The cases dealt with in the present paper came under review during the course of my duties as Medical Officer to the Leeds Committee under the Mental Deficiency Act. They comprise examples of the four varieties of mental defectives defined by that Act, viz., idiots, imbeciles, feeble-minded, and moral imbeciles, and include most of the clinical types described by writers on the subject. The commonly accepted division into primary and secondary groups has been adopted; a third group, containing cases which appear to combine the characteristics of both types, and a fourth group containing “doubtful” cases, in which the data are insufficient to allocate them definitely, being also added. It has seemed useful, too, to give columns showing the number of cases corresponding to the accepted clinical types, those complicated by epilepsy, those exhibiting pronounced stigmata of degeneration, as well as those showing a definite family history of neuropathic affections, tubercle, or alcohol respectively. It is obvious that many of these cases will figure under the several heads. The following analysis then shows the proportion of cases under each of these heads of the total number of cases examined, viz., 200:

In the preceding papers I have endeavoured to review what is at present known of the clinical history of aphasia; having first ventured critically to analyse a certain number of cases recorded by independent observers in various parts of the world, I have then minutely detailed several cases which I have myself had the opportunity of personally watching.

Data from five behaviour management (token economy) units were analysed for periods of 10–20 weeks before and after the use of a food substitute (Complan®), provided when insufficient tokens had been earned to buy a full- or part-meal. The efficacy of this form of negative punishment to control disturbed and aggressive behaviour was examined. No evidence was found to suggest that the contingent use of a food substitute made any contribution to the therapeutic process.

The author records two cases in support of his view that the syndrome of acute delirious mania is frequently an effect of renal disease, is, in fact, a hyperacute uræmic insanity.

It is obvious that it would be quite impossible within the short limit of time at our disposal to enter into a full and complete account of all the data collected with reference to these admissions, which commenced on January 1st, 1892, and terminated on December 31st, 1899; I will therefore confine my remarks to the more important features presented by them.