ii. Leading cases of lunacy reported in NT. — 1. The cnse in the syvngogue at Capernanm (Mk r-^--^, Lk 431-37). The symptoms indicated by the Evangelists are —
(1) The predominance of unclean habits and in- stincts. Mk. speaks of the man as being under the influence of an unclean spirit ; Lk. of the spirit of an unclean demon. This might possiblj' mean no more than that the victims of this malady habitually haunted unclean places, as tombs, and desert regions believed to be the habi- tation of demons. But the greater probability is that it points to 'moral alienation,' which Esquirol {Maladies Mentales) declared was the proper char- acteristic of mental derangement. ' The subtle influence of e2:)ilepsy, or rather of that condition of the nervous system which gives rise alike to epi- leptic seizures and certain mental symptoms, is most strikingly manifested in the change which takes place in the moral character' (Bucknill and Tuke).
(2) Convulsive seizures. This feature is not made jirominent in the case before us, but is indi- cated by the words of Mk P^, ' And the unclean spirit tearing (RVm ' convulsing,' <nrapd^a.v) him and crying with a loud voice.'
(3) Uncontrolled imimlse, leading the victim in defiance of all that was fitting and customary to burst into the assembly at the hour of worship.
(4) The patient's belief in and identification of himself with an alleged evil spirit. He speaks of himself and the evil power as one— 'What have we to do with thee ? ' This may be explained as an example of a well-known delusion classed as demonomania, but the question must not be fore- closed (see below). At least, however, an element of delusion may be traced in the feeling of entire and inevitable subjection to the monstrous control
(5) The acknowledgment of Messiah. This has been claimed as the classical criterion of demonic possession, all ca.ses Avhere it is not found being regarded as not due to this cause even although the Scripture so attributes them (jNIenzies Alex- ander). But argument from silence is always perilous, and especially so in dealing with the Gospel narratives. And other cases might yet be genuinely demonic Avliere the confession is appar- ently or really absent. And, on the other hand, the acknowledgment might reasonably be regarded as the last vestige of rationality in the otherwise deranged nature.
LUNATIC
LUNATIC
93
Attempting to classify tlie above, it may be ranged sj-mptomaticallj' under Clouston's head — 'States of Defective Inhibition, or Impulsive In- sanity,' the chief characteristic of which is un- controllable impulse, and Avliich includes general impulsiveness, epileptiform impulse (indicated by the convulsions), animal, sexual and organic im- l^ulse (pointed to by the term ' unclean ' applied to tliis and other instances). Clinicallj' considered (according to the causes) it most nearlj' approaches epileptic insanity. This ' means insanity with epilepsy, whether the convulsive atiection has pre- ceded tlie insanity and has seemed to be the cause, or whether it has appeared during the course of the mental disease onlj as a symptom or complica- tion'(Bucknill and Tuke). The presence of epi- leptic insanity is not always indicated by epileptic fits but by the character of the mental disturbance, the paroxysmal gust of passion, the blind furj-. And therefore Defective Inhibition is difficult to distinguish from Mania. Out of 385 epileptic women observed by Esquirol (Maladies Mentalcs, vol. i.), onlj' 60 were free from mental derange- ment, and nearly all were unstable, peculiar, easily enraged.
2. The case at the foot of the Mt. of Transfigura- tion (Mt 17"--", Mk 9'"--^ Lk tF'-*).— Two sides are plainly marked in this disorder: (1) The pliysical. Uncontrollable paroxysms accompanied by foaming at the mouth and gnashing of teeth, succeeded by utter prostration. The afHiction had been from infancy, pointing to some congenital disease involving the other physical features — deafness and dumbness. (2) The mental. At least idiocy, but more probabl}' lunacj', a feature of which was the suicidal mania manifested. The indication is that during the time while he Mas free from convulsions and their effects the patient was not mentally disturbed. The .suicidal imjnilse was apparentlj- spasmodic and periodical, but no very solid ground is given to theorize upon.
Tlie epilepsy is more pronounced than in the previous case, and the suicidal tendency is added. But possibly, if the previous instance liad been fully described, it might more nearly approximate to tlie one under consideration. The classification must be under tiie same general head — Defective Inliibition or Epileptic Insanity (rather than Epi- leptic Idiocy — as Alexander). ^3. The Gerasene victim (Mt 8^-^, Mk o^'^, Lk g26-:i9) — 'j'jjg physical symptoms, the convulsions, tliat characterize 1 and 2, are here absent, and the features of mental derangement become all- prominent. The victim is possessed bj' an un- governed violence, having the command of a morbid muscular energy. This uncontrollable power was one that increased, for the description implies that in the earlier stages they had been able to control him in some measure by binding, but that the binding iiad increased the violence of tlie power so that he could no longer be bound (Mk o^-*). 'The tenses used (deSeadai, Sucnrdadai, <TvvTiTpl<pdai) denote the relation of these past acts to the present inability' (Gould, Intrmat. Crit. Com. on 'St. Mark"). The malignant power con- trolling the life drove him into the tombs and mountains, causing him to utter frenzied cries and leading to impulses of self-mutilation, apparentlj^ also to homicidal tendencies (Mt 8^). Loss of personality is the dominant feature of the case, evidenced by the absence of the sense of all fitness, causing him to destro.y his clothing and rush about in nakedness, and by his positive feeling of being possessed by a legion of devils whicli tore his life asunder. At times he thoroughly identifies him- self with the power that controlled his life ('we are many "), and is terrified by the fear lest he and they should be driven from their hiding place. A