we may always be assured, that if mental anxiety or perturbation be more than commensurate with the exciting cause, it may be presumed that the individual is labouring under the incipient indications of insanity.[64] This view of the case is strengthened if an hereditary predisposition to the disease should also be present. “It will be said,” says Esquirol, “that there are individuals who, in the midst of affluence, grandeur, and pleasures, and in the full enjoyment of reason, have suddenly put an end to their existence, immediately after parting with their friends in good spirits, or after having written letters on business with perfect correctness. Can these be said to be insane when they commit suicide? Yes; most undoubtedly. Do not monomaniacs appear perfectly sane on all other subjects, till the particular idea is started which forms the burden of their hallucination? Are they not capable of curbing the expression of their delirium, and dissembling their aberration of intellect? It is the same with sane individuals, over whom the suicidal idea tyrannizes. A physical pain, an unexpected impression, a moral affection, a recollection, an indiscreet proposition, the perusal of a passage in writing, will occasionally revive the thought and provoke the act of suicide, although the individual the instant before should be in perfect integrity of mind and body.” In general, most persons actually insane wish not only to be esteemed free from the malady, but to be considered as possessing considerable intellectual endowments; hence, _real_ lunatics seldom allow the existence of their lunacy; but are always endeavouring to conceal from observation those lapses of thought, memory, and expression, which are tending every moment to betray them, and of the presence of which they are much oftener conscious than is generally apprehended or believed. Alexander Cruden, when suffering under his second and last attack of mental aberration, upon being asked whether he ever was mad, replied: “I am as mad now as I was formerly, and as mad then as I am now, that is to say, _not mad at any time_.”