Dr. Janet is unrivalled in the delicate and elaborate psychological analysis of hysterical and neurasthenic mental states on the borderland of insanity. In the present paper he presents a well documented study of classes of obsession (which would by some be classed under folie du doute), marked by an excess of scrupulosity, more especially an excessively scrupulous body-consciousness or modesty, obsessions of crime and sacrilege, and hypochondriacal tendencies. Under this head he introduces an interesting discussion of hysterical anorexia. True hysterical anorexia, he states, is rare, and should not be diagnosed unless there is more or less complete suppression of hunger, and also an exaggerated tendency to physical exercise—both these symptoms resting on anæsthetic conditions. He then narrates the case of a young girl, Nadia, whose symptoms had been falsely diagnosed as those of hysterical anorexia, but were really what Janet would call an obsession of scruple. She refused to eat, but remained hungry, sometimes very hungry, so that she would sometimes devour greedily everything she could put her hands on, especially in private. But eating always causes horrible remorse. There is no suppression of hunger, nor is there any tendency to exaggerated movement; she takes exercise, but with an effort. Regarded superficially, the idea that animates her is the fear of becoming fat, like her mother. But that idea is not isolated, but really connected with a whole system of complex ideas. It is not a mere matter of coquetry; she looks on being fat as something almost immoral, something so shameful that it would prevent her from showing herself in public. She will not eat in the presence of others, nor can she even bear that others should hear her eating; she feels about eating (as she herself admits) as others feel about urinating. Nor is her feeling of shame confined to eating; from an early age she has been ashamed of her face, her hands, her legs, her feet, and regards them as ugly and badly made. But deeper, perhaps, than any other idea, is the desire to remain a little child, and be loved as a child. Such a case Janet regards as typical of this class of obsessions, very interesting from a clinical point of view, since they give rise to all sorts of symptoms—anorexia, chorea, writers' cramp, incontinence of urine, impotence, etc. Altogether they constitute a great neurosis, analogous in many respects to hysteria, but not to be confounded with it, the distinction being important both as regards prognosis and treatment. While such cases might be regarded as victims of a phobia, Janet thinks it better to regard them as primarily the victims of scruple—emphasising their troubles of will, and the ideas which they form of these troubles—and he regards the phobia as secondary. Janet considers John Bunyan as a fine type of obsession of scruple. He believes that suggestibility plays a very small part in such cases; they are endogenous, as he expresses it, rather than exogenous, and their obsessions are an index of the things that are most sacred to them.

Attention may be drawn to this elaborate and systematic study by Professor Grasset, who is also publishing (in the Bibliothèque Scientifique Internationale) a volume entitled Maladies de l'Orientation et d'équilibre. The author, who shows a wide knowledge of the work on this subject done in other countries, considers it important to remember that vertigo is constituted of two sensations: (a) a sensation of displacement of the body in relation to surrounding objects; (b) a sensation of loss of equilibrium. He defines it (“synthetically and schematically”) as a “subjective psychic phenomenon constituted by the transmission to the cerebral centre of a double sensation: a false sensation coming from the apparatus of orientation, and a sensation of the inadequacy of the polygon (by which he means the ensemble of the automatic centre of orientation and equilibrium) to ensure equilibrium.’’ Physiological vertigos are taken into consideration, though the study is chiefly devoted to the pathological varieties, and the symptoms are classed as anæsthetical, hyperæsthetical, and paræsthetical. A full schematic table of the objective and subjective symptoms is presented.

In continuing his investigations into this subject, Davis has confirmed his earlier result as to the marked influence of exercise on one side or the body in increasing power on the unexercised side, while bringing out many new results in matters or detail. The experiments were made with the dynamometer and the ergograph. The influence of the factors of length of hand, length of fore-arm, previous muscular development, and temperament are taken into account, and the sexual differences also noted. As regards temperament, Davis finds it most convenient, from this point of view, to recognise three temperaments: the nervous, the motor, and the phlegmatic. The influence of this factor of type is found to be very important. Persons of the nervous type tend to be quick in muscular and mental reaction, short as regards height, and light in weight. Persons of the phlegmatic temperament are found to be slow in muscular and mental reaction, tall as regards height, and heavy in weight. Persons of the motor type are in all respects medium. There are, of course, many cases of mixed type. On the whole, however, they require different degrees of exercise to produce the full effects of cross-education, the phlegmatic, as a rule, considerably more than the motor. Exercise that is too slight, or too severe and fatiguing for the individual, will fail to produce proper development. “If the work is just right in intensity and amount the anabolism provoked is greater than the katabolism, and there is development of the part used. An almost endless variation of conditions would be necessary to make the adjustment of exercise suitable to all individuals. Exercise must be prescribed per order just as a dress must be fitted to the individual.’’ Davis emphasises the conclusion to which his experiments point: that the mental factor is of much more importance than the muscular factor. Cross-education is mainly a matter of nervous centres and nervous channels. These researches are of considerable interest, both theoretical and practical.

These experiments were carried out on school children at Madison at the suggestion of Professor Jastrow, with the object of testing the results of Porter at St. Louis. Porter found a marked tendency to a direct relation between weight and mental precocity; weight, he then argued, stood for motor ability, and hence a child increases in mental efficiency directly as he increases in motor ability. These conclusions have been seriously criticised.

Verson, in 1868, discovered in the epiglottis nerve-endings, which he regarded as essentially resembling those which Schwalbe and Lovén had then recently discovered in the tongue of man and other mammals, and regarded as the primary organs of taste. Michelson, in 1891, brought forward experimental evidence to show that they really were capable of conveying sensations of taste. In the present paper Kiesow and Hahn, after setting forth the present state of the question, describe their own experiments, carried out at the Physiological Institute of Turin. They tested the inner surface of the epiglottis, as well as the interior of the larynx, with reference to reaction to the ordinary taste stimuli—sweet, bitter, acid, salt. Only three subjects were available for complete investigation, one of these being Kiesow himself. Schroetter's laryngeal sound was used in applying the test solutions, and various precautions were adopted in order to eliminate the obvious sources of error, while all doubtful trials were left out of account. In all three subjects the majority of experiments revealed the existence of sensibility on the laryngeal surface of the epiglottis to all four orders of test substances, although the sensations were of less intensity than when the same stimuli were applied to the tongue. All the subjects declared that they had never experienced taste sensations at such a depth, and were able to indicate on the external surface of the neck the spot at which the sensations were localised. Sweet and bitter sensations were always easily recognised. Kiesow, however, was unable to identify acid stimuli, which he felt as salt, possibly because the end organs for acid in his case were lacking, and their place taken by those reacting to salt. The experiments within the larynx, made on Kiesow alone, also revealed the presence of taste sensations.

How it is that we obtain voluntary muscular control is a problem of great interest and importance, for it helps to explain the origin and nature of the will. Bair has investigated the conditions and processes by which such control is gained in the case of a particular muscle. He selected the retrahens aurem because of its complete isolation from other muscles, the inability of most people to contract it, the comparative ease with which control can be learnt, and the definite movements attending contraction; moreover, this muscle is adequately supplied with motor and sensory nerves, and there is every reason to suppose that control over it is acquired in the same way as over any other muscle. Of the fourteen subjects on whom the experiments were made only two could move their ears at the beginning of the investigation, and then only by vigorously raising the brows.

In the various cases of ereuthophobia (or morbid blushing) recorded, it appears to be clear that the emotional element is preponderant; but one point has been neglected, that is, the investigation of vaso-motor reflexes. The study of the case here recorded throws some light on this aspect of the question, especially as the patient, being intelligent, ably seconded the authors in the determination of certain points of their experiments.

The notes of a case—an epileptic female suffering from complicated delusional insanity—are given to show the preponderating influence of dreams upon the mental life. E. V—, now æt. 45 years, was brought up as a child under unsatisfactory conditions (family quarrels, unkind mother, etc.). She was married at the age of twenty-six, and took to gambling. She had her first epileptic fit when thirty-one, after a violent emotional shock (witnessing the paternal house on fire); it was followed by disordered mind for forty-eight hours. Subsequently fits recurred for a time every six months, always followed by short periods of mental disorder; then they became more frequent. When thirty-seven, after an attack, she developed hypochondriacal ideas and delusions of persecution with auditory and sensory hallucinations, on account of which she was sent to an asylum.

Dr. Weygandt, in an article entitled “Psychology and Cerebral Anatomy in Special Relation to Modern Phrenology,” which appeared in Die Deutsche Medizinische Wochenschrift, made the statement that the only true basis for the study of psychiatry is the acceptance of the doctrine of psycho-physical parallelism, and quotes Wundt's definition of this parallelism in support. Dr. Juliusburger feels it his duty to pen a somewhat indignant and scornful reply, and points out, in the first place, that whereas in 1863 Wundt, in his lectures, treated human and animal psychology from a monistic point of view, it is only in later years (1892) that he took up his dualistic standpoint of a psycho-physical parallelism, according to which, although with every psychical act there is a co-existent physical phenomenon, nevertheless these two manifestations are entirely independent of each other and have no causal relationship. Dr. Weygandt agrees with Ebbinghaus that mind and brain are not separable entities—the one a product of the other—but they are an actual combination, varying only according to the point of view from which we regard their manifestations; when viewed from within, these phenomena are psychical, when from without, physical.

The author is interested in determining in what direction the spread of our knowledge of psychology tends; what results seem desirable and probable in the struggle going on in the various fields of energy which are thrashing out its problems. For centuries introspection was practically the only means of study employed by philosophers; then came the experimental method. In this connection Toulouse emphasises the importance in our measurements of having physically and chemically defined standards. It is not only necessary to have a number to express our toil measurement, it must be a number determined by precise conditions. The difficulties under which various workers labour are pointed out, especially that of obtaining average subjects for experiments.

Previous investigations have shown—in harmony, indeed, with daily experience—that alcohol renders more difficult the perception of sensory impressions and the associated mental activity, while, on the other hand, it makes voluntary operations easier. At the same time, in apparent apposition with the latter result, alcohol has little or no influence in increasing work done with the dynamometer or ergograph. In order to follow out the workings of alcohol in a field where its finer influence could be precisely traced and measured, Mayer has investigated its effects on handwriting in accordance with the exact methods of Diehl. In one series of experiments the dose of absolute alcohol taken was 30 grammes, in another series 60 grammes. The results are recorded in full detail in this paper. It was found that alcohol has a slowing influence on writing movements; in small doses the pauses are shortened and the pressure increased; in large doses the pauses tend more to be increased, while the pressure is decreased; there is no recognisable influence on the way of writing. These results are recorded in detail with the precision that the instrumental study of handwriting now renders possible. Incidentally, Mayer introduces an interesting discussion of the resemblance of alcoholic intoxication to mania, which has often been pointed out. In both there is diminished attention, a flood of ideas with tendency to sound associations, an inclination to arrogance, and increased facility in obeying impulses. As soon, however, as we begin to inquire into the details of psychomotor activity (as may be done by reference to Gross's study of the precise characteristics of the handwriting in mania) profound differences may be traced. Common to both states is the shortening of the pauses, the release of movement becoming easier. In mania, however, there is greater excitability, the shortening becoming more marked in the course of writing, while in intoxication the pauses soon tend to be increased. Movement itself is in both conditions slowed, but in mania with very great rapidity. In mania, also, the writing is from the first large, and tends to become larger as writing is continued, while in intoxication there is no change in this respect. Pressure, again, is much more increased in mania, and rises as writing is continued. The finer variations do not disappear as they do in intoxication, hut are still more marked than normally, and changes in pressure occur with undue swiftness. On the whole the phenomena of intoxication, as evidenced by the handwriting, present a picture of increased excitability succeeded by paralysis, while in mania no symptoms of paralysis appear at any stage in the writing process, but, instead, an increasing excitability overcoming a preliminary tendency to inhibition of movement.

This paper is a further contribution to the experimental study of the action of alcohol on mental function, which has already been the object of several valuable researches by the Heidelberg school.

In this paper the author records the results of a series of elaborate experiments showing the condition of mental function during prolonged abstinence from food. The experiments were made on six individuals; the period of fasting generally ranged between 12 and 36 hours; in one instance it was extended to 48, and in another to 72 hours. In some of the experiments water was withheld as well as food. The psycho-physical tests employed were those current in Kraepelin's laboratory, a few modifications of detail being introduced in some of them. One new method—Griesbach's examination of the range of tactile sensibility—was also tried, but was found very unsatisfactory.

This address was delivered at the conference of the Philological Club at Naples, in 1899. The author points out that the neuroses are as old as man. He passes in review the different phases of these neuroses through which races have come as knowledge advanced. In the early ages as the result of a belief in a vindictive God, the neuroses assumed a melancholic form with religious ideas. The neuroses of the Greeks and Romans were coloured by the realism of the period. There followed an era in which all power was given to Satan, and in consequence an ascetic mysticism resulted, with the foundation of many religious orders, which spread all over Europe. Epidemics of hysterical and demoniacal possession were common. A new era dawned with greater liberty of thought and action. The author then gave statistics pointing to the great advances made in language and education, in our knowledge of the human body, and the laws governing it. From these have followed the neuroses of the present time—the weariness of life, the diffidence, the excitability, the unrest that needs always new and more powerful stimuli, the intolerance of restriction and of discipline that denotes a great hypertrophy of egoism which, in its most marked development, gives us the anarchist epidemic.

Heredity is the most important factor in the causation of recurrent insanity, and Dr. Pilcz quotes many distinguished authors in support of this view. Kraepelin puts the proportion of cases of recurrent insanity with hereditary taint at 80 per cent., while Morel regarded folie circulaire as a manifestation of hereditary taint.

The author, studying the ætiology in 102 cases (78 males and 24 females) of general paralysis admitted under his care to the Brescia asylum between 1894 and 1900, found 16 cases (13 males and 3 females) in which alcoholism appeared to him to be the sole cause of the disease. He gives in this paper a very brief résumé of the clinical history of these cases, and of the macroscopic brain lesions noted in ten of them. He finds that alcohol is capable of generating a true general paralysis, and that cases of alcoholic origin do not differ in any respect from cases of other causation. In six of his cases the disease was of the exalted type, in one of the hypochondriacal, and in nine of the simple demented type. The cases ran a progressive course without remission, terminating fatally in from two to three years. The distinctive characters which some authors assign to alcoholic general paralysis or pseudo-general paralysis—generalised tremor, slightness of speech trouble, frequency of remission, etc.—were not noted. Hallucinations and the delirium of conjugal infidelity, also said to be specially common in such cases, were only found in one instance.

From the beginning of the year 1889 to the end of 1899, 128 cases of progressive paralysis came under observation in the German Tirol; out of this number there were 104 men and 24 women. The amount of insane patients during these eleven years came to 5·4 per cent.; out-patients as well as in-patients were included in this calculation. The age at which the disease made its appearance varied between thirty and sixty-four.

This thoughtful paper treats of the different characters of nervous diseases manifested in women from those in man. It groups the mental alienations of women into six classes, distinguished by temperament, and profound alterations of constitution brought about by disease. In the mental derangements of the female, observes the professor, there is a more pervading change in the whole temperament, not only mental perversions, but a multiplicity of organic sensations which act upon the entire personality, inducing states of exaltation and depression, emotions of joy and grief, of fear and anger. These complex changes sometimes culminate in the reeling of altered personality. The structural differences between the male and female render the latter less able to react upon external nature. Her frame is adapted to maternity, conception, gestation, labour, lactation; then the renewal of the periods induces profound changes in her organism. These functions affect even the disposition of the bones and ligaments, the increase and diminution of the unstriped muscular fibres, the activity of the sympathetic ganglia, the vascularisation of organs, and the augmented cellular secretion and enlargement of the glands. The totality of changes, so diverse and profound, subject the feminine constitution to grave fluctuations, which alter its relations to the outer world and affect the psychical manifestations.

Dr. Henneberg has read deeply in the extensive literature of spiritualism and occultism. He treats of table turning and spirit rapping, and what he calls psychographs, in which the subject, believed to be in a trance, writes to the dictation of the spirits of the dead. He mentions cases in which the mental derangement resulted from being hypnotised. Persons who practise these so-called communings with spirits have fallen into hysterical conditions. Some of these were previously disposed to neurosis, so that the tendency was merely aggravated. In other instances hysteria appeared as the result of these practices in persons previously healthy. Dr. Henneberg gives in detail the description of eight cases in which insanity was the result of concentration on spiritualistic experiments. He observes that it is the duty of the physician to warn persons disposed to nervous diseases against any dealings with mediums, magnetisers, and faith healers, who work on the imagination.

The subject of this paper who records her own experiences was a Miss L. S—, described as a highly gifted and well-educated lady. She was admitted to the asylum at Zürich, December 21st, 1882, being then thirty-two years of age. There was a record of insanity in her family. As a child, she was intelligent, imaginative, and impressionable, unpractical, not good at arithmetic, but fond of drawing. As she grew up, she had religious scruples and doubts, especially about the time of confirmation. She was affected by listlessness and melancholy. At her own request, she was sent to a parsonage in the Pays de Vaud, where the cloud soon passed away. When twenty-one years of age, L. S— visited Italy. Amongst her Italian studies she read the Decameron. This book did not affect or excite her at the time, but left much that was impure in her memory, which had an evil effect in later days. She never read any other books of an indelicate character. She fell in love with a man with whom she used to study, who was nine years younger than herself. Apparently they were engaged to be married. He became insane, which deeply affected her. Before her own mental derangement she had a lasting dull headache, especially at the occiput, and sometimes pains and peculiar feelings in the head, but the attack of mania came on quite suddenly. When admitted to the asylum, she was very much excited, and seems to have been put under restraint and treated with the Deckelbad (the warm bath), the head remaining uncovered through a lid. She describes her terrors, the chain of ideas which rushed through her mind. She recalls that she used many words to which she gave quite a different meaning to that they usually bear; some of them were of provincial or of foreign origin. She did not think she was insane nor recognise her excitement, and was surprised that people were afraid of her. She could, however, appreciate the mental alienation of her fellow-patients. She took great pleasure in feeding birds; she had many hallucinations and dreams which passed into her memory as illusions. She heard voices though she denied it. Her hallucinations or delusions were of various kinds and degrees, rising from mere suppositions to convictions; sometimes when spectral figures appeared to her she would guess who they were, try to identify them with real persons; for example, she saw an elderly woman of commanding aspect, very pale, and dressed in white robes, whom she supposed might be Queen Elizabeth of England. In honour of this personage she thought she saw a young horse sporting about in the sea. Looking out at the window of her cell, she saw the figure of a little grey monkey, of almost human expression, rising from the ground, and making signs for her to come away with it. This she felt willing to do, and thought that there was a kind of understanding between them. Another time, she thought that she was in purgatory, and that her companions in the asylum were going through penance there. She believed that she saw Pope Leo XIII, Dante, St. Catherine of Siena, and Francis of Assisi, and nourished the delusion that her grandmother was the original of Gretchen in Faust, and that her family were connected with Goethe. She thought that the currents of air which passed through the gratings were intended as signals from persons who wished to help her, and she stuck little things in the wire to keep up the correspondence. The birds who flew about the windows she took as messengers of freedom. She heard a tumult outside which she believed to be caused by anarchists, and a hollow voice as if preaching, but so quietly that she could not follow the words. She also heard noises like that of machinery. She thought that her teeth had been so calcified that they were all grown together, and expected them to be forcibly separated. A large number of hallucinations and delusions are tabulated in a brief form. After thirteen months' detention in the asylum she was discharged cured, and although nearly twenty years have now elapsed, she has had no return of mental derangement.