In the population of Scotch Asylums, there are so few persons below the age of 10 years that, for practical purposes, it may be correctly said there are none. of the general community, on the other hand, 25·6 per cent. are persons below that age. It is clear, therefore, that the death-rate of the population of asylums cannot properly be compared with the death-rate of the general population. To make such a comparison it is necessary to deal only with the deaths occurring among the 74·4 per cent. of the general community who are above the age of 10 years. When this is done, it appears that the mean annual death-rate for the general population is 1·7 per cent. as compared with 8·3 per cent. for the population of asylums. These figures refer to the whole population of asylums, and to the whole of the general population above the age of 10 years; but in order to show the rates at which persons of different ages die in asylums, and the rates at which persons of corresponding ages die in the general community, the following table has been prepared. It is founded on 3,800 deaths occurring during the seven years, 1870–1876, in the Asylums of Scotland, which had a mean population of 6,421 during those years.

In a short paper like the present I cannot pretend to exhaust the chloral subject, but I hope very definitely to express my opinions, and also to give the grounds on which I have formed them.

The object which I propose to myself in this paper is twofold. The first is to lay before you briefly the general statistical results of five years, in regard to those who have been sent for treatment from the districts of Cheshire, to which the asylum is allotted; and the second is to give the results of some further experience, as bearing on the question of “Local Differences in the Distribution of Insanity,” of which I adduced some illustrations in my Annual Report for 1873, and which were subsequently published in a separate form in the “Journal of Mental Science” for April, 1875.

No part of the treatment of certain conditions of insanity is more important than that which relates to the administration of food when from any cause there is inability to take it, or persistent refusal of it.

I have been disappointed rather than surprised that no one has given us a full and useful analysis of the Statistics of the Causes of Insanity and of the Occupations of the Patients admitted into Asylums during the year 1876, in the Thirty-First Report of the Commissioners in Lunacy; at present they are a mere rudis indigestaque moles, and I must say that the effort to extract much valuable meaning from them appears to be an arduous one. Thinking that the Tables given in continuation of the same series in the Thirty-Second Report may meet a similar fate of neglect, I somewhat rashly propose to endeavour, if not to extract their full meaning, at least to state what are the facts they most clearly enounce, and, if possible, to suggest a meaning for them. I do this the more readily that they are not an extensive series, and are, therefore, somewhat manageable, and may admit that they have a certain attraction for me, as the most remarkable novelty they demonstrate happens to be a circumstance that on a small scale I have been aware of for some years, and had frequently thought it desirable to have tested on larger numbers, and yet is one to which I do not recollect ever to have seen attention directed. This circumstance is the frequency with which, in comparison with other lunatics, the general paralytic is married.

While on a trip through Holland in the year 1877, I visited the well-known School for Idiots at the Hague, and, thinking that my observations might perhaps prove interesting to others as well as myself, I have put together the following notes:—

It has been pointed out that, however potent Islam has proved in the history of civilisation, progress within its narrow boundaries is unknown—its development is at once full-blown. And especially is this true with regard to the treatment of its lunatics; for whatever credit may be due to the pioneers of Mohammedanism in originating the idea of the separation of the insane from the sane, it is sadly marred by the fact that in thus caring for the welfare of the community at large they have quite overlooked that of the luckless minority.

In one visit to an asylum, during which all conversation has to be carried on through the medium of a dragoman, it is not easy, however intelligent he may be, to gain all the facts which one desires bearing on the many questions which arise in reference to the insane in a land placed under such different conditions from our own, as is Egypt. Hence no further excuse is needed for the insufficiency of my observations on the Cairo Asylum, which I visited on Dec. 11, 1878.

It will be impossible for me to discuss this evening the different theories that have been brought forward to account for the production of aphasia (including under this term all forms of affections of speech), and I limit myself therefore to a few remarks upon one of them.

The subjoined cases are of most interest from the duration of the symptoms which were finally recovered from.

For the notes on this case I am indebted to my colleague, Dr. Savage.

At a meeting of the London Hospital Medical Society, held on January 10, 1879, at the house of Mr. Hutchinson, Cavendish Square, a very able and interesting paper was read by the host on the medical poet, Keats, which was followed by a lively discussion. The Poet's chief composition, “Endymion,” was of course discussed by the essayist, who made various discriminative remarks upon its meaning. The question might have been asked whether Keats himself caught the psychological belief hidden in the ancient myth upon which this remarkable work of genius is founded? As no reference was made to this aspect of the question, we may say that Keats makes no allusion to the idea which we suggest underlies the fable. We beg to supply the omission. Every one knows that the Greeks regarded Selene as the cause of madness. It was under this influence Endymion fell. The form of his unwisdom for which he suffered need not be a matter for conjecture. Young and ardent he had gained a giddy height. Ambition beckoned him thither. Success turned his head. The kiss of Selene shadowed forth his fate.

We have received a very interesting and able paper on the above subjects, read by the author (formerly a member of the Medico-Psychological Association) at a meeting of the Bengal Social Science Association, on the 13th of June last.

Many cases have come before me in which there was great restlessness; the patient could not be still for a moment; was alternately excited and depressed; slept badly, or not at all; was intensely hysterical, and could not attend to business; while others have complained of failing memory; of want of power of attention; of suicidal thoughts; of intense melancholy; others of sounds in the ears; voices, sometimes distinct, sometimes not; and some or all of these of long continuance; but yet all disappearing under treatment upon the hypothesis I have mentioned. These symptoms often alternate with, or accompany, those which I mention next.

Mr. W. Irving Bishop, an educated and able young American gentleman, who is now visiting Scotland, has, at the request of many of the Professors of the Universities of Edinburgh and Glasgow, and many other influential citizens of these towns, been giving several “Exposures of Spiritualism” before very large audiences. By means of a careful study of the mode in which the most famous professional conjurors amuse and deceive their audiences, through a knowledge of the automatic and reflex action of the brain, and by great perseverance and practice in performing the “tricks,” he has been able to rival the most celebrated mediums in befooling an audience. His peculiar anatomical construction enables him to do feats which no ordinary man could do. He offers to pay one hundred pounds, and a well-known American physician adds a thousand to this, if Mr. Bishop cannot do any “manifestation” whatsoever done by any medium, or Spiritualist, after he has been allowed twice to see it done by such a “medium.” His offer has not yet been accepted, either in America or Europe.

During the last few months, the air has been rife with public clamour against private asylums and “mad doctors,” or “body snatchers.” Mrs. Weldon, who escaped between the signing of her certificates and her removal to an asylum, gave in an address, delivered in St. James's Hall, extending over two hours and a half, a detailed narrative of the attempt to place her in an asylum last April, her flight, and her determination not to rest until the Lunacy Laws are amended. A gentleman who had been in an asylum, placed there, he asserted, by his brother, an M.P., because they differed in politics, entered upon a tirade against the Russians, and was with difficulty brought back to the question by the meeting. Mrs. Weldon gave a song, and after a resolution had been passed, thanking her for her discourse and expressing the opinion that the Laws of Lunacy required amending, the audience separated. The meeting was orderly, and Mrs. Weldon had no occasion to use a rattle, with which she had provided herself, to call her audience to order.

The following are extracts from a very interesting and important paper by Dr. Coates in Vol. lxi. of the “Medico-Chirurgical Transactions.” They certainly show that if microscopic investigation is so fruitful in such “functional” diseases, we need not despair of yet demonstrating under the microscope the lesions of convolutional structure in acute mania or melancholia.