We are all of us familiar with the expression “to run amuck,” but perhaps comparatively few of us are familiar with the significance of the term in the Eastern Archipelago. Amuck, or, as it is properly spelt Amok, is a Malay word, and means a furious assault, its derivatives, Mengamok and Pengamok respectively, meaning to commit a furious assault and the person who runs Amok.

Little has been written, and comparatively little is known with precision, concerning the insane of Greece—whether we speak of the little kingdom alone, with its present population of nearly 2,500,000, or of the Greeks in general, who live in Macedonia, in Asia Minor, in Egypt, or elsewhere outside of the present limits of Greece. This whole community, diverse in origin and residence, but united by a common language and a common religion, considers itself as one, and sends to the two asylums in Greece—the old Phrenokomeion of Corfu (founded in 1838), and the comparatively new Dromokäiteion in Athens—insane persons from all the countries in which Greeks reside. Thus, during the year 1892 the Athenian Asylum (which takes its special name from a Greek family named Dromokäites, whose wealth has endowed it) received 70 admissions; and of these 13, or nearly one-fifth, came from places outside of Greece. A smaller proportion among the 175 (more or less) who now reside in the Corfu Asylum are from outside of Greece, and it is probable that this proportion is constantly diminishing there. But Athens, from its central position, its rank as a capital, and the affection with which most Greeks regard it, is likely to draw to itself more and more the persons attacked with insanity outside of Greece. This fact will increase a little the visible insanity of the kingdom; but so many are the causes tending to conceal the extent of this malady there that the circumstance of these outside accessions need hardly be taken into account. There is no census of the Greek insane, even professing to be exact, and I have been forced to rely, in my tours and inquiry during two visits to Greece (in 1890 and 1893), on the estimates of careful persons and my own observation.

I propose in the following paper to review briefly the treatment that has recently been made use of in myxœdema, and compare the several ways in which it has been carried out, after a few preliminary remarks on the pre-thyroid methods.

We are in the habit of regarding general paralysis as in the main a disease of the prime of life—of a time when the fresh vigour of youth has subsided, but before the first touch of decay has laid its hand upon the organism; when the mental faculties are strained to the utmost in the pursuit of wealth or pleasure, or social distinction, or in the keen struggle for existence entailed upon so many of our race. We are not indeed unaccustomed to meet with cases of this disease occurring both before and after this epoch of life, but the association of general paralysis with the period of childhood and puberty has hitherto been a very unfamiliar idea. Nevertheless, scattered cases have from time to time been published which tend to show that the period of life which appears to offer most exemption from all the ordinary causes of the disease may still claim its victims, and that at, or about, the period of puberty cases may occur which, both clinically and pathologically, appear incapable of separation from the ordinary forms of the disease with which we are so familiar.

At the commencement of our description of subdural membrane formation, we deferred consideration of the sudden lessening of intracranial pressure, which we regard as the most important cause of its production. This is a point we shall take up now, along with some other general questions connected with subdural membrane formation.

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.