The object of the paper to be now read is to evoke discussion on certain questions connected with the above scheme. Inasmuch as the system has received but a limited trial in this country, but few facts concerning its actual working are to be expected as yet. It is, however, deserving of consideration in this its embryonic period. An out-patient clinique was started at the Wakefield Asylum in January, 1890, and also adopted at the other West Riding Asylums. I can only speak of the results in the first-named institution.

July 15th.—The following differences between James and Odo were noted in the first few months of the latter's existence:—James's eyes from the first were noticeably wide open, and seemed to look. They seemed much larger than Odo's. Now they are soft and languid. James was somewhat delicate during infancy, but grew out of it; stomach easily deranged. Softness of eyes in some measure due to very long lashes; but I find comparative brightness or languor of eyes a sure guide to his state of health. Odo's eyes have steadily grown in apparent size, because (the converse from James) the older he has grown the wider he has opened them. They are now wide, round, and bright (blue). James has very large pupils; Odo not. Odo apparently healthy, can partially raise himself up; has cut thirteenth tooth; has a placid temperament; does not cry much, i.e., will lie awake for long periods, which James never would do; sleeps all night for most part, which James seldom did. In short, thus early the one shows an excitable, the other a placid temper. Odo objects to being taken by a stranger, although he very soon gets over his misgivings. At this age James showed no distrust of strangers. Odo has a distinct manner to the three persons he knows best—nurse, mother, and father. He coos and smiles to mother when she comes to take him. He only smiles to father. Smiles more but talks less than James did at same age. By talking I mean saying “coo,” “ug-gug, and the expression called “crowing” Cries at once on being scolded. James did not understand a scold at same age. Odo always tries to seize father's moustache when taken by him. In the case of women it is the hair he goes for in preference to anything. Odo makes use of smiles at five months old, and used them unconsciously at four months, which James (see notes on him) did not do till his seventh month. On the other hand, Odo uses his hands only to grasp things, or at most to put them to his mouth. At the same age James always put them to his mouth and could play with them, that is, pull them about.

I thought it might prove of some interest to demonstrate at the psychological section the instrument I have hitherto used at the West Riding Asylum for the purpose of registering the reaction time to a sight and sound signal. The instrument in its original form, as made by the Cambridge Scientific Instrument Company, may be familiar to you, but lately I have so far modified it and extended its utility that I think it will be well to indicate the changes introduced in detail. The original, with minor alterations, has been described so fully in Dr. Hack Tuke's new “Dictionary of Psychological Medicine” that I shall only briefly refer here to the general scheme of its construction, referring those who seek more minute particulars to this article.

For the benefit of those who have not followed the recent discussions I have compiled tables of the cases of myxœdema treated by thyroid injection and feeding that have thus far been published in this country. These, I trust, will be found useful and easy of reference. The main points of each case are arranged under a few convenient headings, viz., the sex and age of the patient, the duration of the disease, the length of time the treatment had been carried out at the time of reporting, the dosage and method of administration employed, the results obtained, and, where such existed, any ill effects that were seen to follow or occur during the course of the treatment. In all there are details of 100 cases shown. A glance at this summary will bring out certain points of interest and importance.

Derkum (“Journ. Nervous and Mental Disease,” 1892, xvii.) gives an anatomical description of a (Chinese brain, the seventh which has been carefully examined. In this the features characteristic of the other brains were again noted, namely, unusual degree of convolution, disposition to anastomosis in the perpendicular and horizontal directions, and marked obliquity of the orbital surfaces of the frontal lobes (with the last-mentioned may probably be associated the peculiar position of the eyes in the Chinese). Blending of the central and Sylvian fissures is said to be a frequent feature of such brains. For other details see the original paper.

Dr. Eugene Riggs, of St. Paul, Minn., U.S.A., the Chairman of the Committee on the History of the Treatment of the Insane, appointed by the National Conference of Corrections and Charities, read the report at its twentieth annual meeting, held June 12-18, 1893, at Chicago. The article is evidently drawn up by himself, and endorsed by the Committee. It constitutes an interesting and valuable review of the progress made in the care of the insane, the first era being that of neglect, the second that of detention more or less severe in character, and the third that in which we live, including the last twenty years. Dr. Riggs commences with the dawn of intelligence in the care of the insane in England in 1792, when the Retreat at York was founded. The period between this date and 1815 is recognized as one coincident in France with the beneficent work of Pinel, reinforced a little later by that of Esquirol. “Since that time both there and here (America) the battle for the increasingly intelligent application of that principle has been going on.”

In the “Allgemeine Zeitschrift für Psychiatrie” (xlviii. Band, 3 Heft) there are published some statistics about the suicide of young persons, which are of terrible interest. During the six years 1883-88, 289 scholars committed suicide.