Reviews, abstracts, and papers concerning this subject having appeared from time to time in the Journal of Mental Science, I shall, with the exception of making a few incidental explanatory quotations, confine myself to an account, more or less brief, of some of my own cases and to the remarks suggested by them.

At the last annual meeting of the Medico-Psychological Association, held at the College of Physicians, London, in July, 1870, I brought forward a resolution which, after full discussion, was amended and agreed to, in these terms:— “That it is desirable to facilitate the early admission of all acute cases of pauper insanity into county (and borough) asylums, by providing for the proper care and treatment of chronic and harmless cases elsewhere.” The object of the resolution being to ensure for acute cases that prompt treatment which is so essential, and to prevent the overcrowding and overgrowth of asylums, by providing for the transfer of incurable and harmless cases to workhouses, or to lodgings, or to reside with relatives, under proper care, treatment, and supervision. In the absence of any such provision, the enlargement of asylums progresses—this will be shown by the returns of the increase of pauper insanity in England and Wales. Several institutions have attained such dimensions that the difficulty of proper management has become great. In such overgrown establishments the individuality of the curable patient is liable to become lost amongst the crowd of idiots and incurables. The delay in obtaining the forms required by the Lunacy Acts, prior to the admission of insane patients to pauper asylums, is a great hindrance to early treatment. As regards chronic cases, this delay is of little consequence, and from the comforts being greater in the asylum than in the workhouse infirmary, and it being to the interest of workhouse officials to send insane paupers to the asylum, the accumulation of chronic and incurable cases therein can easily be accounted for.

The case of W. C., a boarded-out lunatic, who recently made a murderous attack upon the wife and child of his guardian, has brought under public notice and discussion several matters connected with lunacy administration in Scotland. It would, obviously, be improper to discuss questions here which are still under the responsible consideration of the General Board of Lunacy. Therefore I do not intend to refer to such questions, and may venture to express the hope that the subsequent discussion will be confined to the one point raised, viz., the mode of procedure adopted by the criminal authorities.

In the absence of all medical testimony, opinion respecting the man's mental condition during the period in question must be based upon the ordinary evidence brought forward at the inquest. And it so happens that, notwithstanding the remarkable finding of the jury, the conclusion at which most people would arrive, after perusing the evidence and the in coherent statement found in the handwriting of the deceased, insonsi-mprpolfeesseionnoaulgh, opiannidon.quitTehuws, iththine “the DeailsycoTpeeleogfrapohrd,” inaryin reference to the case, relates the circumstances and the evi dence, and then says : “After all this, it is impossible to avoid the conclusion that the assailant of Mr. Hamburger was not altogether responsible for his actions. We may even go further, and say, although the jury were of the opinion tmhiantd, thethreat wtahse nodeceevaisdeedncewatos sdheocwidedwlyhat inwsaanse” his wshtaetne hoef attempted to murder Mr. Hamburger. It is sufficient for my present purpose to affirm the correctness of the opinion here qiioted from a lay paper, without entering into such details of the evidence as might be taken either for or against that opinion.

In the previous paper on the subconscious and conscious mind it was tacitly assumed throughout that excitation processes, though capable of activating the responding organ, yet are kept within the limits of that organ's capacity to respond. In the case of the heart, however, it was definitely pointed out that the responding organ had a limited capacity to give a normal response; also that the intensity of excitation processes could exceed this capacity (1, 3).

Although much of a speculative kind appears to have been written upon the subject of climacteric insanity, more especially as regards the pathology of the disorder, the accumulation of actual facts, bearing upon its genesis, symptomatology, and terminations is comparatively small. Exception must be made for the highly practical paper lately read by Dr. Savage at the Medical Society. A further contribution dealing as far as possible with matters of observation may be serviceable. For the purpose of this paper, in addition to the cases coming under the direct observation of the writers, the records of Bethlem (10 years, 102 cases) and the West Riding Asylum, Wakefield (10 years, 120 cases) have been drawn upon. We are indebted to Dr. Salter, Clinical Assistant, Bethlem Hospital, for much assistance in collecting the cases, and Dr. Percy Smith for permission to use the records of Bethlem.

Several fallacies may occur in the recording of the pressure of the cerebro-spinal fluid. These fallacies may be related to (1) the type of apparatus used, (2) movements of the patient, and (3) reading of the pressure.