Studies in Forensic Psychiatry | Page 8

act, the possibility of considering the man insane at the time
of the commission of the act is obviated in a large measure.
CASE II.--R. S. C., a white male, age 48 years, who is now serving a life sentence for
murder. One brother and one sister died of tuberculosis. Another sister and two maternal
aunts were insane. Father alcoholic. Patient has always been regarded as rather sickly.
Had the usual diseases of childhood and has been subject all his lifetime to frequent
headaches. His school career was very irregular in character and he never advanced
beyond the elementary subjects. Socially, he belonged to a very ordinary stock of
frontiersmen and his chief occupation consisted of farming and certain minor
speculations. He apparently led an honest and more or less industrious life. Married in
1886, and his conjugal career is uneventful. In March, 1901, he moved to Addington,
Indian Territory. This was a newly-established frontier town and he had bought,
sometime previously, several lots there, intending to establish himself in the lumber
business. Soon after this he got into some financial difficulty with a town-site boomer,
and finally, in a fit of passion, shot and killed the latter and wounded a relative of his own.
He was admitted to the Government Hospital for the Insane, December 13, 1901, from
the Indian Territory. From the medical certificate which accompanied him on admission
it appeared that soon after the commission of the crime the patient began to show
evidence of insanity by incoherent talk, false ideas, nervousness, and outbursts of vicious
excitement. Later, this was followed by mutism, refusal to eat, and stupor. On admission
to this hospital he was in a deep stupor, absolutely oblivious to everything about him.
Eyes were wide open and staring, pupils dilated, voluntary movements markedly in
abeyance. He was mute except for an occasional incoherent mumbling to himself. He
evidenced no initiative in feeding himself, but swallowed food when it was placed in his
mouth. Habits were very untidy; involuntary evacuation of bladder and bowels were
present. His mental content could not be determined at the time, as his replies were
indistinct and monosyllabic, and were obtained only after much effort. He appeared to
comprehend what was wanted of him, although this was not absolutely certain. His
perception was very dull, ideation slow and laborious. His attention could be gained only
after considerable difficulty, and he had to be aroused first from a more or less profound
stupor. Spontaneous speech was almost wholly absent, but occasionally he would utter a
word or two about his wife and children. No delusions or hallucinations could be elicited.
Physical examination showed him to be quite thin and emaciated. Gait slow and unsteady.
Voluntary movements retarded. Knees trembled and knocked against each other. No
paralyses or pareses noted. Marked general tremors were occasionally seen. Musculature
well developed but flaccid. All deep reflexes diminished. Cremasteric absent. Other
superficial reflexes were noted to be normal. Organic reflexes abolished. Involuntary
urination and defecation. There was a systolic murmur present and a slight impairment of
the upper lobe of the right lung. Breath very offensive. He remained in this stuporous
condition, leading a more or less passive existence, for about a month after admission.
For two months following this he was quite agitated, and his outward reactions indicated

that he was quite depressed. On April 25th, about four and a half months after admission,
when asked how long he had been in the Hospital, he replied three days. From that time
on he began to improve. Consciousness became clearer. In June, he talked and acted quite
rationally. He had a total amnesia of what had transpired during his stuporous and
agitated states and a retrograde amnesia for several days prior to, and including the
commission of the murder. He continued clear mentally and in a more or less normal
state until the latter part of November, 1902, when he again went into a stupor. From this
time until the later part of April, 1903, he had alternating periods of stupor and lucidity,
with amnesia for the stuporous states. On June 21, 1903, he was discharged as recovered
and returned to the Indian Territory to undergo trial for his offense. Unfortunately, no
mention is made in the hospital records of any possible relation between his periodic
stuporous states and any environmental condition which may have provoked these; nor
does there appear in the hospital records any mention of the degree of insight, if any, the
patient possessed at the time of his release from the institution.
He remained in jail at Ardmore, I. T., until April 8, 1904, when he was tried and found
guilty of murder in the first degree. He was then returned to jail and after about a year's
sojourn there was sentenced