I have often stated in conversation that Shakspere, in depicting the agitation into which Othello was thrown by the artifices of Iago, subjected the Moor to an epileptic seizure. Almost without exception, this statement has at first been contradicted; but a perusal and an analysis of Scene 1, Act iv. of the tragedy of “Othello” have, I think, convinced all enquirers that the dramatist's design in the matter was not open to doubt.

A question that has been prominently before the public for the past few years, and which has not always been discussed with the cool reason so weighty a subject demands, is the control, custody, and treatment of the insane community known as private patients; and for the purpose of present argument I class those patients as private patients whose cost is defrayed without aid from the State—either in the matter of board, lodging, or attendance; for though private patients who reside in hospitals for the insane receive this aid, the building in which they reside is provided from special funds (and most hospitals have a small income from invested funds or annual subscriptions), it amounts to very little, and is absorbed in the free cost, or mitigation in the cost of maintenance, of a few patients. In speaking of lunatic hospitals, I leave out of the question the great Hospital of Bethlem, where the maintenance of the patients is entirely defrayed from the funds of the charity.

Syphilis has always been regarded as one of the accidental causes of Epilepsy, and ranks, indeed, among those which exert the most decided influence on its development. The epileptic malady, when so originated, throws almost into the shade the other constitutional accidents, or sequels of the syphilitic infection, if they are not—as it often happens—in suspension or latency. The first point, therefore, to be considered before we proceed to the description of its characters, is—at what stage of syphilis does the neurosis commonly occur, or rather, is there a secondary and a tertiary epilepsy, distinct from each other, as is held by Fournier, who judges it difficult to connect the former, principally exhibited by females, like a transient specific neurosis, with any lesion of the nervous centres; whereas the latter should be, on the contrary, manifestly consecutive to encephalic lesions, thus constituting one of the manifold expressions of that complex organic state known as cerebral syphilis.

Alcoholic excess is associated with epilepsy in two different ways, as cause or as an effect of it. In the first instance, intemperance may appear as a hurtful habit of the individual favouring the development of the spasmodic neurosis, or again, as a constitutional tendency entailed by parent on offspring with similar dreadful consequences. In the second instance, the moral perversion ordinarily wrought by their disease on the character and conduct of several epileptics, drives them to vicious indulgence in drinking, which aggravates and changes the original character of their fits. The majority of writers have not distinguished in estimating the relationship of intemperance to epilepsy, or insanity, the number of cases immediately ascribable to vice from those in which the uncontrollable passion, or craving for drink, is, as it also happens with masturbation, merely the sign of the outbreak of an inherited predisposition to insanity, or epilepsy, or of the early stages in the evolution of either of these maladies as consequence of accidental causes. Nor has the influence which traumatic injuries to the head, syphilis, or other derangements possibly coincident with the abuse of alcoholics, by themselves exert, been taken into proper account in calculating the part of the latter in the spread, on a wide and increasing scale, of mental and nervous affections. Although this discrimination is by no means always practicable, we may yet arrive at it by diligent inquiry and with a material change in the results, as evinced by the cases we pass on to analyse.

To treat of Nonsense in any connection with the abnormal developments of the human mind may seem to some popular philosophers a solecism; but it is not. The connection is very real, and even, if one examines it, essential. The absurd in farce, or in dreams, or in insanity consists simply in the eccentricity of our association of ideas.

“Well, doctor, what do you think is the matter with my patient?”

In the Journal of “Mental Science” for April, 1877, I published a note on this subject, and had to regret that the conclusions deduced were drawn from comparatively so small a number of cases, that some further statistics on the subject would be. necessary to show how far the figures then given could be depended upon.

That there are two methods by which to approach the study of mind—the one inward and reflective, the other outward and transitive, including more especially the anatomy and physiology of the brain and nervous system—is by high authorities, even in physical and biological science, now generally admitted.

The physiological action of Alcohol upon thermogenesis has been the subject of much dispute, and its effects upon tissue metamorphosis is still a moot point with many authorities in Therapeutics.

From the earliest historic period insanity seems to have been regarded as a disease that required restraint. The teaching of Conolly showed the fallacy of this view as regards mechanical restraint, and now—at all events in this country—medical psychologists are unanimous in condemning the practice, and the tendency is to give an ever increasing freedom to the mentally afflicted. Notwithstanding this, however, it cannot be denied that although the inmates of our asylums are no longer chained to walls, tied up in strong garments, or otherwise made harmless by mechanical means, a vast deal of what has very appropriately been termed “chemical restraint” goes on, and goes on, I believe, to the great injury of those it is supposed to benefit.

It was only when special attention was paid to the training of idiots, that an idea began to be formed of their actual number, and it is only within a few years back that in the census of civilized nations idiots were distinguished from lunatics, or as it is generally put, born insanity was distinguished from acquired insanity. Even yet to some people it will be startling to hear that in most countries there are as many idiots and imbeciles as there are lunatics, and that in some countries there are more. According to Koch, there are for every hundred lunatics in Prussia 158 idiots; in Bavaria, 154; in Saxony, 162; in Wurtemberg, 97; in Austria, 53; in Hungary, 140; in the Canton of Berne, 117; in France, 66; in Denmark, 58; in Sweden, 22; in Norway, 65; in England and Wales, 74; in Scotland, 68; in Ireland, 69, and in America, 79. Large as this proportion is, there are many reasons for believing that it is considerably understated, both in our own country and in America. In France I have already pointed out that, although in the census of 1872, there were only 35,133 idiots given, it was found by a special commission to inquire into the diffusion of cretinism, that there were about the same time in the country 122,000 cretins and idiots, that is, 230 idiots for every 100 lunatics. Moreover, from the known unwillingness of parents first to believe and then to admit that their children are imbecile, we may fairly assume that there must be a large number of idiots under five years of age, who are never returned as such in any census, and of whom a large proportion die in early years. Koch found that in Wurtemberg only 43 idiots were returned under 5, while between the ages of 6 and 10 years there were 294 returned.

Arethæus asserts that several physicians, and among them the famous Asclepiades, observed that venery cures epilepsy developed at the age of puberty. The same opinion was professed by Scribonius Largus, and, with these authors, the corruption of retained semen originated the spasmodic malady in such cases, Alfarins à Cruce, commenting on these primitive ideas, contends that, in similar instances, the change of age effects the cure improperly attributed to venery. His pupil Sinibaldi, declares venery powerless against fits, exploding after the age of fifteen, especially in adults, or individuals of an advanced or old age. But in epilepsy à putrescent, upon seminal retention, venery may prove of such great moment as to occasion altogether its cure.

Although my attention has been directed for some years past to the consideration of this subject, the number of cases of lead poisoning coming under my observation is inconsiderable, and I put forward the following with the hope of inducing others to place on record their experiences rather than with the idea of formulating definite conclusions.

From the short time at my disposal, and from not having beside me the complete records of the asylum, my remarks to-day must necessarily be more limited in their scope and desultory in their character than under other circumstances would have been the case. I must content myself with bringing before you, in a very general way, some facts relating to the proportion of insane amongst the different races and people which go to make up the much diversified population of British Guiana, and I may notice also a few of the more prominent forms of insanity seen in that colony. What I have to say may, I trust, possess sufficient novelty to be interesting, and may prove none the less suggestive, although its object be not to support any preconceived or pet theory. British Guiana, although a West Indian Colony, forms part of the mainland of the Continent of South America, and amongst its inhabitants is seen a diversity of races as great, if not greater, than in any other country of like extent. There are two large primary divisions into which the population may be separated, namely, those born in the colony—in local phraseology called creoles—and immigrants. In 1871, the date of the last census, the population of the country numbered 218,909, consisting of 103,775 creoles and 115,134 immigrants. Neither in these numbers nor in any subsequent calculations are the aboriginal Indians (bucks) included, who inhabit the interior of the Colony, and who do not supply any contingent to its known insane population. The first division or creoles comprises a very large population of blacks of fine negro blood, descendants of the local slaves of pre-liberation days and of black immigrants subsequently brought from Africa or the neighbouring West Indian islands. In this class are to be found the greatest number of the coloured people of mixed African and European extraction in various degrees of combination, with a few white creoles of pure European descent. Amongst the immigrants are included, firstly, the black and coloured people who have come from the other West Indian colonies, chiefly from Barbadoes; secondly, negroes born in Africa imported as free labourers, and who mostly belong to the West Coast tribes; thirdly, many East Indians (coolies) brought under indenture to work as labourers on the sugar estates; fourthly, a good number of Chinese, introduced for the most part under similar circumstances; fifthly, Portuguese who have come from Madeira and the Cape de Verde Islands; and, lastly, a comparatively small proportion of Europeans.

The renewed interest felt at the present time in hypnotism, or Braidism, induces me to return to a consideration of the subject to which I drew the attention of the readers of this Journal in 1866, in an article on “Artificial Insanity.”

To judge from the sparse literature of the subject, cerebrine has not often been chemically studied. The first work of any importance was done by W. Müller. Müller obtained the body, which he called “Cerebrine,” free from phosphorus by digesting the brain with baryta-water. He also analysed it, and proposed the formula, C34 H33 NO6.

Out of 946 cases admitted into the Bristol Asylum since January, 1870, symptoms of General Paralysis of the Insane have existed in 116; of which 83 occurred in males, and 33 in females, the admissions being respectively 440 males and 506 females.

Much attention has been directed of late, more especially in America, by Dr. Pliny Earle, to the ordinary mode of calculating recoveries from insanity. Having examined with some care into the different results of several modes of making these calculations, I propose to state in this paper the conclusions to which I have been led, and to suggest an improved form of tabulating cures in the Reports of our asylums.

Preliminary.—The greater part of the letterpress and accompanying plans were sent into the competition lately requested by the Borough Magistrates of Hull, and were awarded the third premium. The elevations and architectural details were designed with much care and success by Mr. B. S. Jacobs, of Hull; the sanitary and sewage works were prepared by Mr. George Bohn, C.E.; while the writer is responsible for the ground and first floor plans, and for the internal arrangements generally.