At the annual meeting of alienists, in Switzerland, in 1888, Wille directed attention to the writings of Felix Plater, who practised at Bâle nearly three centuries before, and in these writings are to be found the first definite descriptions of general paralysis; but it was not till after Willis in 1672, Haslam about 1800, and Bayle twenty years later, had each independently described the disease, that any great interest was awakened in it. Since that time, however, it has furnished a fruitful source of interest and discussion to many physicians, which has not only been abiding, but as the disease began to be better understood, has increased to a wonderful extent.

G. D—, æt. 69, admitted September 21st, 1896, for the eighth time. He was maniacal on admission, and had remained so for twelve months.

In January, 1898, he commenced to complain of pain on micturition; his urine was strongly alkaline and contained pus. He stated that two months previously he had inserted a piece of vulcanite pipe stem into his urethra. On passing a sound no foreign body was detected in the urethra, but a stone was felt in the bladder.

It would perhaps be allowable to take it for granted that the number of suicides has been steadily increasing in most of those countries which furnish us with trustworthy statistics, but after the discussion in Section E at the last meeting of the British Medical Association, I think it better to go over some of the reasons which have led me to subscribe to the view generally received by those who have carefully inquired into the subject.

In the Neurologisches Centralblatt for July 15th, 1898, Drs. Luithleu and Sorgo describe a method of staining the central nervous system, which at that time I believed to be new. However, Dr. Wright, in the summer number of Brain for the same year, and therefore about the same time, referred to, without describing the same method, so that it is obvious that it had already claimed some attention from neurologists.

In introducing the subject upon which I have the honour to address you, I am actuated rather by a desire to raise a discussion than to state any new theory or fact. It is some time since the “Care and Treatment of the Epileptic” was discussed at a meeting of this Association. Since then, and more particularly recently, there has been a further broadening of our ideas as to the sphere of work of alienists, and attention directed to the conditions of life of classes of people with whom we are not in touch in our routine daily labours. This has followed upon, and in some degree been associated with, the widening of our ideas as to the mental states we include under the term “insane,” and certifiable as such, a consideration which is in part answerable for the so-called increase of lunacy.

The object of the following paper is to present the result of a number of observations touching certain aspects of the question of habitual inebriety, notably the rôle of maternal alcoholism as an agent in race degeneracy.

Elsewhere I have dwelt on the occurrence of beri-beri in temperate climates and on the clinical features of that affection as I have seen it. At an early date I hope to be able to publish in detail the clinical records of a number of interesting cases. It is not my intention on the present occasion to dwell, save incidentally, on the symptomatology of the disease, nor to indulge in any speculations upon its origin or essential nature, for these latter points are, unfortunately, still in the region of speculation, and the light which I can throw upon them is scanty and indirect.

The olfactory organ in man appears in a rudimentary condition as compared with its highly developed state in certain macrosmatic animals. To comprehend the immense change that has taken place in the smell apparatus, together with the development of the higher brain, and which has attained its climax in man (of those animals still possessing a sense of smell), it is necessary to be acquainted with the anatomy of the limbic lobe in macrosmatic animals, and to follow the transitions occurring until the high mammal type of brain be reached. Moreover, in this process is to be found the only means of discerning in the human cerebrum the rudiments of an important organ and of allocating its present site of functional activity. The researches of Kölliker, and, still later, of Elliot Smith, have largely removed the confusion existing in respect to the true limbic lobe, and the definition of this and its constituent parts may now be safely attempted. The extensive and hardly yet completed work of the latter author, contained in a series of valuable contributions to the Journal of Anatomy and Physiology, and in the Transactions of the Linnean Society, N.S.W., has been used by the present writer in giving the following sketch of the constitution of the limbic lobe and the cerebral commissures.

In 1880 Lady Brabazon, now the Countess of Meath, offered a grant of money for materials to any workhouse or infirmary that would try her scheme. The scheme consists in teaching infirm and crippled inmates of workhouses to employ their idle hands usefully, and in this way “beguile many a weary hour, and add zest to their lives.” Carlyle's picturesque tourist well describes the condition of many a workhouse inmate: “They sat there near by one another, but in a kind of torpor, especially in a silence, which was very striking. In silence! for what word was to be said—an earth all lying round, crying, ‘Come and till me,’ ‘Come and reap me?’ Yet we sit here enchanted, we know not why. In the eyes and brows of many of these men hung the gloomiest expression—not of anger, but of grief and shame, and manifold inarticulate distress and weariness.”

The subject of this paper is but a small part of a very much greater question—the responsibility of the insane. The query embodied in its title is one which, at the present day, it would seem necessary to propound with bated breath. To the minds of many very eminent persons, no doubt, the very fact of such a question being raised at all would indicate a want of sanity on the part of the querist who was rash enough to propose it for discussion. And yet the diversity of view, which is only too evident when the subject of the “responsibility of the insane” is brought before any assembly of alienists, shows that opinion on this matter is still very unsettled, and we seem to be as far from finality as ever. In proof of this I need only refer to the discussion on Dr. Reginald Noott's paper at the general meeting of the Association in London in October last, reported in the January number of the Journal of Mental Science.

During the year from May, 1898, to May, 1899, 26 male and 28 female patients in the Derby County Asylum were attacked with the disease variously known as dysentery, dysenteric diarrhoea, or colitis, and characterised clinically by bloody stools and rise of temperature, and in advanced cases showing in post-mortem examination extensive thickening and ulceration of the lower end of the large intestine, with numerous microscopic hæmorrhages into the submucous layer. Of the 54 attacked, 23 died, in 13 the colitis being apparently the direct cause of death, in 10 a contributory cause. Some brief notes of our attempt to ascertain the cause of the outbreak may be of interest, though the results obtained were mostly negative or inconclusive.