The wet pack was first systematically used by Lucas, an English physician, in 1850. His description of its use is on record prior to that of Freisnitz, the German hydrotherapist, to whom the credit attaching to its introduction has been generally ascribed.

Prior to the discovery of the Wassermann reaction it was practically impossible to obtain a correct estimate of the incidence of syphilis amongst the insane, owing to the infrequency of physical signs in specific cases, and the difficulty of obtaining reliable histories. Experience has shown that in a large number of cases a positive Wassermann reaction with the serum may be the only evidence of syphilitic infection; more over, Dr. Mott (Archives of Neurology and Psychiatry, vol. vi) has shown that definite skin lesions are comparatively rare in general paralysis of the insane.

The purpose of this article is rather to present a general review of the methods of intrathecal treatment of general paralysis, and the results obtained thereby, than to record our own limited and necessarily inconclusive experience.

Last year a paper was given by one of us on the history of dysentery at Wakefield Asylum since its opening in 1818(a), and it was shown that all the evidence pointed to carriers and chronic cases as being responsible for its presence, persistence, and perpetuation there. After an epidemic period they kept the infection alive, and gave rise to the sporadic cases which always occurred in the inter-epidemic times.

For the sake of brevity, I use the term hyoscinism to designate the symptom group which may arise from the administration of scopolamine hydrobromide in repeated doses.

A Full account of the cases on which this paper is founded cannot now be given, as some of them are still under observation; and in others, which have ended fatally, the histological examination of the tissues is not yet complete. We think, however, that sufficient data have been collected to make a preliminary communication desirable. The condition to be considered may be described as “encephalitis,” or “encephale myelitis,” rather from the want of a better term than from any conviction on our part that it is essentially inflammatory in origin.

Lethargic phenomena have often been studied and described in connection with hysteria and hypnotism. It has been pointed out by hypnotists that a state of lethargy occurs at times which takes its own time to disappear. Lethargic states in hysterical persons, whether under the influence of hypnotism or not, are not rare. According to Charcot's classical descriptions the lethargic state can be produced artificially during hypnosis by closing the eyes in the cataleptic phase, but it can likewise be primarily caused by fixation. During the lethargic state consciousness is obscured, sensitivity to pain is diminished, and the tendon reflexes are increased.