitution" that was essentially in conformity with Common Sense.
"Man," he observed, "being destined for the social condition,
has received from the author of his being the faculties necessary
for discovering and understanding his relations to his fellow-men,
and possesses the liberty, to a certain extent, of regulating
his conduct agreeably or directly opposed to their suggestions."
Being endowed with these intellectual and moral powers, he further
reasoned, "we become accountable for the manner in which they
are used,—to our Maker, under all circumstances, and to
our fellow-men, when the institutions of society are injured."
And so it stood to reason that an impairment of either
kind of power might diminish or eliminate an individual's liability
for his acts. Thus where an individual was shown to be incapable
of "feeling the influence of those hopes and fears and of all
those sentiments and affections that man naturally possesses,"
the doctor held that "an essential element of legal responsibility
is wanting, and he is not fully accountable for his actions."79
Accordingly, it was with considerable
dismay that Ray surveyed the "legal relations of the insane,"
and he would only grow more disheartened about the prospects for
reform in successive editions of his treatise. The crux of his
criticisms was no different from that of previous medical writers,80
but there was certainly a new element of sarcasm in Ray's analysis,
even as he mostly repeated what were by now familiar complaints
about the retrograde nature of common law adjudication. What
most distinguished this treatise from its predecessors, however,
was the exhaustiveness with which its author catalogued the infirmities
of the legal system and the specificity of the remedies he offered
to ameliorate the situation. Scores of judicial decisions were
dissected for the benefit of the reader, so that he could "see
for himself how little of true philosophy has presided over the
department of criminal jurisprudence" and how many insane defendants
were unfairly placed "on the same footing with men of the soundest
and strongest minds" and sent to the gallows, though they displayed
only the "the slightest vestige of rationality."
This state of affairs was rendered
even more galling as the alienist's analysis turned to the civil
side of the docket, where the slightest signs of mental disorder
might be grounds for stripping an individual of control over his
property and person. Ray could find no "physiological or psychological
ground" for this civil-criminal distinction. Indeed, it appeared
to him that the common law had gotten the matter exactly backwards.
For the disposal of property was a rather routine affair, usually
having "nothing in it, to deprive the mind of all the calmness
and rationality of which it is capable." The same could hardly
be said of criminal acts. While "abstractly wrong," they might
be "right and meritorious" under certain circumstances, and "if
strongest and acutest minds have sometimes been perplexed on this
point, what shall we say of the crazy and distorted perceptions
of him, whose reason shares a divided empire with the propensities
and passions?" The ease with which criminal liability was found
in such cases compelled the conclusion that the common law took
"more account of property than life."81
Ray's program for legal reform
was quite transparently and unapologetically self-serving: he
proposed that both substantive and procedural rules be revamped
so as to maximize the influence of medical specialists such as
himself. In place of all the "fallacious" tests and "fancied"
standards of mental soundness promulgated by common law judges
through the ages, he proffered a single alternative—the
one most often recommended by practicing alienists. Their clinical
researches demonstrated that the surest sign of insanity was "a
well-marked change of character, or departure from the ordinary
habits of thinking, feeling, and acting, without any adequate
external cause." In other words, there were no objective criteria
for determining states of mind—each individual subject had
to be "compared with himself, not with others." What was lunacy
in one might "speak relatively to health" in another, though the
doctor hastened to add that "striking peculiarities of character,
such as amount to eccentricity, furnish strong ground of
suspicion of predisposition to madness." In order to implement
this reform properly, Ray went on to insist, courts would necessarily
have to liberalize their rules of evidence, admitting "proof drawn
from the nature of the act in question"—even in criminal
cases—as well as more general testimony regarding the actor's
"natural character" as exhibited over the course of his lifetime.
Only then would it be possible to ascertain whether the act was,
in fact, attributable to him. It was, of course, conceivable that
this inquiry could be managed by judges and jurors, without the
need for medical intervention, but this was hardly ideal, from
the doctor's perspective. To the contrary, he rather audaciously
claimed that questions of civil and criminal responsibility could
only be properly resolved by consulting men who possessed "a well-earned
reputation in the knowledge and management of mental derangement."82
Ray was soon joined by a chorus
of asylum superintendents, who would form the core of the emergent
profession of psychiatry in nineteenth-century America. They compared
notes with one another through the vehicle of the American
Journal of Insanity (which began publication in 1844), collectively
elaborating a scientific framework within which to understand
and treat mental disease. In doing so, antebellum alienists confirmed
many of the conceptual changes that had been wrought in the preceding
decades. While the essence of insanity in the eighteenth century
was described in terms of "intellectual incoherence," these professional
men tended to speak in terms of "will out of control." In their
view, it was also a more "democratic" ailment, in that it was
no longer conceived as a state of being outside the bounds of
humanity, but instead as a state of mind into which anyone might
fall, and from which they might recover.83 The implications
of this new conceptualization were obviously profound, especially
for the legal system, and antebellum alienists did not fail to
draw them out—both in print and from the witness stand,
where they were increasingly called to testify as experts in the
1840s and 1850s. Appearing in all sorts of civil and criminal
proceedings, they worked to unsettle the presumption of sanity
that had long structured these legal contests, emphasizing the
recondite quality of mental disease, which might escape the perception
of all but the most experienced of medical men.
Alienists' testimony pointed to
the inadequacies of traditional common law definitions of insanity,
which required a "total depravity of reason." Moreover, their
psychological models were more fundamentally at odds with the
"philosophy of intellect" upon which Anglo-American jurisprudence
was based. While it was at least conceivable that the law's existing
cognitive tests of insanity could be widened to accommodate delusional
states of mind, the same could hardly be said of the moral forms
of monomania, whether affecting the will, emotions, or moral sense.
In attesting to the existence of these disease entities, the alienists
were effectively contending that an intact intellect was no sure
indicator of moral agency—that thought and volition were
not invariably connected as was supposed at common law. Such diagnoses
threatened to throw many a legal proceeding into utter disarray,
all the while raising the far more disturbing possibility that
moral freedom was itself a delusion. As they contemplated the
prospect of such chaotic courtroom scenes, American lawyers were
prompted to reconsider the Common Sense premises of their practice
and to compose treatises of their own on the jurisprudence of
insanity.84
IV. "Illusive Liberty"
It was not long before these medical writings began to be noticed
in law journal articles and deployed in courtroom disputations.
As early as 1800, Thomas Erskine would make his speech on behalf
of attempted regicide James Hadfield, famously arguing for an
acquittal on grounds that the accused acted under the dominion
of a circumscribed mental delusion—believing in a supposedly
divine decree—which irresistibly impelled him to point and
discharge his pistol in the direction of the king. Erskine's success
in this case was seen by many at the time as a momentous development,
signaling the common law's movement away from the stringent traditional
criterion of a "total deprivation of reason."85 His speech
quickly gained notoriety on both sides of the Atlantic, and soon
was republished for the benefit of the American legal profession
in an appendix to Thomas Cooper's Tracts on Medical Jurisprudence
(1819), the first work of its kind published in the United States.
A scientist as well as a lawyer by training, Cooper offered readers
reprints of the "most approved" treatises by British physicians
on the subject, along with some medical notes of his own and
a digest of the common law relating to insanity.86
From his marginal comments, it appeared that Cooper had adopted
the operating premises of the medical specialists of his day.
"I consider it as a point now settled," he declared, "that there
is no such thing as a disease of the MIND." Though insanity might
be precipitated by "moral" as well as "physical" causes, it was
"essentially a disease of the bodily organs," and so "the cure,
if at all, must consist in the cure of a bodily disease." Yet
given his familiarity with the accumulating body of medical learning,
Cooper would have remarkably little to say about its legal significance.
Indeed, in the digest that closed out the volume, he simply rounded
up the usual common law authorities, letting Coke, Hale, and Blackstone
have the last word on the matter of mental unsoundness.87
While it would be several decades
before another American jurist would attempt to offer a comprehensive
view of the subject, several English treatises were produced by
practicing barristers in the interim and quickly exported to the
United States. Of these, three deserve particular mention, as
they enjoyed the widest circulation and also clearly display the
gradual process by which the new medical psychology was assimilated
into legal analysis: George Dale Collinson's Treatise on the
Law Concerning Idiots, Lunatics, and Other Persons Non Compos
Mentis (1812), Leonard Shelford's Practical Treatise on
the Law Concerning Lunatics, Idiots, and Persons of Unsound Mind
(1832), and Joseph Chitty's A Practical Treatise on Medical
Jurisprudence (1834). In Collinson's treatise, citations to
medical authorities were substantially outnumbered by allusions
to Enlightenment mental philosophers, chiefly Locke and Stewart,
as well as an array of literary figures, including William Shakespeare,
John Dryden, and Samuel Johnson. By contrast, Shelford struck
a fairly even balance between medical and non-medical writers
in his discussion of insanity, and Chitty would look almost exclusively
to the former class for insights into the workings of the diseased
mind. However, all three jurists commonly acknowledged that the
scientific norms of their own profession dictated greater incorporation
of the concepts and classification schemes newly promulgated by
medical men.88
The tentativeness of the law writers'
initial approach to the subject of mental disease was typified
by Collinson's Treatise. This work remained organized around
the traditional common law categories of persons non compos
mentis, with chapters on each sort, essentially restating
the positions of Roman and early modern English jurists. However,
interspersed between them were two more "philosophical" ones,
relating to "the nature of lunacy" and "the justice and expediency"
of the laws governing those of unsound mind. In his disquisition
on lunacy, Collinson followed Stewart in locating the seat of
the disorder in the faculty of the imagination and summoned up
Johnson's fictional tale in Rasselas as an illustrative
case. In the part excerpted, the astronomer narrated his own descent
into madness, coming to believe that he was solely responsible
for the regulation of the weather. He was finally relieved of
this duty by the poet-philosopher Imlac, who dispelled the astronomer's
delusion by drawing him into "sublunary" activities and advising
him always to keep prevalent the thought "that you are only one
atom of the mass of humanity, and have neither such virtue nor
vice, as that you should be singled out for supernatural favours
or afflictions." From this story, Collinson drew the moral that
"insanity may be occasioned by too great an indulgence in visionary
scenes," though he hastened to add that this was not meant to
imply that "so severe an affliction is usually the consequence
of misconduct on the part of the unhappy sufferer." To the contrary,
he observed that it was most often a "hereditary complaint, or
the offspring of some violent passion, such as love, grief, or
fear."89
In allowing that insanity might
be brought about by the misconduct of the sufferer—that
it might result from "an abuse of the faculties of the mind on
our part, as well as the hand of our Maker," Collinson was simply
restating conventional wisdom among practicing alienists. Yet
in doing so, he underscored the extent to which this scientific
way of thinking about mental disease created new problems for
the legal system. If insanity was not always (or perhaps even
usually) caused by a supernatural agent, was it rightly regarded
as an excusing condition under the law? Could courts still sensibly
repeat the ancient common law maxim that the madman was "sufficiently
punished by his madness alone"?90 If the onset of the disease
could be tied back to voluntary acts of the patient—however
remotely—was he then to be held accountable for the actions
he performed under its influence?
Sensing that he had only begged
the question of responsibility in his discussion of the nature
of lunacy, Collinson endeavored to provide an answer, only to
collapse into incoherence from the effort. He was at first inclined
simply to bracket off the question of causation, pronouncing that
the law was unconcerned with the etiology of insanity, attending
only to its perceptible effects upon conduct. But as he went on
to consider the legal status of insane persons from one field
of law to the next, the jurist arguably contradicted himself,
particularly as he took up the discrete question of criminal responsibility.
Although perfectly willing to accept evidence of irrational conduct
as sufficient grounds for the imposition of civil restraints on
a person, Collinson insisted upon more substantial proof of involuntariness
before that person could be excused from liability for his crimes
and trespasses. He considered it both just and expedient for courts
to appoint guardians over persons who appeared "unequal to the
pursuit of a regular and continued line of conduct, or the management
of private affairs," and yet those same persons were to be held
accountable for any harm caused by their unreasonable conduct,
unless there was credible evidence of "an absolute dispossession
of the free and natural agency of the human mind." In fact, Collinson
bluntly acknowledged that insanity was more narrowly conceived
in the criminal context so as to exclude "sudden gusts of passion,
and the insensibility of intoxication, which are obviously and
immediately referrable to ourselves." He further intimated that
this exclusion could be defended on grounds of expediency, if
not justice, for it was practically necessary to draw such lines
in order to deter harmful conduct. However, all this assumed that
"self-created causes" were readily discernible, which the
jurist himself seemed to be far from believing, given his concerted
efforts to define away questions of causation. One suspects that
Collinson was, in the end, not clear in his own mind about the
constitution of the moral agent or the basis of legal responsibility.91
The perplexity about human agency
and accountability would only deepen as medical authorities were
more fully integrated into discussions about legal responsibility,
a process that can be traced through the works published by Shelford
and Chitty. Though these jurists also looked to the Common Sense
philosophers in constructing their view of "what constitutes mind
in its healthy state," this mental model would be destabilized
to a significant degree as they drew out the legal implications
of the recent advances in psychological medicine. For the chief
lesson that Shelford and Chitty learned from the medical writers
was that rationality was—at best—an equivocal sign
of sanity and therefore an uncertain basis for determining legal
responsibility. The jurists' task was rendered all the more challenging
in view of the "want of entire coincidence respecting the precise
standard of mental health," even among medical men. Without a
common measure, it was obviously impossible to determine what
constituted a deviation in the first instance, let alone one severe
enough to be deemed a legally disabling disease. After more than
a little hand-wringing, both Shelford and Chitty found their way
past this fundamental difficulty of definition, submitting that
the provisional and somewhat conflicting classification schemes
lately formulated by medical practitioners were at least superior
to those supplied by Coke and Hale.92
In conformity with the alienists'
schemes, Shelford characterized insanity as a bodily disease,
which could affect any or all of the mind's faculties—including
the emotions, will, and moral sense as well as the understanding.93
He further recognized that the disease had "moral" as well as
"physical" causes, proceeding to list a number of contributing
factors, without distinguishing between those that were or were
not a product of human will. Among the enumerated factors were
fever, repeated intoxication, injuries to the head, hereditary
predisposition, excess in pleasure, factitious passions, mistaken
views of religion, parturition, errors in education, intense study,
and misfortune. All the while, Shelford took pains to emphasize
that it was not every mental aberration that constituted disease,
but only those that were "serious and complicated."94
Yet as he went on to survey the
alienists' attempts to clarify what it was that distinguished
insanity from depravity and eccentricity, Shelford would find
them all wanting in one way or another. And so he finally settled
upon a decidedly practical test, defining mental disease as a
"continued impetuosity of thought, which totally unfits
a man for judging and acting with the composure requisite for
the maintenance of the social relations of life." No sooner had
the jurist adopted this formulation, however, than he bemoaned
its insufficiency, apparently finding greater wisdom in a quoted
passage from Byron's Dream, wherein the bard intimated
that "what the world calls phrensy" was a deeper wisdom, that
melancholy was "but the telescope of truth."95
In the end, Shelford's ambivalence
about the scientific enterprise of defining insanity led him to
reaffirm the traditional common law rules of responsibility. Indeed,
he strenuously urged that civil incompetence not be found on proof
of "extravagant" conduct alone, and he was certainly no more inclined
to authorize a legal inference of insanity from the fact of a
criminal offense. Though "philosophers" (used here as a term of
abuse, meant to encompass medical men) might prove that crime
invariably flowed from some sort of mental disturbance, Shelford
remained convinced that it was "dangerous in judicature" to excuse
proven offenders from punishment, so long as they retained the
capacity to distinguish right from wrong.96
While a more enthusiastic consumer
of medical science, Chitty would be even less willing to countenance
reforms of existing common law rules and procedures. Though his
volume was suffused with the language of anatomy, physiology,
and pathology, the jurist's engagement with these disciplines
had little apparent impact on the way he thought about the "law |