(II.) The Emotions act upon the Heart and non-striated muscles with a power equal to, if not greater than, that which they exercise over the voluntary or striated muscles; causing contraction, spasm, and paralysis.

If the term insanity, as applied to man, is one that it is difficult, if not impossible, accurately to define;—if human insanity includes a great number of the most diverse mental and bodily conditions or phenomena,—the term madness, as applied to other animals, is still more vague and unsatisfactory in its definition, and animal madness includes a much more heterogeneous group of the most opposite kinds of maladies. While the said term madness has been borrowed by veterinarians from human medicine, it is evidently regarded in a different signification when applied to other animals than man. So much so, that while the character of the mental phenomena in certain diseases of the lower animals must be, and is, admitted by all veterinarians, they deny, nevertheless, their parallelism to those of insanity in man, on the ground that animals have not sound minds, and cannot, therefore, possess unsound ones! Such a belief merely illustrates the utter ignorance and prejudice regarding the mental constitution of animals, which appear to be characteristic of veterinarians as a class.

The term “general paralysis” is not, it must be admitted, a satisfactory one, but, though many attempts have been made to improve upon it, nothing better has yet been agreed on. However faulty the term may be, it is best to have a clear understanding as to what the words may be supposed to imply.

In the “Journal of Mental Science” for April, 1863, there appeared a paper by Dr. W. Carmichael McIntosh, entitled “Asylum Notes on Typhoid Fever.” In his introductory remarks, Dr. McIntosh notices the increased interest attached to the occurrence of physical diseases as observed in the insane, and the value of observations thereon, when the sane and insane suffer from the same disease and are under observation at the same time. There is then an opportunity of noticing the influence of such blood poisons as the scarlatinal and typhoid, as affecting two classes of the community; and as the patients are under medical observation from the very commencement of the illness, peculiar advantages are offered for a close investigation of all symptoms, mental and physical, from their first appearance. Dr. McIntosh further observes, “additional light might be thrown upon mental pathology and treatment, if such observations, sufficiently extensive, were correctly made and recorded. Alienists have long noted the influence of physical diseases in the course of an attack of insanity; and recently cases from foreign journals have been given by Dr. Arlidge, where recovery has followed wounds causing profuse suppuration in melancholia and general paralysis; scarlatina in suicidal melancholia; dysentery and acute rheumatism in monomania; dysentery and a compound fracture of the elbow in religious monomania; lastly, profuse intestinal hæmorrhage is mentioned by M. Baillarger, as ushering in recovery in a case of “painful hallucination of vision consequent upon injury from a railway accident.” It is with the view of adding a few cases to those which have already appeared in the various journals that the following examples of insanity, with intercurrent scarlatina, are published; so that when a sufficient number have been recorded they may be collected for comparison and further examination, and it may be that some useful and interesting results may be obtained. For as we are in the habit of watching the effects of drugs introduced by ourselves in cases of insanity, in the hope that ultimately we may arrive at a scientific method for such medicinal treatment, there appears no reason why we should neglect, but rather the reverse, the observation of cases in which, through contagion, a specific blood poison has been introduced into the system, and which produces characteristic and obvious symptoms. In the present state of matters one would scarcely feel inclined or be justified to run the risk of exposing an insane patient to the poison of typhus or measles for the chance benefit which might result to the mental state; but it is not unreasonable to think that some day we shall be able to modify the course of many diseases, perhaps mental among the others, as we now do in the case of small-pox through vaccination.

At the last annual meeting of the Medico-Psychological Association, held at the College of Physicians, London, in July, 1870, I brought forward a resolution which, after full discussion, was amended and agreed to, in these terms:— “That it is desirable to facilitate the early admission of all acute cases of pauper insanity into county (and borough) asylums, by providing for the proper care and treatment of chronic and harmless cases elsewhere.” The object of the resolution being to ensure for acute cases that prompt treatment which is so essential, and to prevent the overcrowding and overgrowth of asylums, by providing for the transfer of incurable and harmless cases to workhouses, or to lodgings, or to reside with relatives, under proper care, treatment, and supervision. In the absence of any such provision, the enlargement of asylums progresses—this will be shown by the returns of the increase of pauper insanity in England and Wales. Several institutions have attained such dimensions that the difficulty of proper management has become great. In such overgrown establishments the individuality of the curable patient is liable to become lost amongst the crowd of idiots and incurables. The delay in obtaining the forms required by the Lunacy Acts, prior to the admission of insane patients to pauper asylums, is a great hindrance to early treatment. As regards chronic cases, this delay is of little consequence, and from the comforts being greater in the asylum than in the workhouse infirmary, and it being to the interest of workhouse officials to send insane paupers to the asylum, the accumulation of chronic and incurable cases therein can easily be accounted for.

Considering the amount of attention which has lately been given to cerebro-spinal meningitis, and the obscurity which still hangs over the disease, I think the following case, which occurred in the Asylum at Carlisle, in April, 1867, worthy of record. It was a sporadic case, but its accessories and accompaniments invest it with some of the interest of those epidemics of the disease which have lately occurred:—

T. C. had been a patient in the asylum for five years; he had laboured under melancholia with periodic exacerbations and suicidal tendencies. On the whole he enjoyed very fair bodily heath, except when he became somewhat weak at times from refusal of food. But he generally got over this in a few days. He had most obstinate and severe psoriasis over shoulders, arms, hands, and legs.