The meditations of the philosopher cannot be uninfluenced, nor the heart of the philanthropist be unmoved, by the fact, which statistics prove, that there are at the present moment in England alone more than thirty thousand people who are deprived of all their active rights as human beings, and made, as far as possible, nonentities in the world. About twenty-six thousand of these are actually shut up in lunatic asylums; and of that number but very few are ever likely to leave their undesired abodes until they take their leave of life itself. It cannot, then, be unprofitable to endeavour, in one department of an extensive subject, to follow the gradual course of mental degeneration, and, by the exhibition of it, to justify the world's manner of dealing with the particular discords in nature's general harmony.

Fever and other diseases amongst the insane attract attention in their mental as well as in their physical relations; and if at the same time both sane and insane suffer, a comparison of the cases is interesting. Besides, in an asylum the patients are especially under charge from the first faint indications of the malady, and the previous history, habits, and constitution of the individual arc familiar. In ordinary cases of fever amongst the community at large, the particular currents of the patient's thoughts and volitions do not attract special attention, save in protecting him from injury; and if insanity or other brain disease subsequently occurs, the features of the fever-poisoned brain are generally unknown and forgotten. Additional light might be thrown upon mental pathology and treatment, if such observations, sufficiently extensive, were correctly made and recorded. Alienists, on the other hand, have long noted the influence of physical diseases in the course of an attack of insanity; and recently cases from foreign journals were given by Dr. Arlidge,* where recovery has followed from wounds causing profuse suppuration in melancholia and general paralysis, from scarlatina in suicidal melancholia, from dysentery in mania and melancholia, from dysentery and acute rheumatism in monomania, from dysentery and a compound fracture of the elbow in religious monomania; lastly, profuse intestinal hæmorrhage is mentioned by M. Baillarger as ushering in recovery in a case of painful hallucination of vision consequent upon injury from a railway accident. Numerous other interesting cases are mentioned in the pages of our medico-psychological literature. Professor Laycock lately made known to me the case of a young girl, set. 15, an epileptic, who had typhus fever for five weeks, and never had a fit all that time. As she recovered, the fits returned as before (several daily), and ultimately the patient became acutely maniacal.

From the time of Hippocrates downwards a special connection has been assumed to exist between certain forms of insanity and diseases of the abdominal organs, but it is only recently that diseases of the lungs have been ascertained to have any relation to mental derangement. Arnold, who epitomised everything known about insanity before his time, does not mention any disease of the lungs among even the “remote causes” of insanity, although he includes among these, diseases of almost every other organ of the body. Esquirol and Georget were the first to show the frequency of lung disease among the insane. Burrows and Ellis were the first to refer to the frequency of phthisis pulmonalis among the insane in this country; but the subject has scarcely received that attention from the profession which its importance and interest demand. Dr. McKinnon, the first Medical Superintendent of the Royal Edinburgh Asylum, came to the conclusion that “the scrofulous and insane constitutions are nearly allied.” Dr. Skae, in his annual report for 1847, remarked the great frequency of tubercular deposits in the bodies of those dying insane.

Communications which have been recently made to me by a well-informed foreign physician, coupled with the subject forming the final plot of the most popular novel of the season, induce me now to bring before our Association the important question of the existence and condition of English patients resident in the foreign asylums of France, Belgium, and Germany.

There has recently taken place before the High Court of Justiciary in Edinburgh a trial for murder, in which the insanity of the prisoner was pleaded as the defence, and in the course of which several questions of great difficulty and importance were raised. We give a brief abstract of the trial, with a still briefer comment.

We record below a summary of this important trial. It will be seen that the evidence of the existence of mental disease was sup-ported by Dr. Harrington Tuke, who was employed as an expert in the case. In spite of his convincing testimony the prisoner was sentenced to death. The ‘Times' of to-day (March 28) informs us that this sentence was executed on the 27th inst.