JAMA. 1912;LVIII(11):771-772. doi:10.1001/jama.1912.04260030169011.
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The object of reporting this case is to point out the imperative need of early diagnosis of mental disease and to cite an example of the wrongs suffered by the insane because mental disorders are overlooked.

Every prison surgeon has, no doubt, met, in his routine examination of prisoners, persons who properly belong in the hospitals for the insane. My statements apply to only those individuals who are sent to penal institutions because they have been convicted wrongfully of some statutory offense which was the symptomatic expression of an unrecognized mental disorder; they do not apply to those persons who are instinctively criminal and whose constitutions are so degenerate that they frequently develop active psychoses when brought into conflict with the law.

It is of paramount importance that the general practitioner should be able to diagnose mental disorders in their incipient stages, that appropriate custodial and medical treatment may be


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