We have already pointed to the great practical importance of the measurement of fatigue in traumatic neuroses. It is particularly important for our purpose because, as we have already observed, exaggerated fatigue is always present in this disease, and so it gives the best opportunity of testing the general applicability of our method to the clinical measurement of fatigue.

Brazil, with its vast area, comprising a fifth of the western continent, its various climates, and its population of 2 1,000,000, formed of several ethnical groups, offers an admirable field for the study of the comparative racial pathology of the insanities.

Death-Rate statistics of persons dying in large institutions are often inexact, as their accuracy depends to a very large extent on the personal factor of their compiler. Unfortunately, the statistics of the death-rate from tubercular disease, particularly phthisis, occurring in asylums leave no room for doubt that the insane, as a class, are particularly liable to contract tubercular disease. The English Lunacy Commissioners in their report for 1902 say: “The proclivity of the insane, whether confined in asylums or not, to tubercular disease, especially pulmonary, has long been recognised.” In all asylums, according to Clouston, who was amongst the first to draw attention to the fact, consumption is between three and four times more common than in the general population at the same ages.

The normal English child has thriven apace of recent years, as the result of a healthy popular tendency to foster his mental and physical well-being as thoroughly as may be. But there exists among the poor a race of unfortunates–happily a small one–whose interests have rarely met with adequate recognition. It consists of the imbeciles who find their way into pauper lunatic asylums–the children legally certifiable as idiots. They cannot, I admit, pay a dividend in hard cash on the money sunk in their education, and their appeal for special attention mainly rests on their helplessness. My aim is to speak briefly of the measures already taken in their interest elsewhere, and to describe in a little more detail those adopted with success at Hellingly. Lastly, I propose to discuss the cost of our scheme, and to attempt to analyse the benefits derived therefrom.

With the view of testing to what extent an interchange took place between the perpetrators of the four major crimes I have prepared a return of 370 convicts and long-term prisoners in Scotland, convicted of (i) homicides, assaults, etc.; (2) crimes against property with violence; and (3) vjitliout violence; and (4) crimes against chastity. The result, an interesting one, finds expression in the following figures.

In previous papers (i) we have recorded observations on the ground of which we have contended that a diphtheroid bacillus, having cultural and morphological characters resembling those of the Klebs-Löffler bacillus, plays the chief part in the production of the toxaemia of general paralysis. We have at the same time insisted upon the importance of weakening of the local and general defences against bacteria, and have attri buted the chief part in the production of this impairment to syphilis, chronic alcoholic intoxication and the excessive use of nitrogenous foods. A little more than a year ago we thus summarised the case in support of the diphtheroid hypothesis.

Patient P–, Indian female, about 46, admitted April sth, 1899, stated to have been insane eighteen months previous to her admission.