When that bilious critic and merciless crucifier of human foibles, Carlyle, himself a degenerate, wrote that nine-tenths of the world were fools, he was much nearer truth than most men think. When we take an introspective view of our sane personality, we shudder to see how near it is to the borderlands of insanity and the bizarre and eccentric world of crankdom. There hardly lives a man who does not possess some eccentricity, or who does not cherish, hidden, perhaps, deep within himself, some small delusion, which he is ashamed to acknowledge to the outside world. Social relations and the iron rules of custom hold in place the balance-wheel of many a disordered mind. The mental equipoise is kept at the normal standard only by the powerful aid of the will, supported and assisted by extraneous adjuvants, such as fear of punishment, fear of personal harm, and, above all, by the fear of ridicule. Many a man hugs his delusions closely to his heart, indulges them only in the secret recesses of his soul, and, their sole owner and acquaintance, carries them with him to his grave.

Any man who has a retentive memory, and one capable of minute analysis, can look back in his life and recall moments when his insane personality got the better of his will, and ran riot in forbidden pathways. He may not have committed an insane act; yet the thought, the impulse, the delusion was there and only outside influences kept it from breaking forth. Who fails to remember certain times in his life when he has had an almost overpowering desire to cry out in church, or to laugh on some sad or solemn occasion; or, having a razor in his hand, has had an impulse, sudden and intense, to draw it across his throat; or, being on some high place, has been seized with the desire to hurl himself downward? This shows how near indeed the healthy mind ever hovers on the borderlands of insanity.

Man stands so close to the portals of insanity that he can look through the gateway, when he takes an introspective view of his psychical being, and can see the phantoms and mental ghosts of his insane personality.

We have every reason to believe that, among civilized races, there is a vast amount of latent insanity. Taking the tables of our insane asylums, we find a thousand and one causes given as the exciting factors in the mental overthrow. Love, religion, anger, disappointment, etc., down through the long list of psychic and Æsthetic emotions, until it seems as though even a breath of wind would be sufficient to destroy the mental equipoise.

Among savage and uncivilized races, insanity is of infrequent occurrence. Only when a race begins to elevate itself and take on a higher view of morality, when new rules and new laws, new customs and innovations, tending to place individuals in a state of comparison, arise, does insanity make its appearance. The untutored savage, living in a state of communism, is untroubled by the jealousies and heart-burnings of his civilized congener. He lives in the to-day and allows the to-morrow to take care of itself. Devoid of ambition, a mere animal, sensual and indolent, he cares only for the gratification of his physical desires. The mental attributes of a civilized being are, in him, wanting.

Psychos is the result of evolutionary development, and the chief reason why insanity is not as prevalent in the savage as in the civilized man, is because the brain of the savage lacks development. I do not wish to convey the idea that insanity is purely psychical in its nature. Insanity is the result of a material change in the structure of the brain produced by morbific action. The manifestations of insanity are merely the symptoms of a disease that involves the brain. The savage has less development of psychical function, consequently he is less liable to mental lesion. I mean by psychical function that portion of the brain in which psychos has its origin. Alienists consider the habits of men as being the factor in the production of insanity. Habits and heredity are undoubted factors in the production of diseased minds, and, in fact, are the chief agents. You cannot, however, expect to find a disordered function where that function is absent. Savages have paresis, apoplexy, and imbecility, seldom or never insanity. The reason is patent—they lack the psychic function, that peculiar element, whatever it may be, which raises civilized man so high above them. That this element can be developed in savages I do not for one instant deny. The ploughshare of evolutionary civilization will bring it to the surface sooner or later, and when it does insanity follows. I have only to point to the American negro to prove the truth of my proposition; even he is partially exempt, simply because his civilization is of such recent date that his brain has not yet acquired its full quota of the psychic element.

I will venture to assert, so true is the fact that insanity is the product of civilization, that, if it were not for the combating influences of social laws, assisted not a little by scientific medical aid, all North America could not contain the vast and enormous army that would constitute the civilized world’s array of lunatics.

There seems to be in the minds of men an instinctive awe of anything that appertains to the insane. In olden times a disordered mind was considered of divine or diabolic origin as it evinced good or evil tendencies. This belief lasted even until the present century. Many old women who were the victims of senile dementia and kindred ills, were accused of witchcraft and intercourse with the devil, here in the United States, not a century ago. Witches were executed in England and men burned at the stake in Spain, not two hundred years ago, for the crime of demoniacal possession. Even in this enlightened age men are accustomed to consider insanity rather from its psychical standpoint than from its physical aspect. They do not take into consideration the fact that insanity is due to a physical lesion, and that its vagaries are but the symptoms of brain disease or brain deformity. The inhabitants of the borderlands are invested with a certain shadowy mystery which separates them from the rest of mankind, and which makes them appear to us as denizens of another psychical world than ours.

In the Middle Ages, cranks, whose eccentricities took a religious turn, were considered holy. St. Simon Stylites was a very pronounced crank, and a very holy man also, because he chose to live the greater portion of his life perched on a pillar seventy feet high. St. Anthony was another holy crank who never, in all his life, washed his feet. Poor Joan of Arc was burned at the stake because she was “possessed of a false and lying devil.” She has been recently proposed for canonization by the same church that burned her, and thus, in a measure, had justice done her. I do not think, however, that this is any recompense for the terrible agony inflicted on this unfortunate victim of hystero-epilepsy.

Says Maudsley in “Responsibility in Mental Disease”: “Some of the prophets of the Old Testament presented symptoms which can hardly be interpreted as other than the effects of madness; certainly if they were not mad, they imitated very closely some of its most striking features.” Jeremiah takes a long journey to the river Euphrates and hides a linen girdle in a hole of a rock. He then returns home and in a few days makes the same journey, and finds the girdle rotten and good for nothing. Ezekiel digs a hole in the wall of his house, and through it removes his household goods, instead of through the door. Hosea marries a prostitute because he said he had been commanded by God so to do. Isaiah stripped himself naked and paraded up and down in sight of all the people.

Some of the greatest changes in the world’s history have been effected by dwellers in the borderlands. Mahomet was an epileptic, and his first vision was the result on an epileptic convulsion or seizure. The character of his visions was exactly like that of those visions which an epileptic sees and describes at the present time. Mahomet believed in his visions, and, what is more, got more than half the world to believe in them also. Gautama was a dweller in the borderlands, yet his followers now number five hundred millions.

The novel mode in which an insane man regards things may be an inspiration which reflection could never attain, and it sometimes happens that opinions which seem to the world to be the ravings of a madman, have turned out to be true. The insane man has the world against him, and though he may pose for a short time as a reformer, sooner or later lands in the asylum.

It sometimes happens that the crank will succeed in getting converts. A notable instance is Schweinfurth, or “the Christ,” as he calls himself. I am firmly convinced that this man believes in his delusions. One thing is certain, and that is, his disciples believe in him implicitly. This man is dangerous to society, inasmuch as he has caused the separation of several wives from their husbands; the wives abandoning their husbands to follow him to “Heaven,” as he calls his farm house.

The crank is, generally, a harmless individual, and is not anti-social unless his delusions take the form of homicidal impulse, pyromania, kleptomania, etc.

Homicidal impulse is the most dangerous to society of the many mental vagaries and derangements which afflict the dwellers in the borderlands. Its invasion is sudden and its impulse is, generally, overpowering. A man may be walking the streets presumably in perfect health, and yet have, all the while, a voice whispering in his ear “kill, kill.” His insane desire at length reaches its acme, and he throws aside every mental restraint and kills the first individual he may chance to meet. Again, he may desire to kill some particular individual, and will carefully and systematically arrange his plans for the successful enactment of the homicide. The murderers of Garfield and Harrison probably belong to this latter class, though in the case of Prendergast, the slayer of Mayor Harrison, this opinion may be erroneous. There is something about his photograph that leads me to believe that he is a moral imbecile, rather than an intellectual dyscrasiac.

A clerk in a solicitor’s office, at Alton, Hampshire, England, one afternoon took a walk outside the town, when he met some children. He persuaded one of these, a girl of nine, to go with him into a neighboring garden. A short while after, he was seen walking quietly home; he was seen to wash himself in the river and then go back to his office. The little girl did not return home, and, search having been instituted, her dismembered body was found strewn about the garden. The clerk was arrested, and in his diary was found this entry, recently made: “Killed a little girl; it was fine and hot.” This man was either a sadistic sexual pervert, or a victim of homicidal impulse. Maudsley gives this instance as an example of the latter, while Krafft-Ebing gives it as an example of the former. There is a great difference between these two mental derangements. The victim of homicidal impulse kills without any ulterior object, while the sadist kills in order to gratify his unnatural and perverted sexual appetite.

The victim of homicidal impulse is, to all outward appearances, perfectly sane otherwise. His impulse frequently leaves him for years and then returns with overpowering force.

Epileptics who have just passed through violent convulsions, will frequently attack bystanders with great fury. Some alienists declare that homicidal mania is frequently only a masked epilepsy. All epileptics should be carefully watched; they may become dangerous to society at any moment. Numerous instances are recorded of murder committed by sufferers from petit mal, a form of epilepsy. I once saw a negro walk up to a white man, who was a stranger and unknown by him, and fell him to the earth by striking him with a club. The negro was arrested, and the next day swore that he was entirely unconscious of having struck anyone. It was proven at his trial that he was subject to mild epileptic attacks.

I believe that all suicides are due to mental aberration. It may be the result of a momentary and sudden loss of mental equipoise, or the final and fatal ending of a premeditated desire carried through days, weeks, months, and even years.

We see a man, blessed with everything that makes life enjoyable, genial, gay, with a ready smile and kindly word for everyone, suddenly, in a moment, pass forever out into the unknown—self-killed, a victim of his own creation. We stand amazed! Why did he do it? We can find nothing in his past or present condition to warrant such an action.

He was the victim of momentary aberration, or, perhaps, deep in his mind, buried and hidden even from himself, there dwelt a desire for self-slaughter, when a “physical pain, an unexpected impression, a moral affection, an indiscreet proposition” uncovered this desire, and he at once committed the deed!

There are epidemics of suicide. Let the papers chronicle some peculiar method of suicide selected by some unfortunate, and others will immediately follow his example. Unconscious cerebration also hurls many souls out of the world. I was called to see a gentleman who had attempted suicide by slashing the radial artery at the wrist. I found him holding a compress on the severed vessel and greatly alarmed. He swore to me that he was totally unconscious how he had come to do the deed, and that he did not know that he had cut himself until he felt the pain and saw the blood flowing from the wound!

Viraginity and effemination, while not mental insanities, strictly speaking, are, nevertheless, mental deformities, and their unfortunate victims are dwellers in the borderlands. Mild forms of these types of degeneration are very abundant. The effeminate, cigarette-smoking, soda-drinking young man of the comic weeklies, and the loud, horsy, slang-using, vulgar, masculine young woman are seen everywhere.

Effemination and viraginity are the results of the weakening effects of luxury and consequent debauchery. Nations, time and again, have felt the dire effects of effemination and have sunk beneath them. The Grecian, the Roman, the Egyptian nations are familiar examples. The satirists of the golden age of the Latin people dipped their stili, metaphorically, in gall and bitter wormwood and berated the effeminate nobility time and again. One of them advised the Roman ladies to look for men among the gladiators and the peasants! Anacreon’s poems are filled with allusions to effemination and the delights of psychic hermaphroditism.

In the time of Louis XIV., of France, the royal palaces were filled to repletion with effeminants, who vied with the women in the splendor of their robes and the salacious eccentricities of their conduct. The case of Alice Mitchell, who killed Freda Ward in Memphis not long ago, was one of pronounced viraginity.

Fortunately, for the good of the community at large, there are, comparatively speaking, few viragints. The careful mother restrains, tempers, and abolishes the hoydenish habits of her “tom-boy” girl early in life, and turns her thoughts toward feminine pursuits and desires. The unfortunate effeminant, however, is encouraged in his feminine tastes and habits by his unwise mother, who likes her boy to sit beside her and sew and knit, if he so desires. She discusses matters of the toilet with him, and, in fact, treats him as she would a daughter. In the end, his psychic hermaphroditism becomes complete, and one more unfortunate goes out into the world to swell the ranks of crankdom!

Kleptomaniacs are greatly to be pitied, for they are generally women in whom the moral sense is very much developed. The victim of kleptomania will steal any and everything; they are like magpies in this respect. An acquaintance of mine, a most estimable lady, a devout Christian, and a most exemplary wife and mother, is the most incorrigible thief I ever saw. She has often picked my pockets while I was engaged about her sick-bed. The merchants of the city where she lives know her infirmity, watch her while she is in their shops, and respectfully and kindly relieve her of her pilferings when she starts to leave. She expresses great sorrow for her unfortunate insane impulse, and has often begged her husband to have her placed in an asylum. This he refuses to do, as she is perfectly sane otherwise. The husband was called away for several weeks, and, on his return, took me to his house and showed me her room. In the room were the objects stolen during his absence. It was the most miscellaneous collection of valuables and trash I ever saw. She had gathered together everything from a darning-needle to a tombstone, a small specimen of the latter forming a unit of this heterogeneous whole. This form of mental dyscrasia is much more frequent than people suppose, and the antecedents of shop-lifters and the like should be carefully examined before a judgment on their criminality is passed.

“Eccentricity is certainly not always insanity, but there can be no question that it is often the outcome of insane temperament, and may approach very near to, or actually pass into, insanity.” Alienists rely on the eccentric and peculiar changes which take place in the characters of their patients, who either present themselves or are brought to them for treatment, to establish their diagnosis. If a modest and truthful man suddenly becomes a braggart and a liar; or, if a humane man becomes cruel, or a neat man slovenly, there is reason to suspect brain trouble. The intellect may appear intact, so also the reasoning powers, but these eccentricities indicate a deviation which may lead to mental destruction. The last faculty to develop in the mind of man is the moral faculty; this faculty is the one first lost by diseased brains. If a man, who suddenly becomes dissolute and licentious (who, heretofore, has led a virtuous, moral life), be examined, in nine cases in ten his brain will be found to be diseased. The little cloud, which at first is no larger than a man’s hand, grows ever larger and larger, and in the end overspreads the entire mental sky!