General paralysis of the insane was first described by Haslam in 1798, thus its recognition is now a century old; and although an enormous amount of labour has been devoted to the search for the essential cause of this disease—perhaps the most fatal to which human flesh is heir—opinion is yet far from unanimous as to its origin. There is no doubt that the view that syphilis is the prime cause finds most favour at the present time; but in view of the want of uniformity of opinion on this matter, I have felt that a serious attempt to arrive at a definite conclusion would be welcomed by the alienists of this country. Such an attempt might at least help to clear the ground for future investigation.

In a previous paper has been demonstrated the possibility of localising the fundamental emotions in circumscribed areas of the cortex of the brain.

In the year 1896 I directed the attention of my fellow specialists, in the course of details of observations relating to two women, to the subject of pathological dreaming, till now only slightly investigated, and showed how intense hysterical dreaming states had been developed from previous reveries. The literature which has appeared since then contains but few references to this matter.

In this brief sketch it is my intention to refer to a few of the points which I regard as having an important bearing on the construction of asylums in tropical countries.

Some writers lately have been inclined to drop this name, and although the matter has been investigated pretty fully, I do not think it has been much inquired into from the pathological point of view. The following notes will therefore probably not be uninteresting, and they may lead to the subject being more thoroughly investigated.

This is the third or fourth time that I have been the occasion of bringing the subject of Punishment before your notice, and my justification for treating of it again is that I am given to understand you are not yet—all of you—of my opinion. On the first occasion I had but one adherent, but that one, Sir William Gairdner, was in himself a host. On the last occasion a good many voices were raised in my favour, and to-day I hope we shall be unanimous. You will remember that the first time I brought the subject forward, it was in connection with the thesis that every lunatic is not necessarily to be considered exempt from punishment; that most lunatics ought properly to be punished for some of their wrongdoings; and that the practice in every asylum is to punish lunatics upon occasion. To this it was objected that although the fact was admitted that we do pursue towards lunatics the same course of conduct that is called punishment when applied to sane people, yet, when applied to lunatics, it is not punishment, because we dare not call it punishment. This led me to a disquisition upon the nature of punishment, in which I arrived at the conclusion that punishment is the painful consequence of conduct; and to this conclusion I still adhere, but subsequent meditation has shown me that although it is the truth, it is not the whole truth, but that there is another aspect of punishment of equal importance. Moreover, I think that the chief reason of the disagreement between my critics and myself was that, while I looked at one side of the shield and maintained that it was black, which it was, they were looking at the other side and maintained that it was white, which it may have been—in parts. In other words, I was looking upon punishment from the point of view of the punishee, which some of you, at any rate Dr. Noott, will consider was the proper point of view for me to take; while others regarded it from the point of view of the punisher.