In a previous communication to the Turin Academy of Medicine, the author called attention to the frequency of transverse ridging of the nails in the insane, and suggested that the phenomenon was a sign of oscillations in histogenetic activity dependent on unstable conditions of metabolism in mental disease. The present paper is a further discussion of the subject.

The three cases of this anomaly reported by the author, were met with in a population of about 2700 persons. In two of the cases, both hands and feet presented six digits; in the third case the condition existed in the feet only. An exhaustive examination of the family history of the cases through three generations failed to disclose any hereditary tendency to polydactylism or any degenerative taint. In only one of the cases were the parents of kin second cousins. One of the subjects was above the average in intelligence, the other two were somewhat weak-minded.

Professor Pfitzner has continued his interesting “social anthropological studies” at the Strasburg Anatomical Institute by an attempt to investigate the influence of social rank and of creed, an attempt not without difficulties, owing to the slight range of social class among the persons dying in hospital, and the absence of any fit standards of comparison among persons of higher social class. As regards the latter point he has, so far as size of head is concerned, reached certain results, though not without the expenditure of much time and diplomacy in gaining information from hatters, in the course of which he was compelled to acquire a large number of hats. He found that while the sizes of very cheap hats range very well with the sizes of the heads of his subjects at the Anatomical Institute, the more expensive hats have a different and higher range of size. He himself possesses a remarkably large head, and he finds it impossible to obtain a hat that fits him among the very cheap class of goods, even the manufacturers, when the tradesmen offered to procure the article desired, being unable to supply the right size; but among the expensive class of hats he has no difficulty in finding one to fit him, or even one that is too large. He concludes, therefore, that the well-to-do social classes have larger heads than the lower social classes. In a somewhat similar manner, by acquiring skill in estimating the height of well-to-do persons as they passed his shoulder in the street, he was able to convince himself that the hospital subjects are short as compared with the well-to-do, and that, in fact, heights which are fairly common among the latter practically never occur at all among the former.

Professor Penta has for many years been occupied in studying criminals in the prisons of Naples, one of the most favourable regions in Europe for such studies. In the present paper he sets down some of the latest of his general conclusions on the subject of the nature of criminality. These conclusions differ widely in many respects from those of Lombroso. He notices in the first place that he finds a very great difference between those prisoners who are confined in establishments reserved for minor offenders and those, convicted of more serious offences, who are confined in the convict prisons; the first are a much more dangerous class than the second, much more incorrigible, and much more often lacking in moral sense. He finds also that while the first group—the more dangerous persons who only commit slight offences,—come mainly from the cities, the others come from the country. The individuals of the first group also belong in much larger proportion to the class considered by Lombroso to be merely insane. So that the offence and its punishment, taken by themselves, furnish a very fallacious criterion for diagnosis and treatment.

In this paper Professor Tschisch sets forth his conception of pain as a form of death. Pain, he points out, does not depend on the intensity of the stimulus; a Paquelin cautery at a white heat causes much less pain than at a lower temperature. The really significant fact is that those chemical substances which produce pain kill living tissues. Pain is bound up with the existence of nerves, and appears before the tissue is killed; so it is that it arises under comparatively weak stimulation, while strong stimulation produces death. “Those chemical substances which excite no pain cannot kill any living tissue. Every chemical agent which changes living tissue into dead arouses pain.” Thus it is that excitations like strong light, loud sounds, repulsive smells, cause no pain; while heat, cold, mechanical and electrical stimuli, poisons, arouse pain. It is true that some poisons cause no pain; such poisons, however, do not act directly on living tissue; those which act directly on living tissue, like corrosive sublimate, produce pain. Pain is thus the first reaction of the organism to stimuli which kill living tissue; it is the guardian of the organism, the messenger which brings warning of approaching danger; it announces that death has already begun to appear.

Professor van Biervliet has now completed his very careful study of right-sidedness and left-sidedness (already summarised in the Journal) by a still more careful investigation of ambidextrous persons. In the first place by photography, according to a special and uniform method, he finds that in the ambidextrous the two sides of the face, as well as the arms, are fairly alike, the face being slightly more developed on the right side, as among left-sided people, but not in so marked a degree. They occupy much the same position, indeed, throughout the investigation. When compared with right-sided and left-sided people as regards sensory acuteness, it is found that while the right-sided have predominant sensory acuteness on the right side, both the left-sided and the ambidextrous can see further, hear better, possess more acute tactile and muscular sense, on the left side, so that ambidexterity may be regarded as a variety of left-sidedness of more symmetrical anatomical type. In all respects the ambidextrous almost or quite resembled the left-sided.

Féré has always consistently upheld the doctrine that states of fatigue constitute the physical basis of very many psychoses and neuroses. His experimental work has largely been devoted to the illustration of this relationship, and he has lately carried out, in accordance with an elaborate but uniform method, a long series of observations showing the results of very various stimuli in affecting fatigue, as measured by work done.

This paper is an English version of an address read at the Vienna Congress against Alcohol.

In this very interesting paper Fété reports a further series of experiments supporting his theory of the nature of the stimulant action of alcohol and tobacco.

This is really a valuable ætiological study, and is important in that it contains the author's views regarding some recent pronouncements by what one might call the newer pathological school. Otherwise the paper is a reiteration of Dr. Clouston's well-known teachings on melancholia, a position as strong to-day as when first taken up some years ago, and strengthened, if anything, by the opposing and divergent character of present-day views.

Dr. Näcke has here supplemented his valuable and elaborate study of the external stigmata of degeneration in general paralytics by a study of the internal somatic stigmata. The investigation covered the heart, lungs, liver, kidneys, and spleen. The subjects included 104 general paralytics and 108 normal subjects. The inquiry has been carried out with the care and thoroughness which always mark this investigator's work. He admits, however, the existence of an Achilles heel in his investigation. He was unable to carry out the inquiry on the normal subjects himself from lack of material, and this part of the work was undertaken by Professor Nauwerck, of Chemnitz. The material was so far as possible identical in racial and other respects, and everything was done to ensure, so far as possible, identity of method, but it is admitted that a small margin must be allowed for the varying personal idiosyncrasies of the two workers. It may be added that it seems fairly clear that such allowance cannot vitiate the main results reached.

The author comments upon the rarity in general paralysis of spontaneous fractures, i. e. fractures arising from some slight cause, and out of all proportion to that cause,—when it is a known fact that in most maladies of the nervous system these fractures are comparatively common. When one remembers the deep and varied changes produced in the organism by general paralysis this is all the more remarkable.

The interest of this case is enhanced by the fact that minute clinical descriptions of this particular form of insanity are few in number.

The author records two cases in support of his view that the syndrome of acute delirious mania is frequently an effect of renal disease, is, in fact, a hyperacute uræmic insanity.

Dr. Crothers puts forward the thesis that in a certain number of cases the development of psychoses and of organic diseases of the nervous system is due to a single profound intoxication by alcohol. In some instances the symptoms of the nervous affection follow immediately on the intoxication; in others a considerable latent period intervenes. Puberty and late middle life are pointed out as times when intoxication is peculiarly liable to be followed by these paralcoholic disorders. The author believes that morbid inebriety appearing late in life has often this origin.

Reference to this subject has been made on more than one occasion in the pages of this Journal, but the matter is of sufficient importance to call for further notice. Dr. Laufer considers as proved that hypochlorisation, i. e. the reduction of the chlorides in the dietary, enhances the efficacy of the bromides in the treatment of epilepsy. This method of treatment we owe to Drs. Ch. Richet and Toulouse. The object of the present paper is to explain the modus operandi. It is pointed out in the first place that, without the addition of an atom of salt, the dietary, provided that it is a physiological one, contains a sufficiency of NaCl, that the customary use of salt as a condiment and as a culinary addition furnishes a luxus supply, and that the withdrawal of this luxus, without producing any harmful effect, makes itself felt as a slight reduction in the NaCl exchange of the tissues. Next reference is made to the tendency of bromides to accumulate in the tissues generally, and in particular in those of the liver and brain, observers differing as to the greater relative affinity of these two organs for the bromide. We are then asked if it would be surprising that in the presence of a deficiency of chlorides such kindred salts as the bromides should fix themselves in the tissues in greater quantity after the manner of a substitution. That such substitution does in fact obtain has been proved by various observers by the demonstration, e.g., that hydriodic and hydrobromic acids appear in the stomach, and to some extent replace hydrochloric acid when animals are given iodides and bromides in appreciable quantities; and yet more directly it has been shown that the administration of bromides during hypochlorisation may raise the bromide contents of the tissues above that of the chlorides even (Nencki and Schumow Simanowski).

This paper describes a case of inveterate epilepsy, in which periods of mental calm along with convulsive seizures alternated with periods of delirious excitement without convulsions. The effect on this case of the above-mentioned treatment was to suppress wholly the delirious periods, whilst at the same time the spasmodic attacks were greatly diminished.