There exists still much difference of opinion as to the part played by cancer in the ætiology of insanity. In the case here related by Jacquin, he believes that the malignant tumour was a strong factor in the causation of the insane attack; but it is important to remember that injections into the body of the tumour were made, and that some septic mischief was set up thereby. A woman, æt. 31 years, was admitted into the Hospital de la Croix-Rousse (Lyon) on July 3rd, 1899, with a swelling on the right side of the neck of the size of a walnut, thought to be lymphadenoma. Three days later iodoform with ether was injected into the tumour after incision. After a few days' suppuration the wound healed. Three months later, the patient returned with the tumour a good deal larger—the size of a small fótal head. There was a good deal of pain, and signs of pressure on the right brachial plexus were present. Every third day arsenical injections were made into the tumour without any result. On November 29th, the patient was admitted into Bron Asylum suffering from delusions of persecution, with hallucinations of hearing and sight. From a fistulous opening in the tumour, very fótid blood-stained matter escaped. There was marked cachexia. The delusions and hallucinations persisted, fever set in, the general condition grew worse, and the patient died on February 12th. There was no autopsy.

Under this title, Dr. Pianetta discusses the pseudo-paranoiac symptoms which occur in degenerate subjects, illustrating his remarks by three personal observations. As characteristic of the group of “paranoids” which he describes, the author indicates that they manifest a tendency to erroneous interpretation of outside impressions in some special direction, without, however, elaborating a systematised delirium; their mental state is thus that of incipient paranoia,—at times, perhaps, undergoing an exacerbation which renders them for the moment symptomatically indistinguishable from cases of typical paranoia. The author points out the affinities of these cases to the paranoia sine delirio of Tanzi and Riva, and to Magnan's mental degeneracy with episodic syndromes, with which, indeed, the cases recorded appear in all respects identical. The first observation is that of a man with hereditary taint, in whom mental disorder first appeared shortly after marriage; recovery was rapid, but the patient subsequently manifested neurasthenic symptoms with a disposition to hypochondriacal, self-depreciatory, and persecutory ideas. Generally these ideas had an obsessional character and were more or less readily repressed, but at times they acquired the force of delusions, were supported by hallucinations, and on one occasion led to a suicidal attempt. The author draws special attention to the passage from obsession to delusion in this case. The second observation refers to an individual hereditarily unstable, eccentric, and morbidly vain, who presented at intervals a tendency to disconnected delusions, chiefly hypochondriacal and persecutory. In the third observation, the patient, aged twenty-three, mentally degenerate as a result of insane heredity and of infectious disease in childhood, presented at intervals imperfectly defined delusions of persecution. Of very defective ethical development, he was repeatedly condemned for theft and for sexual offences, and two of his persecutory episodes occurred in prison.

Dr. Deiters commences his article by stating that, since Samt's investigations on the forms of epileptic insanity, it has generally been recognised that the mental symptoms are very characteristic; indeed, some hold that the presence of epilepsy may sometimes be inferred from the psychical manifestations alone. Sometimes, however, insanity combined with epileptic seizures takes a different character, approaching the forms of other vesaniæ. He gives at some length the description of a patient fifty-five years old, who had epilepsy combined with delusions of a paranoic nature. He had led a vagabond life, had been in prison for stealing, and had been passed on to a workhouse as incapable of earning a livelihood. When admitted to the asylum at Andernach, he was found to be lazy and indifferent, to have religious delusions, and suspicions of being poisoned. He said that at night people put “oprigus” under his nose, and that he was going to be made pope. Finally, he imagined that he was actually crowned as pope, and that Christ had appeared to him and held a chalice over his head, etc. Other cases of hallucination and systematised delusions have been described by Gnauck, Pohl, Buchholz, and others. Magnan thought that several psychoses might exist together. Deiters observes that the forms of insanity which he specifies are technical divisions rather than specific diseases, but that fairly distinct forms may supervene the one upon the other. He thinks that the mind never remains intact after repeated epileptic seizures. Epilepsy prepares the ground for insane ideas, but the character and sequence of these ideas may now and then take an unusual course.