never considers the danger of letting this type of
criminal loose to prey upon it; just so he has served his just and
legally prescribed sentence. But let the victim of the "insanity dodge"
prejudice endeavor to gain his freedom, and society is at once up in
arms.

Thus the matter stands, and until the public learns to know its
criminals as they actually are, this problem will remain unsolved. The
prognosis of the acute prison psychotic complex is good in the majority
of instances. The removal to a hospital regime usually serves to put a
stop to the process and it is important for the expert witness to bear
this in mind for obvious reasons.

We have thus far discussed the psychoses developing in prisoners
awaiting trial, and we shall now turn to that group of cases which are
sent to us from penal institutions which serve for the confinement of
the convicted criminal.

At the outset we shall endeavor to draw a distinction between the class
of individuals we have just discussed, and that which we are about to
consider now. We have seen that the former is made up of individuals who
in most instances have come in conflict with the law for the first time,
and that the mental disorder which they develop stands in the closest
relation with some definite experience in their life. The patients who
come to us from prisons and penitentiaries on account of some mental
disorder which developed while they were undergoing sentence are in most
instances habitual criminals with a marked criminal career back of them.
They differ so essentially from the preceding group, that what has been
said about the former can hardly apply here.

The first really worthy contribution to this subject was made by
Siefert,[4] the physician in charge of the psychiatric department of the
penitentiary at Halle. He published, in 1907, the results of a study of
eighty-three prisoners who became insane while serving sentences. He
divided his patients into two sharply differentiated groups, the true
psychoses, _i.e._, the well-known forms of functional and organic mental
disorders, and the degenerative psychoses, _i.e._, psychotic episodes
developing upon a soil of degeneracy and which according to him form the
typical prison psychoses. Before we go any further it must be mentioned
that Siefert did not take into consideration the mental disorders
developing in prisoners awaiting trial.

"The true psychoses develop out of endogenous causes, attack and
manif