be that the
jurors ought to be told, in all cases, that every man is presumed to be
sane, and to possess a sufficient degree of reason to be responsible
for his crimes, until the contrary be proved to their satisfaction;
and that, to establish a defence on the ground of insanity it must be
clearly proved that at the time of committing the act the accused was
laboring under such a defect of reason, from disease of the mind, as not
to know the nature and quality of the act he was doing, or, if he
did know it, that he did not know he was doing what was wrong." (The
remainder of the answer goes on to discuss the usual way the question
is put to the jury.)

Now, with that commendable reverence for judicial utterance which is so
characteristic of the English nation, and is so conspicuously absent
in our own country, it was assumed until recently that this solemn
pronunciamento was the last word on the question of criminal
responsibility and settled the matter once and forever. Barristers and
legislators did not trouble themselves particularly over the fact that
in 1843 the study of mental disease was in its infancy, and judges,
including those of England, probably knew even less about the subject
than they do now. In 1843 it was supposed that insanity, save of the
sort that was obviously maniacal, necessitated "delusions," and unless a
man had these delusions no one regarded him as insane. In the words of a
certain well-known judge:

"The true criterion, the true test of the absence or presence of
insanity, I take to be the absence or presence of what, used in
a certain sense of it, is comprisable in a single term, namely,
delusion.... In short, I look on delusion .... and insanity to be
almost, if not altogether, convertible terms."*

* Dew vs. Clark.

This in a certain broad sense, probably not intended by the judge who
made the statement, is nearly true, but, unfortunately, is not entirely
so.

The dense ignorance surrounding mental disease and the barbarous
treatment of the insane within a century are facts familiar to
everybody. Lunatics were supposed to be afflicted with demons or devils
which took possession of them as retribution for their sins, and
in addition to the hopelessly or maniacally insane, medical science
recognized only a so-called "partial" or delusionary insanity. Today it
would be regarded about as comprehensive to relate all mental diseases
to the old-fashioned "delusion" as to regard