In the observations which I am about to address to you, I purpose to set forth by illustrations the character and course of a form of mental derangement which has its special cause, certain characteristic features, and a definite course, almost invariably from bad to worse. I speak of that kind of insanity which is brought on by self-abuse. In doing this, however, I have another object in view; I am anxious to use my exposition in order to exemplify a new and practical classification of insanity which has been proposed and sketched out by Dr. Skae.

Medical Psychologists have long been familiar with a peculiar form of disease which is characterised by a combination of disorders of the intellectual and motor faculties. The French physicians, to whom is due the honour of having first minutely described it, have given to it various names, according to the views then generally held and the special opinions of the individual observers: General incomplete paralysis (Delaye); general paralysis of the insane (Calmeil); general progressive paralysis (Requin, Sandras); paralytic insanity (Parchappe), &c. In Germany the terms general paralysis, paralysis of the insane, and most recently paralytic dementia have been generally employed. Familiar though this disease has become to medical psychologists, and though much discussion has taken place regarding it, within a narrow sphere, still slight has been the interest hitherto taken in extending that sphere. These poor patients, whose treatment either cannot or can only with great difficulty be pursued in the ordinary relations of life, who from henceforth appear hopeless, are gladly handed over to physicians to the insane, and with the entrance of the patient into the asylum all interest in the disease ceases. The time is, I believe, at hand when in regard to this, as well as to many other matters, the veil of the asylum will be removed, when once for all the barriers will be thrown down which divide mental pathology, as we must still call it, from that of the remainder of the nervous system. Each has a series of facts to oppose to the other, and it is certainly surprising how many points of connection there are between them. The question is merely one of comprehension: mental pathology often manifests itself in a manner which outwardly is not easily understood, though it must be admitted sufficient pains have not always been taken to understand these manifestations.

The Hospital de los Locos at Granada is the oldest lunatic asylum in Europe, having been founded by Ferdinand and Isabella shortly after the conquest in 1492. It was therefore opened some fifty years before the first Bethlehem Hospital, which stood in the present Bethlem Court, off Bishopsgate Street. It has apparently been carried on these two hundred and fifty years without any alteration in the original structure or any advance on the method of the original treatment. I induced to visit it last April, from a notice of it in Ford's Handbook. “At the corner of the Plaza del Triunfo (he writes) is the Hospital de los Locos, founded by Ferdinand and Isabella, and one of the earliest of all lunatic asylums. It is built in the transition style, from the Gothic to the Picturesque, having been finished by Charles V. The initials and badges of all parties are blended. Observe the patio and light lofty pillars. The filth and want of management of the interior is scandalous, and yet this is one of the lions which Granadians almost force an Englishman to visit; possibly from thinking all of us Locos, they imagine that the stranger will be quite at home among the inmates.” The asylum is a two storey square building, with enclosed courts, which form the patients' airing courts. They are of small extent, and excluded from all view by the buildings, which, however, shade from the sun. In one of the courts I noticed a large summer house, over which a vine was trained. The dormitories contained twenty-five beds each, and were large and well ventilated. Single rooms opened off them, with rather unpleasant arrangements (to English ideas) for night stools; but then all these arrangements in the best hotels in Spain are nasty to a degree, and at the railway stations, if possible, worse. What a boon the earth closet system would confer on travellers in Spain! The patients, about 250 in number, were on the whole quiet and orderly in their conduct, and fairly clothed and tolerably clean, when contrasted with the population at large. So quiet was the whole system that I did not hear one sound in all my visit, but then the Spanish people are a quiet, phlegmatic race, patient of suffering, and who stupify themselves with the constant and excessive use of tobacco. I saw one man in permanent restraint, with formidable leg locks and chains, but he could walk freely, and had the use of his arms. There was, I was told, no straight jacket in use at the time of my visit, but I was shewn a strong implement of the sort, with a lot of leather and straps about it, and which was said to be frequently required.