A distinguished Dutch neurologist, crossing the ocean recently, was asked to state the object of his visit to America. “I am bent on study,” he answered. “I wish to study nervous diseases among the most nervous people on earth.” Waiving the fact that nervousness and mental disease in America are to an overwhelming degree found among the foreign born element, and cannot, therefore, be truly attributed to American environment and influences, the allegation that America is a ripe field for the study of nervous disease must be acknowledged. Everywhere throughout the country attention is being called to the alarming increase in insanity in the past decade. Without doubt such disturbing reports take far too little count of the effect upon statistics of the wonderful advance in later times in accuracy of recognition and registration of insanity, and of the constantly increasing tendency to house, restrain and treat the subjects of mental disease.

In a Paris restaurant on January 2nd, 1911, an alcoholic shot and killed, without provocation, a peaceful diner. Dr. Vallon, the medical expert, concluded that the accused, who had a family history of insanity, was a congenital deséquilibré, a chronic inebriate addicted to alcohol and ether; that the murder had been committed in a state of intoxication, and had been forgotten by the prisoner; that he was not insane, and was criminally responsible; that, nevertheless, in consideration of his hereditary and acquired predisposition he might be considered as having been in a state of pathological inebriation at the time when the act alleged against him was committed; and that in consequence his responsibility was modified. The trial took place on August 3rd, and the accused was acquitted and discharged; but the members of the jury in a letter to the Ministre de la Justice represented that criminals acquitted as irresponsible, remained a danger to the public safety, and earnestly requested that the competent authority should send such persons to custody in a specially constituted establishment, to be detained until it should be duly certified that they were no longer dangerous.

The most important event in the department of psychiatry in Germany since my report in 1910 has been the Fourth International Congress for the Care of the Insane, which was held at the house of the Prussian Deputies in Berlin, from October 3rd till the 7th, 1910. The Congress was attended by about six hundred members. It compared favourably with its predecessors in the number and practical and scientific importance of the reports and in its general arrangements; it was evident that the interest of psychiatrists and of laymen in those congresses is on the increase. In addition to the meetings of the members, there was an important exhibition of models, plans and photographs of establishments and institutions for the insane, of sick-rooms and of machinery, of work done by patients in public and private institutions, and of scientific apparatus and books, which was visited with great interest, and which gave a very true idea of the progress in Germany in the care of the insane. The exhibition had been arranged by Dr. Alt, at Uchtspringe (Altmark). A no less true insight into German methods is given by a work on German Hospitals, which was edited by Dr. Bresler. A copy of this work was presented as a souvenir to each member of the Congress. It was edited with the assistance of the superintendents of the public and private asylums, and contains in an elegant volume of 666 pages the description of about seventy institutions for the insane, illustrated with numerous plans and photographs. This work has since been continued, and a second volume of 465 pages, with illustrations, has recently appeared. At the same time a similar work has been edited by Dr. Schloess, of Vienna, on Austrian asylums for the insane, copies of which (and of the second volume of the above-mentioned work) were also presented to the members of the Berlin Congress. So that it may be truly said that seldom have members returned from a congress with so abundant a supply of literature. A special number of my Weekly Journal of Psychiatry and Neurology was devoted to the members of the Congress, and contained about fifty portraits with short biographical sketches of the most distinguished alienists present. The more important papers are perhaps worthy of mention in this retrospect.

From April 1st to the 7th this year the Twenty-second Annual Congress of Alienists and Neurologists of France and of French-speaking countries, consisting of a membership of about 300 adherents, was held in Tunis, and the writer attended as a delegate of the Medico-Psychological Association of Great Britain and Ireland. More than thirty institutions for the care and treatment of mental cases were associated with the Congress, and numerous delegates representing learned societies as well as foreign countries attended. The President of this year's Congress was Dr. Mabille, Medical Superintendent of the La Fond Asylum at La Rochelle; Dr. Arnaud, Physician to the Mental Hospital of Vanves (Seine) was Vice-President; and the General Secretary was Dr. Porot, the very able and energetic Physician to the French Hospital in Tunis. An important paper announced for discussion was by Dr. Régis, Professor of Clinical Psychiatry in the Faculty of Medicine at the University of Bordeaux, who contributed a very full and exhaustive paper upon the “Care of the Insane in the French Colonies and Dependencies,” with a review of their treatment in the adjoining colonies such as those of England and of Holland. Dr. Régis was assisted in his paper by Dr. Reboul, of Annam. Another paper was by Dr. Chavigny, Major of the French Army Medical Service, upon the “Mental and Nervous Symptoms associated with Malaria”— obviously one of considerable importance in view of the expansion of French Colonial Government; and a third paper by Dr. Dupré, one of the teachers and a Fellow of the University of Paris, was upon mental states arising from, and connected with, perversions of the natural instincts. Although these were the three main subjects, other papers connected with neurology or psychiatry were presented to the Congress for discussion, among them being—one upon “Goitrous Insanity” by Drs. Fraikin and Grenier de Cardenal, one relating to “Insanity and Renal Disease” by Dr. Beriel, one by Dr. Gelma on “Delusions of Persecution.” Other papers were by Drs. Petit, Mignot, Adam and Levassort. A valuable report upon an experimental study relating to the association of ideas in the Insane was presented jointly by Dr. Auguste Ley, Professor in the University of Brussels, also physician to the Mental Sanatorium at Fort-Jaco, Uccle, near Brussels, and Dr. Paul Menzerath of the same hospital laboratory. Another paper was by Dr. Levassort upon “Degeneracy in its Relation to Perverted Instincts,” and two others bore upon the same subject, viz., one by Dr. Berillon, relating to the influence of suggestion upon normal as contrasted with abnormal instincts, and the other by Dr. Simonin who related his experience in the French Army in regard to mental enfeeblement, a clinical and medico-legal study. A paper by Dr. Haury upon “Hooligans in the Army and their Rational Treatment,” formed a suitable complement to the chief paper of the day by Dr. Dupré.

The Commission appointed by the County Board or Barcelona to inquire into the administration of S. Bandilius Lunatic Asylum has issued its report. The sad condition of matters therein revealed is an ample justification of the demand which the public had made for an inquiry. A medical inspector has been appointed to remedy the abuses.