Music, as a term, suffers much from diffusiveness. When we reflect that, in one sense or another, it denominates anything between the idle notes of the plough boy and the finished performance of an opera singer, between the productions of a Jew's harp and of a cathedral organ, between the playing of two or three foreign tramps and of a Philharmonic Orchestra; when we reflect that man's attitude to music is at one time active and at another passive, and when we also reflect that the acceptance of sound as music by man is largely dependent on his individual views and tastes, we must see how impossible it is to invent a definition of music that will serve as a universal standard, to which we can refer psychological observations without lengthy qualifications and limitations. I put forward this self-evident proposition in order to show how easily we may fall into error in particular considerations, if the term is used generally and without specialisation.

In venturing to read before you a paper on “Tuberculosis in the Insane; its Prophylaxis,” I am deeply conscious of the responsibility of my position. The very mention of tuberculosis seems to reopen long vistas of investigation and research, which stretch far away into the distance of the earliest medical times. Since the days of Galen and Mangetus the learned in medical science have with unwearying persistence investigated and studied the pathology and treatment of this disease. To the work of these I fear I have little to add, but I submit that neither the presentment of old truths in a new light, nor the adaptation of past experiences to present needs, is without its value. It is from this point of view, then, that I have ventured to approach so vast a subject.

It has long been recognised that the neuroglia presents difficulties of a very special kind in the way of its histological study. These difficulties are due mainly to the remarkable lack of affinity shown by its extra-nuclear part for the usual staining reagents. No histological method that has yet been described serves in a satisfactory manner for the complete investigation of this tissue in its normal and pathological states. The most generally serviceable at present in use is, I think, beyond all question the fresh method of Bevan Lewis. It at least furnishes us with a reliable test for the presence or absence of hypertrophy and sclerosis; but it does not give a complete or clear view of the normal tissue, the fibres remaining for the most part invisible (except in tissues from some of the lower animals), and the nuclear structure being quite obscured. Golgi's method gives us only a silhouette of a small proportion of the neuroglia-cells and fibres. It does not aid us in the solution of questions regarding nuclear and protoplasmic structure. Weigert's new method gives us a very clear view of the fibres and nuclei, but it leaves the protoplasm invisible in the normal state. Its chief deficiency, however, consists in the fact that its use is restricted to the fresh human brain. It is of little value for ordinary postmortem-room tissues, or for those of the lower animals. Other methods that might be mentioned are likewise imperfect in their results, or extremely limited in their utility. In these circumstances it is scarcely surprising that there is still the widest difference of opinion among the recognised authorities regarding the normal structure of the neuroglia. Yet until this question is carried beyond the stage of controversy it is obvious that all our views of the pathological changes occurring in the supporting tissue of the central nervous system must remain vague and unscientific.

Early this year I contemplated publishing a short account of the electric lighting of Claybury Asylum, the first large County Asylum to be so lighted throughout; but at the request of one of the editors of the Journal I consented to enlarge the scope of my paper so far as to include a review of the progress of electric lighting in asylums generally.

I have now dealt at some length with atypical and unusual conformations of brain-surface relevantly to mental standing, by description both of the general and of the local deviations from more usual arrangement; and have described aberrant brain-forms—abnormal defects or aberrations of cerebral gyres and furrows—which may serve as a stigma of degeneracy in the stock from which the individual springs; or may arise from disturbances in the very foundations of being, due to pathological and developmental anomaly during intra-uterine or during early extra-uterine life. In the course of the preceding chapters it has been necessary to discuss so many matters, and with so much detail, concerning the brain-surface morphology, that it will now be useful to resume, on lines both broad and brief, some of the principal features of interest and importance.

Dr. Mott gave a demonstration by means of lantern slides and microscopical specimens to illustrate “some points concerning the degeneration of the neuron.”

He pointed out that the “neuron” must be considered as a very complex cell with processes, of which, as Golgi had maintained, one is the neuraxon or axis cylinder process, the others dendrons. The dendrons receive the impulse which, passing through the cell, is conveyed to the neuraxon. Every neuron is an independent protoplasmic unit, anatomically distinct, in contiguity with other neurons, but not in continuity.

Being engaged, in the course of anthropometrical observations, upon an examination of the hard palate amongst the inmates of an asylum, I have endeavoured to make out a suitable method for the purpose. The proper basis of all such study, I believe, must be cast-taking. Seeing that the procedure to which I am about to refer is only rendered possible by the preparation of a cast of the hard palate, any value which may attach thereto is secondary in importance to the cast-taking. Dr. Eugene S. Talbot, the distinguished American writer upon deformities of the skull and jaws, has devised instruments for measuring the palate, either in the living subject or in casts. For the following method no special instruments are needed; and this may be accounted an advantage. Dr. John R. Lord, clinical assistant at the Joint Counties Asylum, Carmarthen, has been associated with me in working out the details of this method, and I am indebted to him for valuable assistance in cast-taking.

Dr. A. W. Campbell, by way of illustrating the uses of formol, gave a microscopic demonstration of a series of specimens, normal and pathological, taken from various parts of the nervous system, and therewith proved that in formolhardened portions of nervous tissue it was possible to satisfactorily stain all the constituent elements of those tissues and likewise to clearly demonstrate almost all the pathological changes in them which are to be revealed by other previously discovered methods.

That grave difficulties will always exist in the treatment of cases of melancholia in lunatic hospitals is evident to anyone who has lived in such places and considered the matter. The mere congregation of so many distressed beings of different types under one roof is a disadvantage, as patients have to hear and bear numberless griefs in addition to their own, and many painful delusions are suggested to them which might never have entered their own minds.