The term, epilepsia tarda, is applied to the epileptic phenomena occurring in advanced age. A few authors distinguish between epilepsia tarda and senile epilepsy, understanding by the first that form of the disease which is said to appear about the thirtieth year, and by the second that which occurs after 60 years of age.

This is the second of the author's studies on the “feebly inhibited,” and in the preface he justifies the use of that term, on the ground that, while the term “mind” could doubtless be stretched to cover the emotional phenomena he is dealing with, it seems best to consider the hereditary basis of the emotions separately. “The chief problem in administering society is that of disordered conduct; conduct is controlled by emotions, and the quality of the emotions is strongly tinged by the hereditary constitution.”

The author here seeks to analyse the distribution in families of temperament, as expressed in mood, and to test the hypothesis that it is dependent on heredity. Mood is divided into two main clashes (as seen in manic depressive states): the hyperkinetic or exalted, and the hypokinetic or depressed. The hyperkinetic temperament is divided into two grades: a less developed called nervous (and sometimes sanguine), and a more developed called choleric. The hypokinetic temperament is likewise divided into two grades: a less developed called phlegmatic, and a more developed called melancholic. In some families there is a prevailing tendency to the first class of conditions, and in other families for the second class, while yet other families show a mixed state. How can we bring under one general scheme the inheritance of these various types of mood? After several trials the following hypothesis was selected to test. There is in the germplasm a fectot E, which induces the more or less periodic occurrence of an excited condition (or an exceptionally strong reactibility to exciting conditions), and its absence e, which results in an absence of extreme excitability. There are also the factor C, which makes for normal cheerfulness of mood, and its absence c, which permits a more or less periodic depression. Moreover, these factors behave as though in different chromosomes, so that they are inherited independently of each other and may occur in any combination.

The author's object in this paper is to emphasise afresh the fact that neurasthenic symptoms are in some cases the result of underlying disease, organic or other. Half a dozen cases are narrated in illustration of the thesis. The author summarises his conclusions under four heads: (1) Since the early symptoms of disease are often remote from the organ really affected, it is necessary always to make observations away from the point to which the patient calls atttention; (2) it is even yet more important to enter sympathetically into the patient's emotional attitude, in order to gain the knowledge that can only be acquired by tracing its multiform ramifications; (3) the acuteness of the neurasthenic symptoms is parallel to the gravity of the disease and on a different level from, for instance, the spes phthisica; (4) a very wide and broad view must be taken of the treatment.

After an extensive series of observations, of which he gives particulars, the author concludes that essential epilepsy is neither caused by intestinal putrefactions (abnormal fermentations, etc.) nor by intoxication by purins, nor by retention of, hypersensibility to, or intoxication from chloride of sodium.