ANSWER: There are persons who are morbidly conscientious. This is very often a form of insanity. I once heard a good woman say she could not set her tea table without sinning, or buy a dozen eggs without sin, for she instinctively picked out the biggest. The alienists say that quite a number of forms of disordered mental action involve the moral sense. Nervous diseases frequently take on this characteristic. Hence the need of charity for many, who, through an affection of the nerves, dwell in the border land between sanity and insanity. "God knoweth our frame."
— Steele's Answers, pp. 228.