Although ancient writers have given short descriptions of mental diseases affecting children, it was not until the commencement of this century that the subject began to attract attention. Since then Esquirol, Guislain, Delasiauve, and others have written on the matter, and in 1856 Le Paulmier, in a thesis, gave the most complete description of the affection which had previously been published. Numerous authors in England, Germany, and France have since 1856 written on the subject, but still there seems to be a good deal of want of knowledge regarding the mental affections of children.

The care, training, and education of physically and mentally defective children is now an accepted public duty undertaken by the State at the public cost, to the extent at least of providing the necessary schools and institutions, and other needful arrangements. Blind and deaf and dumb children are provided for by legislation, which was passed as the result of the facts of the case relating to the special needs of those children having become apparent by the general enforcement of compulsory education. Imbecile and idiot children have also been provided for by laws passed during recent years; but inasmuch as all the laws relating to those classes of children are either Lunacy Statutes, or have as their object to make provision for weak-mindedness viewed as a special or modified form of insanity, they have been found to be inadequate for providing the necessary facilities for the proper care and education of children of defective intellect, but devoid of those insane characteristics which distinguish true imbecility and idiocy. The probable reason for this hiatus in the legal provision for the education of weak-minded children, is that it has hitherto been assumed that a child who is not a certifiable imbecile is capable of being taught in an ordinary school. That such is a mistaken view many who have had experience among children of defective intelligence have recognised, and the Committee on Defective and Epileptic Children, whose report has just been published, recognise the distinction between the two classes of feeble-minded children and base their recommendations upon it. Indeed, the Committee was appointed to consider the case of such children, because it was found in practice that many children of school age were unable to profit by the instruction of ordinary schools, and yet were not imbeciles or idiots, and the reference to the Committee was limited to that class of children. The Committee say in their report, “the word ‘feeble-minded’ as used in the report denotes only those children who are not imbecile, and who cannot properly be taught in ordinary elementary schools by ordinary methods.” It is clear that if legislative sanction is given to the recommendations of the Committee, a great benefit will be conferred upon non-imbecile feeble-minded children, and upon their parents; and an important step in advance will also be taken in the direction of making more reasonable use of existing facilities for the care and training of imbeciles and idiots.

Points of similarity between alcoholic and epileptic insanity are referred to by many writers on psychology. These short notes, which I bring before you to-day, refer to cases of criminal acts of violence committed by epileptic and alcoholic maniacs, and, I think, exemplify in a very striking manner the similarity above referred to—a similarity in the mental phenomena which preceded and which led up to the specific acts of violence in a series of cases.

I have investigated as far as possible the causes of insanity in the last 1014 patients admitted to the Bristol Lunatic Asylum, 507 being males and a like number females. My purpose has been to ascertain in what proportion of insanity heredity was the prominent factor in causation, and what influence was exercised by alcohol, traumatism, and certain other agencies, where no taint of bad heredity could be found.

Introduction.—In these days of elaborate technique, it may not be without interest to record a method which enables us to demonstrate details of structure in the nerve-cells which have been practically untampered with by hardening fluids or other reagents.

By colitis one understands a disease characterised anatomically by an ulcerative or membranous affection of the large intestine, and signalised clinically by acute sanguinolent or muco-purulent diarrhóa, plus pyrexia and prostration.

It occurred to me that, on the occasion of our division meeting at an asylum which has made special provision for the care and treatment of imbeciles, apart from the other patients, a brief dissertation as to forms of industrial training appropriate to such might not be out of place.

The term “weakmindedness” is a most misleading and ambiguous one, and it is imperative that it should receive early attention. It is confusing from the very comprehensive scope of its significance, and altogether so capable of such extremely varied and general interpretation that it is rendered worthless, and perhaps worse than worthless, for the purposes of actual practice. By some, the slightest departure from the normal mental standard is regarded as “weakmindedness,” although the case in question might be one of mere eccentricity; by others, again, the term is accepted in its full comprehensiveness,—the lunatic and imbecile, the idiot and person of defective intellect (who cannot be classified with either of the above three divisions), are all included together, and in the absence of a qualifying statement, confusion is the result. It is most improbable that any two alienists would be likely to interpret the meaning of the term in the same way, and the Commissioners in Lunacy, who are most strict in the matter of validity of certificate, would certainly not accept it per se on account of its ambiguity.

In the following paper, dealing with the hereditary transmission of mental disease, my conclusions are based on a statistical review of 1200 cases of hereditary insanity admitted into the Cumberland and Westmorland Asylum during a period of thirty years (1865—1895). So far as I can ascertain, no analysis of such a large number of cases of hereditary insanity has hitherto been made by any one observer; there is, therefore, ground for the hope that results of value may accrue from such an investigation. One of the most important contributions to this subject is contained in a paper∗ by the late Dr. Hugh Grainger Stewart, which appeared in the Journal of Mental Science in 1864. That paper was based on the statistics of 447 hereditary cases admitted into the Crichton Royal Institution, Dumfries; the patients belonged mainly to the middle and upper classes of society, with a smaller number of pauper cases. The cases I propose to analyse were almost entirely paupers admitted from the general population of Cumberland and Westmorland. Private patients often come to an asylum from a considerable distance, and from beyond the limits of the district in which the asylum is situated; inferences drawn from the tabulation of such cases are scarcely likely to give so reliable a picture of the features of insanity in any district as when the cases analysed stand for almost the entire insane population of all the districts from which the patients come.

The Lunacy Bill of the present session has advanced so far in its parliamentary gestation, that it will almost certainly escape the fate of its predecessor of last year.

The report of the Departmental Committee on “Defective and Epileptic Children,” and the contemplated developments of the Barony Parish in Glasgow, point to new and very striking sociological departures.

The joint committees of the British Medical and Medico-Psychological Associations have formulated a recommendation in regard to this clause, which is practically identical with that in the present Scottish Lunacy Law.

The Local Government (Ireland) Bill has passed through the stage of Committee, and, as it is little likely to be modified in the House of Lords, may be considered to have reached its final shape.

The progress which this Bill has made does not justify any expectation that it will become law in the present session of Parliament, and so for still another year these unfortunates may be permitted to drink themselves into criminality, lunacy, or the grave, as accident shall determine.

This Bill, marking a very wide departure in our law of evidence, is so far advanced that there is every probability of its becoming law in the present session, but probably its clauses will yet undergo such considerable modification as to render criticism of its existing form unnecessary.

The appointments of Dr. Shuttleworth as an examiner under this Board will be generally recognised as the best that could be made. Mrs. Dickinson Berry, M.D., who is appointed, presumably for the examination of the female children, has high qualifications for the post.

The retirement of Dr. Norton Manning, to which we draw attention in Notes and News, naturally reminds all who are interested in the care of the insane of the reception houses established during his régime in New South Wales.

In the newspaper reports of a recent action for slander it was stated that the British Medical Association had officially recognised hypnotism as a therapeutic agent. The medical man whose evidence led to this incorrect statement has shown that his remarks had been misapprehended by the journalist. It is of some importance to recall the circumstances, to show how the matter really stands. The committee appointed to report upon the subject included well-known names, and after a considerable interval presented their conclusions. They expressed themselves as satisfied of the genuine nature of the hypnotic state, and were of opinion that, as a therapeutic agent, hypnotism was frequently effective in removing pain, procuring sleep, and alleviating many functional ailments. As to its permanent efficacy in the treatment of habitual drunkenness, the evidence before the committee was encouraging, but not conclusive. They specially indicated that care in the employment of hypnotism was necessary, and suggested important limitations.

The special committee appointed to consider whether any measures should be taken on behalf of this Association, in support of the sufferer in this matter, by his desire has taken no action.

The Handbook has now been thoroughly revised, and is in process of printing. The publishers will probably be enabled to have it ready for distribution soon after this number of the Journal is in the hands of our readers. As their stock has been exhausted for some time, and the demand continues urgent, we make special acknowledgment of the energy and labour bestowed upon the production of the fourth edition by the Committee, and we trust that the improvements made will still further secure that confidence of teachers and nurses which has been so freely bestowed in the past.