ON THE RELATION BETWEEN

LAW AND MEDICINE, WITH ESPECIAL REFERENCE

TO THE PRINCIPLES OF THE MEDICAL

JURISPRUDENCE OF INSANITY.

BY EDWARD C. MANN, M.D., Brooklyn, N. Y.,

Member of the Medical Society of the County of New York; New York Medico-Legal Society, etc.; Superintendent Sunnyside Private Hospital for Mental

and Nervous Diseases; Associate Editor of Medico

Legal Journal of New York.

In the relations that exist between medicine and law, the testimony of experts is necessary for the purpose of arriving at truth in certain medico-legal investigations. The testimony of skilled witnesses is essential to a due observation and appreciation of facts, and such testimony can only deserve its name and fulfill its function when the witness is really skilled, that is, when he possesses those qualities of mind, that education of habits, and those stores of information which alone can make him a competent observer. It is because medical witnesses have often been unskillful in the particular directions in

which their evidence has been taken, that so much discrepancy has occurred in their statements. Scientific testimony does not fail in the matter of facts because it is too minute, too cautious, or too true, but rather because it is wanting in minuteness, carefulness and precision. When it fails, it is because it is not the testimony of an expert. When facts are admitted there is often a great diversity of honest opinion with regard to their interpretation, which results from the varying range of experience and the different temperament of mind of those giving medical evidence. It is the want of observation of facts which mars much expert testimony. A man must have a broad and progressive, and not an antiquated and stagnant mind, to survey a wide range of human thought and feeling in such a manner as to be able to give valuable opinions. The conditions therefore which determine the existence of discrepancy in the statement of both facts and opinions, are to be found in the nature of medical science and in the varying power of observation and reflection possessed by experts.

The ultimate object of both the medical and the legal profession is truth.

Many ideas entertained twenty years ago are not accepted by science to day. Science is progressive, and its existence is one of growth and change.

Its growth must remove old lines, which, although expressive of the truth entertained twenty years ago, do not express the truth as that is now received.

As the result of this, in medico-legal inquiries, the

issue that is raised is often the wrong one. The real point may be that of capacity or incapacity of a person. to manage his affairs, make a will or contract a marriage. The issue is raised as to sanity or insanity of mind and then by the present Code of New York, which is like that of some other States, the Judge has no option under the code, but to instruct the jury to insist on a test which it is impossible to apply, which is antiquated, and which fails to express the science of the present.

Let us look for a moment at this difference in opinion as to the sanity or insanity of an accused person on trial, see what gives rise to the difference in opinion, and, from the method of forming the given opinion, try to ascertain which is probably the correct one. In any given case the lawyer is governed by a precedent that may be wrong. The law decides to adopt a line, to which science must be brought to bear in its legal relationship. The law says, the line shall be drawn here, and all the evidence that an expert can give must be brought to that standard and tried by that test. Very good, provided, that the law will say to me as a physician, "We stand ready to make fresh lines of a provisional nature, as we recognize that science is progressive and that all tests must, in proportion to its progress, fail to represent its true position." But the law does not say so. If I am called upon in my professional capacity to treat one of our judges, I am expected to act in conformity with the fine modern distinctions which have been established between numerous forms of acute specific