which
engrafts itself upon the individual without any apparent cause, a
psychosis possessing a course and termination wholly independent of
outside influences, a psychosis having no tangible relation to any
definite situation; or have we here a psychogenetic disorder, a
pathologic reaction of a degenerative constitution to an unfavorable
situation, a paranoid picture developing as an outgrowth of the
individual in reaction to a definite experience?" In other words, are
we dealing here with a case of dementia praecox, or with one of the
degenerative psychoses? If we agree with Stransky[5] that dementia
praecox depends upon an intrapsychic ataxia, that it is the disturbed
cooerdination between the intellectual and affective faculties of the
individual which makes the picture of dementia praecox what it is; this
is not a case of dementia praecox. The acute emotional reaction to all
situations which this man manifests, the development of the psychosis in
consequence of the depth of his feelings concerning the unpleasant
experiences and the entire absence of this important incooerdination
between his feeling and acting, would, in itself be sufficient to
separate his psychosis from dementia praecox. If we agree with Kraepelin
and others that dementia praecox has a more or less definite onset, a
more or less definite course and termination in a dissolution of the
individual's psyche, our case is not one of dementia praecox. Our patient
has had the same attributes of character and personality always. There
is no indication in his life history of a definite onset of a retrograde
process, or of any progression towards dissolution. His psychosis, such
as it is, is the outgrowth of his degenerative personality, and if we
assume this to be true, if we consider the psychotic manifestations of
this individual as a pathologic expression of his anomalous personality,
the question arises--to what extent have his criminal acts likewise been
pathologic expressions of the same underlying degenerative basis? I
believe that the relation between the criminality and mental alienation
of this man is analogous to that existing between two branches of the
same tree. The same degenerative soil which makes the development of the
psychosis possible in one case, expresses itself in crime in another
instance. The factors which determine whether the one or the other phase
will manifest itself, depend largely upon environmental conditions, and
are acciden