Most of us are in the active discharge of the duties of medical attendance on the insane, many of us are at the head of large public institutions. We are by the public expected both to be learned, ready and exact. Serious calls are daily made on our knowledge of medicine and surgery, but by many of us I am certain these are much more readily responded to than the calls on our powers of administration and on our judicial functions as guardians and care-takers, as well as the physician and friend of our patient. Now to my mind no one portion of duty is more unpleasant than having to listen to complaints of illtreatment, or even negligence and carelessness made by patients, to investigate them, to weigh, balance and decide on the best course of action.

The hallucinations of the senses in the insane resemble the voluntarily induced semi-consciousness of the mesmerised. In the mesmeric trance there is the disregard of external agencies that is seen in the maniac who, regardless of suggestions from without, carries out his own wild train of thought in apparent unconsciousness of what is going on around him, or even memory of what has occurred to him, after the trance or the paroxysm has passed away—and so in sleep, dreams prove an active state of the cerebral centres, although no recollection of them may remain on awaking. Sleep has been likened to temporary death, and so dreaming may be compared to temporary insanity. The insane man walks about in a waking dream; he is a veritable somnambulist. The somnambulist, like the maniac, or the ecstatic, has but a confused recollection, or no remembrance at all of what has occurred in the attack of mental disorder, or in their perilous sleeping performances, like Fakirs in their trance-like condition, they become insensible to external influences.

Four centuries ago, by his celebrated Bull proclaiming death without mercy against witches, sorcerers, and all dealers with Satan, Pope Innocent VIII. plunged Europe into a state of social distraction and delirium. One half of the people were said to be bewitching or bewitched. The crime of witchcraft or devil-dealing—a token of heresy—was held to be the precursor of antichrist, and there was no lack of propitiatory sacrifice. “The seats destined for criminals in our courts of justice are blackened with persons accused of this guilt. There are not judges enough to try them. Our dungeons are gorged with them. No day passes that we do not render our tribunals bloody by the dooms which we pronounce, or in which we do not return to our house discountenanced and terrified at the horrible words we have heard. And the devil is accounted so good a master that we cannot commit so great a number of his slaves to the flames but what there shall arise from their ashes a sufficient number to supply their place.” So says Florimond, the historical mouthpiece of the time. In Germany they burned them at the rate of 500 a year, bringing the total for the whole period of persecution for witchcraft up to more than 100,000 human beings. It is said that in France, about the year 1520, fires for the execution of witches blazed in every town. People had to be busy smelling Satan in others lest they themselves should be suspected and taken in hand.

After a brief reference to the frequency of hallucinations in general paralysis they will, in the second place, be considered in relation to the question of cerebral localization.