There are questions upon which the sagacity and ingenuity of observers have been vainly exercised since the beginning of time. They remain for examination, waiting a definite solution, which may never be discovered. Such is the question of the nature of epilepsy.

The relation of criminality to the other forms of pathological and abnormal humanity is one of degree. If we represent the highest degree, as crime, by A6, A5, say, would stand for insane criminality, and A4 for alcoholism, perhaps, A3 for pauperism, A2 for those weak forms of humanity that charity treats more especially, and A for the idea of wrong in general, particularly in its lightest forms. Thus, crime is the most exaggerated form of wrong; but these forms are all one in essence. A drop of water is as much water as is an ocean.

Sir Henry Holland, in his chapter on Sleep, considers its investigation should include causes which prevent as well as those which favour or produce it. In the investigation of sleeplessness we assume the converse of this as true, and advert briefly to what experimental physiologists regard as causes and accompaniments of sleep before engaging on its pathological condition, for the therapeutics of sleeplessness imply a knowledge of both. Disturbances of sleep are so constantly the heralds and associates of mental disease as to make insomnia, more than any other condition, common to all, or pathognomonic. The object of sleep, says Sir Henry Holland, is reparation, and sleep itself repose of sensibility and volition, whose cause is a change of condition of the nervous substance closely related to these functions, probably never to be ascertained by investigation, “yet,” he continues, “not the less real as a change on that account.”

I feel greatly honoured by being allowed to open a discussion on the working of this Act; but as Bethlem admits more private cases in the year than any other institution in the kingdom, and as the chief alterations in the law concern the admission of private patients, it is perhaps appropriate that the discussion should be opened by someone resident at Bethlem. I feel I cannot do this better than by bringing before your notice facts which have occurred, and if in doing this I weary you, it will be merely a small reflection of the weariness we have experienced in the last six months from this new law.