Gentlemen,—I have chosen as the subject of this address a question which, though it is almost as old as the present system of treating the insane, has been revivified with so much vigour as to demand at our hands the close attention which we should feel bound to give to it had it been entirely new. I am about to offer you some remarks on what is called “Hospital treatment for recent and curable cases of insanity.” The reintroduction of this question is undoubtedly due to the necessity for the consideration of the great increase of the insane population; and it is appropriate in point of time; indeed, the time has been determined by the change in the composition of those bodies whose sanction and help are required for any new departure in this direction.

In taking this chair I have first to acknowledge the courtesy and consideration which induced the Council of the Congress to select as the President of this section the senior officer of the Lunacy Department of the mother colony, and next—it being my good fortune to occupy this position—to express my personal gratification at presiding over the first session of the important section of psychological medicine.

So far as my researches extend little attention has been paid to the subject of this paper. Yet I think it would be rash to assume that what is unrecorded is necessarily rare, even in days when so much more is put into print than any of us can either read or mark, much less digest, and when the number of writers seems in danger of exceeding the number of readers. Insanity, in some degree, as a sequela of surgical operation, though certainly rare, is, I believe, less uncommon than usually supposed, and it is chiefly in the hope of eliciting additional information from others that I venture to record my own small experience. On two subjects medical science has still an infinite deal to learn: first, the influence of disease on the mind; secondly, the influence of mind on disease. In attempting to contribute a little to the first-mentioned subject, I can really deal only with a subdivision of it, viz., the effects that may be produced on the mind by surgical measures undertaken for the relief of disease.

The January number of the Journal contains a most interesting paper, entitled “The Confessions of a Young Lady Laudanum Drinker,” which relates what the writer went through during the endeavour to break off the pernicious habit she had acquired. In this instance after the daily dose of laudanum had been spontaneously lessened from four ounces to one quarter of an ounce, the supply was suddenly stopped. It does not appear that any means were taken to lessen the physical and moral tortures which followed, and which the writer so vividly describes as to give one a better idea of the condition of such patients than I have elsewhere seen. Fortunately the desired end was gained, but my experience in dealing with such difficult and unhappy cases convinces me at the cost of much more suffering than need have been, had another method been followed.

Recent investigations into the origin of crime point as a rule to the conclusion that all forms and manifestations of delinquency may be traced back to the operation of three causes, which have been called anthropological, social, and cosmical.∗ These three causes sometimes act individually and sometimes collectively, as well as in varying proportions, according to the nature of the crime or the character of the criminal. With respect to the second cause, it is admitted by criminalists of all schools that adverse social surroundings is one of the most potent factors in the production of crime. Some writers lay down the doctrine that crime is entirely social in its origin; they adopt as their motto the celebrated maxim of Quetelet, that society prepares crime, the criminal only executes it, and maintain that an adequate amelioration of the present unequal conditions of existence would quickly bring about the extinction of the whole criminal population.†

Should the future provision for the insane poor in Yorkshire, and not in this county only, but in other counties of England, be conducted on the same lines as the past provision has been?

This paper aims at being something more than historical, and faces the practical questions which naturally arise from the survey which I have just made.

The following pages contain the account of some analyses of the urine in general paralysis, together with observations on the temperature in this disease in relation to the nitrogenous excretion.

(1) Movement in mau has long been a subject of profitable study. Visible movement in the body is produced by muscular contraction following upon stimulation of the muscles by efferent currents passing from the central nerve-system. Modern physiological experiments have demonstrated that when a special brain-area discharges nerve-currents, these are followed by certain visible movements or contraction of certain muscles corresponding. So exact are such reactions, as obtained by experiment upon the brain-areas, that movements similar to those produced by experimental excitation of a certain brain-area may be taken as evidence of action in that area, or as commencing in discharge from that area (see Reinforcement of Movements, 35; Compound Series of Movements, 34).

Nearly fifteen years ago Dr. Kitching, on his retirement from the duties of Superintendent of the York Retreat, after twenty-five years of devoted service, wrote for the guidance of the Committee and myself a paper containing many excellent suggestions for the improvement of the Institution he loved so well.

Judging by the numerous reports that have already appeared, this drug seems to be attracting considerable attention, and to us who are engaged in the treatment of insanity it has a special interest. During the past three months I have made a number of experiments, with results confirmatory of the favourable notices which have hitherto been published.

My present purpose is to show the importance of acquiring further knowledge as to the conditions of development, and as to the physical and mental brain-powers of children, and the desirability of diffusing a knowledge of scientific methods of study among those whose profession it is to train children.

This subject is probably more frequently alluded to and more fully treated in foreign than in English psychological literature. It may therefore be not unprofitable to review the details of some of the more interesting cases which have from time to time occurred in this country, and to discuss briefly their mental peculiarities.

The case of the brothers John and Richard C. is of interest, inasmuch as it presents a comparatively rare picture of psychical and physical identity.

The manifestation of vital activity demands the consumption of material, and the diminution or absence of this material, of a necessity, and proportionately, compels the diminution of absence of the power of manifestation of vital activity. Take, for instance, the comparatively crude example of starvation.

The subject of the following notes was a girl eighteen years old, who was admitted to the Royal Edinburgh Asylum on the 28th of March of last year.