The condition of uneducated deaf mutes often nearly approaches that of a being destitute of language. It is true that even if they are not taught signs they contrive a few of their own invention; but these signs are of a very simple kind, and neither fitted nor intended to express any abstract notions, so that the deaf and dumb are in a much worse condition for obtaining knowledge than the blind. The deaf mute sees everything, but understands nothing; whereas in using the senses still remaining to him the blind man is guided by the words of others into true interpretations. We thus find that the deaf and dumb in the narrow circle of their own cogitations are in a very benighted condition, but it would be absurd to say that they do not possess or exercise reason. After they have become educated and are able to communicate by signs or writing, deaf mutes sometimes detail what they remember of the bounded state of their intellect before being sent to school. They record accidents and events which have made an impression on their mind; but it is clear that their speculations upon the nature and causes of things have never gone below the surface. In the Reports of the American Asylum at Hartford, there are a number of answers to questions put with a view to find out what were the thoughts of uneducated deaf mutes. One of them when asked, What did you formerly think when you saw a person die ? replied that he thought “he was deceiving the people, and that he would rise up.” He thought that “a man that was died was buried alive, and wondered that he did not rise from the dead in a few days.” Other deaf mutes by observing that the dead bodies of animals rotted away, arrived at a nearer idea of death. They rarely thought that they would die themselves, and an existence beyond the grave occurred to none. Many attended public worship for years without knowing what was the object of it.

At noon, on Tuesday, the 15th of January last, Mr. Eugéne Hamburger met, in the busy Metropolitan thoroughfare, “Holborn Viaduct,” a jewel dealer, named Jackson, with whom he had some slight business acquaintance. With the view of exhibiting his wares, Hamburger consented to accompany the dealer into an as yet unoccupied office of the latter on the Viaduct. Upon entering the room, Hamburger was about to take a parcel of pearls from his bag, when Jackson fired a pistol at him, wounding him in the head, and afterwards continued the assault by drawing a dagger and stabbing him. In the struggle that ensued, Hamburger succeeded in overpowering and disarming his assailant, who escaped from the room and disappeared. The wounded man thereafter proceeded home in a cab, and recovered from his injuries.

Gentlemen,—On taking formal possession of this chair, to which your generosity has called me, which confers honour on its occupant because it has been tenanted by a succession of able and distinguished men, and which is to me especially venerable, because my father once filled it, I shall, I believe, be conforming to excellent precedents if I begin by passing in rapid review before you the principal occurrences of the last twelvemonths, affecting the interests of the Medico-Psychological Association.

Cervical Sympathetic Nerve. I. Experimental Observations on Animals with Results. A. Oculo-pupillary Branches.—The experimental investigation of the functions of the Cervical Sympathetic Nerve begins, as is well known, with Pour-four du Petit, who, in the year 1727, showed that it exercises considerable control over the movements of the pupil.

This connection may result—

1st. From the presence of symptoms which resemble, or are identical with, those which we recognise as expressions of the physiological function of the sympathetic, and which we have enumerated and explained in the former part of this essay.

2ndly. From pathological anatomical changes in the sym pathetic nerve.

Those conditions usually go together, but not invariably; thus, the pathological alterations may be completely wanting, or, on the other hand, they may be found in cases which were not before suspected to have any connection with the sympa thetic system.

We begin with the consideration of the affections of the cervical sympathetic, afterwards taking up those which pro bably have relation to some change in the thoracic and abdominal portions of that nerve.

The disease described by Heberden (1768) as Angina Pectoris, which is sometimes also termed Stenocardia, is not an anatomically definable cardiac affection, but rather a group of symptoms, originating in very different and for the most part unknown conditions. Although, therefore, we include a short account of it in this essay, we do not wish to indicate it as our belief that it is caused exclusively by changes in the sympathetic system, but that it seems to us that the latter, inasmuch as it takes the principal part in the formation of the cardiac plexus—which is almost certainly the starting point of angina pectoris—is undoubtedly in some way connected with the occurrence of the phenomena under consideration.

In any large group of cases of general paralysis, there are such differences in the mental symptoms, the paretic signs, the mode of onset, the course, intercurrent affections, duration, variability and mobility of symptoms, and pathological anatomy of the several cases, that one must feel that there are varieties of the disease. This has led to subdivisions of the affection, or grouping of its cases, scarcely any of which have had a pathological basis. True it is that Bayle, who was the first to differentiate general paralysis, and who attributed its striking phenomena each to a special morbid change, was led to place his cases in five series, in the first of which were simply the lesions of chronic meningitis, and in the second abundant serous effusion was added to these; in the third consecutive inflammation of the grey cortex; in the fourth arachnoid false membranes (cysts); and in the fifth various cerebral affections, complicated the chronic inflammation of the soft membranes. Yet many of his explanations are obviously incorrect, although his work marks a marvellous advance in science. Again, Baillarger, Requin, Prus, Duhamel, Duchenne, Sandras and others, held that general paralysis occurred either with or without insanity, and the first-named of these denied that the insanity is anything more than secondary and accessory in general paralysis of the insane.∗ Further, he speaks, and in this is followed by Lunier, of the symptoms of general paralysis as being produced by (1) chronic meningo-encephalitis, and by (2) chronic hydrocephalus (Dance, Moulin), or serous effusion following apoplexy (Rochoux, Moulin), or symptomatic of organic lesions. But they do not in any way distinguish between the cases arising from the two kinds of lesion, further than that Lunier asserts an absence of trembling of the limbs in those from lesions of the second kind.

Part I.—On Wordless Thought.—The object of this essay is to enquire how far thought can go on without language, and what is the nature of its association with words, or other symbolic means of expressing or communicating ideas ?

The question how far disease of the surface of the brain may reveal itself by symptoms which point to the exact position of the morbid process, is one of considerable interest, not only in a physiological point of view, in relation to the functions of the convolutions, or from a diagnostic standpoint, as indicating the seat of the diseased action, but also in a therapeutic aspect, in showing where local treatment may probably be most beneficially carried out. In order, however, to be able to decide whether certain symptoms indicate disease in an organ, it is clearly of great consequence that we should know what are the functions of that organ in health. Regarded in this light recent experimental researches into the nature of the cerebral functions, and especially those located in the hemispherical ganglia, are of no small value to the physician. True, very many of the results obtained by such observers as Hitzig and Ferrier, are still problematical; but though this be granted in reference to their more detailed observations, there are certain of their broad general conclusions—those, particularly, that have been corroborated by pathology—which may now be considered as well nigh established on a firm basis of fact; and I make this remark, notwithstanding the vigorous and hostile criticism of Dr. Brown-Séquard. Amongst these conclusions the one with which we are here most concerned, is, that the convolutions bounding the fissure of Rolando are charged with motor function, especially in the upper and lower extremities.

Metropolitan (English) cases of spurious hydrophobia are both less numerous and less instructive than those that occur so frequently in the Midland counties and their great cities, especially in Lancashire, Yorkshire, Warwickshire, Derbyshire and Staffordshire. But some of the London cases are, nevertheless, full of interest. Thus, death from a cat-bite formed the subject of an inquest at the St. Pancras Coroner's Court, in April, 1877. The deceased was a woman of 64, who was described as naturally irritable and nervous, and who was sent to the insane ward of the St. Pancras Workhouse in a “state of mania…… on account of her madness.” And there she “died from congestion of the lungs, brought on by hydrophobia”—said the verdict.

Naturally, if a child be dull or stupid, he will be slower to learn the use of the senses or the muscles, and, accordingly, we find that some idiots of the lowest type are not able to learn to walk or grasp. I remember one case distinctly where the only acquired motions were receiving food into the mouth, and following with the eyes the spoon with which he was fed.

As the knowledge and appreciation of light are rendered more distinctive by the near presence of a shade, and as the idea of absolute smoothness is presented to the mind with a keener readiness when viewed in relation to an inequality of surface; so in mental science such phenomena as are normal, and therefore in a sense unvaried, are better known when studied in connection with others that are abnormal, and in consequence more clearly to be individualised.

The following account of a case of microcephalic imbecility, for three years under observation in the Royal Albert Asylum, Lancaster, may be of interest, both on account of the family history and of certain abnormalities in the structure of the brain and heart observed at the autopsy.

To take one other example as illustrating a somewhat different aspect of this question. An experienced physician arrives in a moment at the diagnosis of a case presented to his notice, but a well read and well informed student may ponder long before attaining a correct conclusion under exactly similar circumstances. In what does the difference between the mental processes in the two individuals consist? It will be said to be a matter of experience merely; but what does this statement imply? In the process of arriving at a diagnosis of the case many facts will have to be observed, many points criticised, and many arguments weighed and valued. Now in the case of the senior observer all these facts, these points, these arguments will perhaps have been passed through the mind some hundreds of times before, in reviewing similar cases; the various steps whereby his final opinion is attained will, by frequent exercise and repetition, have become separately organised in the brain, and, however rapidly his conclusion may have been arrived at, the various steps will have been undertaken. But inasmuch as their influence is exercised automatically, he remains unconscious of their agency, until he stops to analyse the various reasons that have—to a very great extent unconsciously—laid the foundations of his diagnosis and the various details on which his opinion has been founded. The process may involve no more consciousness than is displayed in the movements of the envelope folder; one is aware that the envelope is folded, and the other that he has arrived at a definite opinion; but neither may be awake to the separate steps of the process until they deliberately investigate the details of the preceding movements. In the case of the immature observer, frequent repetition has not as yet made certain processes necessary to the diagnosis of the case familiar to his mind, and in consequence they have attained no sound structural position in his nerve centres; so, like the novice in the mystery of envelope folding, he has to consider each step, and proceed with deliberation, and under the acute guardianship of consciousness.

The study of the anatomy of the brains of idiots is a vast field accessible to research, which may serve to throw light upon some questions of psychiatry, hitherto obscure, but which possess an undeniably practical value. It ought to enable us to comprehend better the questions which relate to hereditary insanity. It is undeniable that the vices of physical conformation of ancestors are transmitted to their descendants, and that this phenomenon is the point de depart of pathological varieties.

Having recently visited, and as regards some of them, revisited many of the French Asylums, I propose to bring under your notice to-day, as briefly as possible, three or four prominent subjects of interest, which more especially attracted my attention. I shall not now attempt to describe the asylums which I visited, but merely to bring into as strong relief as possible those matters in which there is a difference of practice between our own country and France, either generally or in regard to the practice of some celebrated French alienists.

In the following brief contribution it is proposed to bring under notice a class of cases of mental disorder in which digitalis has been administered in this asylum with marked apparent benefit, and to deduce from them a few indications for its successful employment. This is not inclusive of instances of insanity complicated with, or dependent on, heart or other physical disease, in which ordinary medical experience has shown digitalis to be of great service as a therapeutic agent.

Few problems are we called upon to solve surpassing in importance that of demonstrating the insane nature of the evil propensities and criminal deeds, which are the outcome of nocturnal epilepsy. If, during the night, a man be periodically roused from his sleep in great bewilderment and mental agony, that quickly cease; or, if in the midst of apparent sanity, he were to be found, unexpectedly, in the morning, either maniacal, or sullenly disposed to unprovoked acts of extreme violence, we may, with confidence, diagnosticate that he is an epileptic, and irresponsible for what he has perpetrated.

The macroscopical and the microscopical researches on the pathology of the brain, in insanity and other neuroses, though hitherto carried on with zest to an almost unlimited extent, have yet been devoid of any very definite trustworthy results. Nor is this to be wondered at when we consider that infinitesimal particles, acting on the nervous system, are capable of producing very decided effects. Thus, a distinct sensation of smell is produced by so small a quantity of odorous particles as to be practically immeasurable. Therefore, the wonder is, as Dr. Maudsley observes, that any morbid appearances should have been expected to be found in many cases of insanity.