“We have not found any reasons supporting the opinion generally entertained that the community are more subject than formerly to attacks of Insanity.”— Fifteenth Report of the Commissioners in Lunacy to the Lord Chancellor, 1861.

I give here, as of interest in relation to this question of the alleged increase of lunacy, a few figures compiled chiefly from the Poor Law Board returns, illustrating the relations of pauper lunacy to the pauperism of the country and to the population generally.

I purpose to consider in a few pages sundry so-called classes or varieties of insanity, which have given rise to no little dispute. Opinions with regard to these are still at variance, and so it conies to pass, that when we have to approach them, not from a therapeutical, but from a forensic stand-point, we are, by the ingenuity of counsel, launched amidst a multitude of seeming discrepancies, and it is suggested that nothing definite or certain is known about the whole subject. By a closer examination of the cases we see in practice, we shall find, I think, that the greater part of these doubts and difficulties will disappear.

Last summer, in the course of a tour in the United States and Canada, I visited a number of Asylums for the Insane, jotting down my observations and impressions at the earliest opportunity after leaving the respective establishments. They are now submitted in a condensed form in these notes; and I trust that they may convey to the readers somewhat of the interest experienced by myself during my visits. It is almost superfluous to say that the physician-superintendents received me most courteously, and their kind attention will ever be suggestive of pleasant recollections in connection with my trans-Atlantic trip. Without further preface, I shall proceed first to give a short account of the Michigan Asylum,* visited 13th June, 1868.

To wander over the whole field of medico-legal uncertainties would lead us amongst railway injuries, criminal cases of every kind, disputed wills, and various subjects, psychological and non-psychological. Such a wide scope is not the object of this paper, but I wish to place before you some facts of an important department, which I trust will, sooner or later, be brought seriously before the profession and the legislature.

Having in my last paper noticed the different forms in which loss or lesion of the Faculty of Articulate Language is met with by the clinical observer, I now propose to consider the various causes which give rise to this morbid symptom.

Although from an early period of medical enquiry syphilis has been known to affect, more or less seriously, the whole system, it is only within the last decade that attempts have been made, chiefly by foreign pathologists, to demonstrate that this fatal virus does not confine its ravages to the coarser structures of the human body; but that the delicate tissue of the nervous system may be alike destroyed, and the mind's balance unhinged, by its direful effects. MM. le Dr. Leon Gros et E. Lancereaux in a work, Des Affections Nerveuses Syphilitiques, published in Paris, in 1861, have with great care collected a mass of observations from different quarters, but have not added much to our knowledge in defining the symptoms which accrue from syphilitic disease of the brain and its membranes. Indeed the confusion and uncertainty which prevail in this path of pathology are so great, and the subject itself is of such paramount importance, that any cases at all authenticated bearing on this point ought surely to be recorded.