Gentlemen,—In the name of the Irish members of our Association, I desire to greet you all with a very cordial welcome on the occasion of this your second visit to our city. Fourteen years have elapsed since you last honoured us with your presence. I hope that a careful comparison of the present state of the institutions here with their condition then will convince you that the spirit of improvement has been among us, and that we have endeavoured in some measure to keep pace with the progress apparent in other districts in this department of the healing art.

Of all the classifications of insanity with which we have been afflicted in recent times, none has been more diligently vaunted, or more frequently obtruded upon attention, than that of the late Dr. Skae. Emanating from an able and accomplished physician—not in the first blush of his juvenile enthusiasm, but in the maturity of his powers, and the ripeness of his experience—it at once commanded respectful consideration, and was placed in a position of authority. And there, in the progress of time, a strong body of sentiment has gathered about it. Dr. Skae's old pupils, with a fervour which speaks volumes for his influence over his colleagues, and for their loyalty and gratitude, now rally round it, and vigorously repel any attack upon it, and even any approach to it for the purpose of a critical examination. Under their jealous guardianship it has become a sacred edifice—a monument of wisdom which may be adorned or enriched by the initiated few, but which it is sacrilege in the vulgar to attempt to demolish. Its great principles have been pronounced binding by the œcumenical council of Morningside, and he who profanely questions them places his promotion in jeopardy. Fortified, developed, illustrated, by the labours of many distinguished followers, this classification of Dr. Skae's is extolled by some on all possible occasions, and there is an undoubted danger that it may be somewhat widely adopted.

Unconscious cerebration is regarded as so important a discovery that two well-known scientific men have contended for the priority of its publication, and while some people are anxious to give it fresh applications and illustrations, others proclaim it to the public as a new demonstration of science, accepted by physiologists, and stable enough to uphold new theories founded upon it. After having carefully considered the evidence upon which the theory of unconscious cerebration is supposed to rest, I am disposed to think that the facts, or assumed facts, may be explained in a simpler manner, and that the theory itself is superfluous and unproved. For an exposition of what is understood by unconscious cerebration, and on what grounds it is believed to exist, I have used a work called, “The Principles of Mental Physiology,” by Dr. Carpenter, the well known physiologist, who claims to have worked out the theory in his own mind, without knowing that any other had preceded him, and whose recognised reputation is a sufficient guarantee that the argument, in his hands, is sure of being well stated. The term itself seems far from being a happy one. Dr. Carpenter tells us that it has been found readily intelligible; he objects to “unconscious reasoning” as a contradiction in terms, and yet his own description seems either to imply unconscious reasoning, or unfelt feeling; and the difficulty of finding an appropriate term for this class of operations, is really owing to the difficulty of conceiving what these operations really are. In fact, to state them clearly, is to render the theory incredible. To call thought cerebration, may show the desire of a writer to assign thought as the product of brain action; but it is neither warranted by true philosophy, nor by the popular and scientific uses of speech. When the liver secretes bile, one does not say that it hepatates; or when a man breathes, we do not say he pulmonates.

In that general process of evolution by which the human ace, as well as the individual, is governed, each age appears to possess some distinguishing feature which stamps it with a special character. In all those branches of study and of speculation which, from the earliest dawn of mental cultivation, have engaged the attention of mankind—in theology, in history, in philosophy, in law, in science, and in medicine—the student, looking back upon the progressive achievements of his race, recognizes certain well-marked eras. These, although chronologically distinct, afford landmarks when reviewing the progress of the human intellect in its search after that perfect knowledge which stimulates, but ever eludes, the efforts of its votaries. To more than one period the student can point and say: These were days of deep theological disputes, and the schools of divinity attracted the best intellects of the age. of another period he may say: Historical research was here predominant. of another the remark would be true that, while it lasted, the different schools of philosophy divided the intellectual world. And again: Here was an age of great legists; at such a period constitutional and international law gradually acquired shape and recognition. At all periods, whether of intellectual progress or stagnation, the fascination of numbers has thrown its spell over some of the most gifted minds; and, in the exact science of mathematics, the student has enjoyed this singular advantage, that every theorem proved, every problem solved, has been a step gained once for all—alone among the sciences this, within its range, has been permitted to afford a convincing answer to the ever-perplexing question, “What is truth ?” As physicians, we should be ungrateful if, in the most cursory retrospective glance, we omitted to notice those votaries of science, whose patient search for the realization of the alchemist's dream led to so many discoveries in chemistry, and laid the foundations'of that modern science that has numbered among its disciples some of the most brilliant intellects of recent years. The study of medicine has passed through various gradations according to the theories that were predominant; until, in recent years, the cultivation of our art has become so interwoven with scientific investigation, so allied with strict inductive reasoning, and so associated with other and collateral branches of study, that the student of medicine may now be said to embrace in his curriculum the whole scope of scientific teaching, as well as the purely professional practice of the healing art.

Case 1st.—H. J. M. Admitted July 29th, 1872; female; 18 years; single. Hereditary predisposition existed in family; she had at one time been excited for a day or two, and been treated at home; she had lately been subject to considerable anxiety, and had to sit up frequently at night nursing a sick relative. Ten days ago became excited, talking much incoherently; was sleepless, and took food ill. For the two days previous to admission had got worse, more excited, had attacks of hysterics, and did not sleep at night. She had not menstruated for two months.

In the course of a tour, last autumn, through Greece, Turkey, and Asia Minor, I had the pleasure of making the acquaintance of the Physician-in-chief of the Asylum of Constantinople and neighbouring provinces, and through his courtesy and kind attention I was not only enabled to visit the Timar-khané, or Dari-chifa, as it is sometimes called, but also to obtain some interesting information respecting the care and treatment of the insane by the Turks more than three centuries ago. Up to a recent date, the insane were taken care of in the Asylum of Suleimanié, situated near the mosque of that name, but in consequence of the building being unable to meet the demands made upon it, the patients were removed to the Asiatic side of the Bosphorus, and lodged in the Asylum of Toptaschi in Scutari. The asylum, which is situated in the most Oriental and most beautiful suburb of Constantinople, on being approached, presents a rather dilapidated and neglected-looking appearance, and this aspect has been all the more heightened by the recent ravages of fire in the immediate vicinity; but the situation is most salubrious, as it catches the pleasant breezes from the Bosphorus and the sea of Marmora. The building is quadrangular, consisting of two storeys and surrounding a court, in the centre of which there is placed a fountain at which the patients perform their frequent daily ablutions before prostrating themselves in prayer at the calls of the muezzims from the minarets of the neighbouring mosques. The day and single rooms on the ground floor open into an arcade or colonnade which surrounds the entire building. The upper floor is used for dormitories which open into a corridor. In these the better class of patients sleep, and the more turbulent and excited sleep in the single rooms on the ground floor. The windows are protected by strong wire lattice instead of wooden lattice, as is the custom in all Turkish dwellings, and the flooring of both upper and under storeys is of tesselated pavement, which reminded me very much of that seen in the strada dell’ abondanza in Pompeii.