The dissections on which the following account of the structure of the cerebral hemisphere is founded, have been described in detail in a communication to the Royal Society. The results will be here given, without regard to the order in which they are reached, and with a view simply to clearness and comprehensibility.

At the Second Quarterly Meeting of the Medico-Psychological Association (January 28th, 1869), I read a paper on The Alleged Increase of Lunacy. I there observed that the alleged increase of lunacy is a frequent theme of discussion in the public press, as also a subject of anxious enquiry in society, and that there is hardly a Board-room of any county asylum in which the question is not raised with the practical intent of determining the amount of provision to be made for the care and treatment of the insane poor, and I added that, in order to satisfy such enquiries on the part of the Visitors of the Hayward's Heath Asylum, I had recently endeavoured to see if our existing statistical records afford any means of solving this pressing question, Is lunacy on the increase in our generation? Moreover, considering the opportunity of the second quarterly meeting of the Medico-Psychological Association, for scientific discussion, might fitly be used for the farther sifting of this important State question, I then submitted to its critical examination the figures and results with which my enquiry into the alleged increase of lunacy had furnished me. These results, which were worked out in a series of carefully compiled tables, I may thus briefly sum up:—1.—Total Numbers of the Insane.

In succeeding, as President of the Medico-Psychological Association, the distinguished professor whose term of office now expires, I beg to return you my best thanks for the honour you have conferred upon me. I must at the same time express my regret that I was unable to attend the last annual meeting of the Association, when I might, as on previous occasions, have pleaded my total unfitness for the office, and have again obtained your assent to the selection of one more suited for that honourable distinction. Having, however, been placed in what I consider a false position, I have now only to trust to your kind forbearance and beg your support in the fulfilment of the duties.

In the Somerset County Lunatic Asylum, during twenty years, ending 1st March, 1868, sixty-three cases of puerperal insanity came under my care, being 4·6 per cent of females admitted in that period, not including re-admissions. I have drawn up a summary of these cases to lay before the present meeting of the Medico-Psychological Association.

Might it not be possible greatly to extend our knowledge of the effects of medicines in insanity by treating similar classes of cases in all asylums in a similar way for a certain time? Might we not in this way arrive at a much greater degree of scientific accuracy in our treatment of certain forms of insanity than we are able to practise at present?

Many years ago—between 1854, when I was appointed to the medical charge of the Murray Royal Institution, and 1859, when the first Report of the new Lunacy Board for Scotland was issued—I took much interest in the subject of provision on the large scale for the chronic insane; advocating strongly for the harmless, incurable, industrious classes thereof, some modification of what is now variously known as the “Gheel system,” “Boarding-out system,” or “Family system,” of treatment. I was then of opinion that, hesides utilising or applying this system on the small scale in connexion with existing or prospective public hospitals for the insane—it was not only desirable, but feasible, to construct de novo one or more National Colonies on the Gheel plan—adopting of course only those features in the original Gheel that were worthy of imitation, or that it might be found practicable to imitate, in this country—and omitting or modifying those that appeared objectionable. I had no doubt as to the practicability of the scheme; though I was quite alive to the objections that would be offered—the difficulties that would attend its inauguration. Most unfortunately, as it seems to me, such a plan did not at that time, in any form, find favour with the authorities charged with the control of the state arrangements for the treatment of the insane poor in Scotland, and a golden opportunity was thus lost of establishing on Scottish soil an improved Gheel free ab initio from the defects of its grand prototype.

A few weeks∗ ago a gentleman informed the public, through the newspapers, that he had been cured of rheumatism by the fright he had experienced in a railway accident. The remarks which the circumstance has elicited lead me to think that the whole subject of the influence of the mind upon the body deserves more serious and systematic consideration than it has received. It is now some time since I endeavoured to formularise the generally admitted facts of physiology and psychology so far as they bear on this question, and to collect from the sources at my command all authenticated facts illustrative of this influence. Dissatisfied with my work, I laid my cases aside. Judging, however, from the remarks above-mentioned that, imperfect as they are, they may be of some service, I conclude to forward my observations to the Journal of the Association. I must apologise to the reader for treating the subject in so elementary and aphoristic a manner; but I trust the advantage of this method will be apparent as I proceed.

That great criminals are wholly without the moral sense, that violent and habitual criminals are, as a class, moral imbeciles—are startling propositions; but, nevertheless, they have been adopted and advocated with singular show of truth and much ability of late years. Such views are quite opposed to all the doctrines of divines, and philosophers, speculative and practical. That any man, however wicked, is utterly deprived of the moral sense, sounds very new and very strange to us. Our own consciousness tells us all, what Sir Thomas Brown has so finely told us in eloquent words—“Surely there is a piece of Divinity in us; something that was before the elements, and owes no homage unto the sun. Nature tells me I am the image of God, as well as the Scripture. He that understands not this much is yet to begin the alphabet of man.”

Nothing which has been written of late years so fully demonstrates the fact that Insanity is not regarded by the profession at large as a somatic disease, as the book intituled “The Nomenclature of Diseases, drawn up by a Joint Committee appointed by the Royal College of Physicians of London.” This work has been forwarded to every member of the medical profession in Great Britain and Ireland by the authority of the Registrar-General, and contains a list of some nine hundred diseases, a large assortment of poisons, and fifty-seven pages of accidents and malformations under which the British public is authorised to suffer or die. The mind of the Briton, however, is authorised to suffer from only six “Disorders of the Intellect;” the idea of disease as connected with madness is studiously ignored. On what principle the differentiation between a disease and a disorder is founded, or on what system of pathology the distinction is based, it is difficult to say; still, there the opinion stands expressed by very high authority, that Insanity is not a disease of the body, merely a disorder of the intellect.

To some extent we have anticipated the consideration of the influence of emotion on spasmodic action of the muscles, in describing the effects produced by powerful emotional states, as terror, which often causes excessive or spasmodic contraction, sometimes amounting to tetanic rigidity. The sobbing of grief, the laughter of joy, afford daily examples of spasmodic muscular contraction from emotional stimulus. The spasm which chokes the voice and converts the fibres of the platysma myoides into rigid cords in terror, the convulsion and tremors of the facial muscles in despair, the clenched hands, the convulsive opening of the mouth and spasm of the diaphragm and muscles of the chest in fear, the spasm of the jaws in rage, the spasmodic rigidity of the muscles in a maniacal paroxysm, are they not written in the graphic pages of Bell ? With the exception of mania, these spasmodic contractions are consistent with health. We shall include under the present section all convulsive attacks, whether epileptic or not, whether infantile, puerperal, or hysterical, trembling palsy, chorea, spasms of the larynx and pharynx, nervous hydrophobia, and tetanus. Physiologically, when of emotional origin, they may all be referred to disturbance, more or less serious, of the functions of the sensori-motor apparatus, including the medulla oblongata.

At the meeting of members of the Medico-Psychological Association which took place last November, in Edinburgh, a resolution was passed expressing “a strong opinion as to the necessity of making clinical teaching in insanity imperative in every medical curriculum.” It was agreed that it would not be wise on our part, as an association, to specify the details of those measures, which we hoped the various medical schools might feel disposed to take in furtherance of this object. But it is evidently the special duty of members of this association to consider the subject carefully in every detail, and to be prepared to give a mature opinion upon it.

In the present paper I do not intend to deal with those graver affections, such as apoplexy or paralysis, which frequently occur in the aged, and which depend on gross lesions of tissue. Nor shall I mention the severe and intractable neuralgias of advanced life. I desire to direct attention to a class of neuroses, which more or less inevitably attend the decline of life, and which, though they do not involve any serious catastrophe, are the cause of so much suffering that it is surprising that they should have received little or no systematic notice from medical writers. The neglect of these complaints is not merely a negative evil; for, owing to the fact that their neurotic nature is ignored, certain superficial symptoms which they present are treated as if they depended on functional disturbance of the liver, or ordinary stomach catarrh, &c., and very often with depressing remedies, which greatly aggravate the existing evil.

Under the present section it remains to consider the influence of the emotions in inducing hydrophobia, tetanus, and catalepsy.

The cases that I propose to relate belong to a group either entirely overlooked or rarely met with until lately, and, doubtless, confounded with other forms of infantile paralysis. Having through the kindness of Mr. William Adams had the opportunity of seeing an example of the affection in the Royal Orthopædic Hospital, I was enabled to recognise the nature of the two first of these cases when called to see them in October last. I may observe that in a practice of upwards of thirty years, including during several years the charge of a large parochial infirmary for children, I had never recognised the disease. The association of mental imbecility with muscular paralysis, which is peculiar in these cases, has induced me to bring them under the notice of the members of this Association. In order to complete their history and to endeavour to render them the more worthy of your attention, I have embodied in my remarks the principal points that I have been able to gather from the study of M. Duchenne's pamphlet.∗

The prominence which the question of the so-called puerperal insanity has lately attained through the medium of one of our law courts, in one of the most startling cases that have been tried form any years, is of itself sufficient warrant for now bringing it up for discussion, irrespective of its own special-interest on scientific grounds. It is, however, in its scientific aspect, rather than its legal bearing, that I purpose to present the subject to you, but I propose not to lose sight entirely of its legal interest.

C. M., admitted January 17th, 1870, æt. 24. Married; wife of sailor; can read and write; Church of England; from Whitehaven.

The minute pathological anatomy of the brain being at present but little advanced, the following contribution is offered towards its elucidation in mental disease.

If I were asked the especial and characteristic features of this present day, I should most certainly take good care to enumerate that one (feature) which seeks to modify or even undo the legislative acts of our progenitors, that is to say, of those who, living in the new or early times—not the old times—were without that needful experience and knowledge wherewith to realise the truth. As you know well, the science of our forefathers was, at its best, a poor and sickly thing—sadly misshapen and badly used; and as to Psychology, it was, indeed, at a miserable discount.

Reviewing a large number of cases of idiocy and imbecility which have come under my observation, I am able to call prominently to mind three cases in which apparent hypertrophy of muscle, combined with motor paralysis, was present. As these occurred to me before Dr. Duchenne, of Bologne, had pointed out their significance, I did not take steps to verify their condition. So marked, however, was the apparent muscular development, that the muscular feebleness puzzled me much. Faradization was tried in one case without any good result.

Members of Committee: Drs. D. Skae, E. Smith, J. C. Howden, J. Sibbald, J. Batty Tuke, and T. S. Clonston, Secretary.