Before addressing you, I have formally, however imperfectly, to express my full appreciation of the high honour conferred upon me at your hands in thus placing me in the Presidential Chair of your beneficent Association. I say beneficent advisedly, for when men have banded themselves together for the cultivation of science and the improvement of the condition of the insane, they associate to fulfil these functions as practical philanthropists. These good intentions have been realised in fruitful performance in words and deeds, and we hold our Annual Meeting to-day with a desire, an ability for good work that cannot fail to mark the year as one of humane progress.

I. General Remarks. — It has frequently appeared to me that a rapid and easy method of staining according to Nissl would be of great advantage. It has been my routine practice to cut a fresh section and to stain according to Bevan Lewis in every case of insanity in which an autopsy had been obtained, and from that to record a few microscopic notes. A fairly complete description of neuroglial changes could thus be recorded, but only in a minor degree the changes which had occurred in cell protoplasm, i. e. cytological changes and various degenerations. For this one has to stain according to the method of Nissl, a method which stands out supreme for this purpose. But even Nissl's method is by no means perfect, and there are many drawbacks and imperfections. Hardening in alcohol causes considerable shrinkage; in fact, the main part of the cell is occupied by the nucleus. Alcohol also largely dissolves out fat, and therefore fatty degeneration cannot be shown. Again, it is not every asylum laboratory that has equipment for Nissl's method, but every asylum has the means of making a Nissl preparation according to a way I am about to describe.

This paper is only intended to be a preliminary note upon the specific gravity of the brain in the insane, and contains the results of experiments upon thirty cases conducted at the West Riding Asylum, Wakefield, during the early part of this year. Over 1400 investigations have been made upon these brains, and as the inclusion of data from different parts of the country might cause scientific inaccuracies, it has been thought advisable to publish the present results separately, prior to the initiation of a further series of experiments.

The bacterial disposal of sewage has been so widely discussed during the past year or two, that possibly some apology is due to the Association for the introduction of a subject that has ceased to be novel. So far as Hawkhead Asylum is concerned the subject is still in the experimental stage, and the brief outline of the experiment contained in the following communication is the outcome of a correspondence with some of my friends who suggested that the question is not without interest to asylum superintendents.

“It is to be hoped and expected that with the spread of knowledge and education alcoholic intemperance may come to be regarded always and everywhere as vicious and reprehensible. It is a grievous matter that it should be lightly regarded in any quarter as a venial offence, and I should gladly support some more rigorous form of punishment for the vice of occasional intemperance than can now be meted out.

It was originally our intention to cover the whole ground of the pathology of the cortical nerve-cells in relation to insanity. But in the course of our more recent investigations we have been strongly impressed with the fact that there are certain as yet little known, but very grave fallacies, into which investigators in this field are in danger of running; and it seemed to us in the first place imperative to clear these up before formulating conclusions regarding the relation of cortical nerve-cell changes to insanity.

I have lately been engaged on a research into the normal and morbid histology of the choroid plexuses of the lateral ventricles.

Before this body it is unnecessary to revert to the inadequacy of conducting scientific investigations in psychiatry along the restricted plan of confining the research to material found within the asylum by some one exclusive department of investigation, such as the routine governed and mechanical methods of microscopical research. This restricted plan has largely governed psychiatric research up to the present time. Now, however, that many of the sciences tributary to psychiatry have attained a growth and capacity to be of service in psychiatric research, the restricted plan of research may be relegated to the past.

The interest of the following case centres in the severity of the lesions, both macroscopic and microscopic, which were found post mortem.

A man, E. C—, aged twenty-eight, is at present a patient in the Northampton County Asylum. This man has since childhood suffered from epilepsy, and although at one time the fits were for several years in abeyance, just now they are frequent and often severe. The attendants, who have known him for many years, state that while the severe fits are of the usual type, the lesser ones are often followed by “antics” and “playing the fool.” In one of these less severe attacks, which I witnessed recently, the convulsions had all the characters of a genuine epilepsy, and were followed by the usual stage of stertorous passivity. But this stage was of short duration only, the patient suddenly springing up and adopting the “segment of a circle” position, the occiput and heels alone touching the ground. Suddenly relaxing, he then raised his trunk from the ground and bent forwards towards his feet five or six times in succession. Then, falling on his back, the knees were flexed and the thighs drawn up on the abdomen, and then as rapidly stretched out. This he repeated several times. Drawing up the thighs again, he placed his hands on his buttocks and rocked backwards and forwards, shouting loudly a stave or two of “We won't go home till morning.” Finally he burst into a loud laugh, gesticulated extravagantly, got up from the ground, picked up his hat, and sat down complacently on a bench. These last movements were performed quite automatically, and without the least evidence of conscious appreciation. In fact, he continued for some hours in a dreamy state, and not till the next day was he fully and clearly conscious. I have no doubt at all that the convulsion was a genuine epilepsy, and it is quite obvious that the subsequent performance corresponded in detail to the series of movements demonstrated by Richer in hysteria major.

Under the presidency of Dr. Urquhart, the Association met this year in Edinburgh after an interval of ten years.

The annual meeting of the British Medical Association was held in Edinburgh in the week succeeding the Medico-Psychological meeting. The meeting was one of the most successful that the B.M.A. has ever held, whether as to numbers of members attending or as to the quantity and importance of the matter discussed. Edinburgh possesses many advantages as a place of meeting. The fame of its great medical school is world-wide, and it is full of ardent workers who are determined to maintain and extend its ancient renown as a centre of medical teaching. The social amenity and the accessibility of the northern capital render it specially attractive to the southron.

In the present number we publish an interesting article by Dr. Ira Van Giesen, Superintendent of the Pathological Institute of the Commission in Lunacy of the State of New York, upon the above subject. The necessity for a many-sided, comprehensive study of insanity is earnestly represented by Dr. Van Giesen. It is very much to the credit of the New York State Lunacy Commission that it has recognised the importance of the collaboration of skilled workers in various departments of science for the elucidation of the problems of mental and nervous disorders, and has established an adequately equipped institute where the work can be efficiently carried on. Each department of the institute is in charge of a trained investigator, and the whole is under the supervision of a Director. We question very much whether the like of this institute is to be found on the Continent—we refer, of course, only to the special department of work with which it is concerned. As for our own country, it may confidently be stated that we have nothing to compare with it. In London and Edinburgh the pathological laboratories in connection with the asylums are within easy reach of the great hospitals, where correlated branches of work are in vigorous existence; but this is a very different thing from having the several departments in association at a single scientific centre, in charge of officials working under one authority. Several inconveniences must attach to this dissociation of branches of work. Nevertheless we recognise the propriety of an attitude of grateful appreciation in respect to these departures. They certainly constitute a long step in advance of the condition of things obtaining elsewhere in the kingdom. Elsewhere local authorities have provided a mortuary in connection with their asylums, and of late we believe that a room “for the finer histological work”—a phrase somewhat familiar in official reports—has in many instances been added thereto. Immured therein the pathologist too often finds himself in need of the sympathy of workers in the sister sciences. Problems arise upon which he would fain have the light of bacteriology, of physiological chemistry, of animal experimentation, and his work must frequently remain stunted for the lack thereof. Such an institute as that now referred to is doubtless a costly undertaking, and could scarcely be expected from any local authorities in this country but the most wealthy, or from combination of the less wealthy. We anticipate that the Hospital for Acute Cases in the West Riding of Yorkshire will be opened shortly, and if, as we believe, there are to be in connection therewith various departments of investigation, this may perhaps with justice be described as the first step in this country in the direction of the ideal institute. Such a departure cannot fail to be watched with the greatest interest by those engaged in the treatment of mental diseases.

At last the Evidence in Criminal Cases Bill has become law. It is not necessary to say more of the statute itself here than that it makes every person charged with an offence, and the wife or husband of such person as the case may be, a competent witness for the defence at every stage of the proceedings, under the conditions specified in the Act. The arguments for and against this measure, which we believe to be a pre-eminently salutary one, have been agitated in this country for many years, and are familiar to every educated section of the community. The combatants on both sides will now be content to wait to see their predictions verified, or the reverse, by the event. The great danger against which the judiciary will have to guard in superintending the administration of the new statute will, in our opinion, be the possible abuse by counsel, from excess of zeal, of the right of cross-examining prisoners electing to give evidence on their own behalf. But from the admirable manner in which the judges have confirmed the right of “summing up” enjoyed by counsel for the prosecution under Denman's Act, within safe working limits, we have no fear of the result of the fresh test to which the Legislature is now submitting their firmness and capacity.

Whether the flogging of prisoners in gaols for breaches of discipline is good policy or not is a question in regard to which experts may and do entertain very different opinions. But there will be little disposition in any quarter, we should think, to criticise adversely the provision of the new Prisons Act that such punishment shall only be inflicted in cases of mutiny and violence, and then after judicial inquiry by a Board of visiting justices, with a stipendiary magistrate to act with them if necessary, and after ratification of the sentence by the Secretary of State. This reform in the law will achieve several desirable ends. It will confine what is, under any circumstances, a brutal punishment to cases of real gravity and brutality; it will protect prisoners against the whims to which even visiting justices are subject; and it will secure that uniformity of practice in regard to prison floggings which has hitherto in England been conspicuous by its absence.

The Inebriates Act of 1898 marks a very distinct and important advance in the treatment of habitual drunkards.

The Lunacy Bill of the past session, after passing the Lords, was withdrawn in the House of Commons, owing to the lateness of the session.

This case before the House of Lords was an appeal from an order of the Court of Appeal affirming an order of the Recorder of Plymouth on a case stated by him. The question in dispute was whether a female pauper lunatic was settled in the appellants' union. The lunatic was born at Plymouth, but had gained no settlement of her own; her mother, a single woman, was born in the defendants' union, and had acquired no settlement.

Are two medical certificates necessary for a “not a pauper,” lunacy case? The Lancet (July 30th, 1898) draws attention to a statement made by a correspondent that “the justices of his district are in the habit of signing removal orders for lunatics of the working and artisan class on one medical certificate only.”

The recent will case, in which the possibility of undue influence by means of hypnotism was raised, is concluded, and the questions in relation to this possibility can now be considered apart from any reference to that particular case.