Punishment is the positive infliction of suffering as a righteous result of wrong-doing, and as a deterrent from its repetition. But the wrong-doing of the insane is the result of their malady, which produces it either directly through delusion, or indirectly by perverting their moral sense and relaxing their self-control.

The two cases can only be linked on account of the rapidly fatal issue associated with actively violent mania. The first was a case of acute general paralysis, and the second of mania due to injury to the head.

We direct the attention of our readers to the Correspondence of the Parliamentary and Pensions Committee of the Association with the First Lord of the Treasury, the Commissioners in Lunacy, and the President of the Local Government Board, which will be found in “Notes and News.”

T. P., an unmarried man, 28 years of age, was admitted a patient of this asylum in October, 1880, suffering from a first attack of insanity.

There can be no doubt that there is a growing feeling on the part of the Medical Superintendents of our large asylums to take into consideration the question whether on the whole the discontinuance of beer as a beverage is not a moral as well as a financial advantage, and it is worth recording in this Journal that at the present time, to our knowledge, there are seven and twenty pauper asylums in England in which the Committees, with the approval of the Superintendents, have discontinued the use of beer as an article of ordinary diet. The question, we need hardly say, is a practical one, and has nothing whatever to do with “teetotalism;” the course pursued should be determined by what is found to be best for all concerned, and if beer at meals is useless—if it can be shown that the health of the asylum population does not suffer from its removal—and if, as alleged, there is a moral gain not only among patients but attendants, then we must acknowledge that common-sense and humanity would alike sanction its discontinuance. For the Medical Superintendent, the health of the patients and the good order of the household are the primary considerations; we must not allow the idea of saving money to interfere for a moment with these objects. If, however, on these grounds we can recommend this dietetic change, the saving to the ratepayers is not a small matter. They are always entitled to consideration, but more especially are they so at the present day. The Cumberland and Westmorland Asylum was, we believe, the first to make the experiment, at its opening, under the superintendency of Dr. Clouston, and the present Superintendent, Dr. J. A. Campbell,∗ regards it with great favour as an unquestionable success. When visiting the Lenzie Asylum, last autumn, we enquired of Dr. Rutherford what plan he adopted, and were informed that he did not give his patients stimulants, although so many are employed in out-of-door work. In December last, the Visiting Justices of the Devon County Asylum decided that at the commencement of 1883 the daily supply of beer should be entirely discontinued, and that in future neither it nor spirits should be allowed unless ordered by the medical staff. On going round the Derby County Asylum in October of last year, we found the energetic Superintendent of that institution had gradually diminished the use of beer, and contemplated its entire discontinuance. This course has now been adopted, and Dr. Lindsay is sanguine as to its satisfactory working. We transcribe the remarks made by him in his last Report:—“In a few years it will probably be found that in the majority of English pauper asylums, beer will not be given as an article of ordinary diet; the minority at present giving do beer will soon, I believe, be converted into a majority. I am of opinion—an opinion, I believe, shared by many Asylum Medical Superintendents—that the small allowance (half-a-pint) of asylum beer of the quality

Although it is certainly no part of our duty to discuss the charges brought against lunacy doctors abroad, while, indeed, we think that as a general rule it is in much better taste to mind our own business, there is the legitimate motive which the discussion of such charges permits, of endeavouring to learn the lesson taught by the failure, if such it be, of laws enacted for the custody of the insane, and thereby seeking to ascertain whether there is any corresponding defect or source of danger in the legislative enactments of our own country. It also behoves the critic of foreign institutions, or of the scandals alleged to occur in other countries, to remember that he may easily fall into the error of forming an erroneous opinion or a harsh judgment from an insufficient acquaintance with all the circumstances of the case.

Dr. Ripping, in the “Zeitschrift für Psychiatrie (Band xxxix., Heft 1), considers the important clinical question of the relation of the diseases of the sexual organs in women to mental alienation. While he admits that changes in the uterus and its appendages, whether physiological or pathological, have an effect upon the mental susceptibilities of women, he is doubtful whether this effect is profound enough to become a potent cause of insanity. He is rather disposed to place such affections in the second or third line of causes as adjuvantia. The uterine diseases and the mental disturbance are sometimes the result of a common cause. “I have never observed,” writes Dr. Ripping, “a single case in which the insanity was a pure reflex neurosis of disease of the genital organs.” If in some patients this seemed to be probable, it was found on more careful examination that there were other circumstances which gave an easy and unforced explanation of the mental derangement. It is only after uterine disorders which, from their severity, implicate the whole organism, or lower the strength, as in continued bleedings, that insanity can be held to supervene as a result.