Mr. President and Gentlemen,—The fact of my having been frequently summoned as a medical witness in the civil and criminal courts of justice, in cases in which monomania has been alleged to exist, ana the examination of the evidence in two recent and important cases of disputed wills induces me to bring under the notice of the Medico-Psychological Association the present practice of the Courts in relation to monomania, and to attempt a concise description of this form of disease for consideration and discussion.

Those of us who have kept our attentions directed to the insane poor of Middlesex—to say nothing of outside counties—must have been struck with their largely increased and increasing numbers year by year. Whilst it is a high source of satisfaction to us to know that there are diseases, neither few nor far between, which it is in our power to very materially modify and diminish, if not entirely to eradicate—whilst, in other words, typhus and cholera and other bodily ailments succumb, in so material degree, to light, air, and water—it must be and is with deep regret we are compelled to confess our inability to contend, with anything like a parallel success, against the dominant and proximate causes so painfully rife among us throughout the length and breadth of this land, and within the small area of the county of Middlesex more especially, of the mind's disorders and irregularities of action. The art and science of hygiene embraces, it may be said (to speak critically), but the outside conditions, the accessory or predisposing phenomena, which lead to insanity; it takes cognisance of the distal links in the chain rather than of those proximal—of the remote and not the near or immediate cause of madness, ln what, then, it may be asked, does this proximate or immediate source or starting-point of this dire malady, as it exists among the unfortunate classes alluded to, consist? The reply is a brief one; a single word can embrace it in all its entirety, and that word is—” POVERTY.” Poverty, of which it has been truly said “it eclipses the brightest virtues, and is the very sepulchre of brave designs” It is, indeed, the boast of modern medicine to prevent disease—to strangle it at the birth. It is our pride to develop that condition of things in the physical world with which preventible disease is incompatible; but how and where shall we find the clue to the removal of poverty ? Is there no hope ? Can it be said that poverty is a normal state of things ? Is it not true, rather, that it is the mere product of a civilisation only spurious and unreal—of a Christianity only theoretical ? I am disposed to believe this, and hence it is I am sanguine that the beneficent results of a reformed and progressive legislation, dictated by the really good and truly wise among men, will, ere very long, so greatly diminish poverty that insanity will decline to no small extent among us. But pending such a state of things, and accepting the fact as it stands, let us see if we cannot lessen somewhat the evil complained of, i. e. attack the effects of poverty, or, what is the same thing, reduce more or less the great numbers of insane poor in Middlesex, for whom to this time there has never been, and is not now, the necessary asylum accommodation.

Mr. President and Gentlemen—Allow me before I go into my subject to thank you for the kindness you have displayed to me in electing me a honorary member of your Association, and much more so as it is perhaps to-day for the last time that I shall have the honour to address you before my retirement from this branch of science.

The subjective character of sense-consciousness.—To the physiologist of the present day it must be clearly manifest that, in respect to what is revealed to us by the senses, we have no immediate knowledge of anything but sensation. Even according to Sir Willam Hamilton, perception proper takes note of nothing but the sentient organism. “All perception is a sensitive cognition; it therefore apprehends the existence of no object out of its organism, or not in immediate correlation to its organism, for thus only can an object exist now and here to sense”∗ An effect is produced upon the peripheral extremity of a nerve of sense; this is conveyed to the appropriate centre, and there calls forth a sensation.

The nerve-current which transmits sensations to the brain, and the orders of the will to the extremities of the body, requires a certain time to travel in. Impressions coming from without are not perceived at the instant they are produced, they travel along the nerves at the rate of 20 to 30 métres (25 to 40 yards) in a second, which is the same speed as that of the carrier pigeon, of a hurricane, or of a locomotive engine at its quickest, but very much less than that of a cannon ball. For instance, we can only be conscious of an injury to one of our feet about one twentieth of a second after it has actually occurred, and the commands of the will proceed equally lowly from the centre to the peripheries of the nervous system. In he human body the time thus occupied is unimportant, but let us take the case of a whale, where the telegraphic network of the nervous system is far more extensive. A boat attacks the whale, and a harpoon is driven into its tail. The impression thus produced has totravel over some forty yards before reaching the head-quarters of the will; a second is thus lost. How long a time is then required for reflection? That must depend upon circumstances; but at any rate it is certain that the will has need of some definite amount of time for its decision. The order to capsize the boat is despatched to the tail, but another second must elapse before the telegram reaches its destination, and in the time thus employed the whaling boat has pulled off and escaped the danger.