The object of this paper is to show the important part played by introspection in the mechanism of certain delusions, and especially in the genesis of psycho-motor hallucinations. The complete notes of a case carefully observed in this connection are given—that of a woman aged forty-three years. Tormented by the thought of wrong-doing, by ideas of doubt and fear, the patient was especially anxious to analyse and explain her mental condition. She at first is satisfied that her ideas take birth within her mind, then believes that she is selfhypnotised; a stage further she suspects the domination of some indefinite power which directs her thoughts, experiments upon her, hypnotises her, and speaks within her. If she thinks evil of certain persons she hears them “inside “herself replying, insulting her. At times she moves her lips when speaking her own ideas, and is conscious of a conversation, an asking and a replying, going on in her head. Ideas of guilt are generally associated with these phenomena, and she asks forgiveness for these ideas, which spring up without the intervention of her will. The explanation which satisfies her best is that she is hypnotised and made to think, and the measure of her guilt is the consent which she gives to certain of these ideas—this consent being withheld in the case of others. The thesis which the authors endeavour to prove is that the interior language is the principal source of a considerable number, if not of most, psycho-motor hallucinations. They urge the importance of a careful study of the mental life of patients, and the fallacy of restricting observations to somatic examination alone.

These five cases are interesting on account of the important question of the aetiology of general paralysis.

In vol. xxi of the Archivio (1900) the author published a note on some cases of morphological anomalies of the extremities in the insane; and in the present paper he records the result of an autopsy on one of these patients—an hereditary degenerate with partial syndactylism of the right hand. Several anomalies were found in the bones of the hand and in the muscles of the forearm. The osseous abnormalities were most notable in the second phalanges; in two fingers (index and middle) that phalanx was absent; in the ring and little fingers it was rudimentary, and in the latter it was partially blended with the ungual phalanx. The ungual phalanges of the index and middle fingers were united, and bore a single nail. The os magnum and unciform bone were blended. The rest of the hand skeleton was normal. The muscles of the hand and forearm were all somewhat atrophic. Their most important anomalies were the absence of the extensor indicis and of the tendon of the flexor sublimis digitorum to the little finger, and a reversal of the ordinary arrangement of the flexor tendons, the deep flexor being perforated by the tendons of the superficial muscle.

Dr. Stradonitz, in a long paper, recommends historical research in connection with hereditary disease, and prescribes some methods of inquiry which are sufficiently obvious. Every one has two parents and four grandparents, and in this ratio his ancestors might go on doubling at each generation, till three hundred years back the ascendant roll might have 1024 persons. Actually this never takes place through the marriage of cousins in the first, second, and farther degrees.

The author divides the stigmata of degeneration into four classes—anatomical, physiological, psychological, and sociological. The first group he discussed in an earlier paper contributed to the same journal, and the third and fourth groups he proposes to deal with later on. The present paper is devoted to the physiological group, and is, as the author expressly points out, a simple catalogue of the several functional disorders which, for good, bad, or indifferent reasons, various observers have brought into the wide net of “dégénérescence.” It is needless to add that the catalogue is a long one, seeing that some authors claim for the degenerate a monopoly of tubercular diseases and of post-nasal adenoids; and one expansionist even goes so far as to insist that every departure from the left occipito-anterior presentation in childbirth is to be accounted a stigma. The paper is followed by a useful list of the literature on the subject.

This is the report of a case of homicidal obsession developing as a result of nervous exhaustion in an individual of the so-called criminal type.

In various cases, the author has noted at the moment of death a cænæsthesic sensation—doubtless associated with arrest of motor, respiratory, and circulatory functions—which is not without interest. The cases here described were mostly tuberculous, and included individuals of both sexes, and of atheistic as well as religious beliefs. In all the cases, the last sensation to which expression was given was one of flying, of moving upwards. In some cases death was peaceful, in others painful. In one case a girl died clasping the iron bars of the bed, in horror of being borne upwards.

In this paper, the author reports two personal observations which presented a combination of mental disturbance with symptoms of peripheral paralysis, and in connection therewith enters at some length into a critical examination of Korsakow's disease.