It is not the object of this paper to give an exhaustive account of the pathology of general paralysis, but rather to describe what appears to us, as the result of our own observations, to be the most prominent histological feature of this fascinating and fatal disease.

In a former paper read to a meeting of this Association I attempted to gather together what has been handed down to us about the nervous disorders and hallucinations of Mahomet, of Luther, and of others great in history. It gave me much gratification to see that the paper formed the text of an interesting discussion. As we learn more of the influence of external circumstances and physical conditions on human belief and conduct, the records of the past are read in a new light. As science shows us the relation of events previously unknown, we see more surely how things really occurred; what was perplexing becomes clear; embellishments and additions fall off; and we are confirmed in the belief that the past was governed by the same laws as the present. Thus the knowledge of nervous diseases, and the experience gained by the study of hallucinations, illusions, and the errors and deceptions of the human mind, may explain some of the difficult problems of history.

A recent holiday sojourn in Morocco having enabled me to complete certain information which I obtained some years ago while on a tour through Turkey and Asia Minor with respect to how far cannabis indica and syphilis are factors in the production of mental disease in the East, I proceed to record the following information which I have gathered on the subject:—

The second law of heredity is equal in importance to the first, and since it is of special importance in the study of insanity, and since both the law and its consequences have been hitherto almost overlooked by alienists, it is necessary to insist upon it with additional emphasis, and to discuss it at some length. This is the more necessary since there has been no formal enunciation of this law, although the several positions that it includes are very generally recognised. The following is the somewhat cumbrous expression of what I propose to call the Law of the Limited Dissimilarity of Parents.

I have sought to point out and to illustrate how all-pervading was the hold which the belief in witchcraft obtained upon all classes of society in the sixteenth and seventeenth centuries. I have pointed out how a species of criminal lunacy arose in connection with this belief; and how in the same connection, society might be said not only to have created a crime, but also to have manufactured the criminals.

There is a very general impression among members of the medical profession abroad that it is only by the free use of stupifying drugs that British alienists are able to dispense with the use of mechanical appliances in the management of the insane. It cannot be gainsaid that, by the use of toxic remedies, noisy and violent patients may be as effectually controlled for the time being as by any species of mechanical appliance; nor can it be denied that in many of our asylums narcotics and sedatives are employed in such doses, so continuously, arid for such purposes as to justify the appellation of “chemical restraint.” But there are no facts to bear out the assumption that it is by excessive drugging we are enabled to avoid the use of restraining apparatus in our asylums. On the contrary, there is incontrovertible evidence to show that in foreign asylums where mechanical restraint is extensively practised, chemical restraint is likewise employed to an extent not thought of in this country. Dr. Wilbur∗ has been at pains to collect statistics for purposes of comparing the relative extent to which mechanical and chemical restraint is carried in British and American asylums. The result of his investigation clearly shows that in British asylums and in the few American asylums conducted on non-restraint principles, chemical restraint is not the substitute or alternative for mechanical restraint, but that, on the contrary, the general rule seems to be: the more mechanical restraint, the more chemical restraint.