Dr. de Montyel gives the results of his investigations on the sixth of the reflexes which he undertook to study in general paralysis. The discrepancies noticed in the conclusions of many other observers are attributed to their studying patients in various stages; in all researches of this nature it is indispensable to follow the only method susceptible of furnishing data which may be compared with one another,—that is, following up and examining the same patients from the onset to the termination of the disease. Out of 104 cases of general paralysis this method was satisfactorily carried out in the case of thirty only, the others having succumbed either in the first or second stage; 680 satisfactory observations were made, and the results of these are carefully tabulated. The following are some of the author's general conclusions:—Accommodation is more often abnormal than normal in general paralysis; exaggeration of the reflex is rare; diminution is twenty-four times more frequent—abolition being slightly more common than simple diminution. The reaction is nearly always equal on the two sides; in a few rare cases one finds normal accommodation on one side and abolition on the other. In the early stage only does one find normal accommodation more frequent than abnormal; but in the second, and more so in the third stage, abnormality is the rule. Abolition is commoner in the late stage. In more than a third of the remissions there was abnormality. Certain differences in the accommodation reflex are found in the various forms of the disease; it is more often and more profoundly altered with conditions of excitement. As regards the ætiology the reflex was always found abnormal in traumatic general paralysis; next in frequency (i. e. after abnormality of reflex) comes the alcoholic form. Alteration of the reflex is common with cases at the extreme ages of incidence of the disease (after fifty and below thirty). Accommodation was more often and more profoundly affected in the first two stages of general paralysis in proportion to the impairment of motor power. The investigation of the accommodation reflex on account of its frequent and early alterations may be helpful in the diagnosis of doubtful cases, but it affords no indication as to the slow or rapid evolution of the disease. H. J. Macevoy.

The authors restrict the denomination of post-operative psychoses to delusional disorders which occur in the sphere of ideation alone; so that neurasthenia, for example, following upon an operation, is excluded. They also exclude delusional states directly due to toxæmia, which are transitory and differ in their symptoms and treatment—just as puerperal insanity differs from the transitory puerperal delirium arising from septicaemia. They admit, however, that the line of demarcation between these two groups of cases may be hard to draw. Moreover, as has been pointed out by Magnan, we may have a febrile or toxæmic delirium superposed upon a true psychosis. Hereditary predisposition is a marked feature in post-operative insanity, so much so that one may deny the possibility of an operation alone causing a psychosis in a healthy subject; at the same time this is no argument for rejecting this class of cases. Gynæcological operations are not more likely to cause post operative insanity than other operations; the confusion with simple neurasthenia has led to this opinion. The symptoms of post-operative insanity are most variable, and have furnished some justification for denying its existence as a separate form; moreover, in cases where general paralysis and other well-defined psychoses have supervened (or appeared to) upon an operation, we must attribute the occurrence to a mere coincidence. The variation in symptoms, or in the character of the psychosis, arises from the variability in the mental conformation of the patient and the varying predisposition—the all-important factor. The nature of the operation itself is another factor to be considered. The prognosis varies considerably as well as the treatment.

Out of a total of 3916 cases of insanity (2493 male and 1423 female) observed at the Moscow Clinique for Mental Diseases between November, 1887, and January, 1901, there were 682 of general paralysis —590 men and 92 women; so that nearly 25 per cent, of the male and 6.57 per cent, of the female cases were general paralytics. The proportion is larger in recent years than in the earlier years of the foundation of the clinique. The greater number of cases in men were between thirty-six and forty years of age; in the case of women the commonest age is thirty-one to thirty-five years. The authors give notes of three cases of juvenile general paralysis. Various tables of classification dealing with occupation, nervous heredity, alcoholic inheritance, presence of syphilis, etc., are given, and the following are some of the authors' general conclusions:—General paralysis is uncommon or even rare in the case of farm labourers. The importance of heredity is great in the case of general paralysis, as in other psychoses or mental diseases. Syphilis was present in more than 75 per cent, of the cases, and in 90 per cent, of these there was an interval of from six to twenty years between the date of infection and the appearance of morbid symptoms. Alcoholism is of importance in the ætiology of general paralysis in men; in over 60 per cent, there is a marked history of abuse. The demented form of general paralysis was observed in half the male cases, the maniacal form being next in frequency. In women two thirds of the cases were of the demented type, and a quarter of the maniacal. The demented type was decidedly commoner in recent years. Concerning certain symptoms especially noted in general paralysis, the authors found that among men exaggeration of the knee-jerks was present in about half the cases, absence in one fifth; among women exaggeration was found in about 60 per cent., and absence in 15 per cent.

This is a serious study of the claims advanced in favour of paraldehyde as a hypnotic since its introduction into medicine in 1882. The ideal soporific which shall with certainty and without delay secure an untroubled refreshing sleep, approaching natural sleep as nearly as possible; the soporific which shall neither lose its efficacy nor accumulate its effects, and which shall, moreover, be easily dispensed and agreeable to take;—such a drug, like the philosopher's stone, has yet to be discovered. Among soporifics, however, as things are, paraldehyde can claim many virtues, and further experience and better knowledge have only strengthened its position. In the Freiburg Asylum, Dr. Bumke says that paraldehyde has more than held its ground against sulphonal, trional, and hedonal, and that it and scopolamin are now alone employed.

The authors draw attention to the continuous arising of new remedies for and new methods of cure in epilepsy, and the as constant disappointment of our hopes which further trials of the new agents bring. In particular they make reference to the combined opium and bromide cure of Flechsig, which later developments and several recorded cases of death whilst under the treatment have brought into discredit. They point out that the epileptic seizures may, for various reasons, disappear for long periods—two to twenty-nine years, as the more recent statements of Sinkler make clear,—and the futility, therefore, of the attempts to demonstrate the curative value of drugs by observations extending over periods of three to four months, or at the most one year. In spite of these objections, however, they determined to make trial of the Toulouse-Richet method, so strongly had it been recommended.

This is the interesting account of a case, mostly the autobiography of the patient, relating the development of an idea of morbid blushing in a boy, which persisted for years, and finally apparently led to suicide, after the victim had at one time seriously contemplated blinding himself on account of his ereuthophobia.

The following are some of Dr. Browning's conclusions: 1. “In the young there occurs a class of cases characterised by recurrent attacks of heterogeneous type, and that may conveniently be called pseudo-epilepsy.”

The case is that of a girl æt. 18 years, who was admitted into the Mulhouse Hospital on January 11th, 1899. She was illegitimate, and her family history was unknown. From the age of eight she had frequent convulsive attacks, occasionally preceded by an aura (visual), during which there was loss of consciousness, frequent biting of the tongue and lips, and injury to the head, and occasional involuntary micturition (no doubt epileptic). At the onset of menstruation she had some nervous disturbance. After admission two small bluish spots were noticed on the right knee; similar ones had apparently been present before, and others were observed on several occasions during her stay in hospital. They were painless, and usually disappeared in a few days. During her stay in the hospital she had several apparently typical epileptic attacks. She was treated with bromide of potassium.

A. D. Q— was admitted into Armentières Asylum, September 14th, 1888, at the age of 39. His early symptoms began apparently after the death of his wife about four months before; he was depressed, said he couldn't eat, that he was dead, left off working, and stayed in bed. On admission he presented all the signs of general paralysis of the melancholic type, with delusions of negation. The disease progressed rapidly, and he died in January, 1889.

This paper is one of the most notable contributions of recent years to the anthropological and psychological study of the juvenile criminal. It is based on careful observation of a series of twenty-two youthful assassins who were under the author's care for considerable periods of time in the Plötzensee Prison at Berlin. Full notes are given of each case, comprising a history of the crime, the personal and family antecedents of the criminal, his physical and mental condition, with anthropometric details, and, in most of the observations, with good photographs of the individual at different ages. The main facts brought out by the inquiry are then summarised, and their bearing on various problems of criminology is discussed with that union of thoroughness of method and breadth of view which invariably distinguishes Dr. Baer's work A paper of this scope and character cannot, of course, be adequately treated within the limits of a short notice, and the present résumé does not aim at more than indicating a few of its salient points.