In my work on “The Factors of the Unsound Mind” I gave a condensed account of the case of Mr. H. as forwarded to Charles Dickens, editor of “All the Year Round,” now nearly a quarter of a century ago, and published by him in No. 128 of that Journal, October 5th, 1861. It is headed “Mr. H.'s Own Narrative,” and it was forwarded to the editor, much to his surprise, in correction of the first of “Four Stories” published in an earlier number. That it is a genuine narrative, and no fiction, I have every reason to believe.

Most of you are aware that not many months ago the Editors of the “Journal of Mental Science” invited communications from members of the Association of which it is the organ on a subject which never loses its interest, simply because events are frequently occurring which force medical psychologists to direct their attention to it. I refer to what usually passes under the name of Moral or Emotional Insanity. The very fact that it is thus forced upon our notice proves it to be a practical, not a merely speculative question. I offer no apology, therefore, for making it the theme of my paper to-day, especially as I have not joined in the discussion which has taken place in the Journal, and which now has terminated. I say “discussion,” but one of the most marked features of these communications is their essential unanimity.

Dr. D. Hack Tuke in his interesting work, “Chapters in the History of the Insane in the British Isles,” has shown how the asylum of to-day was evolved from the madhouse of old. Originally the madhouse was simply a prison in which persons who had shown themselves dangerous to their fellows because of madness were confined and punished. With the general advancement of knowledge and civilization, the lamentable lot of the madman improved. One barbarous and inhuman custom after another was dropped, and at length it was dimly recognised that madness was a disease. Then for the lunatic the day of salvation was at hand—the cell, the chains, and the whip became things of the past, and he stood emancipated from all but his terrible disease.

While on a short visit to Madrid some little time ago I determined to find out how Spain treated her lunatics. I visited the public asylum of Santa Isabel at Leganes, but was refused admission, as there was no resident physician, and the village doctor, who was supposed to make his rounds at 9 a.m., was away ! A friend, however, kindly gave me an introduction to the leading Spanish alienist, Dr. D. José Esquerdo, who, he told me, had a private asylum at Carabanchel, and thither I went. This little village is about three miles from Madrid, and easily reached by tramcar. Dr. Esquerdo's asylum stands on an elevated, sandy plain, about 200 métres from C. Alto, and is approached by a steep, rugged road. In external appearance it is most unlike our ideas of a private asylum: not a tree to be seen for miles, and the whole block of buildings is enclosed by wooden palisades.