It is remarkable that mental aberration of a severe degree can be present yet be so concealed as to go unrecognized or unattended by otherwise sophisticated clinicians. It is a rare person who has not been shocked at accounts of some irrational, destructive act committed by a seemingly normal human being who suddenly became berserk. Often, for a long time afterward, people are preoccupied with finding clues that could have warned of such impending behavior. Not infrequently, the alerting signs, if they had been interpreted correctly and heeded, were present, and the act would have been preventable. But, while hindsight is often too late to help the injured or dead, if one can learn from the experience, it becomes salutary to review situations that might otherwise be considered macabre speculation.
For example, a BRIEF REPORT on page 2188 describes an extraordinary case of mutilatory autosurgery. This article is not presented,