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C ■•..w WITH A Description of the brains of two murderers. ■'^**Bt WILLIAM OSLER, M.D., M.R.C.P., Lond. ProfeSBor of the Institutes of Medicine in McGill University, and Physician to tlie Montreal General Hospital. [Read hvfore ihe Medico-Chirurgicol Soi'iptv of Montreal.] Mentally and bodily, we are largely the result of an here- ditary organization, and the environment in which we have been reared. The '1 of a bushman nurtured in the family of a philosopher wi' be able, witii favourable surroundings, to rise much above his race level ; the chiUl of a philosopher, reared among the bushmen, will not reach his paternal standard, but the grossness of the savage natures around him will have weight M pull him down, and what is fine will learn to sympathize with the clay. In the former case, the individual cannot tran- scend his organization ; and in the latter, he cannot burst the iron bars of his environment. That the mental and moral status of a man is determined by the conformation and development of his brain is an axiom with the school of physiological psychologists. The conformation is a matter of inheritance ; the development, of education (in its widest sense). The different mental condi- tions of individuals are the expression of subtle differences in cerebral structure, just as the diversity in the features of men is the result of minute variations in the arrangement of the tissues ^.:.;'Jli£- of the face. That a faulty physical basis can have no other sequence than a faulty mental and moral constitution is acknow- ledged and acted upon by every one, so far as idiots and imbeciles are concerned, but that mental and moral obliijuity is invariably the outcome of an ill-conformed or ill-developed brain is a doc- trine novel and startling, though logical enough from the stand- point of modern physical fatalism. Endeavours have recently been made to put this theory on firm grounds by showing that in a large number of criminals the type of brain differs from that in the law-abiding members of the community. Anatomists and physiologists have of late paid much attention to the conformation of the brain surface, and the convolutions and fissures are now studied with care and minuteness. In a typical European brain, the cerebellum is completely covered by the cerebrum, and the general arrangement of the gyri and sulci is such that there is rarely any difficulty in mapping them out and assigning their proper names to each. Thus on the external surface of each hemisphere we recognize two fissures which are constant and invariable in position — the fissures of Sylvius and of Rolando^ (^central suhnis.) Other rissures constantly present, but less definite in their arrangement, are : the inter-panetal, which passes through the parietal lobe, the parleto-oecipital ; separating the parietal and occipital lobes, best seen from the median surface, the superior (1st), inferior (2nd), and ascend- ing (3rd) frontal sulci and the 1st and 'Ind temporal. On the median surface, the calloso-marginal, the parietal- occipital, the calcariiie and collateral arc well marked and distinctive. The convolutions or gyri separated by these fissures are re- markably uniform, and, though often intersected by subsidiary sulci, can usually be determined without difficulty. Of these, the only ones which need be now mentioned are the three frontal, 1st, 2nd and 3rd, the general direction of which is parallel to the longitudinal fissure and the two central gyri which bound the fissure of Rolando on either side. In the typical brain the main fissures arc unconnected with each other ; thus the fissure of Rolando is isolated and does not 8 unite with the Sylvian fissure below, or the ascending frontal or ascending parietal sulci on either side. The Sylvian fissure does not join with any of the sulci above or below it. Prof. Benedikt of Vienna has made a special study of the brains of criminals,* and believes that he has met with peculiari- ties sufficiently marked to warrant the following proposition : '• The brains of criminals exhibit a deviation from the normal type, and criminals are to be viewed as an anthropological variety of their species, at least amongst the cultured races." The two peculiarities on which he lays stress are (1st) the con- fluence of many of the primary fissures and (2nd) the existence of four horizontal frontal gyri. He proposps to establish a con- fluent fissure type of brain, and he illustrates its most important characteristic by saying, " that if we imagine the fissures to be water-courses, it might bo said that a body floating in any one of them could enter almost all the otiiers."" This, of course, means the absence of numerous bridges of nerve matter which normally separate the fissures — defects, marking an inferior de- velopment of the brain. Between the normal type with isolated fissures and the type with confluent fissures there will naturally be transitions, but he calls attention to the numbei- and variety of the connections in his series of the brains of 22 criminals as supporting the truth of his profjositiou. He states that tlie brains of individuals in the lower grades of society approach nearer to the 2nd type, and it is probable, though, as yet, full data are wanting, that the brains of the inferior races of men also conform more closely to this than to the type with isolated fissures. Let us see now how far he has been able to establish the truth of this view. Of 38 hemispheres from the 22 criminals the folhrwing were some of the most interesting points : — I. The fissure of Rolando communicated with ; (a) fis. Syl. completely in 18, incompletely in 6. (6) with 2>rd or ascending frontal, complete in 11, incomplete in 2. • On tho Brains of Criminals, Vienna, 1879. Translated by Dr. Fowler. (Wood & Co., New York, 1881. Cent. f.d. med. \Vissenschaften, 1876, and iVo.46, 1880. ^/ 31 '5^ (o) with the \st or superior frontal sulcus, complete in 0, incomplete in 1. (d) with inter-parietalis, complete in 7, incomplete in 4. Of the 10 hrains there was not one in which the fissure of Ro- lando had not on one side a connection with some other fissure. Altoj^ether there were AS connections, ;};") on the left and 23 on the right side. II. The Si^lvittn fissure communicated with : {(I.) fis. R. in 18 completely, in u incompletely. {b^ mi\\ frontal sulci in 18, incomplete in 7. In 7 brains it existed on botli sides ; only absent on both sides in o. (c) with fis. inter-parietalis in 2'J, incomplete in 6. ((i) with 1st temporal in 18, incompletely in 4. III. The A's. inter-parietalis communicated with: (a) fis. R. complete in 7, incomplete 4. (ft) fis. Sijlv. complete 22, incomplete 7. (t?) 1st T. complete 19, incomplete nr., the other the /«/'. ocei/). The 2nii temp. huI. is not well marked. The sup. occip. «///. joins the par. ocaip. ; the inf. ocoip. sid. the \st temp. On median s\n-facc, par. orcip. fis. unites with sup. occip.. and by a shallow sulcus with //«. crnniata ol' pre-aune us. Oalearine fis. normal ; cuneus small. Fis. collatera/is long, and sends numerous tissures into gyri Unyualis and fusiformis. Sul. caUoso-mary. has many fissures entering the \st front, (fijr. Qyr.fornicatus is fissured longitudinally. Orbital gyri normal ; ysQWmiixkQiX frontal maryinal sul. No external orbital fissure. Ivsula well developed, and has 9 gyri. Riyht hemisphere {PI. II., Jiy. 4). — Fis. Sylv. joins "Srd or asc. front, sul. (a), and the asc. par. (h) (retro-central) by shallow furrows. Fis. liol. unites Avith \st front, (f) and asc. par. (t?) sulci by narrow giooves. The asc. front, sul. arises by a shallow fissure from the fis. Sylv., and then at the base of the 2nd front, yyr. joins the 2nd front, sul. \st, 2nd awd -Wd frontal yyri are well developed and distinct posteriorly. Anteriorly they are fused and crossed by many secondary sulci. Asc. frontal yyr. is very narrow in its centre. Inter-parietal fs. has a well marked radial portion (the asc. par. or reti*o-central). The sagittal part passes back and presents three divisions — one (f ) enters the sup. par. lobule, a second (/) passes directly back and joins a fissure in the position of inf. ocoip., which reaches to the tip of occip. lobe, and the third (y) part passes vertically down and unites with ^sf temp. sul. and has a branch which crosses the 2nd temp. yyr. Asc.-par. convolution is large below, narrow above. The anyular, supra-maryinal vend sup. par. lobule are much fissured. \st temp. sul. joins i.-par. ; the 2nd is not marked. Several oblique sulci cross the 2nd and 3rd temp. gyr. Sup occip. sul. pma par. occip. 10 On the median surface, par. occip. fin. joins s?fp. oecip. ; the calcarinc enters seiitsiari hippoiunnpi und ']Oins the /?s. coIhUerah's by a aliallow f^roovc. Fin. eoUateralis lar^e and deep. The cuneus is small ; pre-euneus (lob. (juad.) is large and its anterior boundary ill-defined. Oalloso-marf/inaJ Jh. extends to level of base of 1st frontal, and then curves up to the margin of the hemisphere, being in- terrupted by a broad annectant uniting the gt/r. fornicat. with 1st front. Beyond this there is a short extension which joins a complex series of sulci in the pre-cuneus. Orbited (/ijri normal. There is a narrow frontomarginal mil. There is a well-marked e.vternal orbital fissure. The chief points to be noted are : — 1. The absence of complete coveringof cerebellum by cerebrum. 2. On both sides the p7'e and rctro-cetitral Jissiires were sepa- rated from /js. of Sijlvins by very narrow and grooved gyri. 3. The left ^s. Rolando joins fis. eruciata of pre-<;uneus, and on the right side it is imperfectly separated from \st front, and asc. par. sulci. 4. The inter-parietal, on both aides, joins the 1st temp, sul, and on the right side is much more developed and joins the occipital. 5. On the median surface the calcarine on the right side enters the scissura hippocampi. There remain two questions for consideration : first, to what extent does Professor Benedikt's confluent fissure type of brain prevail among ordinary members of the community, and how far is it reliable as an indication of defective development ? With a view of ascertaining how far the confluent fissm-e type of brain exists among the lower classes in this community, I have ex- amined carefully Go hemispheres from 34 individuals, all of whom were patients in, and died at, the General Hospital. Most of these were preserved by Giacomini's method, and as no special note exists as to the social standing or character of any of the individuals from whom they were obtained, the results are of value only so far as they show to what extent confluence of fissure occurs in that class from which the Hospital wards are recruited. 11 1 . The Fissure of Rolando communicated with — a. FissKre of Si/Ivins, in 8 completely, in 7 incompletely. />. Frontal (tulci., complete in 12 : incomplete, 9. a. Inter-j)arletal sulci, complete in 7 ; incomplete, 9. 2. The Fissure of Sylvius joined — a. The F. U. [see above.] /). 'YXxQ frontal in 20. c. The inU'r-parietaU complete in 26 ; incomplete, 8. d. The Ast temporal, in 15. 3. The Inter- parietal united with — u. The F. R. [see above]. b. The F. S. [see above]. c. The parieto-ocoipital in 18. d. The horizonal ov sitp. occipital i.; 14. e. The \»t temporal in 19. 4. The Calearine entered the seissn^'a hippocampi in 25. 5. The callano-niarf/inal joined the par. -occipital in 1. 6. The parieto-occipital iomod — a. The inter-parietal in 18. b. The horizonal occipital in 3. From these limited observations we may conclude — 1. That a considerable pro[)ortion of the brains of Hospital cases are of the confluent fissure type. 2. The chief difference to be noted between Prof Benedikt's series of criminals' brains and those which I have just gone over is the somewhat greater number of unions between typical fissures, more particularly between the fis. Rol. and contiguous ones. Thus in his set this fissure connected, completely or incompletely, with the fis. Si/l. in 24 instances ; in my series in only 10. In the other fissures the dispr(i|)ortion is not nearly so great. 3. Considering the number of brains of ordinary Hospital patients which ])resent in some degree the confluent fissure type, it would seem more reasonable not to assign as yet any special significance to it until we have fuller information about the arrangement of the convolutions in the various races, and until a much larger number of the brains of criminals of all countiies have been examined. 12 Professor Benedikt's cases were nearly all Slavonians or Hun- garians, and though Betz of KiefF, a leading authority, acknow- ledged the atypy of his specimens, it would have been more satis- factory to have had a comparison between these specimens and an e({ual number taken from law-abiding members of the same races. It may be urged that in Hospital patients the brains should con- form in considerable numbers to this 2nd or confluent fissure type, as many of them are individuals in the lower ranks of life, and not a few belong to the criminal class. This applies, how- ever, much more forcibly to dissecting-room material, which, as Dr. Benedikt says, " consists of the remains of those who have suffered complete shipwreck in life through low grade of intelli- gence, imperfect motor development, or through crimes and vice." In the series of brains which I examined, there were no dissect- ing-room specimens, and it did not include the brain of any notoi'ious criminal so far as I am awai'e. As to how far confluence of fissures is indicative of a low type of cerebral organization we also want fuller information. When existing in high degree, there is certainly an absence of many important annectants or bridging areas of brain substance, but when we consider the variable size of convolutions bounding the typical fissures, it is easy to see that defect in one part might be more than compensated for by excess in another part, and even a neighbouring part. In several of the brains which I examined, notably No. 10, the confluent fissure type existed in an organ with a rich convolution system. In the brain of Moreau, the retro-central fissure on the left side was separated from the inter-parietal by a distinct gyrus,which might as well be regarded as an excess, as absence of an annectant and confluence of two fissures might be considered a defect. With reference to the type of four frontal convolutions which Prof. Benedikt has found in such a large number of his speci- mens, I will only say that in 10 of the hemispheres examined it was observed in a greater or less degree of development. No- Avhere was it better seen than in the lijaiii..Qfl..ilayven). To enter upon the anatomical significance of this would be beside the question on this occasion. .3 Professor Benedikt's conclusions are those of a thorough- going somatist, who would bring all human conduct within the ramie of orjjianic action. " The constitutional criminal," he says, " is a l)urdened individual, and has the same relation to crime as his next of blood kin, the e[)ileptic, and his cousin, the idiot, have to their encephalopathic conditions." And again, " the essential ground of abnormal action of the brain " (i.e., I take it, bad conduct,) " is abnormal brain struc- • ture. His 44 criminals were what they were because of defects in the organization of their hemispheres : they belonged to the criminal variety of the (lemis homo. No wonder he says " that this [)roposition is likely to create a veritable revolution in ethics, psychology, jurisprudence and criminalities." He wisely adds that it should not yet serve as a premise, and should not, for the present, leave the hands of the anatomists, since it must be re- peatedly proven before it can finally rank as an undoubted addition to human science. Crime is commonly regarded as the result of yielding to an evil impulse wiiich could have been controlled ; and this element o( pomble control is what, in the eyes of the law, separates the responsible criminal from the irresponsible lunatic. The belief in a criminal iw/chosia is spreading, and is the outcome of sounder views of the relation of mind to brain ; and these investi- gations of Prof. Benedikt, to which I have so frequently referred, may serve as a foundation to a natural history of crime. But if this in the case, how are we to regard our criminals ? What degree of responsibility can be attached to the actions of a man with a defective cerebral organization ? Where is there scope to eschew the evil and to do the good, when men are " villains by necessity, fools by heavenly compulsion, knaves, thieves and treachers by spherical predominance." Any one who believes that with all our mental and moral processes there is an unbroken material succession, must consistently be Sideter)ninixt, and hold, with Spinoza, that '• in the mind there is no such thing as abso- late or free will, but the mind is determined to will this or that by a cause which is determined by another cause, this by yet another, and so on to infinity." For a long time to come, how- ■^'s:s:^ 14 ever, the majority of individuals — including some who are incon- sistent in so doing — will continue to hold the intuitionisf view, nowhere better expressed than by Shakespeare, when he puts into the mouth of that arch-criminal, lago, the words : " 'Tis in ourselves that we are thus and thus. Our bodies are our gardens to the which our wills are gardeners ; so that if we will plant nettles or sow lettuce, set hyssop and weed up thyme, supply it with one gender of herbs ov distract it with many, either to have it sterile with idleness or manured with industry, why, the power and corrigible autliority of this lies in (Uir will." " Theft and murder," as Huxley well says, '^ would be none the less objectionable were it possible to prove that they were the result of the activity of special theft and murder cells in the grey pulp." One thing is certain, that, as society is at present constituted, it catuiot afford to have a class o^ criminal automata^ and to have every rascal pleading faulty grey matter in extenu ation of some crime. The law should continue to be a " terror to evil-doers," and to let this anthropological variety (as Bene- dikt calls criminals) know [)()sitively that punishment will follow the commission of certain acts, should prove an effectual deter- rent in many cases, just as with our dogs, the fear of the whip exercises a restraining influence — immediate as well as prospec- tive — on the commission of canine crimes. The Brains of Oriininah. — Dr. Osier read a paper on this subject, and recorded the results of an examination of the brain of the murderer Hayvern, who was executed at Montreal on 11th Dec, 1881. (See paye ^85.) lie first referred to the observations of Benediktof Vienna, who, in 87 hemispheres from 4'1 criminals, has found certain peculiarities which he regards as indicative of a lower type of cerebral organization. The points upon which he most dwells are the confluence of many of the principal fissures, and the existence in a considerable proportion (27 of the 87) of four frontal gyri, the fourth being formed by the splitting of the first or second gyrus. This is regarded as an animal similarity. Hayvern was a low, dissolute fellow, addicted to drink, with no special neurosis in his family, who, on June 29, stabbed a fcUow- r 15 convict. The brain weighed 4H§ ozs., and was fairly well formed ; the cerebellum was completely covered by the cerebrum. On examination it was found to conform in many respects to Bene- dikt's cases, and was atypical, according to his views, in the following particulars : The union of the Sylvian fissure with the first frontal gyrus ; the junction of the intcr-parietal with the [jarieto-occipital and first temporal fissures ; the extension of the calcarine fissure into the scissura hippocampi ; the union of the collateral and calcarine sulci, and in the fusion of the first frontal gyrus, so that there appeared to be four frontal convolu- tions arising from the ascending frontal or anterior central gyrus. To ascertaiii how far these peculiarities exist^'d in the brains of hospital patients, Dr. Usler examined 48 hemispheres from 24 individuals, and found that a very considerable proportion were of the confluent fissure type. Thus, the Sylvian fissure joined the fissure of Rolando in H hemispheres, the frontal sulci in 18, the interparietal in 10, and the first temporal in 1*2. The chief diiference between Benedikt's series of brains of criminals and those examined was a greater number of unions between the typical fissures, more particularly the fissure of RolanJo, which in the tormer joined contiguous sulci in "24 instances. In 9 of the 4tj hemispheres there were four more or less distinct frontal gyri. He thought that nuich fuller information was needed about the arrangement of the sulci in the diiferent races, and many more criminals would have to be examined before any positive result was arrived at as to the constant atypical character of the brain in members of this class. Speaking of Benedikt's con- clusions, he (juestioned whether it was wise to speak of criminals as an anthro[)ological variety of their species. On his views there is no place left for responsibility ; but society cannot aflbrd to have a class of criminal automata, and every rascal pleading faulty gray matter in extenuation of his crimes. Dr. Henry Howard (Mctb-^ktpt. Longue Pointe Asylum) asked if it were known how many of the brains of the series of hospital cases were from criminals, and whether a larger proportion pre- sented abnormalities than could be reasonably thought to belong to this class. He believed in a criminal class as distinct as a ■^e-i'.. /t./;v i. 16 mercantile class, and regarded the mental and moral condition of the individuals belonging to it as dependent absolutely on their physical organization. Hayvern was not responsible for his act ; it was not premeditated, but performed under the influence of an uncontrollable impulse ; and he thought that there was evidence to show that it may have been connected with the epileptic neurosis. Dr. Kingston wanted to know how it was, if viciousness and crime were the product of defective cerebral organization, that some notoriously wicked men had reformed and lived sober and honourable lives ? Was it probable that with such a change there was any alteration in the structure of the brain ? Dr. Cameron thought that, for Benedikt's conclusions to have any value, it must be shown that criminals have invariably atypi- cal brains and all other people normal ones. Most criminals have some degree of control over their actions, and the law is an effec- tual deterrant in many instances, particularly where the penalty enacted touches the person. He illustrated the rapid abolition of garroting by the introduction of the lash, and quoted facts to show the good effects of capital punishment. Dr. Shepherd remarked that it was somewhat difficult to say what was the typical brain. The majority of observations were upon the lower classes ; we lacked data as to the arrangement of the fissures and convolutions in a large number of the intel- lectual members of society. He had freijuently seen brains of the confluent fissure type in the dissecting-room. Dr. Mills said that, with reference to the series of brains from hospital patients examined by Dr. Osier, the question arises as to how far such patients belong to the criminal class. In about one thousand patients that he had observed closely, he did not think that many of them ranked in this class. Dr. Osier, in reply to Di-, Howard's question, stated that the series of brains which he had examined were nearly all preserved by Giacomini's method, and no data existed from which the social status of the individuals could be ascertained. In the 43 hemi- spheres (19 perfect brains and 5 halves), 19 presented one or more atypical features.