Makrizy, an Arabic historian, who wrote in the year 1421, tells us of the first hospital and lunatic wards with which Egypt was endowed. It appears that in 1278, a.d., a mamaluke called Kalaoon was attacked by a violent colic at Damascus, and, being cured by medicines from the hospital there, he vowed in gratitude that he would build a similar hospital should he ever come to the throne of Egypt. The following year he commenced a reign of eleven years, during which he seized Tripoli, recaptured Damascus, and governed his subjects at home by alternate acts of cruelty and beneficence. In one of his fits of anger he is said to have delivered up Cairo to sword and plunder for three days. He bartered one of his buildings for an old palace, turned the latter into a hospital, and built close by a school, and a mosque for his own burial place. His architect worked with such energy that the whole was completed in less than twelve months; but his excessive zeal made him unpopular with the ecclesiastics of the day. This is not to be wondered at, for he compelled all the artisans to work exclusively for him; he looted the citadel of Roda of granite and marble columns, and he used to stand on the scaffolds himself, and, by the aid of mamalukes in the streets, compelled passers by of every rank to carry stones for the building, so that no one would come that way if he could help it! Kalaoon endowed the hospital with money for wards and out-patients, and desired that all should make use of it—rich and poor, great and small, bond and free. His arrangements included doctors with fixed salaries, male and female nurses, beds and bedclothes, special wards for fevers, ophthalmia, wounds, diarrhoea, obstetrics, and phthisis, kitchen, wine, dispensary and medicines, and even a medical lecture-room. Fifty readers of the Koran were provided for the mosque-tomb, to lecture to thirty students of theology belonging to all the four sects, also a library with six eunuch attendants, and a school for orphan children.

Section VIII. Need of Wide Clinical Knowledge.—If anyone thinks that the study of Diseases of the Nervous System as they are Dissolutions will take his attention from their clinical or practical consideration he is mistaken. I urge two methods of study, one scientific and one clinical. Without a considerable clinical knowledge of cases no one is fitted to begin the scientific, comparative, study of nervous diseases. For the scientific study of insanities a very wide clinical knowledge is necessary. It would never do to confine attention to cases described in text-books by Alienist Physicians, to what I may call “orthodox” cases of insanity. Not being an Alienist Physician I say this, and what follows in the present Section, under correction by the Members of this Society, who of necessity know very much more of “Diseases of the Mind” than I do. I should not presume to address Alienist Physicians on their special subject had I not the hope that from a long study of simpler diseases of the Nervous System, I might contribute something of at least indirect value for the elucidation of the most complex problems they have to deal with. In a later section I shall urge a study of cases of abnormal mental affections, many, of which are not, in a clinical regard, cases of insanity at all, and, so far as I know, are not dwelt upon in books on Insanity.

It being necessary to extend the accommodation of the Montrose Royal Lunatic Asylum, it was deemed advisable to erect a hospital entirely detached from the main building; in which all the bodily sick and other inmates who required special medical care would be brought together, and placed in circumstances more favourable to treatment than they could be in a ward of the asylum proper.

Those who were present at the Glasgow meeting of the British Medical Association will remember that our Scotch members, especially Dr. Turnbull, endeavoured to get up an excursion to Kennoway. It was hoped that at least twenty would avail themselves of the opportunity, but the hope was not fulfilled; then ten, but this also failed; lastly five, but I am sorry to say there were not even five righteous men found in the Psychology Section of the British Medical Association. The excursion was therefore abandoned.

The following relates to antifebrin as an antipyretic remedy. The cases were those of insane adult males. And what I shall have to say chiefly concerns phthisical pyrexia. Subsequently, I will briefly touch on the use of antifebrin in various inflammatory febrile maladies affecting the insane.