The way in which some diseases seem to confine themselves to particular localities and classes of persons, and the reasons for this have always been favourite studies in medicine; and year by year such questions attract more and more attention. The reason of this is obvious. Those problems have some of the definiteness of pure physical science about them: their study throws a direct light on the nature of disease, while their solution tends to its immediate prevention. Hence the prominence which they have assumed in the new branch of preventive medicine. There is scarcely any word which means so much in this science as the localisation of disease, in its active and in its passive phase. To know why a disease breaks out in a certain place, and to be able to keep it from spreading farther may be said to be the two first aims of public medicine. The first thing to be done is, of course, definitely to connect the disease with its habitat. This can be done far more readily in the case of some diseases than in that of others, but there is no disease that is not more or less localised as to places or the class of persons whom it attacks. The weak points of man's constitution are so many, and the trials to which it is subjected vary so widely with locality, climate, food, work, and circumstances, that this must be so. The infinitely numerous seeds of disease and dissolution are of many species; and while each seed only germinates as it finds fit soil, each species also requires suitable conditions. This is as true in regard to the brain, and the departures from the normal performance of its higher functions, as in regard to every other organ of the body, though as yet but little attention has been directed to this fact. The wide series of diseases which are at present called Insanity prevail more in some places than in others, attack some classes of persons in preference to others, are hurried into actual development, or retarded where latent tendencies to them are in existence, by certain things which have a local prevalence, and they evidently assume one form rather than another through local influences. The extent to which this is the case is as surprising as it is certain. When one comes to look carefully into the reports of lunatic asylums in different parts of the country it is found that there are forms of brain disease (or varieties of insanity as they are called) present in abundance in one place which have almost no existence in another. Diseases of the brain which kill more than a third of all the patients in the asylums of some of our counties do but kill 5 per cent. of them in others. But I shall not anticipate the numerical proof of what I have been stating. This investigation must be very largely conducted on the numerical method, and fortunately the distribution of insanity and its varieties can be more thoroughly made out in this way than that of almost any other disease. When it attacks in a decided form any person in the classes which constitute nineteen-twentieths of the inhabitants of this country its treatment is so difficult and costly that if it is of long duration it almost necessarily must be done at the public expense. This implies that it is publicly recorded in the official documents of the Commissioners in Lunacy and the Poor Law Board. In this way a fairly trustworthy account can be got of the number of persons in every county and district of England and Scotland who are suffering from this disease in any one year. It is true that these numbers include also the persons who are chargeable to public funds on account of idiocy or marked imbecility, dating from birth, and the numbers of the latter cannot be distinguished in these documents from those who labour under insanity. But as congenital brain defect and acquired brain disease certainly have the closest connection hereditarily and in their essential nature, this does not seriously affect an investigation into the local occurrence of insanity founded on the numbers recorded in the official documents I have referred to. The numbers of the insane who are paid for out of their own funds or by their relations, and who appear in those documents as private patients, are left out of the account, because those numbers are comparatively small, and it is impossible to fix correctly the local occurrence of this class of insanity, it being determined in these official records more by the presence or absence of the institutions for its treatment than anything else. This omission affects slightly the scientific accuracy of the results obtained, but does not affect their practical value and medical interest.

Although a certain number of those who are subject to epilepsy may pass through life without displaying any sensible diminution in mental capacity or power, it is nevertheless true that in a vast majority of the sufferers from this disease the mind is rapidly and seriously damaged by the recurrence of the seizures which are characteristic of it. Epilepsy, indeed, is one of the most prolific causes of insanity in this country, and fills our lunatic asylums with patients of a dangerous and intractable class. It would not, perhaps, be going too far to say that it invariably exerts a prejudicial influence on the minds of those who are afflicted by it, and that the statements which have been made to the contrary have arisen out of imperfect observation. Unfortunately, we have as yet no test types by which to gauge the scope and accuracy of the ‘mind's eye,’ and hence serious impairment in its range and precision of action may readily exist without detection. Apprehension may be dimmed, judgment confused, and memory shortened, while no suspicion of mental failure has occurred to the patient or his friends. Then, again, modifications of disposition and temper are apt to be attributed to outward circumstances rather than inward derangements, so that when essentially morbid in origin they may fail to be recognised as such. Hence it is, I think, that epilepsy has often been credited with a blamelessness to which it has no just pretension. Its evil effects have not been found out, or have been traced to some other source, and it has been concluded that epilepsy may co-exist throughout life with perfect intellectual and moral integrity. Nay, some authors have gone further than this, and have written of epilepsy as if it were a thing to be desired, and, like the goitre of the Roman ladies, added a new charm to its victims. Falret says that epileptics sometimes evince real intellectual activity, and a rapid circulation of ideas, which corresponds to a certain degree of cerebral excitement. A roll of eminent epileptics has been drawn up, including the names of Cæsar, Mahomet, Napoleon, and Molière, and a connection has even been suggested between fits and genius. Dr. Morel has referred to a marvellous quickness of conception and imaginative intensity as distinctive of the epileptic condition in some persons. Surely, however, such qualities are not to be regarded as the fruits of epilepsy, but rather as characteristic growths of that kind of soil in which the pernicious plant is most likely to take root and flourish. Surely the fact—if it is one—that some great men have suffered from epilepsy in peculiar forms does not establish any causal relation between epilepsy and greatness, for how much greater might they not have been but for epileptic limitations? And surely the wild whirl of epileptic excitement is not to be confounded with the well-ordered evolutions of genuine intellectual activity. The experience of those who have seen most of epilepsy, will, I believe, confirm the assertion that no good thing can come out of it, and that it entails a blight and a blemish upon the mind of everyone who is affected by it. It robs the brain of its cunning; it strips the mind of its ornaments, of its garments of delicacy and gracefulness, and reduces it to savage rudeness and unrestrained movement. And then it wraps round it its own strong web of disease, fold after fold, layer after layer, more and more confining it, and becoming at last its inevitable cerement. Esquirol has ably summed up the effects of epilepsy on a man's physical and psychical nature. He has shown that it shortens life, deranges nutrition, that it degrades the mental faculties, and that it undermines rectitude of character, and disposes to suicide, violence, falsehood, venery, and onanism.

The tale of Pentheus had long been familiar to the Greeks, and had been already handled by æschylus, when Euripides was led to undertake it. Towards the end of his life he resided at the court of Archelaus of Macedon, and was evidently greatly impressed by the fresh scenery and customs which came before him; like a true poet, he was inspired by these to choose a theme in which he might best represent his newly gained experience, and produce one of the most striking and beautiful of his plays, in which both the subject itself and his mode of treating it are to my purpose.

In 206 cases of pulmonary phthisis, 132 in males and 74 in females, published in the “Ed. Med, and Sur. Journ.,” I found scrofulous tumours and tubercles in the brain in two males and two females.

The subject of a uniform system of asylum statistics has occupied the attention of some of the most eminent alienists in this country, among whom we may mention Dr. Thurnam, Dr. Conolly, Sir Charles Hood, Dr. Bucknill, Dr. Robertson, and Dr. Maudsley. In a very able paper on this subject, published in the January number of this Journal for 1861, Dr. Robertson gave forms of Medical and Financial Tables, and made suggestions as to the Domestic Statistics for an Asylum Report which are now very generally adopted in substance in the best English Asylum Reports.

At Dr. Williams' request I have conducted during the past six months a few experiments with the galvanic battery in mental diseases. Thinking the results of these observations will be of service to those who intend pursuing this branch of study, with his permission I take the liberty of recording them.

The three establishments which will most repay the trouble of a visit, a e the Bicêtre, the Salpêtriére, and Charenton; The Bicêtre is for male, the Salpêtriére for female paupers, and Charenton is a large private asylum for both sexes.

Mr. Darwin has called his book by the title of “The Expression of the Emotions in Man and Animals,” but he has gone into the mechanism of other conditions besides “Emotionls.” “Affirmation” and” Negation,” “Reflection,” “Meditation,” and “Helplessness,” are not necessarily associated with “Feeling,” and may more conveniently be called states of mind than emotions. If this had been better recognised it would have prevented the making of such an “antithesis” as Indignation on the one hand and Helplessness on the other. An indignant man is no doubt in an emotional condition, but a man who shrugs his shoulders in sheer help-lessness may be, and generally is, simply devoid of all emotion whatever.