Puerperal Insanity has been my chief clinical study for the last seven years, and the present paper comprises the results of this experience. My observations will be founded on a minute study of forty cases.∗

The problems which present themselves to any community in regard to insanity at the present day, are much more complex than that presented to primeval society—which was simply self-protection. Primeval society canonized or exterminated the insane as they were given to ecstatic visions or violence. Even in Anglo-Saxon lands at the present day, while one portion of the community starves and freezes the insane and calls out for their blood, another portion makes them its religious leaders.

Every “psychiater” knows that “psychoses” are divided into two great groups: primary “psychosis” and hereditary “psychosis.” These two groups differ very much in their manifestations, in their course, and in their final issue. Such a classification can therefore be considered as rational, logical, and satisfactory.

It has been said that recognition will come sooner or later to the man who can wait. With the gratifying exception of his long connection with this Journal, the writer cannot say that this has been his experience. In a work named “The Alphabet of Thought,” &c., published twenty-five years ago, was contained what he fully believes, after painstaking subsequent research, to have been the foreshadowing, at least, of one of the most important Laws of Thought. The late Dr. Mansel, Dean of St. Paul's, was acquainted with the writer's views, the work mentioned and the chief contents of this essay having been submitted to him, and the writer would here record his gratitude to the late Dean for the unusual courtesy with which he examined their contents. Since, however, the writer's views were strongly opposed to the Dean's, he never expected from that gentleman anything but adverse criticism. This fact has, however, completely failed to shake the author's confidence in conclusions which for nearly forty years he has submitted in vain to the most pitiless scepticism he could bring to bear upon them. Most of Mansel's strictures, together with the passages to which they refer, are here presented to the reader, and also extracts from letters received from the same gentleman bearing on the chief point herein discussed. Replies to both are given, combined with the later views at which the author has arrived.

Certain therapeutic effects upon the human organism ascribed to cocaine,∗ occasioned me to make use of the drug in suitable cases of psychosis and psycho-neurosis. Stimulant action and exhilaration (Euphoria) on the one hand, and on the other depression of undue sensitiveness, these were the effects I looked for from the alkaloid. Unfortunately, I am able to record scarcely a single case of certain and permanent cure following the use of the drug.