My attention was directed to this case by Dr. Arthur Mitchell, Commissioner in Lunacy, in the course of his official visit last spring. He informed me that it was one of so-called Kalmuc idiocy, a form of idiocy rarely met with in asylums, but nevertheless not really uncommon. Dr. Mitchell pointed out in this case the distinguishing physical characters of this class of idiots. Some of the more prominent of these are obliquity of the eyes and palpebral slits, shortness and flatness of the nose, depression at its root, broadness or squatness of the hands, transverse fissuring of the tongue, shortness of stature, disproportion between different parts of the limbs, smallness of the head, and shortness of its antero-posterior measurements. Certain mental characteristics are said to be very constantly present, and these will be referred to in the details of the case. The peculiarity of the eyes and nose give the face a Kalmuc look, and hence the name.

The name of John Howard stands alone in history as the pre-eminent type of disinterested benevolence, and the tendency of his work has been universally accepted as having less admixture of evil than perhaps that of any other man. Respect and admiration have been lavished upon him without measure; whether by those whose sympathies were naturally with the objects of his commiseration, or by those who simply desired to emulate his singlemindedness and active humanity. There is this peculiarity in his wide reputation, namely, that the criminal as well as the unfortunate have a direct interest in applauding his beneficence; while the good cannot but admire his devotion to the cause of the helpless, and his straightforward simple method. It would be too much to say that he preceded as well as excelled all other labourers in his special field, or that without him prison reform would never have been achieved, or would have been even indefinitely postponed; for a Parliamentary Committee had reported fully on the subject 70 years before, and Mr. Popham was Howard's immediate predecessor in introducing some important practical legislative improvements. But it is indisputable that Howard awakened an enthusiasm on the subject without which it is impossible to say how far those improvements could have been carried; and further—that he was the principal means of the complete exposure of the frightful abuses and defects of prison management which were then so prevalent. The expansion of his indomitable labours to nearly every corner of Europe, while it established England's pre-eminence in the stupidity as well as cruelty of its maladministration, furnished him not only with ample proofs that these evils were almost equalled in some foreign countries, but with many examples and patterns (for instance, in Holland and Switzerland), which he copied and laboured to introduce generally; and added such weight and volume to the public opinion, which he created or converted to his views, that there is no similar movement which has been more widely, energetically, and persistently sustained.

There is a general idea expressed in text-books, and more or less freely asserted in practice, but which I shall prove to be a fallacy, that a high-arched palate is so frequently met with in idiocy and imbecility that it may be taken as a sign of their existence. Indeed, when a case of this kind is brought forward the patient is made to open his mouth, under the conviction that a high palate will be found as certainly as a superficial alteration of the tongue in gastric disturbance. We shall see that the connection is an accidental one; and there is, in reality, no relationship between the development of the intellect and the height and width of the palate. If we consider that the bones of the cranium are developed in a different manner from those of the face, and that ossification at the base is complete long before that of the bones forming the palate, it is clear that there can be no primâ facie reason for thinking that because a person has an imperfect brain he should therefore have an imperfect palate; yet such an interdependence is held. It is quite true that a constitutional taint, such as rickets or syphilis, which affects the ossification of the bones generally and the cranial sutures, would probably affect the palatine bones, and hence it is that many idiots and imbeciles are found to have high or imperfect palates: but on the other hand some modifying taint may dwarf the height of the body, may affect the shape of the head to such an extent as to make an idiot of the microcephalic type, and yet leave the palate untouched, perfect in all conditions of width, height, number, quality, and regularity of teeth.

The chief point of interest in the subject to which this paper has reference, centres in the questions where and what was the provision made for the insane in England in the earliest period in which we can discover traces of their custody? As this enquiry at once leads us to Bethlem Hospital, I thought when Dr. Williams, some weeks ago, asked me to contribute a paper to the next Quarterly Meeting of the Association, that it might fittingly occupy a portion of our time this evening.

The short notes which I am going to bring before you refer more directly to the power of repair of bony structures and soft tissues in fractures and wounds, occurring in cases of insanity; and I have the less hesitation in calling your attention to the subject, because I see by the last “Commissioners' Report” that during 1874 twenty-six fractures occurred in the Scotch Royal and District Asylums. I hope, therefore, to hear some useful remarks on the subject from the members present.

The two following cases, which were tried at the Glasgow Circuit Court, in May, 1876, seem of sufficient importance to deserve record and comment in the “Journal of Mental Science.” In both the facts were undisputed, and the interest centred in the mental condition of the prisoner.