r, a patient
who has committed a crime under stress of such an irresistible impulse
should be put under permanent custodial care.

_Physical Signs of Insanity_

The physician who is skilled in psychiatry finds in very many insane
patients marked physical signs. There are pains, insensitive areas,
hypersensitive areas, changes in the pupils of the eyes, unrestrained
reflex action, and partial loss of muscular control, as shown in
talking, walking, and writing. Constipation and insomnia are very
early symptoms of disease in a very large proportion of the insane.

It is productive of no good result for a layman to try to classify the
insane. The matter of classification will be for several years in a
condition of developmental change. It is enough to speak of the
patient as depressed or excited, agitated or stupid, talkative or
mute, homicidal, suicidal, neglectful, uncleanly in personal habits,
etc.

_Illustrations of Various Types_

There are very interesting features connected with typical instances
of several varieties of insanity, as they were noted in certain cases
under the writer's care. A depressed patient with suicidal tendencies
cherished the delusion that war with Great Britain was imminent, and
that in such an event British troops would be landed on Long Island
between New York City and the spot where he conceived the cattle to be
kept. This, he argued, would cut off the beef and milk supply from the
city. He therefore decided to do his part toward husbanding the
present supply of food by refusing to eat; an act which necessitated
feeding him through a rubber tube for many weeks. He also attempted
suicide by drowning, throwing himself face downward in a shallow
swamp, whence he was rescued. This young man was an expert chess
player even during his attack.

A maniacal patient wore on her head a tent of newspaper to keep the
devil from coming through the ceiling and attacking her. She
frequently heard her husband running about the upper floor with the
devil on his back. As a further precaution she stained her gray hair
red with pickled beet juice, and would occasionally hurl loose
furniture at the walls and ceilings of her rooms and assault all who
approached her.

A man who presented a case of dementia pulled the hairs from his beard
and planted them in rows in the garden, watering them daily, and
showing much astonishment that they did not grow. He spent hours each
day in spelling words backward