Clinical and Pathological Notes. – II. By Dr. M. J. Nolan, Resident Medical Superintendent, Down District Asylum, Downpatrick.

Case 5. Microcephalic idiocy; epilepsy; cerebral asymmetry; microgyria; ulegyria; scalp suggestive of atavism. – H. C –, æt. 41 years, admitted to asylum from a work-house August 4th 1902; died of epilepsy December 22nd, 1902. No previous history obtained.

His physical appearance would have rejoiced the heart of an evolutionist, as prima facie he was a perfect specimen of the Simian type. His dwarfed figure was bent forwards; his coarse grinning face seemed to protrude from between the misshapen spreading ears. The small receding skull was encased in an ill-fitting scalp, on which the rough black hair grew in ridges. He progressed by means of a side shuffle, preserving his equilibrium by spreading out his elongated forearms. He gave vent to meaningless spasmodic grunting sounds. In personal habits he was most depraved, showing an absolute disregard of the calls of nature. His voracious appetite was apparently gratified by the ingestion of any material. There was nothing calling for special comment in the nature of his epileptic seizures, which were frequent and severe. He was deaf and dumb. Beyond grabbing clumsily in the neighbourhood of his genitalia, he gave no indication of sexual feeling. An examination as to his mental faculties had an almost negative result. He could not be said to possess any one of the intellectual faculties except in the most rudimentary degrees. Hence in describing his appearance it was stated he was prima facie of Simian type, but his intelligence was infinitely below that possessed by the ordinary anthropoid ape. He proved clearly the force of Dr. Ireland's contention that the intelligence of a monkey is very different from that of an idiot – the gauge of the Simian intellect cannot be reached by merely deducting so much from the human. H. C – was as far below the intellectual level of the average ape as the latter is inferior to the highly developed specimen at present the delight and wonder of a London music hall, where, in spotless regulation garb, he discusses with evident appreciation and discrimination the elaborate menu set before him. H. C –, if placed before such a meal would have brought his voracious appetite to play not alone on the viands, but on the napery, glass, and cutlery, and by preference would probably try the latter as a hors d’œuvre. During his period of residence here it required the undivided attention of the attendants to prevent him from eating filth and garbage and otherwise unwittingly endangering his life by senseless acts.