The State Secretary for the Department of Instruction has to some extent been an agent in the progress of mental science by rendering compulsory for students of forensic medicine a course of lunacy in an asylum extending over two months. By an unfortunate imitation of the Italian system, which in a single chain unites subjects of so diverse a character as toxicology, legal medicine, and mental diseases, the best method of freniatric teaching is not obtained. In Spain, a physician at the end of his career knows nothing at all of mental infirmities and affections. The action of the State Secretary is the more surprising when one remembers his order founding and establishing separate and compulsory chairs, both clinical and theoretical, of dermatology, otology, and ophthalmology. Alienists in Spain are disappointed, and regret that so incomplete a step should have been taken in so important a matter, for physicians at present look either dumb or foolish at court when cases of criminal responsibility, civil incapacity, etc., are being tried.

In this paper the author discusses at some length the nature and relationships of the various reflexes which have been described in the foot. There are at present very marked differences of opinion among the various authorities as to the value and pathological significance of these reflexes.

The author describes a case and the pathological appearances found after death, and bases upon it some considerations regarding cerebral tumours. The patient for years had suffered from a monoplegia affecting the one arm, and was also subject to attacks of epilepsy. There was no headache, no vomiting, no disturbance of vision, and no weakening of the intellect. Twenty-five years after the beginning of these symptoms dementia supervened. At the autopsy, a tumour about the size of a small hen's egg was found in the middle of the right Rolandic region in correspondence with the posterior third of the frontal lobe. The tumour was an endothelioma, rich in cells probably of a sarcomatous nature, and without any nervous elements. The author points out the complete absence for twenty-five years of any mental symptoms is in complete accord with the theory of Bianchi, the unilateral nature of the lesion and the extraordinary slowness of its development giving time for compensation. An examination of the contents of the softening showed that the vessels remained normal; the nerve-fibres were very markedly altered, and the nerve-cells were reduced in number. The permanence of any cortical nerve elements was due to the slowly progressive interruption from the gradual compression and to the absence of any inflammatory process. The softening that surrounds tumours has been attributed by some to the compression of the small vessels, or to a superadded obliterative arteritis caused by syphilis or tubercle, the degeneration of the nervous elements following this. The author regards the extension of the softening to have been caused, not by the pressure of the tumour itself, but rather by pressure of fluid surrounding it. This produces in some cases an increase of tension, to which the white matter cannot offer sufficient resistive power, and hence the degeneration.

The year 1902 was distinguished in Belgium by the meeting of the International Congress for the Care of the Insane—a meeting remarkable not alone for the importance of the subjects that were dealt with, but also for the number of distinguished foreign alienists who attended from all parts of Europe. Dr. Peeters, Physician and Director of the Colony of Gheel, served as President of the meeting, and conducted the proceedings with the greatest kindness and tact, displaying at the same time his thorough familiarity with all questions connected with the care of the insane on the most advanced lines. The Congress concluded by the adoption of certain resolutions which will entitle the proceedings of this assembly at Antwerp to rank among the most important works that have been done in connection with the organisation of asylums and of colonies for the insane.

In the discussion of obsession the point at issue has been especially the relative importance of the intellectual and the emotional element. Recent experiments apparently establish that organic modifications (muscular or vaso-motor) are anterior to the affective state, and therefore to the idea, and not consecutive.