The following notes have been time to time in the hope of contributing materials which will serve to elucidate the important subject of the gradual unfolding of mental capacity in childhood.

Every asylum physician must regret the necessity that exists for the employment of narcotic hypnotics in medical practise among the insane, and there are probably few who have observed it who do not deplore the far too extensive use of sedative and depressing drugs, which is unfortunately the common custom in some asylums.

In accordance with a resolution adopted by the Irish Branch of this Association in November, 1888, we are now assembled in a District Asylum, and this being our first provincial meeting I need hardly mention what a very great pleasure it affords me to offer a hearty welcome to the members who have been good enough to come to Mullingar to-day.

A discussion on the origin and nature of pachymeningitis hæmorrhagica at the present time is very desirable on account of the remarkable difference of opinion of those who have studied it. Two theories regarding its formation exist, and the best pathologists and neurologists have ranged themselves almost equally on either side. This fact of itself betokens that each view probably has some elements of truth in it, and that neither contains the whole truth. What, then, is greatly to be desired under these circumstances is a new theory that will combine the elements of truth contained in each of the old theories, and supply the deficiencies of both.

It is unnecessary to expatiate to this Association upon the extreme desirability of inducing the patients in asylums to employ themselves usefully, nor is it needful to dwell at length upon the extreme difficulty that is often experienced in so inducing them. It may be taken as a fact that many inmates of asylums who are able to work are unwilling to do so, and, if we listen to their explanation, the unwillingness is not altogether unreasonable. “I was placed here,” such a patient will say, “against my will. I did not come of my own accord. I am under no obligation to facilitate the plans of those who put me here, nor of those who keep me here. My refusal to work is a protest against the deprivation of my liberty. If I have to engage in the work of the asylum I should, in the first place, forego my protest, and to that extent admit the justice of my incarceration; and in the second place, by making myself useful to the authorities, I should give them a positive interest in detaining me here all the longer. Besides, why should I give the benefit of my skill and experience free, gratis, and for nothing to those to whom I am, to say the least, under no obligation? The labourer is worthy of his hire. Before I came here I worked hard and long. I had no objection then to work, and why? I tasted the reward of my labour. I was paid for what I did, and the more I worked the more payment I received. Pay me here for my labour, and I am willing to work for you.”

A short account will next be given of the other cases I have had the opportunity of examining.

The specimen to be described was obtained at the post-mortem examination of a patient in the Northumberland County Asylum.

At the present time, when our fin de siècle knowledge of “general paralysis” enables us to recognize under that generic term many types of the disorder, and when the relation between it and syphilis continues a rather vexed question, little apology is needed for introducing to notice the following cases. They illustrate unmistakably some of the instances in which syphilis is solely responsible for what. Is termed by Dr. Savage” A process of degeneration which ultimately produces the ruin we recognize as general paralysis.”∗ Whatever may be hereafter formulated from the present evolutionary crisis in the history of the disorder there can be but little doubt that syphilis will be one of its most intimate and important relations. The story of its methods is briefly sketched in the following two short life-histories—in one asserting itself in the offspring of its victims by right of impure heredity, in the other carrying death direct into the vital centres by the force of its malignant virus.

The accompanying illustration represents what is believed to be a hitherto undescribed abnormality of the scalp. The condition was discovered accidentally. I observed an attendant cutting a lad's hair, and remarked that he was not doing it very well, as there appeared to be numerous scissor-marks. It was explained that the marks were due to the arrangement of the hair. This led to careful examination of the whole scalp. Its condition is very well represented in the illustration. On each side there are five deep furrows, passing from behind forwards. Those nearest the middle line are straight; the others slightly curved, and they are the more curved the further they are removed from the middle line, and at the same time they diminish in length. When the hair is of ordinary length the condition of the scalp would not be suspected; it is only when the hair is very short that the furrows become evident. For the purpose of preparing the accompanying illustration the hair was cut as short as possible, but the hair growing in the furrows was necessarily left somewhat longer than elsewhere, with the result of indicating with great clearness the course and arrangement of the depressions. The furrowing of the forehead is not abnormal, but is produced by the patient whenever he is annoyed, as he was when the photograph was taken.

That Tennyson touched the finest chords in our nature none will dispute. But there are poets who have done this without being what the lamented Laureate* unquestionably was—a psychologist. “In Memoriam” is full of psychology as well as feeling. He went deep down into the springs of human thought and action. “Lucretius” is psychological if any poem in the language is.

The case which, by the kind permission of my chief, Dr. Conolly Norman, I am enabled to bring under your notice to-day, is one of acute insanity occurring in a male adolescent, and marked in its course by the somewhat unusual symptom of sexual perversion.