Gentlemen,—I cannot commence my address without reminding the Association of the regrettable circumstance which has resulted in my having had conferred upon me the honour of occupying this position to-day.

In the “Journal of Mental Science” for April, Dr. Alexander Robertson has referred to some observations of mine on the effects of galvanism in the treatment of insanity. These observations were made more than ten years ago. The cases chosen were not quite suitable or satisfactory; they were few in number, and the treatment was not thoroughly carried out. Still the results were far from being unsatisfactory; in fact they alone were quite sufficient to satisfy me that electricity, if properly and perseveringly applied in suitable cases, is a powerful means of cure. I am confirmed in this opinion not only by the results of these crude experiments, and others more recently and more carefully performed, but also from the value of electricity in other neuroses to which insanity is analogous. There are few who can deny, at least reasonably deny, that such neuroses as paralysis, chorea, neuralgia, anæsthesia, &c., are benefited in a most decided manner by electricity. There are forms of insanity, as all authorities on the subject affirm, which seem, if they really are not, identical with these neuroses, and it is not at all preposterous to assert that if it does good in one form of nervous disease it must do good in the other.

According to the latest returns, published by the Commissioners in Lunacy in their Blue Book for 1883, sixty-seven thousand four hundred and eighteen patients were registered as under treatment in the various asylums of England and Wales, and as being under private care during the previous year.

Following the estimation of the state of the blood comes naturally that of the state of the circulation; and for the purpose of the alienist the efficiency with which the peripheral circulation is carried on is the main thing to be determined. From his point of view it is of far less importance to discover an insufficiency of the mitral valve than to find a cold blue flabby hand or nose; for a damaged valve is consistent with an efficient supply of blood to the highest nervous centres; but if one part of the peripheral circulation is seen to be badly carried on, the inference is unavoidable that the circulation in other peripheral regions is similarly defective. The direct evidence of the condition of the cerebral circulation obtainable by the ophthalmoscope should not be neglected. Although the “heat of the head” is a matter of prime importance among the laity, and is commonly considered by physicians as of some value, yet, having regard to the fact that the whole of the face and scalp are supplied by branches of the external carotid artery, while the encephalon receives its blood mainly from the internal carotid, I was for some time doubtful whether much stress should be laid on this external temperature. I have, however, seen a case in which not only did the head sweat freely, but steam rose visibly for many consecutive hours from the scalp of a woman lying in a well-warmed ward, and without any fluid or medicament being applied to the head. In that case there was found after death the most excessive congestion of the whole cerebral substance.

The older writers on Insanity including Pinel, and Esquirol, believed that functional disturbances of the higher nervous centres were the chief factors in producing mental disease. Whether this is the case or not, and whether functional disease of the brain may exist without appreciable change of structure, there can be no question that the quantity and quality of the blood circulating through the higher nervous centres affect their functions in an important manner.

There is apparently no subject in the present day upon which more seems able to be said and written, or about which the public appears to have less exact knowledge, than that of the Lunacy Laws.

One chief feature in this case is the opposite opinion formed by two judges as to the law of lunacy, and we are inclined to think that, with all its faults—we had almost said follies—the trial of Weldon v. Winslow was more according to law than was the one of Weldon v. Semple. Both judges seem to have agreed in thinking there was something “shocking” in lunacy proceedings, and that there was necessity for immediate change in the laws regulating detention of persons of unsound mind. Everything in the lunacy world indicates unrest and unstable equilibrium, and we only hope that legislation will not follow in a panic.

Dr. Gierke, of Breslau, has, in two articles in the “Neurologisches Centralblatt” (Numbers 16 and 17, 1883), given the results of special researches on the neuroglia. He accuses Deiters, Boll, Golgi, and Jastrowitz of making incorrect descriptions, and of mistaking the results of their own reagents and dyes for natural structures. Gierki promises to publish his researches at greater length with illustrations, which are highly necessary in the description of delicate tissues. In the meantime he gives a number of details which could only be fairly reproduced by translating his papers. The neuroglia is the supporting tissue or frame-work of the nervous centres. It forms one-third of the substance of the grey matter, and its cells throw out branching processes which, taking the shape of flattened fibres, form sheaths for the nerve tubes. These never lie against one another, as Boll imagined. The cells of the neuroglia in the spinal cord of the sheep have a diameter of from 0·005 to 0·008 mm., and their processes are sometimes as long as from 0·4 to 0·2 mm. The neuroglia is everywhere, save at a part of the medulla oblongata, where the nerve tubes of the stratum zonale Arnoldi crowd upon one another, and lie directly under the pia mater. In other places, as in the substantia gelatinosa Rolandi, the neuroglia prevails, and there are few nerve elements. In contradiction to those who hold that the perivascular spaces may be owing to retraction of the dead tissues or contraction of vessels, Dr. Gierke maintains that there is not the slightest doubt that the perivascular spaces exist in the living brain. They are of varying calibre, and their strongly developed cellular ramifications are analogous to the sinuses in the lymphatic gland. In some places, as in the central canal of the spinal cord, he has found the large vessels surrounded by perivascular canals, which he has traced into real lymphatics.

Newcastle.—The day-space of what may be called the “refractory ward” for women has been increased and a similar improvement is contemplated on the male side. It is also intended to warm the single rooms.