The line of demarcation between sanity and insanity, like that between health and disease, is sometimes so nebulous that it becomes exceedingly difficult to decide where the one ends and the other begins. It is not a matter of wonder, therefore, that differences of opinion should arise in this connection, particularly when the question of responsibility is raised. There has been not a little discussion as to the existence of so-called moral insanity as an entity, but despite the objections to its recognition, the disorder has retained its place in mental nosology. Perhaps the term moral imbecility would be preferable. The affection must be looked on as a degenerative one of congenital origin. The general intellectual functions may be unimpaired, while the moral sense is lost in greater or lesser degree.
What must be considered one of the most remarkable instances of moral or criminal responsibility on record has been
MORAL INSANITY.. JAMA. 1904;XLIII(11):740-741. doi:10.1001/jama.1904.02500110034007