Epilepsy, Responsibility and the Czolgosz Case
I define epilepsy as
a more or less transient and spasmodic affection of the psychic
functions, with or without motor or sensory manifestations.
There is a more or less sudden and
unaccountable break in the continuity of the conscious mental activities
of the subject, so that cases of muscular spasm or tremor, as in
tetanus, chorea, etc., in which there exists no apparent aberration
of consciousness, are excluded from this category. And yet a mental
factor presumably exists in all convulsive cases, since when mind
has departed, as in death, by shock, even electricity almost immediately
fails to produce a reaction.
Dr. Russell Reynolds has defined the
essentials of epilepsy as a diminution of intelligence and muscular
spasm. But muscular spasm, as it is usually known, is not a constant
condition, while psychic aberration is. Dr. Baker, of the Broadmoon
[sic] Criminal Lunatic Asylum, regards loss of consciousness
as the pathognomonic sign of epilepsy, (1) while Dr. Wilkes, of
Guy’s Hospital, relates several cases in which coma was the only
symptom, and one case in which automatism alone existed (2). Many
similar cases can be cited. But there is no dispute that in some
cases the psychic manifestations exist alone, while in other cases
convulsions with simple loss of consciousness are practically all
the phenomena observed. These two main forms or aspects of epilepsy
often alternate in the same person, either speedily or after considerable
intervals, even months or years. But whether it is mind or muscle
that gives expression to the malady, the manifestation is essentially
a form of spasm, inasmuch as there is a more or less sudden interruption
of the subject’s normal currents of vitality and intelligence. Dr.
Hughlings-Jackson has curtly described these convulsions as a brutish
development of many of the subject’s ordinary movements, and the
description is quite as appropriate to psychic cases, although not
in any reversion sense.
The sensory perversions in epilepsy
exist either during loss of consciousness or are manifested by some
kind of hallucination during one of the stages of a fit. Common
sensation is usually diminished.
It is evident to most thoughtful observers
that epilepsy is manifested by a great variety of conditions extending
all the way from a momentary lapse of thought, or a vertige, or
a simple automatism, to the condition of violent mania or clonic
convulsions. The petty varieties seem to bear much the same relationship
to the sthenic forms that a trickle does to a flood, or a whiff
to a tornado; while the equation in epilepsy is, of course, more
complex. Drs. Gowers, Fere, and Hughling-Jackson find that there
are as many epilepsies as there are epileptics.
The modern theory of the origin of
a fit places it in the gray matter of the brain, i. e., the cortex
cerebri, more or less of which is supposedly surcharged with nervous
energy, whatever that may be. But there seems to be no substantial
support for such a view, for we do not know that any organic cell
can store anything in the way of excessive cargo. A morbid cell
is a functionally defective cell, while a cell functioning normally
is an orderly agent, whatever its degree of activity may be, and
cannot be conceived as reserving anything for a sort of whimsical
flash, which must necessarily disturb its own integrity. Even the
discharged energy of the gymnotus electricus is not a surplussage
but the product of a conservative provision, in natural economy.
That during a cell’s activity its energy can be raised or lowered
within certain limits, according to whether it is well or ill favored,
is not questioned, and thus its power of resistance to certain irritants,
or its capacity to respond to certain exactions, will vary with
altered conditions, i. e., with its supply and demand of 
means for energizing. There may exist an excessive sensitiveness
or activity in brain cells in epilepsy, or the inhibatory [sic]
relations may be disturbed, owing to defects in the nerve cells
of the brain, i. e., the cortical neurons and their branches, which
defects may impair connection and thus increase resistance. But
all such views are merely speculative, as indeed is the case regarding
the pathology of other insanities, for in a considerable proportion
of all so-called idiopathic forms of insanity, the brain shows nothing
whatever that can be described as abnormal. Thus it is evident that
lesions found in cases which are not produced by mechanical violence
can only be regarded as mere casualties or products and not as causative
factors. Indeed those occasional cases of insanity of many years
standing, but which finally recover in a more or less sudden manner,
quite disprove the necessity for any organic pathological correlative.
And to this we may also add the evidence of the many recorded cases
of extensive and destructive brain lesions existing without any
mental manifestations whatever of a distinctly aberrant character.
Epilepsy is indeed frequently associated with gross lesions of some
kind, the removal or mitigation of which is sometimes, but quite
seldom, followed by relief from the epilepsy. Such recoveries are
probably due to what may be termed an accidental alteration of functional
balance, or some form of sympathetic readjustment. At all events,
we must look for a form of functional perversion irrespective of
any organic disease. Nor is it necessarily a brain disease any more
than fainting or vertigo are, without denying that the brain takes
a part in the act. A physical shock or mental shock may cause any
of them. For example, a blow on the stomach, or a fright; while
in monkeys a trifling intravenous injection of absinthe will produce
epileptic fits without exception. (3) It is said that practically
the same result takes place in man. Dr. Julius Donath produced epilepsy
in animals at will by stimulating the cervical sympathetic, while
if the sympathetic was cut no fits could be produced (4). Yet removal
of the superior cervical ganglia from both sides of three epileptic
patients did not affect their fits. And lastly, the observations
that chickens hatched by incubators and squirrels and various other
creatures deprived of their liberty almost invariably become subject
of epilepsy, go to show how slight a variation in the tempering
of the mental nexus is required to permit a disjointing,
so to speak, of the associative processes. They also indicate that
the essential element in epilepsy is a psychic defect, whether it
be appreciable or not, for it is to be noted that the chickens referred
to have no natural mother, while the other creatures have lost their
natural home or environment, while their food and other conditions
are about the same as in normal cases. These are observations worthy
of farther reflection. It is therefore evident that the problem
of epilepsy is essentially one of physiologic psychology.
Epilepsy occurs everywhere
from the top to the bottom of society. It afflicts the saint, the
sage and the sinner alike and even the infant in the cradle, so
that it cannot be charged as an evil for which the subject is in
any way necessarily responsible, since it may arise under conditions
for which the subject could in no way be responsible. Of course
evils cannot arise when strictly normal conditions exist within
and without, for the simple reason that everything must have an
efficient cause, so that if we seek for originating causes we must
carry our analysis into the realms of heredity, tradition and moral
and intellectual environment.
But in facing the question of personal
responsibility it is sufficient to define epilepsy as essentially
being an abnormal mental state for which the individual is not responsible
because its origin is spontaneous and is not a matter of choice.
I do not mean to say that conditions preventable by the subject
are  not at times contributory
causes. But this point is not legally available, inasmuch as its
decision depends upon the subject’s private personal experience
and even if admitted, the elements of heredity and environment could
be pleaded as complications and predisposing factors and, most likely,
the sine qua non of the case.
At this point just a word regarding
the principle of responsibility. We are responsible creatures only
in so far as we possess the powers of discernment and choice, i.
e., if we have the power to know correctly and also the privilege
of knowing to an extent equal to our needs both in regard to ourselves
and our social duties and in addition if we possess the power of
choosing equal to our needs and social relations, then indeed we
are responsible, i. e., we are competent to respond to the requirements
of any position we are rightfully placed in. In other words, we
must in some way be co-ordinate and co-equal to the conditions required,
else we simply cannot comply with them, so that justice cannot exact
by a standard that is any higher than the factors which the heredity
and history of the individual can furnish for a formula of conduct.
Thus the standard of justice is no more and no less than the standard
of the individual subject. It is quite evident that we must know
right before we can do right in the sense of a moral obligation.
While it is also a well known fact that we may know the right and
not be able to do it. If either of these factors, which are the
prerequisites for responsibility, be absent or defective, responsibility
is correspondingly impaired. Even the knowledge of right and wrong
either in the absolute or relative sense in any given case is not
proof of responsibility, for often where the knowledge exists the
power to choose that which is clearly right may be lost through
the cumulative effect of habits or conditions which the subject
may have been led or driven into, or perhaps by some kind of seizure
or sickness quite as inexplicable as is the origin of epilepsy.
Witness especially some of the strange and even horrid practices
of certain alien peoples or the marked change of character in some
of our own friends which occasionally follows acute ailments.
But psychologically and theologically
speaking, responsibility, as a qualification implying the liability
to receive punishment in the operation of justice, cannot possibly
exist unless the individual is conscious of ill desert, and this
consciousness must not be a vague feeling arising from the imagination,
which indeed, it frequently is, but it must come as a clear cut
conclusion drawn from first principles, i. e., the knowledge drawn
from common experience applied to the special circumstances of the
case, in order that justice as a process of retribution shall be
properly effected. But retributive justice is infinitely beyond
man’s power of administration and a discussion of it here is beyond
the scope of this paper. However, I think I have suggested how sadly
unjust are our present legal methods which operate in the name of
justice—using, as a rule, but one standard, and, as a rule, applying
but one method of treatment, and that a brutish penalty.
But back to our subject in its medical
aspect. A perverted state of mind is a state of mind which more
or less incapacitates the subject for acting in a proper, efficient
or normal way. He is not himself, so to speak, and he can’t help
it, for the time being, at least. Normally his conduct is presumably
representative of the society in which he has lived prior to maturity
and is regulated by general principles, common experience, inculcated
precepts, prevailing sentiments, common usages and every-day habits.
But when his mind is involuntarily thrown into an abnormal condition
through external and internal conditions which he could not control
and did not create, his ordinary character qualities lose their
inhibitory power over what he would normally regard as wrong-doing.
In this condition he may be dominated by 
notions which are in their nature wrong or by feelings which are
in degree excessive. He may still in a measure be amenable to discipline,
such as threats and kindness, a fact which only goes to show that
his perceptive powers have not been annihilated but are, in certain
aspects at least, weakened and aberrant. Usually (excluding stupor
and delirious mania) there are certain lines of thought that become
distorted through some undue influence, perhaps both physical and
mental, and which deprive the subject of self control. The chief
psychological fault is an imperfect range of his mental vision,
a sort of fragmentary perceptiveness, owing to breaks in the individual’s
associative processes. Thus the power of the subject as a free agent
to respond in a proper way to the standards of society, is crippled
or destroyed because the faculties of spontaneous and voluntary
association of ideas along pre-established lines are damaged or
destroyed. Such breaks may render him abnormally suggestable [sic]
and keen in certain directions and correspondingly obtuse in other
directions, so that a condition of unbridled impulse may arise through
a flock of ideas coming to the front which have been either checked
or dispersed by his common normal habits of thought, the very regulators
of ordinary social circumspection. The ordinary monitors of the
mind are thus thrown out of their normal relations, are devitalized,
so to speak, and rendered inoperative as factors inhibitory to wrong
doing and thereby the individual has lost his responsibility because
the factors which give and constitute responsibility in any true
sense, now fail to respond to the very calls which in the subject’s
normal state would have been effective. The light from the lamp
of reason has become more or less eclipsed or obscured by an alien
and fortuitous agency for which no one as yet has been able to account,
and therefore is in no sense a product of the subject’s choice.
To hold such a person responsible for a crime would be just as reasonable
as to demand that an old-time swimmer who has lost one or both arms
shall attempt to save even a drowning monarch, or to blame a misdirected
stranger for taking the wrong course.
It must be granted that an epileptic
is a lunatic pro tem. His mental balance may be lost for
but a moment or for minutes or for hours or days or weeks or months.
If his conduct during this spell has been ridiculous or even grossly
violent and without any purpose that seems intelligible to others,
he will quite likely be admitted to be insane by even a stupid jury.
But if, as quite often happens, he display an impulse which corresponds
to some known provocation and which he may have held in check for
a longer or shorter period, the apology of insanity is not so readily
granted, for too frequently it is supposed by laymen that lunatics
are entirely devoid of ordinary motives, just as if the loss of
some ideas necessitated the loss of all or precluded the operation
of previously acquired knowledge and sentiment. And yet the rush
of a latent or restrained impulse is to be most expected when the
normal or standard inhibitory powers are thrown aside without a
conscious act. Under such conditions a pent up emotion will naturally
assume freedom of execution just as the conceptions of a musical
amateur have been displayed with transcendent excellence only in
the course of a somnambulistic trance. In both cases the emotions
or desires are untrammeled by certain restraints of previous teaching
and experience and which operate under ordinary conditions. As before
observed, in epilepsy only certain inhibitory or regulating powers
may be lost, while in all other respects the subject may be keenly
perceptive in a more or less automatic way.
The remark occasionally met with that
all epileptics do not commit crime and which is intended to suggest
that the crime is something apart from the epilepsy and should be
so treated, is quite on a par with the observation that all whisky
drinkers do not have red noses. To skeptics we can also quote the
 maxim that it was the last
straw that broke the camel’s back and without it the camel’s back
would not have been broken. There are psychological as well as physiological
variants in the personal equation which are just as inexplicable
as is epilepsy and it cannot be expected that the same cause differently
associated will produce all of the same results. And is it not true
that there are moments in the lives of nearly all men and women
when if but a single thought were obscured, a so-called “righteous
indignation” would quite naturally culminate in a crime. But as
previously indicated the background causative factors chiefly belong
to heredity and environment and which on the moral side are mainly
the products of social and political conditions.
Between spells epileptics must be
regarded as combustible material to an unknown spark, and in the
event of crime they are entitled to the presumption of temporary
insanity. There certainly cannot be a more worthy occasion for the
“benefit of the doubt,” at least until the case is properly studied.
In my opinion the attitude of the medical expert should accord with
the true spirit and purpose of the law, i. e., justice and economy.
The ordinary idea of punishment which is usually the object of a
state trial should be entirely expunged by a rational theory of
remedial treatment, for even the desire to inflict punishment in
the ordinary legal way is itself a sign of an abnormal disposition,
the product of an exaggerated ego and defective intelligence. This
is true absolutely and without exception, so that the attitude of
society which will best serve and the one most likely to secure
justice to offenders is the attitude of true charity, i. e., study,
explanation and the application of remedial treatment in accordance
with the intelligence of the times and the spirit of the universal
It is doubtless a long
way between a yawn and a fit, and yet there presumably exists a
degree of kinship inasmuch as both phenomena are spasmodic and involuntary.
According to Sir William Gowers, the most frequently observed prodroma
of epilepsy are sudden jerks of the body or limbs, and it seems
to me quite probable that the assassin Czolgosz was not far from
being an epileptic, for it was reported of him that he had marked
twitchings of the right forearm while in the court room and of the
lower jaw just before his electrocution. He probably had similar
manifestations at other times. Fear or emotional agitation could
only be regarded as exciting causes at the most, for involuntary
spasms always indicate an important physiological fact, whether
or not they can be regarded as prodromal or epilepsy. It is true
such phenomena are frequently observed in persons quite properly
regarded as sane, although they may possess but a shell of sanity
liable to break down by just a little more pressure. A thoroughly
sound person does not have such manifestations under any circumstances
of purely mental influence.
But in analysing the Czolgosz case
I will discuss his mental condition from three view points, namely:
(1) The act. (2) His behavior subsequent
to the act. (3) His history previous to the act.
The present sketch is necessarily
very brief, yet I think it presents the essential nature of the
case quite distinctly and fairly.
In reference to the act I may first
observe that acts themselves indicate the mental condition of the
actors, when all the circumstances are known, and that in reality
they constitute the best of evidence, just as the work of the mechanic
exhibits his skill, or the lack of it, when the purpose and conditions
of his labors are known.
The evidence of sanity essentially
depends upon the integrity of reason, 
the chief tests for which are constancy, coherence,
and a rational necessity or expediency for all acts.
In regard to the indications of the
act of Czolgosz, I deem the following points worthy of serious consideration,
and as indicating insanity, viz.:
(1) At the age of 28 and after a life
record of an exceptionally (abnormally) retiring and peaceful disposition,
he suddenly appears as a great criminal. Had he been sane, this
would imply an infraction of the law of normal growth.
(2) His act was not only homicidal
but it was also deliberately suicidal, for he expected to be hanged
for it; yet it was not based upon any philosophy, teaching or experience
within his knowledge or imagination which offered him any hope of
reward of any kind, either in time or eternity.
(3) His act was wanton, for he had
in mind no benefit that would or could accrue to any person or class
of persons; while, on the other hand, had he been simply an anarchist,
he would have known that distress or disfavor would fall upon all
of his class. But his act appears as motiveless as is the case in
(4) Such a monstrous conception and
impulse as the wanton murder of the President of the United States,
arising in the mind of so insignificant a citizen, without his being
either insane or degenerate, could be nothing short of a miracle,
for the reason that we require like causes to explain like results.
To assume that he was sane is to assume that he did a sane act,
i. e., one based upon facts and for a rational purpose.
(5) If he thought President McKinley
was “the enemy of the good people, the poor working people,” as
he asserted, the notion must be conceded to be the pure product
of a deluded imagination, for there was no evidence of any kind
or anywhere in support of it. And there is no evidence that Czolgosz
was a prophet, statesman or philosopher of transcendent insight.
(6) His act was not the natural product
of any form of systematic thought. He was not an anarchist nor a
student of anarchy, nor a student of anything else; while the fundamental
principle of anarchy is a denial of the right of any one to interfere
with the liberty of any one else, and thus it is opposed to the
committing of violence in any form.
(7) The “I done my duty” notion was
evidently an imperative idea of a purely impulsive origin, for he
did not believe he had been specially called to do the deed. Such
a condition is common among lunatics, especially in the earlier
stages of their affliction. It is also to be observed that the impulse
arose suddenly from a suggestion through something he read three
or four days before his murderous assault.
(8) His act was not an act of revenge
of any kind, for the President had wronged neither him nor a relative
of his, nor a friend of his, nor any class of people in which he
had the slightest interest.
Now, granting that these points are
true, let us ask where was the rational motive, purpose or basis
in this act? How much was it like a rational philanthropic act or
a criminal act of the selfish order?
If we inspect the remarkably brief
and superficial report made by the State’s medical examiners, (5)
we will find in it a few straws which indicate something of the
condition of his mental undercurrents shortly before and shortly
after the assault. To-wit:
(1) Mental wandering and abandon,
e. g., a few days before the act he went from Buffalo to Cleveland,
a distance of nearly 200 miles, “just to look around and buy a paper,”
as he declared.
(2) Insane vacillation, e.
g., on one occasion he denied that he killed the President or had
any intention of doing so, but a few minutes later he remarked,
“I am glad I did it.”
(3) Logical incongruity, e.
g., he declared that any one had a chance on 
trial and that perhaps he would not be punished so badly after all.
Yet from first to last, he treated the only persons, his lawyers,
who could secure the chance for him, with the most contemptible
(4) Moral chaos, e. g., he
declared he did not believe in government nor in law, nor in marriage,
nor in God.
(5) Insane egotism, e. g.,
his reason for killing the President was “I done my duty. I don’t
believe in one man having so much service and another man should
Now, let us ask ourselves if any of
these conditions indicate a sane and responsible state of mind.
In regard to his previous history,
my investigations, personally made at his home in Cleveland, disclose
the following facts, namely:
(1) As a child he was markedly indisposed
to associate with other children.
(2) As a young man he studiously avoided
the opposite sex and did not have a chum of any kind.
(3) He was seldom distinctly ill,
yet he was almost always complaining of ill health and frequently
(4) He was notoriously prone to fall
asleep in a chair at any hour of the day, and as indicating a common
peculiarity, his bright old aunt termed him an “old grand-mother,”
because he had such “a tired, stupid way.”
(5) He took special interest in nothing,
never spoke at club meetings and was with difficulty induced to
read any kind of literature, even that of the Social-Labor party,
the local club of which he was for some time a member.
(6) At the age of 24 years he quit
work at the wire mill on account of his health, as he claimed to
his relatives, and went to live on his father’s farm, where he remained
until about two months before the assassination. Here he lived in
comparative idleness, claiming that on account of his health he
could not do farm work, and actually did nothing but petty odd jobs
just when he “felt like it.” He had no books and did no reading
excepting as he casually picked up a local German newspaper which
came to the family.
(I wish here to acknowledge my indebtedness
to Mr. L. J. Czechowski, the druggist of the neighborhood of the
Czolgosz family, for his most valuable assistance in my Cleveland
We thus see that his previous history
reveals the development of a distinctly abnormal condition in his
character and which could hardly be expected to continue much longer
without a break or some peculiar overt manifestation, the precise
form of which would more or less depend upon the suggestions made
to such a peculiar mind by passing events.
And yet he has been declared an “anarchist,
sane and responsible” by the State’s medical advisors. If, however,
we examine the introductory remarks of their official report, we
find them congratulating themselves that they had an early chance
to examine Czolgosz “before he had time to meditate upon the enormity
of his act,” which is simply a frank admission that they believed
he did not realize at that time the enormity of his act, and therefore
that he must have been insane. It is also an admission that they
expected a reaction would follow in the assassin’s mind, i. e.,
that he would recover his senses and become sane and then begin
in some manner to play off, so to speak. But it seems that after
all the “done my duty” idea of Czolgosz held him up from start to
finish, quite as insane egos commonly do.
The declaration by the medical examiners
that he was neither insane nor degenerate (degeneracy is supposed
to be a sort of insanity dependent upon or co-existent with inherited
organic defects) quite ignores the theory of evolution, while it
does not even indicate how such a monstrous act could be perpetrated
by a “sane and responsible” person. The sanity of an American citi-
 zen must indeed be a strange
and uncertain quantity according to any standard that admits of
such a declaration.
Czolgosz was not a type frequently
found in our public lunatic asylums, but rather an aggravated specimen
from the insane borderlands. Four years of voluntary idleness on
a farm remote from city privileges, and at a time of life when normal
young men are most alive and ambitious, could hardly do less than
increase the very morbidity which must account for such a choice.
And while it would increase his abnormal feelings and suggestibility,
insane conceptions were but naturally bred under such conditions.
His main delusion, his “duty” as he called it, was fixed to the
last, which is reasonable evidence that it had an established setting
which required but little suggestion of an abnormal kind to break
through his remaining circumspection. Delusions which are based
upon some system of reasoning are not so fixed against opposing
reasoning or evidence as are delusions which more or less suddenly
enter or arise in the mind by virtue of some form of mental disorder
which so entangles them that no amount of reasoning can dislodge
them. Czolgosz can no more be regarded an anarchist or a rational
product of anarchy than a casual visitor to a synagogue can be regarded
as an orthodox Jew. Neither the Cleveland superintendent of police
nor myself could find any trace of any interest or of any association
whatever on the part of Czolgosz with either anarchy or anarchists.
Yet I do not deny that his disordered mind was moved by notions
which he attributed to anarchy, as it is commonly understood. But
I have seen cases which an orthodox sermon or a series of camp-meetings
have led to the lunatic asylum. Yet the normal effect of Christianity
is not that way.
Since writing the preceding
paper, I met with a recent article by Dr. Regis of France, on Regicides,
from which the following extracts are taken (6): Refering [sic]
to the mental condition of regicides Dr. Regis says: “Some idea,
good or bad, following on such prepared soil, soon germinates in
an exaggerated manner; whatever sane reason such a subject may have
possessed up to that date, gives way to a sickly choking ideation
which ends in the subject’s delusional conviction that he is called
on to deal a great blow, to sacrifice his life for a just cause,
to kill a monarch or a dignitary in the name of God, the fatherland,
liberty, anarchy or some other analagous [sic] principle.”
“It is impossible, it seems to me,
to consider these individuals as ordinary criminals and not to see
in them fanaticized, sick men, almost at the point of suffering
from delirium. They are so identical one to the other that the resemblance
may be traced trait for trait.
“On the ground of the ensemble of
their natures, I define them as follows: Degenerates of a mystic
temperament, who, misguided by political and religious delirium,
complicated sometimes by hallucinations, think themselves called
on to act the double role of judiciary and martyr; who, under the
influence of an obsession that is irrisistible [sic], kill
some great personagle [sic] in the name of God, the country,
Liberty or Anarchy.
“Besides, regicides who survive almost
invariably end in insanity and complete dementia. This confirms
my opinion that they are unbalanced. As examples may be cited Sahla,
Galeote, Passanante, Berardi and Acciarito.
“And yet, although sick, although
delusional, although impulsive, they are almost always treated as
responsible individuals, condemned to death both in order to punish
them and make examples of them. For my part I think this method
is both erroneous and unprofitable and that society would be the
gainer by treating these dangerous subjects, who so often cause
upheavals of government, as insane patients.”
Marshall Field Building, Chicago.