I have felt no little difficulty in choosing a subject for the remarks which it is my privilege, in the honourable position of President, now to address to you. Those who have preceded me in the office have, in their several discourses, treated so fully of the most important matters relating to the department of the specialty in which we are engaged, that there seemed little left for me to say. As Editor of your Journal, my opinions, too, are for the most part sufficiently well known to you. On considering what I should do under these circumstances, I first resolved to select for my address the evidence of evolution and degeneration of mind which the study of psychology, healthy and morbid, reveals, with special reference to their bearing on the well-known views of Mr. Darwin. I am persuaded that some weighty facts and arguments in support of these views may yet be drawn from a scientific study of mind in all its manifestations—in animal as well as in man, in man savage as well as in man civilized, in disease as well as in health. Without giving an opinion upon the great question of the day—whether man be or be not descended from an arboreal baboon, it might be justly argued with no little force that, if he were so descended, or had so ascended, many of the psychological facts might be expected to be very much as they are now. The battle ground which the opponents of Mr. Darwin have chosen and hold cannot certainly be pronounced quite impregnable, if the attack be made in the right quarter. This design, though it was partly carried into execution, I thought it best, however, on reflection, to abandon as unsuited to the occasion, and, in the end, resolved to limit my remarks to matters of more immediate practical interest to us as physicians engaged in the care and treatment of insane persons. What I have to say will be of a somewhat desultory character, and for this I must bespeak your indulgence, my aim being to excite discussion and to elicit opinions on matters of great practical interest, rather than to treat them in an elaborate and systematic manner. Instead of attempting to make a scientific display, I shall hope to elicit a display of your scientific experience, by asking, in the Socratic spirit, what we really know, and what we only think we know, concerning some matters of weighty consequence in our specialty.

Passing, now, from the consideration of the influence of emotion upon motility, we proceed to examine the interesting series of phenomena resulting from the operation of the same influence upon sensation. Ever tending to be confounded with the converse succession of events, the influence of morbid states of sensibility in producing emotional disorder, its consideration requires more discrimination than that of the previous section. We can scarcely avoid employing language which is not strictly scientific, and can be only understood in a popular sense. Indeed, with two elements so closely allied as the emotional and sensational—mental feeling and bodily feeling (so-called)—it must constantly happen that in our terms, as in reality, we confound the two together, and in this blending fail to discover which is cause and which is effect, or speak of the consciousness of bodily pleasure and pain as if it were not a mental state. It is, however, perfectly easy, in spite of metaphysical difficulties of this kind, to make clear what is meant by the influence of a powerful emotion upon sensation as a part of that influence of the mind upon the body, which we are endeavouring in these papers to point out and illustrate. For example, there can be no question as to the fact that moral disgust does in some instances cause the sensation of nausea, or that distress of mind may occasion neuralgia, or fright the sensation of cold, or that the special senses may, under fear, be stimulated centrally, so as to cause subjective sensations, whether olfactory, visual, or auditory. These facts remain of interest and importance, although the bare statement of them suggests some questions of difficulty. They are so, whether our physiology regards the functions of the hemispherical ganglia as comprising the sensational as well as the ideational elements of the passions—(see ante, July, 1870, p. 174)—or whether it relegates the former to the sensory ganglia. They are so, although not only do mental and physical sensations merge imperceptibly into each other—for we constantly witness the same results from emotional as from sensational excitement, physical and corporeal pain alike acting upon the body (as, e. g., in quickening the circulation)—but mental sensations are so united with their associated ideas that it is difficult to separate the purely emotional from the ideational elements of passion. It is a penalty which we pay for our classifications and divisions that, however convenient they are up to a certain point, they sometimes lead us to do violence to nature; to dissever that which is inseparable, to sacrifice in the present case, it may be, the intimate cohesion of psychical states to the idol of reducing everything in science to orders and classes.

The circumstances of this case appear to me to be so interesting, in a psychological aspect, that I venture to place them at some length before the readers of the Journal.

In June, 1867, a new era was begun in the Poor Law system by Mr. Gathorne Hardy's Bill, which comprised arrangements for meeting the epidemic requirements of London, and for relieving the workhouses and lunatic asylums of the imbecile, idiotic, and chronic patients, not dangerous or destructive, but quiet in their habits, leaving behind merely the infirm poor and the acute and violent lunatics, for whom the accommodation was thought sufficient. There was also another clause providing a bevy of dispensaries, which however has not been carried out, though it was probably one of the most promising parts of the Bill. As regards the arrangements for epidemics, recent events have shown them to be inadequate; it must be said, however, that in 1867 the idea of meeting visitations of severe epidemics by temporary structures was not even in its infancy, otherwise we might have been spared such structures as Stockwell and Homerton Hospitals, which will never be filled or even half-filled in times of ordinary public health, and which are too small for great emergencies. A rapidly expansive system, as by temporary hospitals or by tents, capable of enlargement and of folding up and packing away when done with, is the proper plan for treating epidemics. What then is the proper one for quiet lunatics and imbeciles ?

In my communication on General Paralysis in the previous number of the Journal, reference is made to tables, showing various particulars in 124 males and 31 females suffering from this disease, and in whom post-mortem examinations were made during a period extending over 20 years. As these tables were found to be too voluminous for publication in the Journal an analysis or summary only was given. A further reference to the subject may not be uninteresting, especially as relates to the spinal canal, the spinal cord, and investing membranes, since any notice of their condition in insane persons is entirely omitted, even by recent observers. These morbid changes, so frequently noticed by myself and colleagues at the Somerset County Asylum, and in many instances submitted to others for microscopical examination, can only have been overlooked in other institutions from the difficulty of exposing the spinal cord, so as to admit of its complete examination, the instruments in common use not being suitable for the purpose. Those I have been in the habit of using for dividing the spinal column, after laying it bare with a large-sized scalpel, are a common tenon saw, a chisel and mallet, the same as used in opening the skull, and both operations may be performed with equal facility after a little practice.

There are two classes of men who occupy themselves in observations on mental functions, frequently working widely apart from each other. These are, the metaphysicians, who investigate the phenomena of mind apart from anatomical or physiological facts, and the physiologists, who keep as exclusively to their own labours. Neither of these classes of men have as yet formed any philosophical system of the mental powers, and other functions of the brain; and it may be safely asserted that it is only by a combination of metaphysics and physiology that we can advance any considerable steps in our knowledge. The philosophical Reid, whose greatest disciple was Sir William Hamilton, stated many years ago, in his “Essays on the Powers of the Human Mind,” that they are “so many, so various, and so connected and complicated in most of their operations, that there never has been any division of them proposed which is not liable to considerable objections.” All the classifications made by metaphysicians differ materially from each other, and what was true in Reid's time is true now. We have a different race of metaphysicians from those who flourished years ago, different from Reid, Dugald Stewart, and Brown, but as yet we seem no nearer than we were to a systematic and comprehensive classification of mental faculties, or more properly, of the functions of the brain. I would not say that no progress has been made, for a vast mass of facts has been accumulated, and careful observations have been made, which will be available at some future period for a scientific and philosophical classification.

An engagement prevented my reaching the meeting at the College of Physicians, on the third of August, in time to hear the President's address, and though I had something to say on the subjects contained therein, I had not the presumption to offer a criticism without having heard it, while the discussion which followed did not enable me to gather what had been put forward. By the kindness of Dr. Maudsley, however, I have been permitted to read his remarks, and have found them in every way worthy of the high encomiums passed upon them by more than one speaker; yet one or two observations occur to me. Dr. Maudsley is fond of paradoxes, and he startles us with one at the commencement. He tells us that he is convinced of the important part which hereditary predisposition plays in the causation of insanity—that he thinks no person goes mad, save from palpable physical causes, who does not show more or less plainly by his gait, manner, gestures, habits of thought, feeling and actions, that he is predestined to go mad. And yet when he is discussing the advice to be given as to the marriage of people sprung of insane ancestors, he sums up his opinion in these words—“I cannot think science yet has the right to forbid marriage to those in whom some tendency to insanity exists.”