Dr. Clouston opened a discussion on this subject at one of the meetings of the Psychological Section of the British Medical Association at Newcastle, and I attended purposely to take part in the discussion and show the plans which I propose to describe in this paper.

When our worthy Secretary asked me to read a paper, my difficulty in giving a direct affirmative answer was not so much the trouble and time the writing of such a paper would involve, but rather the choice of a subject. To give the outlines of some special case, to make a few remarks, and to hear the President, after thanking me, and waiting in solemn silence for the spirit to move some member to start a discussion, call upon the reader of the next paper, did not strike me as worth the trouble; besides, one cannot always have a “special case” on tap in a small private asylum.

A modern philosopher has revived the theory that music has been evolved out of speech; but even adopting the leading views of the evolutionists, this theory seems little in accordance with their own methods. The harmony of sound appears very low in the animated kingdom, whereas the faculty of speech is the last and highest endowment. Some insects and spiders have the power of producing sounds. This is generally effected by the aid of beautifully-constructed stridulating organs. “The sounds thus produced,” Darwin tells us, “consist in all cases of the same note repeated rhythmically, and this is sometimes pleasing even to the ear of man. Their chief, and in some cases exclusive use, appears to be either to call or to charm the opposite sex.”

The subject of Music and the Musical Faculty in connection with insanity is one which has several interesting aspects, and one which, in some directions, offers for observation a field which has hitherto been little worked. I propose to bring together in this paper some of the facts which have fallen under my notice, and to offer a few comments upon them.

Probably most medical officers of asylums have experienced during the last few years an increasing difficulty in obtaining reliable nurses.

The statistics herewith presented as to an item or two of lunacy in Herefordshire have various interesting aspects. Perhaps the one that makes them of most value as elucidating an important side of lunacy statistics generally, and as bearing on the question of an increasing prevalence of lunacy, arises from their being those of the district that possesses the largest percentage of insane persons in England, and probably, therefore, in the world, and from their showing that the persons forming this larger percentage differ in some material respects from the lunacy of the country at large. In other words, the additional persons making the number larger are not more of the same sort, but are of a different class.

The Barony parish of Glasgow has a population of about 320,000. The care of the lunatics chargeable to the parish has engaged the attention of the Board ever since its formation in 1845. Various circumstances have contributed to make the experience of the Barony parish, in relation to lunacy, exceptionally valuable. Unlike most of the other parishes in Scotland the Barony Board has always provided asylum accommodation for its lunatics; it has never been dependent upon a District Board of Lunacy for that purpose. Although at one stage of their history pressed to hand over their asylum to the then existing Glasgow District Board of Lunacy, the Barony Board declined to do so, on the ground mainly that, on account of the largeness of the population and the rateable value of the parish, the Parochial Board was better suited to be entrusted with the management of the arrangements for the care and treatment of its pauper lunatics than a District Board of Lunacy, which had a wider area to provide for, and different interests to consult; and further the Barony Board held that the double management involved in having an asylum of their own along with their statutory obligation to provide for the due certification and maintenance of the pauper insane was a distinct advantage to a Parochial Board, inasmuch as it provided the material for a more complete view of the lunacy requirements of the parish, and gave the members of the Board a greater interest in questions connected with the care and treatment of the insane. In the early years of its management the Board provided for its pauper lunatics in asylum wards connected with the poorhouse at Barnhill. That arrangement was never considered satisfactory by the General Board of Lunacy; but the Parochial Board considered the arrangement quite satisfactory, and opposed the views of the Lunacy Commissioners. Ultimately, however, the Lunacy Commissioners got their views accepted by the Parochial Board, and they determined to build a new asylum at Woodilee, Lenzie. Probably the arguments of the Commissioners were less potent than the rapid increase of patients, caused by a great growth in the population of the parish, in bringing about the new departure. With the erection of the new asylum the Barony Board entered upon what may be called a new era in its relation to lunacy administration, for it soon became evident that it was performing the functions both of a Parochial Board and a District Board of Lunacy. That position ultimately received legislative sanction, and so the parish is now a lunacy district, and the Asylum Committee of the Board is practically, though not in name, a District Board of Lunacy.

The following case is of interest on account of the successful localization of a cerebral disease, as well as from the fact that this is the first recorded case, so far as I am aware, where, in a South African Asylum, the aid of surgery has been invoked to alleviate a cerebral disease giving rise to mental aberration.

E. D., aged 31, a short, stout, dark-featured woman, attended at the out-patient department of the Grosvenor Hospital on February 22nd, 1892. She gave the following history:—Healthy girlhood. Menstruation appeared at the age of 11. The periods were regular, but she had much pain during the flow, which usually lasted for four days, and never was excessive. Married at 27. No family. Two years ago she had an attack of “inflammation in the belly,” and was admitted into a London General Hospital. When there she was told she had a tumour, but nothing further being done she left that institution and went home. Had been in good health and quite regular up to Christmas, 1891, at which date her last period occurred. Soon afterwards she began to feel ill, and had attacks of sickness throughout the month of January. On the evening of February 10th she was suddenly seized with acute pain in the abdomen, and had attacks of sickness and faintness during the night. Turpentine stupes were applied, and gave some relief, and the pain passed off towards morning. Her doctor was then sent for, and he attended for three days, during which time she was kept in bed. At the patient's request, however, he discontinued his visits, but two days later, in consequence of a second attack of a similar nature, he was again called in, and remained in attendance for four days, the patient being kept in bed and under the influence of morphia. At the end of that time she got up, and not being satisfied about her condition she came to the Grosvenor Hospital, where she was seen by my colleague, Dr. Gibbons, who strongly advised her to come into the Hospital. Two days later she was admitted under his care.

After much discussion, and having passed through the searching ordeal of a Select Committee, the new Rules of the Association have been agreed to, and now await the passing of the minutes at the annual meeting to be formally adopted.

It is thought best that the annotation on this subject should rather take the form of a personal communication than an editorial, and therefore I purpose setting before the readers of the Journal the chief points in the case which need special consideration.

The acquittal of the Zierenbergs on the charge of perjury in connection with their unsuccessful action against Mr. Labouchere has naturally occasioned some surprise in nonlegal circles. And yet the explanation is not so remote as might be imagined. In the first place, the issue in the perjury prosecution was much narrower than that in the libel action. In the latter, the whole conduct of the St. James's Home was impugned. In the former, the gravamen of the charge was Mrs. Zierenberg's statements, repeated impliedly by her husband, concerning their affairs in Germany and the arbitration in England in regard to the burning of their property. In the second place, a jury may in a civil case disbelieve evidence on which they would, in a criminal case, hesitate to convict for perjury. Again, in the criminal case of Reg. v. Zierenberg, Mrs. Zierenberg's evidence was not available against her husband. Lastly, the general feeling was that the Zierenbergs had already been sufficiently punished by the result of the civil action. It is, in our judgment, extremely doubtful whether the prosecution ought to have been undertaken.

The result of the Local Government Board inquiry in the Lewisham alleged workhouse scandal is on the whole eminently satisfactory. The Board do indeed find that indiscreet and improper observations were made in Mariano Williams's presence by the superintendent of casual wards, the male attendant, and the master of the workhouse; that there was unexplained delay in providing him with the special diet prescribed by the medical officer, and that he was detained for an undue period in the receiving ward without the supervision of a paid officer. But in regard to all the main charges against the Guardians and workhouse authorities, the report of the Local Government Board is a verdict of complete acquittal. They hold that the medical officers acted with bonâ fide and professional discretion in arriving at the conclusion that Williams was of unsound mind and had suicidal tendencies; that no complaint can be made as to the manner in which his removal to the asylum was effected; that his location in the same ward with Fox was necessitated by the want of adequate accommodation, and that Fox was not a raving maniac, but was already in a state of coma at the time of Williams's admission, although liable to convulsive seizures which might cause commotion. These findings show how much foundation there was for the indictment presented against the Lewisham Guardians, and accepted in certain quarters, whenever it was presented, with a settled determination to treat its formulation and proof as one and the same thing, and with an exuberance of invective which would scarcely have been justified if Williams had been a latter day Norris. There is nothing that the more emotional section of the British Press and public find half so attractive as a lunacy scare.

In a memoir of Dr. Conolly, of Hanwell, the following passage occurs:—” The tone of the chapel bell coming across the narrow valley of the Brent still reminds me, morning and evening, of the well-remembered and mingled congregation of the afflicted, and who are then assembling, humble yet hopeful, and not forgotten, and not spiritually deserted.” These words of the famous mental physician strike the keynote of the following paper, the purpose of which is to invite attention to some of the advantages of daily morning and evening prayer in chapels of lunatic asylums. Such services “daily throughout the year” are beneficial in various ways. They are helpful to chaplains by their fixedness, involving the exercise of their ministrations daily at regular hours. Any restraint imposed on their movements would be amply compensated by the privileges for their congregations and themselves accruing from continuous worship. The chaplain's presence at morning and evening prayer keeps the congregation and himself in close communication, and many of those who may not themselves attend the daily services are yet aware that the opportunity is within reach. The benefits of such services to many of the patients of an asylum are various. The interval of quietude before the commencement is no doubt felt by many to be restful and soothing. The spirit of a sensitive patient which may previously have been ruffled and discomposed by noise or some irritating occurrence is often calmed and quieted in chapel. The daily morning service is a preparation, as elsewhere, for the day's occupations. To use the expression of a patient unfailing in attendance, evening and morning, the early worship “fortifies for the day.” Another referred to the daily ministrations in chapel as “a great comfort.” A letter from a discharged convalescent contained the remark, “The services at the chapel which I have had the privilege of attending have been to me, as it were, wayside seats, where I have often sat and refreshed myself.” “Dear old chapel,” another remarks, “I have spent many sacred hours there.” Another benefit incident to attendance at daily services is relief to the monotony of the lives of many in asylums, especially of the unoccupied. The walk to and from chapel and its services are a break in the day. This is not a chief advantage; still, it is not valueless. The services for morning and evening prayer appear to be specially well adapted to the circumstances of an asylum congregation. The Prayer Book has a soothing tendency very beneficial to sorrowful and disturbed spirits. Many “weary of earth and laden with their sin” have been relieved by joining in the prayers, by hearing some comfortable words of the Bible, by taking part in some well-known hymn, or by some remark from the pulpit which seemed to apply to their own cases. Again, many patients who neither have a Bible of their own nor ready access to another may yet become profitably acquainted with parts of the Holy Scriptures read at chapel services; and what tender memories, healing in their influence, may be awakened by the words and harmony of some familiar hymn, such as “Rock of Ages”—associated, may be, with earliest recollections. The regular use of daily prayers in chapel may indirectly exercise a wholesome influence on the household at large, and not merely on the accustomed congregation. The very knowledge of the regular hours of prayer may be consolatory to some who perhaps themselves cannot attend. The sound of the bell for chapel service may be a reminder of the duty of worship, and perhaps awaken a desire to go to the house of God. The writer recalls the case of a bedridden patient to whom the sound of the chapel bell was a call to his own devotions. Week-day services may afford an opportunity for the occasional invitation of preachers who might not be conveniently able to come on Sundays. Their presence is valuable, and they supply variety of ministrations, specially desirable for congregations who are necessarily restricted in their movements. Not to patients only, but also to members of the staff—attendants, nurses, etc.—the occasional opportunity of attending week-day services in an asylum chapel may in some cases be beneficial, fortifying and bracing the spirit for the day's work, or refreshing it after the long hours of labour. The merciful invitation,” Come ye yourselves apart and rest awhile,” may be gratefully responded to by resorting, for a brief interval of rest and quietude, to some of the frequent chapel services. These should be short, on weekdays not exceeding, as a rule, 20 or 25 minutes; on occasions when a special sermon is given somewhat longer time must, of course, be allowed. Ordinarily the shortened service indicated in the Prayer Book furnishes an office of suitable brevity. It should be made bright with simple chants and hymns in which the congregation can join, and occasionally a very short devotional reading might be welcomed. Others besides members of the English Church (for in large asylums are various religious denominations) would often be comforted by opportunities for frequent worship, and be led to value the ministrations supplied. For the reasons mentioned, and others besides, week-day services in asylums are very valuable. They should be steadfastly maintained where they already exist, and introduced where they do not. Experto crede.

This book may be said to clear away the cloud of obscurity which has for well-nigh four centuries hung over the history of Juana, the Queen of Castile. The kingdoms of Castile and Aragon were politically united by the marriage of Ferdinand and Isabella. They had five children, Isabella, Juan, Juana, Maria, and Catalina.

Dr. Baer is the chief medical officer at Plötzensee, a prison which represents the criminal world of Berlin, and from which (as Dr. Baer himself tells us) the prisoner usually emerges to become a confirmed recidivist. There should be much to say about such a criminal world as this, both in anthropological and in many other respects, and the book, therefore, arouses high expectations.

Dr. Strahan's prominent motive in writing this study of suicide is to emphasize the importance of heredity in its causation, in the hope that something may be done to diminish it in the future.

Mr. Ellis is to be congratulated on the difficult task which he has successfully accomplished in this book, of collecting the enormous material scattered in books and periodicals concerning the differential characteristics of man and woman, sifting it, and presenting it to his readers in an agreeable and methodical manner. He steers remarkably clear of the marked bias which has vitiated in the past the conclusions of various writers on this fascinating subject, and a great feature of the work is, therefore, the calm judicial way in which evidence is presented and the scientific spirit which pervades it.