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CHAPTER II

LAPSED PERIODS

       HERE, then, we have a case of amnesia for a period of three hours, due to alcohol. The great importance of a careful experimental study of such a state is evident, especially if we take into consideration the large number of crimes committed for which amnesia is subsequently claimed by the criminal.

        It is noteworthy in reviewing this case that Mr. X. told me about having vomited as an entirely new recollection, whereas he had told Dr. Gillespie this before. This tendency of subconscious memories to crop out in the upper consciousness momentarily and then to sink back again into oblivion is quite characteristic of functional amnesias. I have often observed it. It is important, too, because in the absence of a knowledge of this fact such a phenomenon might lead to a suspicion of malingering.

        Especially hard is it to get at the truth in cases where a crime has been committed, as often there is little else than the subjective statement of the criminal to the effect that he has no recollection of what occurred.

        In this case there were unfortunately, or fortunately, as the case may be, no unusual occurrences by which the mental condition of Mr. X. during the period for which he was afterwards amnesic could be gauged. I think, however, that we may posit what that condition was in other cases where we have a complete record of what occurred, when we take into consideration that the patients must have been conscious of what they were doing, provided their acts were at all complicated, a thesis I think we are fully justified in adopting, especially after having been able to prove that consciousness actually did exist in a single case―that of Mr. X.

        The following case, for example, is given by Sullivan,¹ and cited as a good example of the automatic type of alcoholic homicide:

        "K――, æt. 28, a sailor. Father mentally unstable, suffered from fits (of uncertain nature); paternal uncle died insane. Patient himself said to have had sunstroke. When sober appeared of normal feeling and intelligence; when intoxicated was violent. Drinking for about ten years at intervals determined by his occupation; convicted three times as drunk and disorderly, the first occasion six years before his crime.

        "On the evening of the eleventh day of a severe drinking bout was seen to go home with his wife being apparently on boisterously affectionate terms with her. During the night he killed her by cutting her throat with a razor as she lay in bed, and made an almost successful attempt to commit suicide with the same weapon. Professed to have no memory of the act, and could not at any subsequent time suggest a motive for it. While under treatment for his self-inflicted wound suffered from severe alcoholic symptoms, nervous and digestive."

        Foster's² definition of automatic, which seems to me to be quite in accord with the facts, is as follows: "Self-acting, i.e., without the intervention of the will (said of physiological acts and of the mechanisms by which they are performed). The term is applied to acts which, although voluntary at first, become habitual and continue to be performed without any further attention being bestowed on them." A classical example is that of the pianist, who, having learned a piece, continues to play it while holding an animated conversation with a bystander. Surely there is nothing in this case described by Sullivan that would bring it within, this conception of automatic. K―― could hardly be accused of having performed such an act as cutting his wife's throat with such frequency that it had become habitual, self-acting, automatic.

        A state of mind which can conceive of two separate crimes, seek out the appropriate instrument for their execution, succeed in consummating one and in nearly completing the second, is certainly of a sufficiently complex nature to warrant the assumption that consciousness was present and directed the several acts. The amnesia which followed may have been functional or organic; experimental research alone could determine this. It is quite conceivable, however, that the violence of the process which brought about the acts may have been sufficient to destroy the physical substratum of the consciousness which accompanied them, a state of affairs possibly present at times in epilepsy.

        Such a case as the following, however, is quite possibly altogether automatic in character³:

        "Take the case of the woman E. C――, first quoted by Dr. Orange.

        "One day, whilst dressing her infant, she rose with the view of procuring same bread and butter for another child. She had a slight seizure, and instead of cutting the bread, severed her infant's arm at the wrist. When she recovered consciousness she found several neighbors and a policeman in the room, the latter taking from her the severed hand, which she was fondling. Once before, in cutting bread, she unconsciously injured her thumb. She had no recollection of either act. During her asylum life she suffered from bath grand mal and petit mal. The attacks usually came an about the third day after the catamenial period. She was occasionally maniacal, gradually drifted towards dementia, and finally died of cancer of the vagina."

        In this case the woman started to do an act to which she was fully accustomed, viz., cut some bread. On starting to cut the bread she had an attack, and the act begun in the waking state was continued automatically in the epileptic state, the baby's hand being cut off because of its unfortunate proximity, being seized instead of the bread and the difference not appreciated.

        It is probable that acts committed in a condition for which there is subsequent amnesia are the results of various causes. The acts of blind fury during which everything within reach is destroyed, and murderous assaults made upon those about, are probably as nearly automatic as any, although I think that these states are often accompanied by a low degree of consciousness, and in a case that came directly under my observation⁴ in which the condition was aggravated, though not caused by alcohol, there was perfectly clear consciousness on the part of the patient of what he was doing, as was proved by subsequent complete recollection. These conditions are probably often, as in the case referred to, the result of angry states waxed into violence by the removal of the ordinary controls of conduct and frequently aggravated by hallucinations, delusions, and obsessions.

        This condition is well illustrated in the case quoted by Sullivan,⁵ although in this case amnesia for the acts committed did not occur.

        "David Baines, æt. 41, fish-dealer. No definite evidence of hereditary taint; his long resistance to alcohol suggests a normally stable brain. His drinking habits dated back some twenty or twenty­five years, and within two or three years of his crime he had several attacks of delirium tremens; also, without actual delirium, he often suffered from hallucinations, tremors, and insomnia. Under the influence of drink he was wont of late to become extremely violent, and would manifest suspicions of his wife's fidelity; he would then accuse her, watch her movements, threaten, or even assault her; on two occasions when in this state he attempted to commit suicide. When sober he did not entertain, or at least did not express, these ideas.

        "From June to Christmas day, the date of the murder, Baines drank very heavily. On Christmas eve he had a violent quarrel with his wife; the wrangling lasted late into the night; Baines stayed up, walking about the house, talking to himself, and occasionally beating his head against the wall. Early on Christmas morning the woman went to a neighbor's house to ask the time. Baines, who had got possession of a knife and had sharpened it, followed her there and stabbed her fatally. Arrested immediately after, he said: 'It is all over last night's affair; I saw it with my own eyes; I did it deliberately over that.' Thirty hours later he was hallucinated and delirious, his ideas referring to the murder of his wife and to his own bodily condition, 'his inside was taken out, half of his penis was cut off.'

        "Questioned subsequently regarding his crime, he stated that his wife, who constantly deceived him, brought a man to the house on Christmas eve; he went to bed, leaving them together, and soon after, the door being partly open, he heard filthy conversation between them, and on looking out saw them having connection in the presence of the children. After this the woman and her paramour left the house separately. Baines slept for the rest of the night. Next morning, armed with a knife, he followed the woman to the neighbor's house; his intention was merely to frighten her, but at the last moment 'something came over me, and I could not help doing it―I don't rightly know how it happened―I was not master of myself.'"

        In other cases there appears strong evidence that the mental condition under alcohol is one which lends itself easily to suggestion, reminding one strongly of the hypnotic state. "The following observation⁶ may perhaps be regarded as an instance of this influence (external suggestion), though the absence of corroborative evidence, and, assuming his veracity, the blurred condition of the culprit's memory, leave the point doubt."

        "P――, æt. 31. No fixed occupation. Mother died of a 'fit'; said to have been demented for some time before her death. A cousin on the maternal side idiotic; another committed suicide. A brother suffered from convulsions in childhood.

        "Prisoner was always idle and unstable; lost several engagements through drunkenness; drinking for over ten years before crime; was once convicted summarily for drunkenness. Had had rheumatic fever and syphilis, and suffered from mitral disease.

        "Three days before the crime, prisoner took a room in a brothel, and went on a steady drinking bout with one of the girls of the house. On the day of the crime, in the afternoon, he went out with this girl; having had some drink in a tavern they entered a cab, directing the driver to take them back to the brothel. On arriving there, P―― got out of the cab, and told the driver that he had killed the girl, that she had asked him to do so. She was stabbed to the heart with a penknife. P―― could give no further account of the affair: the woman told him to stab her, and he obeyed as one might in a dream."

        "A clearer instance of the same agency is given in a case recorded by Prosper Despine, where one of four drunkards, who were carousing together, suggested the hanging of the most intoxicated of the party―a suggestion promptly carried out with results which only failed of being fatal through the accident of outside intervention."

        Thus we see that the mental state during the alcoholic condition may be variously dominated. The presence or absence of amnesia appears to follow no rule, and when present it is probable that the mental condition for the forgotten period was dominated in much the same way as it would have been if amnesia had not followed. Sullivan⁷ records two instances of alcoholics who committed crimes in a "state of obscured consciousness" and subsequently developed delusions which, if held at the time, would have been ample to have constituted a motive. It appears highly probable to me that such a crime was the result of delusions which in the following period of amnesia were forgotten, only, however, to crop up from the regions of the subconscious at a subsequent time to dominate the upper consciousness as delusions. Experimental research alone can determine whether this is so or not.

        I have cited these cases only for the purpose of indicating in a general way the many different states of mind that may prevail during alcoholic intoxication, and to show further, that it is not sufficient to dispose of a case by simply designating it as amnesic. The confounding of amnesia with unconsciousness has been largely responsible for this, but now that we appreciate the distinction an effort should be made to study fully the forgotten period, with a view to determining the character of the dissociated and lapsed mental states.

        This plea needs no justification from a psycho­pathological standpoint. From a medico-legal standpoint, however, while such methods may be of no value in dealing with the criminal whose principal safety from the consequences of his acts lies in the acceptance of his plea of forgetfulness, still there are many cases of "psychical automatism," so-called, during which important business transactions are entered into or consummated, long journeys taken, or various other acts clone, for which there is subsequently no memory, where it might be a matter of great importance to recall what has been forgotten.

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