GOVERNMENT HOSPITAL FOR THE INSANE, January, 1916. CONTENTS CHAPTER PAGE PREFACE v I PSYCHOGENESIS IN THE PSYCHOSES OF PRISONERS 1 II THE NATURE AND TREATMENT OF THE PSYCHOSES OF PRISONERS 66 III THE FORENSIC PHASE OF LITIGIOUS PARANOIA 132 IV THE MALINGERER: A CLINICAL STUDY 156 V THE ANALYSIS OF A CASE OF KLEPTOMANIA 239 INDEX 267 STUDIES IN FORENSIC PSYCHIATRY CHAPTER I PSYCHOGENESIS IN THE PSYCHOSES OF PRISONERS That mental disorder may be due to causes purely psychic in nature is acknowledged by everyone. The older psychiatrists laid much stress on this point, a revival of which may be seen in the present-day widespread psychoanalytic movement. The reaction to the all too-embracing materialistic tendencies which have dominated psychiatric thought in recent decades was bound to come. It was especially the clinician who gave the impetus to this movement, because in pursuing the materialistic bent he found himself totally helpless as a therapeutist in the great majority of mental cases, and was therefore eventually forced to seek more promising paths. Bleuler's attitude towards this question, because of the prominent position he occupies in the world of psychiatry, is interesting. "Bleuler, who succeeded Forel as Professor of Psychiatry and Medical Director of the Cantonal Insane Asylum (Burghölzi) at Zurich, having become convinced that no solution could be arrived at along this anatomical path for the many riddles offered by the disturbed mental life, had for years chosen the psychological path. He was led to take this course because he knew that of the chronic inmates of the asylum, only about one-fifth showed anatomical changes of the central nervous system sufficient to explain the mental deviations exhibited."[1] The results already achieved by this change of attitude in psychiatry are sufficient justification for its existence. One became especially convinced of the potency of mental factors in the production of mental disease from the observation and study of the psychoses of criminals. Here the conflicts which lead an individual to seek in mental disorder a satisfactory compromise are so concrete as to leave no doubt concerning cause and effect.