cases of insanity among women,
the causes are largely to be found in derangement of their productive
organs, and are to be met by special local treatment (ib.).

It does happen, however, at times, that the brain itself is diseased,
_idiopathically_ diseased, as it is technically called; but at other
times it is merely affected by _sympathy_ with some other organ that is
physically deranged. A physical cause there is for all mental insanity,
and that physical cause determines its kind of mania or melancholia, its
duration, its chances of a perfect cure. But what that cause is in a
given case is often very hard if not impossible to determine. Besides
natural and inherited predispositions--some taint of derangement in the
family, often betrayed by fits of epilepsy, hysterics, etc.--exciting
causes are usually traceable. Every form of disease may bring on
sympathetic affection of the brain when the circumstances for such
affection are favorable.

But while affirming that the disease usually arises in the body, and
even frequently in parts far removed from the brain, we must not deny
nor ignore the fact that intellectual and protracted worry, or sudden
and violent grief, can also be the direct cause of disturbance in the
brain. For the brain is the organ not of the imagination alone, which is
put to an unhealthy strain by excessive mental labor, but probably also
of the passions, whose emotions when excessive may cause even permanent
lesion. Hence mental insanity may and does often arise from ill-subdued
passions.

The knowledge of all this may enable the physician to remove the
exciting cause or to mitigate its influence; it may also aid expert
witnesses, judges, lawyers, and jurymen to ascertain the main fact with
which the courts are concerned, namely, the presence or absence of
mental insanity at the time of a given civil or criminal action.

V. Supposing then that, in the case before the court, the fact of
insanity is established, the next question of Jurisprudence to determine
is this: How far and why ought such unsoundness of mind to exclude
responsibility for deliberate acts?

It is a clear principle of reason that no man can justly be blamed or
punished for doing what he cannot help doing; now an insane man cannot
help judging wrong at times; he cannot then justly be blamed for acting
on his mistaken judgments. If he invincibly judges an act to be morally
good whereas it is morally bad, no matter how criminal t