I propose to deal with this subject under the three following heads:

1. 1. What the Act was expected to accomplish.

2. 2. What it is accomplishing.

3. 3. What an adequate Inebriates Act ought to accomplish.

First, then, what was the Act expected to accomplish?

Is there any special connection or affinity between insanity and phthisis? In other words, is there a greater proclivity in the insane because of their insanity to develop pulmonary consumption than in the sane? That such is the case is, I think, an opinion which at least up till recently has been rather widely if somewhat vaguely held, and believed to be well grounded. The ablest contribution on this subject has, I need hardly say, come from the pen of Dr. Crookshank (Journal of Mental Science, October, 1899), and the facts and arguments adduced by him should go far to dispel this idea. In this paper no attempt will be made to treat the question fully, which, after all that has been written by others, would be quite superfluous, but I shall endeavour, mainly by an appeal to some statistics of Irish asylums, to see if from them corroboration is to be found for Dr. Crookshank's conclusion on this particular point. My paper is therefore to be regarded as in a small way supplementary to his.

All the facts which can be gathered from the study of museums or literature point to the conclusion that the sense of light was developed first, then the sense of colour. The tendency has been to regard colour-blindness as “chromic myopia;” but this is not correct unless there is a defective perception of light as well, as shown by the cases which I have recorded. A man may be able to see light of all colours at twice the normal distance, and yet be colour-blind. I specially wish to emphasise the fact that there is no definite relation between light and colour. When light falls upon the eye it sets up a nerve impulse, which is conveyed to the brain. In the impulse itself we have the physiological basis of light, and in the quality of the impulse the physiological basis of colour. My contention is that these two factors are perceived by two entirely different sets of cerebral cells, those devoted to the perception of colour being developed at a later period than those conveying to the mind the sensation of light. All the evidence which can be obtained shows that all objects were first seen as in a photograph, that is, in different degrees of black and white. In the evolution of the colour sense those waves which differ most physically, namely, red and violet, were first recognised as different, the remainder of the spectrum appearing grey. Homer's colour vision was of this class, which represents the degree just preceding total colour-blindness. I have recorded a case of this kind of a man who was colour-blind with one eye, and who was therefore able to tell me exactly how objects appeared with this eye. He said that the spectrum appeared nearly all grey, but with a tinge of red at one end and a tinge of violet at the other; he could see very much better with the colour-blind eye than with the other.

In approaching the subject-matter of this paper I am fully conscious of its importance and the difficulties to be contended with in dealing with such a vexed question, the far-reaching effect of which must of a necessity materially influence the financial position on retirement of thousands of asylum officials of all grades. In adopting the question of superannuation I do not think I could have selected a better or more useful one for the purpose of calling attention to the provisions of the Acts of Parliament which determine the retiring allowances in this country, and the similiar Acts operating in England and Scotland, and, at the same time, eliciting an opinion as to how our common interests could be best served in getting rid of the permissive clauses common to all the Acts.

Literary apologies, it has been said, are either superfluous or impertinent—superfluous if the matter apologised for is of itself worthy of public regard, impertinent if it can lay claim to no such merit. Therefore it does not seem necessary on the present occasion for me to introduce the subject of asylum management with any deprecatory language. It will suffice simply to recall the fact that in this city the question has come up in an acute and even controversial form, and is deeply interesting the community in whose midst we are assembled. We may well hope that the impulse given by this discussion will leave a permanent impression throughout the length and breadth of Ireland. One thing, at any rate, we may expect—the abolition of the standing scandal that has so long permitted the insane poor to be huddled together in workhouses without the benefit of scarcely one of those ameliorative agencies elaborated by modern science wedded to a genuinely philanthropic spirit. It is an oft-told tale, and need not be repeated here. The Poor Law guardian who takes for his axiom “keep down the rates” must shut his eyes to the uncleanliness, the untidiness, the lack of discipline, the absence of proper scientific supervision, the utter discomfort which reigns everywhere—characteristics that have made the name of workhouse a byword and a reproach even among the most degraded. If at any time he is visited with a qualm of conscience, he reflects, perhaps, that the unfortunates in his charge owe their sad destiny to God, or Fate, or Nature, and that anything done for them robs the ratepayer of that which, not enriching them, leaves him poor indeed. These institutions are cheap, but if there is any warning writ more largely than another for the behoof of all future lunacy reform in Ireland, it is surely that supplied by our workhouses against a parsimonious and pettifogging spirit in our provisions for the insane.

We are doubtless of one mind in believing that change of scene and surroundings is necessary for those whose work lies amongst the insane, and I am sure that our thoughts must turn towards the monotonous lives of our patients during our holidays, spent procul negotiis. They are still in the same wards, with the same neighbours, tied to the same narrow round.

Of the innumerable organs and tissues which have been made the subject of research since Brown-Séquard promulgated his doctrine of “internal secretions,” it may be broadly stated that there are practically two only in which the existence of such a specific secretion has been determined beyond controversy, viz., the thyroid gland and the suprarenal bodies. The place of the former in therapeutics is now more or less determined; at all events most have tried it and formed their own conclusions; but the uses of the suprarenal glands in treatment are still, to a large extent, undecided. It is true that in certain branches of surgical practice suprarenal extract has been found so useful as a local application that it may almost be said to have gained a position in the surgeon's regular armamentarium, and that it has been employed internally in Addison's disease by many observers, with somewhat conflicting results (1); while its use in cases of heart failure, and also in obstetrics, has recently been strongly urged (2). But beyond these more obvious applications of the properties of its active principle, there are certain other diseases, notably some forms of psychoses, in which it would seem probable that those properties might render it valuable, and what little use has been made of it in this direction to some extent bears out this expectation.

The district or county asylum patient spends nearly half his time in bed. As a rule he goes to bed at or before eight o'clock at night, and rises at six in the morning.

This demonstration was a further report on the subject laid before the Association at the meeting at Claybury in February last, viz., the morbid changes occurring in the brain and other intra-cranial contents in amentia and dementia. In a paper read before the Royal Society in the spring of 1900, and subsequently published in the Philosophical Transactions, it was stated, as the result of a systematic micrometric examination of the visuo-sensory (primary visual) and visuo-psychic (lower associational) regions of the cerebral cortex, that the depth of the pyramidal layer of nerve-cells varies with the amentia or dementia existing in the patient. At the meeting of the Association referred to it was further shown, from an analysis, clinical and pathological, of 121 cases of insanity which appeared consecutively in the post-mortem room at Claybury, that the morbid conditions inside the skull-cap in insanity, viz., abnormalities in the dura mater, the pia arachnoid, the ependyma and intra-cranial fluid, etc., are the accompaniments of and vary in degree with dementia alone, and are independent of the duration of the mental disease. Since that date the pre-frontal (higher associational) region has been systematically examined in nineteen cases, viz., normal persons and normal aments (infants), and cases of amentia, of chronic and recurrent insanity without appreciable dementia, and of dementia, and the results obtained form the subject of the present demonstration. A paper on the whole subject will shortly be published in the Archives of the Claybury Laboratory.

These observations, carried out at H.M. Convict Prison, Portland, were undertaken to ascertain whether the moral insensibility of the criminal, which is so prominent a psychical characteristic, had any physical parallel.

The sixtieth annual meeting of the Medico-Psychological Association was held in Cork at the end of July under the presidency of Dr. Oscar Woods. About forty members assembled to take part in the proceedings, and to share in the true Irish hospitality so generously extended to them. The President had taken every pains to make the meeting a success, and we feel assured that his kindly efforts were highly appreciated by all those who had the good fortune to attend.