The weight of the brain in insane persons has been investigated by Dr. Parchappe in France, Dr. Bergmann in Germany, and on a larger scale, by Dr. Boyd in this country.∗ Further observations, however, were, for many reasons, to be desired; and having during many years past either weighed myself, or caused to be weighed, the brain of nearly every patient who has died whilst under my care, I ventured to think the large series of observations thus obtained, and which amount to 470 cases, were worthy of being collected, analysed, and compared with the weights recorded by previous observers.

Nearly ten years ago I visited the very ancient establishment above named, whereof notes appeared in Dr. Winslow's ‘Journal of Psychological Medicine’ for 1857, and which, I was led to believe, by the discussion that ensued, rendered this interesting institution better known in Great Britain than heretofore. Since that period, various professional and other travellers, as well English as foreign, have paid visits to Gheel, and also subsequently published valuable reports, with remarks on improvements recently accomplished. Being anxious to inspect a second time this colony, and observe the ameliorations which Dr. Bulkens, its able medical superintendent, had effected, I again visited Gheel during May last; and thinking some account thereof may interest members of the distinguished Society I have the honour to address, my present communication has been drawn up, trusting, at least, it may excite some attention from philanthropists and psychological physicians.

“Nothing in connection with the treatment of the insane has a more direct and immediate effect, for good or ill. upon their condition and comfort, than the fact of their being under the charge of good or bad attendants.”-‘Fifteenth Report of Commissioners in Lunacy,’ p. 55.

In this university the study of medical psychology and mental diseases is wholly voluntary. None of the faculties require candidates for degrees to attend the course I deliver, or examine them in the subjects discussed. Doubtless the faculties of arts, theology, and law, might reasonably object to so great an encroachment upon vested interests and established traditions; but it is different with the faculty of medicine, because moral philosophy has only been added to the curriculum of medical studies since I commenced to deliver this course. I have therefore thought it would be expedient (and suggested it, indeed) to permit students of medicine going up for their degrees to choose between medical psychology and moral philosophy; nevertheless the course is still without even this modified recognition. Nor do any of the other medical boards of examiners of the United Kingdom require it. The Senate of the University of London has, however, very lately recommended the practical study of mental diseases to candidates for medical degrees; but valuable and important as this step is, yet, inasmuch as it excludes medical psychology, it falls very far short of what must ultimately be required in the interests of society of all students seeking general culture or to enter any of the learned professions. I entertain a deep-rooted conviction that mental science, in the modern and practical sense of the term, will sooner or later be forced on the attention of political economists and statesmen as one of the needs of the time; and I am equally convinced that no such science is possible except by the observation and study of morbid mental states. I therefore propose on this occasion to plead for the general study of medical psychology or mental science developed according to this method in this classroom, and although I may not hope to be successful in my pleading, I trust I shall at least encourage you who engage in the study voluntarily to pursue it ardently, as offering its own full reward for any labour you may bestow upon it.

Mr. President,-My first duty on rising to address this Association is to thank you, sir, personally, for your kindness in proposing me, and the members for electing me, to the honour of being a member of the Medico-Psychological Association.

The following observations are based upon fifty cases, and compiled from notes taken by Dr. Howden and myself. They are published merely as a contribution to the statistics of the subject, which are by no means numerous. Of the cases admitted into the Montrose Asylum during the last eight years, 3 8 per cent, were epileptics. Their physiognomical characteristics are given in the following table.

The chemistry of the nervous system is a subject to which little attention has been given by British authors, but their place has been creditably supplied by several foreign chemists, conspicuous among whom are Couërbe, Fremy, Von Bibra, Hauff, Walther, and Schlossberger. These writers have effected something as regards the chemical pathology of the brain in persons dying sane, but with the exception of a few isolated analyses whose results are sadly in want of confirmation, by Lassaigne, Couërbe, and L'Héritier, it may be said that absolutely nothing has been done in the case of the insane. In fact, the field is a terra incognita of unknown extent. I purpose, therefore, to devote some attention to this subject, and to communicate to the profession from time to time the results of such chemical analyses of insane brains as it may be in my power to make. With this view I shall take my starting-point from the results obtained by Bibra and others; and in order to present a standard for comparison, I shall give an abstract of what has been effected by these chemists. I find that this has been so thoroughly done by Von Gorup-Besanez (‘Lehrbuch der Pathologischen Chemie’) that I shall not hesitate to make a free translation of his chapter on this subject, criticising and adding where I think it necessary.

It is not an easy matter, at least I have not found it so in my experience, when brought face to face with an actual case of in sanity, and asked to state the cause of it, to do so definitely and satisfactorily. The uncertainty springs from the fact that, in the great majority of cases, there has been a concurrence of co-operating conditions, not one single effective cause. Two persons are exposed to a similar heavy mental shock: one of them is driven mad by it, but the other is not. Can we say then that the madness has been produced by a moral cause? Not accurately so; for in the former case there has been some innate vice of nervous constitution, some predisposition of it to disease, whereby insanity has been produced by a cause which has had no such ill effect in the latter case. The entire causes have not, then, been in reality the same. And what we have to bear in mind is, that all the conditions which conspire to the production of an effect, whether visibly active or seemingly passive, are alike causes, alike agents, and that therefore all the conditions, whether they are in the patient himself or in the circum stances of life in which he is placed, which in a given case co-operate in the production of insanity, must properly be viewed as its causes. Mental derangement sometimes appears as the natural issue of all the precedent conditions of life, mental and bodily, the outcome of the individual character as affected by certain circumstances; the germs of the disease have been latent in the foundations of the character, and the final outbreak is but the explosion of a long train of antecedent preparations. In vain, then, is it in many cases to attempt to fix accurately on a single cause, moral or physical; a common mistake on the part of those, who think to do so being to fix upon what is really an early symptom of the disease as the supposed cause of it. Religion, self-abuse, intemperance, have all at times been put down as the causes of mental derangement, when they were really morbid symptoms.

The disorder commonly called “general paralysis of the insane” presents so many points of interest to the pathologist and the physician, that as a necessary consequence it forms the commonest topic among the writings of those who specially study insanity. But after so much observation and so many treatises, it is disheartening to find that even now scarcely more than one fact with regard to it is laid down as settled and established beyond the possibility of doubt. One there is, the saddest that can be. It is, that for this malady we hitherto have found no cure; that to diagnose it is to pronounce the sentence, not only of incurable insanity, but also of speedy death. The marvel of the whole is, that although death occurs in every case at no very distant period, though postmortem examinations of general paralytics are made by hundreds every year in this and other countries, yet even at this day no two observers are agreed as to the pathology and morbid anatomy, as to the part in which it has its origin, or which constitutes its peculiar and proper seat. No wonder that the whole of the morbid anatomy of insane brain is vague and ill-defined, when this, the specially fatal form of mental disease, still hides itself from usâ still wraps itself in the mystery which envelopes all that relates to mind. I make no apology for drawing the attention of the readers of this Journal to a paper on the subject, published in the October and November numbers of ‘ Virchow's Archives/ 1865, and for giving a short and necessarily imperfect summary of its contents, it being too long for reproduction. But as every outline must needs be unsatisfactory, I trust my readers will go themselves to the original. In default of opportunity of examining many brains of paralytic patients, I present as a contribution to the English treatises on the subject these observations of another.

The current number (April, 1866) of the ‘British and Foreign Medico-Chirurgical Review’ contains an article on the “Lunacy Commissioners' Blue Books,” on which I wish to say a few words. The high character of that Review and of its editor (Dr. J. W. Ogle, physician to St. George's Hospital), gives a weight to the opinions of the writers of its articles, and almost compels on our part a notice of their statements when such are either inaccurate or unfair to members of the department of the profession which in these pages we represent.

To the students of mind in its healthy as well as in its diseased condition, the doctrine that certain portions of the brain are associated with particular mental powers is necessarily one of engrossing interest. Until lately, however, the facts advanced in support of the existence of this association have been so inadequate, that the majority of thinkers have regarded the doctrine itself, maintained as it has been with so much zeal by Gall and his followers, to be little more than a theory, no doubt probable enough, but deficient in that solid basis of proof which alone could warrant its acceptance on any higher ground. But it has recently been confidently asserted that evidence is at last forthcoming that the organ of one faculty, the faculty of articulate language, has now been discovered. Still, the alleged discovery, though it were established, would give only qualified support to the phrenological view just referred to, as, contrary to all preconceived notions derived from the bilateral symmetry of the brain, the supposed organ is declared to be situated on its left side alone. Conclusions of so weighty moment evidently require that the validity of their premises should be thoroughly tested; and it is in the hope that I may be able in some degree to show how far they are trustworthy, that I have ventured to bring the facts and considerations embodied in the following paper under the notice of this Society.