There has been a considerable amount of attention called to the subject of phthisis in asylums lately, and since the publication of the report of the Tuberculosis Committee the subject has appeared in a broader light. Although much is being and has been done for the prevention of phthisis by means of the Sanatorium movement, and the varieties of the technique of hygiene which are included in that treatment, yet there are still many aspects of the disease (both in the sane and insane) which require precise investigation, such as the variations in the composition of the secretions and excretions when the body is in the state of phthisical toxæmia; the relationship of the tuberculous toxæmia to other toxæmias, such as the influenzal (27), gouty, etc.; the accumulation of toxins, and its relations to recurrent forms of disease. The number of deaths from tubercle here during the past year we find to be ten; in 1900 it was nine, and 1899 it was fifteen, so that from a percentage of 1.3 in 1899 it has dropped to 0'85 in 1901. On examining the position of this asylum in the tables drawn up by the Tuberculosis Committee (1) we find it tenth in the asylums in England and Wales which are classified under Division i, which asylums have a tubercular death-rate of from 0.5 to 2.2, the county asylum at Exminster having a percentage of 1.3. This compares favourably with other asylums, some in the Division 2 having a tubercular death-rate of 5.1 and 8 per cent. respectively.

Before describing this disease as it occurs in Egypt at the present day, let me give a few historical notes of the use of Cannabis Indica, of which hasheesh is the local preparation. For this, and much other information contained in this paper, I am indebted to the report of the Indian Hemp Drugs Commission of 1893. This valuable report was drawn up by a committee appointed by the Government of India, and in its pages a very full account of the use of hemp drugs in India is to be found. Unfortunately it appears that no lunacy expert sat on the Commission, and in my opinion its findings as to the relations between hemp drugs and insanity are not conclusive.

Tænia solium is common enough in this country in man, but its cystic stage is, I think, met with very infrequently; that is the reason I bring this short paper before the meeting in order to elucidate whether cases of the following kind are met with in any frequency in South Africa.

D. R—, æt. 27, butler, of Italian nationality, resident in England for past eight months, married, two children, the younger aged six weeks; in prison for petty larceny.

The accuracy of the description of the present legislative provisions for the insane as the Lunacy Act has often been questioned, and there, indeed, seem many well-founded reasons for believing that they would have been more correctly described as the Lunatic Act.

The life assurance of the insane was recently dealt with by Dr. Poore in his Presidential Address to the Life Assurance Medical Officers' Association, and in the discussion Dr. Savage suggested the possibility of the formation of an association for the assurance of the insane.

The public from time to time is sadly distressed by the occurrence of crimes committed by lunatics whose lunacy has in many cases been known and recognised prior to the criminal acts. Unless, however, the lunatic has previously inhabited an asylum, the occurrence is accepted as in the natural course of things, and in no way regarded as an avoidable event.

The statistical tables of this report have been subjected to very severe adverse criticism, which certainly has a basis of justification.

The contribution on the above subject by the Secretary of the Scotch Board of Lunacy, at the recent Belgian Congress, is a valuable description of this mode of treatment as at present carried out in Scotland.

Discussion has recently arisen in regard to the introduction of hospital-trained nurses into asylums, and the experiment has even been tried of placing them in charge of wards without having had previous experience of the insane. With careful selection and enthusiastic co-operation, this has even worked satisfactorily.

A contemporary reports a Detroit “doctor and scientist,” “after a careful investigation of existing conditions,” as asserting that “260 years hence everyone in the United States will be insane.” The population by that time will amount to a few hundred millions, so that this prophecy affords, an opening for much speculation. Imagination paints the General Paralytic Progressive Party contesting with the chronically Hallucinated Conservative faction.