What scruples are

A SCRUPLE is a groundless fear that there is sin where there is none. Hence a scrupulous conscience (the term is ordinarily used of the habit, not of the single act) is one which from some frivolous reason judges that a harmless action is sinful. A person, moreover, is not said to be scrupulous because of a scrupulous conscience in a single instance; the term is used of one who, either in some matter or in all his actions, is apt to be disturbed with unfounded scruples.

An upright, straightforward, and well-balanced conscience is what it is desirable to have, and so a scrupulous conscience is in itself a bad habit. A scrupulous conscience may indeed be useful for a time to purify the conscience, and to make it more delicate and sensitive to even the appearance of evil; it is sometimes permitted by God for this and other reasons. But if it continues for a long time it causes great trouble of mind, injures the health of body and soul, and sometimes drives its poor victim to desperation, so that he gives up all attempt to be good, or even loses his senses.

171. A scruple is an empty apprehension, and the fear and anxiety arising from this, that there is sin somewhere where there is none; or grave sin, where there is only light sin. Therefore a scrupulous conscience is that conscience which, from some vain cause, doubts concerning the honesty of some action, and therefore fears concerning sin. Fear of this kind can very well stand with a determinate judgment concerning the honesty of the thing; for it rests only on a light and empty motive. But if that fear is with a determinate judgment that something is a sin which in reality is not, this judgment, insofar as it proceeds from an empty motive and afflicts and troubles the soul, can indeed be called a scruple, or a scrupulous conscience, speaking broadly; but properly it is a vincibly erroneous conscience. Likewise there can be a scruple with a true practical doubt whether this is a sin or not, from an empty motive, suspecting perhaps that there is sin, without any determinate judgment that it is or is not a sin. And thus again it is a scruple or scrupulous conscience broadly so called, but properly it is a doubtful conscience. - Ferraris Supplem. v. Scrupulus.

Scrupulous conscience differs from tender conscience. For the latter is a conscience recognizing, fearing, and fleeing both grave and light sins; and it also strives to avoid simple imperfections, as much as it can with divine grace.

174. What are the signs of a scrupulous conscience? - "1. Obstinacy of judgment, by which the scrupulous person refuses to obey the counsels of the wise, consults various persons, but acquiesces in the judgment of none; indeed, the more persons he hears, the more perplexed he becomes. - 2. Frequent change of judgment from light motives, whence arises inconstancy in acting, and disturbance of mind, especially in external operations, for instance in the celebration of Mass, etc. - 3. To have impertinent reflections upon many circumstances which were present in the action or could have been present." L. l. 1, n. 11. - 4. If he thinks that he sins in that in which pious men find no sin at all; if he recites his prayers anxiously and continually begins them anew; if he makes no end of examining his conscience, and explains every smallest thing, and often even repeats it in Confession. - 5. If he uses ridiculous signs, gestures, and other ways for laying aside scruples. - 6. If the confessor, or another prudent man, has judged him scrupulous. - La-Croix l. 1, n. 515 seqq.

45. • It is of very great importance that directors of souls discern the truly scrupulous from the false. For often those are thought scrupulous who are not, and vice versa; and from this immense errors in direction flow, with no small danger of spiritual harm: therefore much circumspection is needed here. The principal signs of scruples are:

1. Pertinacity of judgment, by which someone refuses to obey the counsels of the Confessor or of wise men; and while he consults various persons, he acquiesces in the judgment of none; indeed the more he hears, the more he is entangled.

2. Frequent change of judgment from slight motives, whence frequent inconstancy in acting, and continual disturbance of mind.

3. Fear of sinning in all things, joined with pertinacity of mind against the judgment of the Confessor, of prudent persons, or even against one's own judgment: whence follows frequent questioning concerning the responses of the Confessor, and repeated inquiry whether, in acting according to the counsel given, conscience can be immune from fault.

4. Impertinent reflections about circumstances which were present in the action or could have been present, and certitude anxiously sought in all things.

5. Obstinacy in always repeating the same sin in confession, or in holding that as sin which has already several times been declared by the Confessor not to be such.

6. Continual anxiety concerning past confessions, notwithstanding the judgment of the Confessor, or the repetition of confessions.

• But he cannot be judged scrupulous, at least immediately, 1. who is moderately solicitous or anxious lest he offend God; 2. who after a life spent in sins is still troubled, and after confession does not seem to himself to have made satisfaction, but wishes rather to confess and expiate sins; 3. who still deliberately consents to grave sins, although after the sin has been committed he is greatly troubled and confesses anxiously, for there is a just cause of anxiety, at least moderate: nevertheless even in this one there can be a truly scrupulous person; 4. who in only one or another case has a passing scruple, and does not doubt whether he has sinned in this or that.

Moreover it sometimes happens that the Confessor, after hearing a penitent the first or second time, cannot immediately decide whether he is scrupulous, even if this penitent appears anxious about many things; since some just and reasonable cause of anxieties can be present. But much less can a scrupulous Confessor easily judge whether a penitent is scrupulous, or only fearful. - Lacroix, book 4, no. 517, etc.

47. • Scruples are frequently concerned 1. with daily actions; 2. with depraved thoughts; 3. with confessions. Therefore:

I. To scrupulous persons who in all actions are troubled by fear of sinning, it must be enjoined that they act strenuously against scruples, and abstain from confessing them, unless they are most certain that sin is present there. For although by so acting they sometimes sin materially, nevertheless they will not sin formally by reason of the obedience which they ought to furnish to the Confessor. - St. Lig., no. 17.

II. To scrupulous persons who fear to give, or to have given, assent to any depraved thought against chastity, Faith, or Charity, it must be imposed that they despise these thoughts as mere phantasms, and abstain from confession of thoughts of this kind, unless they can swear that they truly consented to them. - St. Lig., no. 15.

III. To scrupulous persons who are always anxious about confessions, especially past ones, it must be prohibited that they think any more about the faults of past life, nor speak a word about them in confession, unless they can swear 1. that they perpetrated mortal sins; 2. that they never confessed them, especially if they have already completed a general confession. - St. Lig., no. 16.

Moreover the scrupulous and fearful, anxious about past confessions, are to be questioned thus: 1. Did you knowingly conceal a grave sin? 2. Did you propose to repeat sins? If they answer negatively to each demand, their confession must be pronounced valid.

319. Notion and effects. Scrupulous conscience is that which from futile and altogether insufficient motives thinks and fears that some act is sinful. And so a scruple or so-called scrupulous conscience is rather fear or empty anxiety than conscience properly so called or the judgment of a sound mind.⁵² Hence although it is never licit to act against conscience, it is not only licit but also necessary to act against scrupulous conscience. Such a conscience is a true torture almost equally for the penitent and for the confessor. Rather rarely does it produce good effects, but often it causes harms both of body and of soul. For it weakens the brain and the nervous system, sometimes harms health, impedes spiritual progress, renders life sad, indeed sometimes leads to madness or to suicide. Sometimes also suddenly, as if from desperation, a scrupulous man becomes of lax conscience and loosens the reins to vices. - Scrupulous conscience is by no means to be confused with tender conscience, which flees all sins, even small ones. Hence the signs proving the existence of scrupulous conscience are to be attended to.

⁵² Therefore physicians deservedly call scruples a phobia (religious compulsory ideas); cf. P. Raymond, O. Pr., Le guide des nerveux et des scrupuleux. Paris 1911, p. 100 sqq.

323. The so-called privileges of the scrupulous. Since the judgment of the scrupulous is so disturbed that they themselves are not able to judge clearly and certainly in that matter around which their scruples turn, hence neither can they sin gravely in such a matter, since clear and certain knowledge is necessary for grave sin. Hence the first privilege of the scrupulous is that they are excused from diligent examination of conscience, and are not burdened with grave sin in such a matter unless they are able to swear that they certainly and with clear knowledge committed an act gravely sinful. - The other privilege of the scrupulous is excuse from the material integrity of confession. For the integrity of confession is prescribed by a positive divine precept, which does not oblige with great extrinsic inconvenience or with moral impossibility. Now the scrupulous are in such moral impossibility, and therefore they are not bound to the material integrity of confession. Hence let the confessor not permit the scrupulous to make long confessions, but let him say to them: I know sufficiently the state of your soul, so that I am able to bear a right judgment concerning it. Therefore say nothing further concerning your sins. - But if the scrupulous penitent has already exercised strict obedience for some time, a general confession could be permitted to him if he asks, but only once.

I. Scruple is said metaphorically from scrupus, which is a rough little stone hidden in the shoe of one walking, yet bringing annoyance and impediment in walking; and therefore in morals it is a spiritual stumbling-block which impedes a man from proceeding with unoffending foot and free step in the way of truth and Christian practice. Hence an empty apprehension, and the fear and anxiety arising from it, that there is sin somewhere where there is none, or that it is greater than it is, is thus called. A certain mental obsession (kwelgedachte) and hyperesthesia of sin is accustomed to accompany this apprehension; and thus scruple is now a mental disease, and indeed of the moral order: a morbid anxiety of soul concerning an obligation to be executed, or concerning sins committed or to be committed.

Therefore three elements are required for it: first, of the intellectual order, a futile reason which besets the mind and whose solution does not appear, arising indeliberately after the manner of a fixed idea, violently intruding itself, pertinaciously recurring; second, of the affective order, empty fear of sinning arising from this, which holds the attention fixed and impedes the will from turning the mind away from it and determining it to firm assent; third, the effect proceeding from both, agitation, disquiet, and disturbance of soul. It can concern the past, as if someone from a futile reason fears that he omitted some sin or circumstance in confession, that he examined himself insufficiently, that he consented to temptation; or concerning the present or future, as if someone from a similar reason fears that what he does or is going to do is sin.¹

¹ Concerning scruples cf. Pitres and Regis, Les Obsessions et les Impulsions; P. Janet, Les Obsessions et la Psychasthenie; les Nevroses; Dr. Raymond, Nevroses et Psychonevroses; Eymieu, Le Gouvernement de soi-meme, 2nd vol.; Grasset, Demi-fous et demi-responsables; Le Psychisme inferieur; Gemelli, De Scrupulis; d'Agnel and d'Espiney, Psychotherapie des troubles nerveux; Le Scrupule. Likewise Scaramelli, Directorium asceticum; Reuter, Neo-conf., nn. 255-274; Billuart, de Conscientia; St. Alphonsus, Th. M., I, nn. 11-19; Praxis conf., nn. 95-98; Raphael of St. Joseph, Institutiones fundamentales Theologiae moralis, de Conscientia; Durois, L'Ange conducteur des ames scrupuleuses; Pere Raymond, Le Guide des Nerveux et des Scrupuleux; Grimes, Traite des Scrupules; Beaudoin, Tr. de Conscientia; and other authors in this treatise, as Ballerini, Lehmkuhl, Theol. Mechl., Prummer, and Vermeersch; Leroux in the periodical Revue Eccl. de Liege, May, June, and Nov. 1912; Legrand in the periodical Coll. Brugenses, Nov.-Dec. 1922, March-April 1923.

II. Scrupulous conscience. - From what has been said it is now understood what scrupulous conscience in the proper sense is: namely, it is a dictate of the practical intellect founded on scruples; hence it is a conscience which with anxiety doubts, suspects, or probably thinks and fears, on account of light and contemptible reasons, that a work here and now to be placed is evil, when it is not, or that it is worse than it is, e.g., that it is mortal when it is venial.

Therefore from scrupulous conscience properly so called, or formed by scruples, must be distinguished:

a) scrupulosity, that is, a habit or state of so irrationally fearing sin, which nevertheless they often call, but in an improper sense, scrupulous conscience. For it is not conscience, that is, an actual judgment of the intellect, but a habitual disposition by which we are inclined and prone to scruples and to having a scrupulous conscience;

b) a conscience agitated by scruples, or tortured and vexed, which judges an act to be licit, although from light causes it fears somewhat and is anxious lest it be illicit: mere scruple or apprehension, imagination, and anxiety of itself is not conscience or a dictate of reason, but a shadow and likeness of conscience, and can remain while the judgment of a certain conscience despising scruples stands;

c) a fearful conscience, which reasonably with tranquility fears sin from filial fear by which it would not wish to offend God even in the least thing;

d) a tender or delicate conscience, which adverts and judges the smallest defects, but according to the norm of truth.

III. The signs and manifestations of a scrupulous conscience are: 1) pertinacity in the argumentation of one's arguments and in judgment, by which someone out of fear of sin acquiesces in the judgment of no one; - 2) on the contrary, timidity at the same time in conclusions, and therefore frequent change in judgment from a light appearance, so that he is unable to pronounce definitively; and distrust of self, by which someone suspects defects either of the intellect in grasping or interpreting responses, or of words in proposing difficulties, or of memory in retaining counsels given or positive precepts, indeed or even of his own facts, so that he doubts concerning a door closed by himself, concerning a light extinguished, concerning hours recited, concerning Mass heard; - 3) desire of consulting books or asking new confessors; - 4) reflections, accusations, or impertinent, prolix, or repeated questions concerning several circumstances which were present in the action or could have been present, or concerning the response of the confessor; - 5) disturbed and inordinate manners and gestures in avoiding sins or handling affairs, and a manner as if coerced of rushing into an action concerning which he was anxiously inquiring, and as if blind of proceeding in external works; - 6) fear of sin in those things which by all are held as licit; - 7) excessive disquiet and anxiety concerning past actions, e.g., confession, recitation of the breviary, made with moral diligence, and consequently the will of repeating the same again and again; - 8) inconstancy and defect of firmness in the purpose of preserving peace, being silent concerning scruples, omitting a new inquiry into the matter, or simply obeying.

124. The nature and signs of scruples.¹ - A scruple, as we have already noted, is an empty apprehension and the fear and anxiety thence arising that somewhere there is sin where there is not, or that it is greater than it is. A certain mental obsession (obsession de l'esprit; kwelgedachte) and hyperesthesia of sin are accustomed to accompany this apprehension; and thus a scruple is already a mental disease, and indeed of the moral order: a morbid anxiety of soul concerning an obligation to be fulfilled, or concerning sins committed or to be committed.

¹ On scruples cf. Pitres and Regis, Les Obsessions et les Impulsions; P. Janet, Les Obsessions et la Psychasthenie; Les Nevroses; Dr. Raymond, Nevroses et Psychonevroses; Eymieu, Le Gouvernement de soi-meme (2nd vol.); Grasset, Demi-fous et demi-responsables; Le Psychisme inferieur; Gemelli, De Scrupulis; d'Agnel and d'Espiney, Psychotherapie des troubles nerveux; Le Scrupule. Likewise Scaramelli, Directorium asceticum; Reuter, Neo-confessarius, n. 255-274; Billuart, De Conscientia; St. Alphonsus, Th. M., I, n. 11-19; Praxis conf., n. 95-98; Raphael a S. Joseph, Institutiones fundamentales Theologiae moralis, de Conscientia; Dubois, L'Ange conducteur des ames scrupuleuses; P. Raymond, Le Guide des Nerveux et des scrupuleux; Grimes, Traite des Scrupules; Beaudoin, Tr. de Conscientia; and other authors in this treatise, such as Ballerini, Lehmkuhl, Theol. Mechliniensis, Prummer, and Vermeersch; Leroux in the periodical Revue Eccl. de Liege, 1912; Legrand in the periodical Coll. Brugenses, 1922 and 1923.

Therefore a threefold element is required for it: 1st, of the intellectual order, a futile reason which besieges the mind and whose solution does not appear, arising without deliberation in the manner of a fixed idea, violently forcing itself in, stubbornly recurring; - 2nd, of the affective order, an empty dread of sinning arising thence, which holds the attention fixed and impedes the will from turning the mind away from it and determining it to firm assent; - 3rd, an effect proceeding from both, agitation, unrest, and disturbance of mind. It can concern the past, as if someone from a futile reason fears lest he omitted some sin or circumstance in confession, lest he examined himself insufficiently, lest he consented to temptation; or it can concern the present or future, as if someone from a similar reason fears lest that which he is doing or is about to do is a sin.

The signs and manifestations of a scrupulous conscience are:

1. pertinacity in the argumentation of one's arguments and in judgment, by which someone, from fear of sin, acquiesces in no one's opinion;

2. on the contrary, at the same time timidity in conclusions, and therefore frequent change in judgment from a light appearance, so that he cannot pronounce definitively; and distrust of self, by which someone suspects defects either of the intellect in grasping or interpreting responses, or of words in proposing difficulties, or of memory in retaining counsels given or positive precepts, or even in his own deeds, so that he doubts about the door closed by him, about the light extinguished, about the hours recited, about the Mass heard. From both of these arise:

3. the desire of consulting books or questioning new confessors;

4. impertinent, lengthy, or repeated reflections, accusations, or questions, concerning several circumstances which were present in the action or could have been present, or concerning the response of the confessor;

5. disturbed and disordered ways and gestures in avoiding sins or treating affairs, and a manner, as it were compelled, of rushing into the action concerning which he was anxiously inquiring, and of proceeding as it were blindly in external works;

6. fear of sin in those things which are held by all as licit;

7. excessive unrest and anxiety concerning past actions (for example, concerning confession, the recitation of the breviary) done with moral diligence, and consequently the will of repeating them again and again;

8. inconstancy and defect of firmness in the purpose of preserving peace, of keeping silence concerning scruples, of omitting a new inquiry into the matter, or of simply obeying.

A conscience is called scrupulous which, from a slight, indeed even empty cause, doubts concerning the honesty of some action, and therefore fears sin where there is no sin. For a scruple is an empty apprehension, or slight suspicion, by which someone falsely judges something to be a sin. But the word scruple is said to be derived from little stones, or pebbles, which, inserting themselves into the shoes of travelers, create trouble for the feet.

But a lax conscience is called that which from a rather slight reason judges that what is illicit is licit; or finds only a venial sin there where there is a mortal one: it is namely that which, without sufficient reason, bends judgment in favor of liberty, either for avoiding the law, or for diminishing the gravity of fault. This conscience can be distinguished in three ways, namely: 1st, a lax conscience simply, which tends to extend liberty more than is fair; 2nd, a cauterized conscience, which from a long-standing habit of sinning regards grave sins, indeed even most grave sins, as nothing; 3rd, a pharisaical conscience, which makes great things small, and in turn small things great. It takes its name from the Pharisees, who spurned the most grave mandates of the law, while by eating with unwashed hands or passing over empty traditions, they considered themselves guilty of great sin.

For correcting the scrupulous, or at least for dealing more usefully with them, there will briefly be said here something concerning the signs, causes, harms, and remedies of scruples, and also concerning practical rules to be followed both by scrupulous penitents themselves and by their confessors.

It is asked 1° what scruple is. What a scrupulous conscience is.

I answer. Scruple is said metaphorically from a scruple, which is a rough pebble getting into the shoe of one walking, hurting him not so much as molesting him, and delaying his step. Whence a scruple is nothing else than a light and empty little reason occurring concerning the malice of an action, whose solution is not found; and thereupon the mind either opines, or suspects, or doubts, or fears with anxiety, lest the action be evil. It can be about the past, as when someone from a futile reason fears that he omitted some sin or circumstance in confession, that he consented to temptation, etc.; or about the present or future, as when someone from a like motive fears that what he does, or is about to do, be sin.

A scrupulous conscience can be distinguished two ways, as I already said in art. 1: One formed from scruples, and it is a dictamen of practical reason by which one judges, for light and empty reasons, that what he does is illicit, or doubts about it. This conscience is called scrupulous improperly, and it is either erroneous or doubtful, and of it we do not treat here: insofar as it pertains to error, it was treated in the preceding articles; insofar as it pertains to doubt, it will be treated in the following article. The other is agitated and tortured by scruples, namely while one judges what he does to be licit, yet for slight causes fears and is anxious lest it be illicit. Whence, as is plain, insofar as it is scrupulous, it is not properly conscience, but the shadow and likeness of conscience. Therefore by the name of scrupulous conscience is commonly understood either that scruple which is as it were the dictamen of a scrupulous intellect, or the very anxiety caused by scruples, or the disposition of a soul inclined to scruples. Of scrupulous conscience thus taken the following things are to be understood.

It is asked 2° by what signs a scrupulous conscience can be recognized.

I answer. Chiefly by these: 1° If he reputes as sins those things which everywhere among the wise and God-fearing are held as nothing, or often doubts about them and questions others. 2° If he either has no faith in the prudent and learned man, e.g., a prelate or confessor, asserting the action to be licit, or complies with anxious fear, again and again consulting the same man or others, trusting no one and always seeking the greatest security. 3° If in confession he sets forth his sins so exactly that he omits no circumstance, though light or most light, nay sometimes impertinent, often repeating and dwelling upon the same things, and does not acquiesce when the confessor admonishes that it suffices; or never rests concerning confessions made with due diligence, often repeating them in whole or in part. 4° If he recites the prescribed prayers, whether of the breviary, of penance, of a vow, or in the celebration of Mass, with fastidious slowness, frequently repeating them and halting to recall intention and attention. Besides these, the scrupulous man himself can and ought to acknowledge that he is scrupulous, and so to comport himself, chiefly from the testimony of his confessor or of another upright and learned man, to whom his conscience has been laid open, who judges him to be scrupulous.

I. Of the scrupulous conscience, or of a scruple, this is the notion: it is a certain light suspicion of sin, with excessive anxiety in acting. A scruple is distinguished from a doubt, in that the latter is placed in a suspension of judgment; and from an opinion, which rests upon a grave foundation. The last words — with excessive anxiety in acting — constitute the true character of the scrupulous man, who is pressed by continual anguish.

II. From this definition of a scruple, it is plain how erroneous is the opinion of the crowd. Worldly men, and men given over to corruptions, hold for scrupulous those Christians who are zealous and solicitous for eternal salvation; who with the utmost vigilance study to decline both sins and the dangers of sin; who detest the allurements of the raving world — namely dances, games, comedies, and spectacles of every kind — and devote sedulous labor to the most grave precepts of humility and to panting after evangelical perfection. But blind indeed are they who number such Christians among the scrupulous.

V. There are two kinds of scrupulous persons. One is of those who are in very deed upright and of the best morals, and who, through excessive anxiety of declining even the very shadow of sin, are tormented by scruples. The other is of those who stir up scruples for themselves in matters of no moment. They say they are tormented by scruples because they have prayed with a distracted mind, because they have passed a rash judgment upon their Neighbor, because they have not promptly resisted internal suggestions. Meanwhile they stir up no scruple in themselves for not having fulfilled the precept of almsgiving, for living sumptuously and studying to indulge their appetites, for neglecting to fulfill the duties of their profession. It is carried about in the place of a proverb, that the scrupulous are gluttonous, stiff-necked, and lovers of their comforts.

Scruples are as distressing and dangerous to the poor penitent who suffers from them as they are troublesome and difficult to deal with from the point of view of the confessor. Theologians have studied the subject for centuries, and we have the results of their labors in our handbooks of moral theology. There we find the notion of the scrupulous conscience accurately defined, its causes traced, and various remedies prescribed. Among the causes of scruples those of the natural order predominate. Thus, to select one of our modern theologians, although Lehmkuhl teaches that scruples may be due to the action of the devil, and that we must also take into account the permission of Almighty God, yet he pays most attention to the natural causes of scruples. These, he says, may be either bodily or spiritual. In detail he enumerates a melancholy and timid disposition, a diseased state of the brain and of the nervous system, weakness caused by overwork, study, or austerities, weakness of judgment, pride and self-conceit, suggestion by reading scrupulous authors or from coming under the influence of a too scrupulous confessor. It is obvious that these natural causes may, and probably will, manifest themselves in other matters besides scruples of conscience about sin and confession. We are not, then, surprised to find that this is so. A pathological state of mind, of which the scrupulous conscience is only one manifestation, has long been recognized by the medical profession. However, it has been specially studied by the medical profession only within the last fifty or sixty years, and by foreign more than by British doctors. It may be of interest, and not without profit, to see something of what the doctors of medicine have done in this field, a field common to them and to the moral theologian.

It will be best to begin by transcribing a few typical cases. These will convince us that medicine has essentially the same phenomena to deal with as moral theology has. What the moral theologian calls scrupulosity, the medical practitioner calls the doubting mania, in French folie du doute, and délire du toucher, in German Grübelsucht.

My batch of cases is taken from Hypnotism, by J. Milne Bramwell, M.B., C.M., London, 1906.

In the first case, which I select out of many, the moral element is very conspicuous. A confessor would not be astonished if he got such a case in the confessional. He would class it among those in which the sufferer fears sin in all his actions.

‘‘Mr. ——, aged 28, first consulted me in April, 1894. His father was very nervous and passionate, and had suffered from brain fever and chorea. At the age of 14, the patient had many religious doubts and fears, and believed he had committed the unpardonable sin. At 16, while working in a cocoa manufactory, he began to fear that the red lead, which was used in fastening certain hot pipes, might get into the tins containing cocoa, and so poison people. This was the commencement of a folie du doute and délire du toucher, which had never since left him. Instead of going on with his work he was irresistibly impelled to clean and reclean the tins. The following is taken from the letter of a friend to whom he confided his troubles:—‘On October 1st, 1891, Mr. —— told me that he had attempted to commit suicide, as his life was so miserable (he had taken poison). He had read of a case of poisoning through eating chocolate, and connected himself with it, though it was five years since he had helped to manufacture any. He now believed he might have been careless with the molds, and thus have produced a poisoned chocolate, which years afterwards had caused the child’s death!’ The grotesque absurdity of the story, as he related it to me, would have made me laugh, had I not felt how terribly real it was to him. His vivid imagination had pictured every incident of the tragedy: the child buying the chocolate, running home full of happiness, then becoming ill and gradually sickening in awful agony till released by death. The keenness of mind with which he sought to prove the reasonableness of his belief that he had poisoned the child was extraordinary. He wrote:— ‘Yesterday I was unscrewing some gas burners in a provision shop and got some white lead on my hands, and I have been thinking that it may have got amongst the food.’ I found that brooding over this fancy had brought him to the verge of despair, and for weeks his life was a perpetual agony. He worries himself about his work of fixing advertisement-plates to walls, and can never persuade himself that they are securely fastened. He fancies the nails are bad, or the mortar loose, and makes himself ill over it. I have pointed out to him that if a plate fell it would almost invariably slide down the wall. This has not prevented him from painting a most elaborate mental picture of the decapitation of an unfortunate youngster, who happened to be playing marbles with his head against the wall. To enumerate all his troubles would take a small volume. ... When I first saw the patient the folie

du doute and délire du toucher were constant, and most varied in their manifestations. If he accidentally touched persons in the street, he began to fear that he might have injured them, and exaggerated the touch into a more or less violent push. If the person touched were a woman, he feared that she might have been pregnant, and that he might have injured the child. If he saw a piece of orange-peel on the pavement, he kicked it into the road, but soon afterwards began to think that this was a more dangerous place, as any one slipping on it might strike his head against the curb-stone; and so he was irresistibly impelled to return and put it in its former position. At one time he used to bind himself to perform certain acts by vowing he would give God his money if he did not do them. Then, sometimes, he was uncertain whether he had vowed or not; owing to this he gave sums to religious objects which were quite disproportionate to his income. Apart from his peculiar fancies, I found the patient perfectly rational and intelligent; and though his délire du toucher hindered him greatly in his work, he generally managed to execute it, but on some occasions he was compelled to abandon the attempt.’’¹

¹ Op. cit., p. 241.

The next case has also a moral tinge in it.

“Mr. ——, aged 32, April, 1895. Ten years previously this patient began to have peculiar doubts and fears. He felt that if he did anything opposed to popular superstition something dreadful would happen to the Almighty. He was capable of recognizing the absurdity of this when it was pointed out to him; but directly afterwards his morbid ideas returned and governed his actions. Every fresh superstition he heard of was added to his list; and so many unlucky days and places were created by his doing, or failing to do, things against, or in conformity with, these superstitions, that his actions were seriously interfered with. Thus, months often passed before he could find a propitious day for buying an article of clothing, and a still longer time would elapse before he found a suitable occasion to put it on. Sometimes there was nowhere for him to go, and nothing he could do. He was utterly wretched, but had succeeded in concealing his trouble from every one.’’²

² Op. cit., p. 244.

There is no ethical quality in the next two cases.

“Mr. ——, aged 25, first consulted me March, 1890. Formerly strong and athletic, distinguished football player, bicyclist, etc. Two years previously, after the death of his mother from cancer of the breast, he began to fear that he might contract the same disease. This idea grew stronger and stronger; he became neurasthenic, and suffered from insomnia, depression, dyspepsia, etc. Finally the dread of cancer passed into the firm conviction that his left breast was infected by it. He now remained nearly always in one room, and would not go into another without muffling himself up and putting on an overcoat. For some months he complained of difficulty in moving the left arm, and carried it in a sling. I found nothing to justify his fears, but the muscles of the arm were distinctly wasted from disuse.’’ 4

“A man aged 40, of healthy constitution, has since childhood attached prophetic signification to puerile facts and events. To wear a certain necktie promises him happiness or unhappiness. If he does not touch a certain boundary-stone he thinks evil will happen to him. If he does not re-read a certain line, or make a certain letter thicker when writing, something horrible will befall him. At first, his strange ideas were insignificant, or he was able to resist them ; but as he grew older they filled his life and rendered it intolerable. For twenty years he made a pilgrimage every Sunday to the railway station in order to kick a certain post three times with each foot. If he did not do this his father would die. In order to rid himself of these obsessions he made vows and associated threats with them. He said, for example: ‘If I yield to one of my caprices in the course of an hour I shall have apoplexy before twenty-four hours have passed.’ At first this succeeded, but soon the effect of the vows diminished, and he was compelled to make them stronger. The unhappy man now stands sometimes for a quarter of an hour muttering the most fearful imprecations, in order to get the strength to go an errand. If he omits them he is forced to obey the most absurd impulses. He must stop before a certain house, retrace his steps, touch boundaries, stop passers-by, or touch their clothes: in a word, he is obliged to act like a@ maniac. His intellect is perfectly normal, and he attends to his business as if nothing were the matter.”⁴

⁴ Op. cit., p. 250.

3 Op. cit., p. 239.

These senseless fears and anxieties are often connected with the sufferer’s professional duties.

‘*A young priest, not timid in the performance of his other religious duties, suffered agony on entering the pulpit. Another suffered in the same way when he received a confession. A medical student suffered extreme agony at the sight of a few drops of blood. A chemist made up a prescription which caused the death of a customer. He was able to prove that it was dispensed exactly as ordered by the doctor; but, as his existence became a veritable torture from constant fear of making a mistake, he sold his business. A notary had morbid fears only when he had to give a professional opinion. A hairdresser noticed that his hand trembled one day, and then constantly dreaded that this would reappear when he shaved his best customers. The same anxiety did not exist when he had to shave a poor or unknown customer. Dr. Frémineau reports the case of an actor who abandoned his profession on account of extreme stage-fright. This condition only appeared after a successful career. Dr. Bérillon reports several similar cases. Reigler has noticed a morbid fear amongst railway mechanics, to which he has given the name of sidérodromophobie ; this is characterized by an extraordinary aversion to their habitual occupation, and the sight of a train or the whistle of an engine is sufficient to revive their anxiety. Grasset mentions that a distinguished Parisian surgeon commences to be anxious the moment a patient leaves his consulting-room with a prescription. He anxiously asks himself whether he could have written centigrammes instead of milligrammes; and only recovers his mental calm when his servant, sent to seek the patient, brings back the prescription, and he can see that it is all right. Another doctor, he says, is rendered perfectly miserable by the fear of microbes. Brochin reports the case of a doctor who fears no contagious malady except diphtheria, and who shows proof of veritable heroism every time he sees a diphtheritic patient. A case has recently been reported from abroad, where a medical man, dreading that his fees might be the means of contagion, invented elaborate methods of sterilizing them; and I know of a similar case in this country.’’ 6

These cases could be multiplied indefinitely, but they are fairly typical and will serve our present purpose. In all of them the common element of vain fears and consequent anxieties is conspicuous. This same element is that which constitutes the essence of a scruple, and the only difference between them and ordinary cases of scruples lies in the object of the empty dread and anxiety. The scrupulous person has an unreasoning dread of committing sin, and is morbidly anxious about it. While in some of the cases cited a similar object may be discerned, in others the object of dread and anxiety has nothing to do with ethics and morality. We are then justified in regarding the object of these vain dreads as accidental and immaterial; the essence of scruples, folie du doute, or the doubting mania is the same, and it lies in the vain dread of something and consequent anxiety and trouble about it.

5 Op. cit., p. 251.