from responsibility. This is seen in the adoption of the terms monomania, moral insanity, insane impulse, insane delusion, and in the additions made from time to time by writers to the varieties of monomania, among which are placed kleptomania, pyromania, erotomania, theomania, dipsomania, homicidal mania, suicidal mania, etc.
Spitzka, in his recent treatise on "Insanity," which work has at once taken rank among the highest authorities upon this subject, speaking of monomania, says: "Here those alienists who delighted in burdening the infant science of psychiatry with new systems of classification, found a fruitful field for innovation. Whatever the direction in which a lunatic manifested his most prominent symptoms, that direction determined the coining of a new term. . . . The designations 'Gamomania,' or 'the insane desire to marry,' or 'Frauenschuhstehlmonoraanie,' or 'the mania for stealing women's shoes,' are imperishable monuments of this folly." To which judicious remarks I will add that, if such acts or mental conditions are to constitute a basis for the classification of insanity, I see no reason why it should not extend to every faculty, sentiment, or emotion of the mind, and to every act of eccentricity or of viciousness which disfigures human conduct.
Rush, the author of "Medical Inquiries and Observations on the Diseases of the Mind," has been quoted as having said that all men were insane on some subject. To the same conclusion it would seem that certain alienists are inclining. If this be true, then the whole matter we have been considering becomes greatly simplified. All men are insane, and all are irresponsible.
It would be unjust to Dr. Spitzka, in whose opinions I have expressed a concurrence, as well as to myself, if I did not state that Dr. Spitzka is willing to retain the name monomania when the use of the term is accompanied with certain reservations and restrictions, "with the limitation that the prefix shall be understood to denote that the insanity extends in a special direction across the mental horizon." He justifies the continued use of the term, but not its abuse.
It is upon this point alone that our opinions diverge. I can not think it advisable to retain the term monomania, or any of the subordinate terms, either for purposes of classification or for the convenience of clinical description. Most alienists are agreed that, even when they use these terms for classification, they do not mean to say that the subject is insane upon only one point, but this is exactly what the term means, if it means anything. It is true that different alienists offer different explanations or definitions of the term, but nearly all admit that it does not mean insanity upon a single subject; and every one must have seen that, with or without explanations, the use of this term by writers and by expert witnesses renders it difficult, if not impossible, for the reader, the public, or the jury to distinguish in many cases between acts of moral obliquity, eccentricity, or viciousness on the one hand, and actual insanity on the other; between responsibility
