By the death of Dr. Alfred Miller, Medical Superintendent of the Warwickshire County Mental Hospital, the medical profession of Warwickshire, the Warwick County Mental Hospital, and the Medico-Psychological Association of Great Britain and Ireland have sustained a great loss.

The organization of the study of psychiatry and neurology at the Universities in Holland has been very difficult. Schreuder van der Kolk, the well-known reformer of psychiatry in my country, was Professor of Physiology at the University of Utrecht. The fruit of his work was the asylum of Meerenberg, exemplary at that time, very useful still, but he did not organize medical education in psychiatry. He died in 1862. It was not until 1871 that our “Society of Psychiatry” was constituted. The many petitions originating from this society brought about the first possibility of psychiatrical teaching by our “law on higher education,” of 1877. The director of the asylum in Utrecht, Dr. Van der Lith, got the title of a university professor. His lectures were not obligatory, and he retired in 1878. In Amsterdam an energetic young doctor, Arie de Jong, taught psychiatry from 1878 to 1881. When he retired psychiatrical teaching was no longer given in Holland. Organization of this branch of medical education had never existed. Examination in it did not exist. Asylum doctors were mostly recruited from military medical men, returned from our colonies, who desired to add the small pay of the asylum to their pension.

The period of childhood which precedes puberty and lasts about three years is one in which growth, both physical and mental, is slower than at any time until near complete maturity. The child has reached a point of stability, and of almost complete adaptation to its environment. The dawn to the full development of the function of reproduction occupies four to five years, and during this period, and coincident with the formation of the secondary bodily sexual characters, there is a complete mental revolution peculiar to each sex.

In the last few years a vast amount of research has been carried out on dementia præcox.

A cursory survey of the varied fields of human activity suffices to establish the existence of a fundamental rhythm, an action and reaction, an antithetical sequence as it were, by virtue of which the prevailing phase in any movement is inevitably and inexorably succeeded by its direct opposite. Manifestations of this periodicity or cyclical tendency underlying all forms of human endeavour abound on every hand. Peace follows war as night succeeds day; an age of feudalism and despotic rule gives place to one of democratic Government. The time-worn creeds and simple faiths crumble a little before the exigent demands of a higher criticism, and, even as we glow with triumph at the achievements of modern science, we feel the premonitions of new developments whose exponents care for none of those things, and speak not the language of an out-worn materialism. And here it may not be inapposite to remark that the science of medicine is by no means immune from this prevailing principle.

During the course of the last few years the study of the cerebrospinal fluid in both mental and nervous disorders has made rapid progress, and with the introduction of methods of precision much useful knowledge in regard to its physical, chemical, and serological properties has been acquired. Nevertheless, much remains to be learnt, and we propose to submit observations on one aspect of the subject which is still in its infancy, namely, the pressure of the cerebrospinal fluid, and the modifications which it may undergo in the insane. At the outset, however, it will be convenient to refer in as few words as possible to the distribution and circulation of this fluid.

Having been honoured by requests to describe my experiences in Lunacy in Egypt, and my services in Egypt having recently come to a close, I desire on the present occasion to offer to my fellow-workers in England a résumé of the changes in Egyptian Lunacy administration for which I have been responsible during the past 28 years. Detailed accounts of these changes have been printed annually in the Egyptian Lunacy Reports. I shall feel honoured if the Association will accept a copy of the Reports for its Library.

The relative rarity of cases of folie à deux provides the reason for the publication of these notes, together with a comparative simplicity of the mental mechanisms on the side of the passive agent.

An action seriously affecting the interests of the medical profession has been brought by Mr. William Smart Harnett, a farmer, of Springfield, Newington, near Sittingbourne, Kent, against Dr. Charles Hubert Bond, a Commissioner in Lunacy, and Dr. George Henry Adam, the manager of a house for the reception of lunatics at Mailing Place, West Mailing, Kent, and the hearing, including the argument on the jury's findings and the delivery of the judgment, before Mr. Justice Lush, in the King's Bench Division of the High Court of Justice, lasted from February 7 to 29—seventeen days in all. The action was for damages for alleged conspiracy, assault, and false imprisonment, and the jury on the fifteenth day returned a verdict in the plaintiff's favour, awarding a sum of $25,000 as damages. In the preparation of the following account we have made much use of the reports published in the Times.

This case was tried at the Central Criminal Court, on January 16, before Mr. Justice Greer. The prisoner was 37 years of age, and had been employed for four years, as a childrens' nurse, in a family living at Kensington. Two children were under her care, Sonia aged 4 years, and Jean aged 9 months. Until the birth of the second child the mother had been in the habit of going daily to business. As a consequence, the care of the elder child had, to an unusual degree, devolved upon the prisoner, who became exceedingly fond of the child. After the birth of the second child the mother was more at home. The prisoner appears to have resented this, and there were frequent disputes, culminating in a blow being given by the prisoner to her mistress. As a natural result, the prisoner was given notice to leave her situation. That same evening the prisoner's employers went out. On their return they found the nursery window closed and the door locked. Next morning the room was entered by the window. The child Sonia was lying dead upon the bed. The baby was lying unconscious, and died later. The prisoner was also in an unconscious state, and a gas-ring in the room was turned fully on. In the room was found a letter written by the prisoner, which said, “I am taking them both. I could not leave my Sonia to the creature she calls mother.” The prisoner had also written to a friend in these words, “I am taking my darling Sonia with me. I know she would not be happy here without me. I did not want to take Jean, but I could not put her outside.” The prisoner was removed to the Fulham Infirmary. After having been unconscious for six days, she recovered, and made a statement, in which she said that the children did not want her to go, so she said she would take them with her. She also stated that she remembered turning on the gas, and said that she wished she had been allowed to “finish” it.

This case was tried at the Central Criminal Court on December 6 and 7, before Mr. Justice Avory. It was of interest, inasmuch as the question of the accused's mentality was raised both on arraignment and during the trial.

[The following letter written by Dr. J. Warnock was rejected by the Daily Mail. An article of similar pungency found a place in the February number of the Fortnightly Review.]