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Physicians specializing in the diagnosis and treatment of insanepeople (alienists) emerged in the early 19th century and offered their expertise for thecourts to consider in judgments of mental competence. In the Oliver Smith will case(1847), the competency of an attesting witness was contested on the issue of insanity.Four well-known alienists testified at trial. Although the insanity of the witness couldhave been viewed in broader terms, the experts used a narrow definition of insanitybased primarily on the presence of delusions. These opinions were only partiallyconsistent with contemporaneous medical notions of insanity and the broad definition ofcriminal responsibility. We suggest three explanatory factors for the narrow definitionrelated to available medical knowledge, courtroom restrictions including the caseitself, and mid-19th-century relationships between mental medicine and thelaw

A Narrow Definition of Insanity Opined by Medical Experts in the Oliver Smith Will Case in 1847