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ELECTROENCEPHALOGRAM IN WITNESS-BOXAT a general court martial last winter a soldier who

had fired a rifle at a corporal pleaded that he had noknowledge of the affair but had suffered a head

injury a few hours before the alleged time of theincident. No-one had witnessed the injury, andthere was little clinical evidence to support the plea,except that the attack was without motive, unpre-meditated, and was followed by singularly apatheticbehaviour. An electroencephalogram showed abnor-mal changes compatible wtih a head injury of theseverity described by the prisoner, and the abnormali-ties subsided in a couple of weeks. This evidence wasaccepted and the man was discharged. On July 14, aman was tried at the Winchester Assizes for a singu-larly brutal and seemingly purposeless murder. Thedefence was that the act was committed in a periodof postepileptic confusion. Expert medical opinionsupported this view on the evidence available, someof which was tenuous. Evidence was produced thatthe man had an abnormal EEG and that the changesseen after over-breathing were epileptic in character.It was pointed out that although an absolute diag-nosis of epilepsy could not be made on the EEG alone,since no subclinical attacks were seen, the presenceof such a record in a man who had behaviour suspiciousof epilepsy -made that diagnosis very likely indeed.The prisoner was found guilty of murder but insane.A correspondent in the Times of Sept. 16 suggeststhat the verdict might well have been different if theEEG had not been before the court. Since these twocases, similar evidence has several times been calledelsewhere, and it has been accepted in courts of lawin the United States for some time past.The electroencephalogram does not show charac-

teristic changes in every case of epilepsy, and in onlya minority of epileptics are true subclinical attacksseen. Furthermore the relatives of epileptics, them-selves apparently normal, may show similar abnor-malities,! and unstable people, including psychopaths,2criminal delinquents and even constitutionally pre-disposed neurotics,3 are liable to have an abnormalEEG. HILL 4 has pointed out that since it may reason-ably be assumed that a high proportion of murderershave unstable temperaments and are consequentlylikely to have an abnormal EEG, the value of the testis reduced, since a diagnosis of psychopathic per-sonality is no defence in law. He therefore, rightlyurges the most conservative use of the method. It istrue that the EEG provides proof positiye of epilepsyin only a small proportion of epileptics, and that somehave quite normal records, but in the cases cited itwas used, and accepted by the court, as corroborativeevidence. In clinical medicine it is rare, perhapsunknown, to find a test which is infallible, but this doesnot prevent these tests being used to add to clinicalknowledge. In the court of law a final opinion as tofact is reached by question and answer in much thesame way as in medicine, and in the end it is not aninfallible opinion, but only one which may be acceptedbeyond all reasonable doubt. Thus radiology andserology, with all their pitfalls, are called to add tothe sum total of knowledge which is used to achievejustice. The limitations of the EEG are sufficientlyunderstood for it to be used in the same way. Its

1. Lennox, W. G., Gibbs, E. L. and Gibbs, F. A. Arch. Neurol.Psychiat. 1940, 44, 1155.

2. Hill, D. and Watterson, D. J. Neurol. Psychiat. 1942, 5, 47.3. Williams, D. Ibid, 1941, 4, 257. 4. Times, Sept. 25, 1942.

sphere of usefulness includes behaviour disturbancesof all sorts, the epilepsies and the abnormal stateswhich accompany them, as well as the less clear cutdisorders of psychopathic adults and delinquentchildren,5 and of psychotics. It has been acceptedas corroborative evidence of a head injury, and nodoubt will often be used in compensation cases. Nowthat it has been shown to have forensic value, its

application should be guarded, lest it be abused.There are few instruments in the country, andstill fewer operators competent to give an opinionin a court of law. Given the apparatus it is easyto obtain a record, and one who gives an opinionhas few to criticise him, so that the method presentsa fertile field for the unscrupulous. Knowledgeof the clinical interpretation of results is advancingsteadily, and the method is now incorporated intothe routine investigation of several disorders, butuntil recently it has been used mainly for researchpurposes, and has been absorbed into the clinical

sphere with commendable discretion. Now that ithas been brought to the public notice in courts of lawsteps should be taken to safeguard its use.

It is perhaps an over-simplification to suggest thatmen have been hanged for the lack of an EEG. Insanityfor the purpose of determining criminal responsibilityin an assize-court is notoriously different from insanityas seen and studied by the medical man. Many peopleare convicted of murder whom medical witnesses

regard as insane. The official statistics, however,provide material for believing that defences ofinsanity which fail to avert a conviction for murderare nevertheless often sufficient to save a man fromcapital punishment. The trial of Ronald True in 1922for the murder of Gertrude Yates illustrated the sharpdivision between the legal and the medical standard.True was convicted of murder but, after furthermedical inquiry, was respited and sent to Broadmoor.The law-courts accept the fact that epileptic mur-derers are known to medical science. The symptomsof epilepsy in the case of True were slight-little morethan sudden lapses in conversation and memory.NORWOOD EAST, giving evidence on his behalf,explained the two kinds of epilepsy from which Truemight have suffered-epileptic mania or fury, a, wildcondition of excitement lasting a short time and leav-ing no recollection of what had happened, and epilepticautomatism where also the patient would have nosubsequent recollection. Mr. Justice MCCARDIE putthe point carefully to the jury. If True killedGertrude Yates while in an actual epileptic seizure,then, even though he knew the physical nature of theact and also that it was morally wrong and punishableby law, the jury ought to return the verdict of"

guilty but insane." True’s mental instability wasascribed to other causes than epilepsy. Here an EEG

might have thrown light on the diagnosis, but the realobstacle in all these cases is that the machine may con-tribute proof of a specific dysrhythmia from which con-clusions may be drawn, but it cannot tell the jury thestate of a man’s mind at a particular moment in the past.It does not prove sanity or insanity for the purposes ofjudge and jury. By itself it cannot establish automa-tism on some past date ; it cannot declare a man’s con-sciousness or intentions at some moment two months

ago. That missing evidence is what the courts require.5. Jasper, H. H., Solomon, P. and Bradley, A. Amer. J. Psychiat.

1938, 95, 641.