Excerpt from Discussion on Moral Insanity in the Medico-Psychological Society: Paris, 1866 and 1867

Moral insanity was used by Pinel and his school in too restricted a sense, in consequence of which they confined their views to a single trait rather than to the whole character of the case; and thus it happened that there was very little similarity between the cases which they described. Falret uses the term in a generic sense, and applies it to several groups of cases agreeing in the vast predominance of the moral disorder, but differing in the mode of its manifestation. To establish these groups on a pathological basis, and describe them with all possible exactness, he regards as the first and a most necessary step in the study of moral insanity. To the first of these groups he gives the name of maniacal exaltation, the essential character of which is an excessive excitement of all the faculties, an exag gerated and unnatural activity of the emotions, the intellect and the will, and a certain disorder of the actions, without much intellectual distar bance, or incoherence of speech. These patients superficially considered do not seem to be insane, for their discourse is connected and not irrational.

They are incessantly active, both in body and mind. They undertake ex traordinary and useless journeys; they sleep poorly, often rising to wander about in the night. They abound in projects, often abandoned as soon as conceived. Their ideas crowd upon each other and present a disorder of the thoughts, not certainly like the incoherence of mania, but equally re mote from the natural and orderly sequence of ideas in health. The memory also partakes of the general excitation. Old and insignificant ideas, supposed to be long forgotten, are remembered. Long quotations from classic authors, lost since boyhood, are perfectly recalled. The power of original composition is increased. They talk and write continually. Their conduct is strange and improper. They visit people whom they never thought of visiting before. They neglect the little proprieties of life and rules of society. They embark in rash enterprises. They are often rude and insolent. Destitute of reserve or modesty, they resent all counsel and criticism. They are sensitive, choleric, and quarrelsome. They become mischievous, exacting, even malicious. Their eyes are quick to see and their tongues to expose, the faults and frailties of their neighbours. They misrepresent, slander, and lie with extraordinary malice and ingenuity. They delight in causing pain, trouble, and discord. None but those who have lived with them can conceive their infernal inventions and the annoy ance and dissension they spread around them. In truth, their feelings and instincts are wholly transformed by disease. Once kind and gentle, they become violent, malicious, jealous, mendacious, and revengeful. Of all their moral delinquencies, perhaps the most constant and unscrupulous is their mendacity. In this group is included that form of disorder called folie circulaire, in which maniacal exaltation alternates with depression with an interval between of the natural condition. These states are the very opposites of each other, for, in the latter, the patient is still, listless, inter ested in nothing, except to deplore his own folly when exalted, lying in bed, perhaps, and shunning all company and conversation.

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