How wide-spread and how varied the impression was that was created by the late war between the British Empire and the Boers of South Africa, is a matter of common knowledge. There is no means of arriving at an exact idea of the influence it exerted upon one of the belligerent parties, but, so far as the people of the British Isles are concerned, there is abundant evidence to show that it produced an immediate and very profound, though unlasting, modification of national character and conduct.

My object in reading this paper before this important Association of mental experts is twofold: first, to draw attention to the great frequency of mental symptoms developing in the course of an attack of bodily illness; and secondly, to the unsatisfactory condition of our system in this country in dealing with and treating persons suffering from temporary mental disease.

The type of imbecility with which my paper deals is chiefly met with in the special institutions and in the out-patient clinics of children's hospitals, and is fairly common in this country. The somewhat scanty literature of the subject, however, includes descriptions of the leading features of the class which differ a good deal in detail. This divergence of opinion is due, I think, mainly to the fact that observers are by no means agreed as to the degree of deviation from other types which qualifies an imbecile for inclusion in the Mongol group—a disagreement easy to understand when we realise that there is hardly one single feature which can be regarded as peculiar to Mongolism. Further, many recorded cases have been noted only at an early age, when certain later-developed aids to diagnosis are wanting. I have thought it of interest to record my observations of twenty-one well-marked cases met with among the 2000 inmates of Darenth Asylums, where the minimum age of admission is five, trusting that they may afford some guide to the mental and physical forecast advisable in dealing with the infant.

On June 13th, 1750, Dr. Thomas Crow, Mr. William Prouting, and four other gentlemen met in a tavern in Exchange Alley, their object being to promote the establishment by subscription of a hospital as a further provision for poor lunatics. They drew up certain “considerations,” which were printed and distributed to the public.

Gheel is a well-worn theme on which it is hard to say anything that is very fresh. But circumstances of various kinds have of late contributed to renew general interest in this ancient settlement. The condition of lunacy affairs in our own country is somewhat fluid just now, and the insertion of any foreign object may help to bring about solidification. Finally, I had occasion to revisit Gheel during the past summer. On the whole, when I was asked for a paper for to-day it seemed not unsuitable that I should fall back upon this time-honoured topic.

The conditions of life of the whole community in the county of Glamorgan, the staple industry of which is that of coal, in which 17 per cent. of its population are directly employed, are subject to modification through the influence of an arrangement known as the sliding scale, by which the wages of the colliery operatives are determined in accordance with the selling price of that commodity. This scale has undergone several considerable fluctuations in the past twenty-eight years, and these fluctuations have been productive of consequences of no small sociological importance.

Herbert Spencer is dead. The last and greatest of the giants of the Victorian age has passed away; and, in the tumult and clamour of evanescent political strife, the country of his birth is strangely indifferent to the portentous loss that it has suffered. From the uttermost parts of the earth—from the length and breadth of the great continent of America; from France, Germany, and Italy; even from far-off Japan—come messages of condolence and appreciation of the mighty dead; but here his loss is scarcely noticed. Truly, a prophet is not without honour, save in his own country and among his own people. Queen Victoria was a great queen, and worthily ruled a great nation; but to distant generations the name of Queen Victoria will mean as little as the name of Semiramis means to us, while the name of Herbert Spencer will loom as large as to us does that of Aristotle. In a future which may be distant, or may be nearer than we expect, when England, after occupying for a time the position of Holland, has become a sort of Isle of Wight for honeymooning Americans, Golders Hill will share with Stratford-on-Avon the honours of a place of pilgrimage for those who desire to honour the greatest of their race. What Sir Isaac Newton achieved in co-ordinating phenomena in space, Herbert Spencer achieved in co-ordinating phenomena in time. His task was almost superhuman, yet through ridicule and neglect at first, and at last in spite of the affectation of prigs, who feigned that his teaching was obsolete, he kept steadily to his task; devoting his life with wonderful purity of purpose to the completion of his great system of philosophy. He began in spite of scorn and ridicule; he lived to see his philosophy well-nigh universally accepted; and he lived to see it sneered at as antiquated by writers with less than a tithe of his knowledge, and with not a twentieth part the tithe of his intellect. He heaved Germany out of the slough of Hegelianism, only to see his own countrymen plunge and wallow in the same mire—to see them, as they struggled against asphyxiation, affect a sublime superiority over those who stood dry upon the bank, with limbs unhampered and breathing unobstructed.

The case of Miss Hickman appears a very mysterious one in the light of the facts which have become known. An able, sane, sensible, athletic young woman, in the prime of life, and with no known antecedents of mental disorder, a qualified medical practitioner, holding a temporary hospital appointment, leaves the hospital one summer morning without notice, and is never seen or heard of again until her decomposed body is found, two months afterwards, hidden away in a thicket in Richmond Park. The evidence of suicide was conclusive, and at once an hypothesis is mooted that the responsibility of her position weighed so heavily upon her as to unhinge her mind. On this hypothesis is founded a further thesis concerning the unfitness of women to hold positions of responsibility, and especially their unfitness for the profession of medicine. Whether women are unfit to practise medicine need not be discussed here, but it is as well to point out the fatuity of the hypothesis on which the thesis is grounded. Apart from such instances as those of Queen Victoria and Catherine II, which go to show that certain women, at any rate, are capable of holding positions of responsibility even greater than that of house surgeon to a hospital, there is no evidence that Miss Hickman felt her responsibility unduly. As has often been pointed out in another part of this Journal, we are far too apt to speak of crimes as “motiveless” when all we are justified in saying is that we cannot discern an adequate motive for them. We have no surety that we know all the facts, and if all the facts were as well known to us as to the actors in these dramas, the probability is that the number of “motiveless” acts would be sensibly diminished. Every one of us has an outer life, known to all our associates, and an inner life, the whole of which is known to ourselves alone, though glimpses of it may be imparted to intimate confidential friends. To those who know our outer life only, many of our acts may, nay must, appear “motiveless,” although they may have been done after mature deliberation and consultation with our confidants; and if the whole of the inner life were known, it is probable that the residuum of “motiveless” acts would be very small.