An Essay in the Journal of Mental Science for October, 1875, entitled, “Can Unconscious Cerebration be Proved ?” by Dr. Ireland, Superintendent of the Institution for the Education of Imbeciles at Larbert, ends thus:—“In any case the theory of ‘unconscious cerebration’ derives no support from physiology. It is a child of the old metaphysics, to be brought forward and repelled by the study and analysis of mental operations, cognisable by internal examination.”

I propose to show that organic memory consists in cerebral processes, regulated by the laws of evolution and reversion, and common as vital processes to both plants and animals.

Syphilitic Insanity.—This is the first of the varieties of insanity in Dr. Skae's classification that is due to the action of a poison introduced from without. As might be expected, its symptoms are much more definite than those of the more constitutional and hereditary varieties of mental alienation. Something, too, is known of its pathology, and yet it is only about twenty years since the fact was recognised that the syphilitic poison could produce mental derangement at all. It has been described by English, French, and German authors on insanity and syphilis, but Dr. Wille, the latest German writer on the subject, has given us by far the most complete account of the disease in all its forms so far as it is at present known. An excellent abstract of his paper appeared in the “Journal of Mental Science” for January last, by Dr. Addison.† It is one of the forms of insanity that must be studied in connection with the other syphilitic affections of the nervous system, if we wish to understand it. To describe its symptoms without reference to the syphilitic form of epilepsy, of paralysis, and neuralgia, would be a mistake in every respect. Dr. Reade, of Belfast, and Dr. Todd, of London, were the first in this country to direct special attention to the occurrence of mania as a direct result of syphilis. They both showed that it was one of a train of symptoms that had the specific infection for its starting point; that those symptoms proved clearly that the nervous system, both spinal cord and brain, as well as their membranes, were involved in such cases, and that whatever cured the syphilis cured the neuroses. Dr. Duncan published three very interesting cases of syphilitic insanity in 1863.∗ Dr. Hugh Grainger Stewart published three cases in 1870.† Dr. Wille has collated the symptoms of 77 cases of syphilis, in which there were mental symptoms of one kind or other. Many of Lancereaux's cases, given in his work on syphilis, have mental impairment or disturbance as a part of their history.

Gentlemen,—In the name of the Irish members of our Association, I desire to greet you all with a very cordial welcome on the occasion of this your second visit to our city. Fourteen years have elapsed since you last honoured us with your presence. I hope that a careful comparison of the present state of the institutions here with their condition then will convince you that the spirit of improvement has been among us, and that we have endeavoured in some measure to keep pace with the progress apparent in other districts in this department of the healing art.

Of all the classifications of insanity with which we have been afflicted in recent times, none has been more diligently vaunted, or more frequently obtruded upon attention, than that of the late Dr. Skae. Emanating from an able and accomplished physician—not in the first blush of his juvenile enthusiasm, but in the maturity of his powers, and the ripeness of his experience—it at once commanded respectful consideration, and was placed in a position of authority. And there, in the progress of time, a strong body of sentiment has gathered about it. Dr. Skae's old pupils, with a fervour which speaks volumes for his influence over his colleagues, and for their loyalty and gratitude, now rally round it, and vigorously repel any attack upon it, and even any approach to it for the purpose of a critical examination. Under their jealous guardianship it has become a sacred edifice—a monument of wisdom which may be adorned or enriched by the initiated few, but which it is sacrilege in the vulgar to attempt to demolish. Its great principles have been pronounced binding by the œcumenical council of Morningside, and he who profanely questions them places his promotion in jeopardy. Fortified, developed, illustrated, by the labours of many distinguished followers, this classification of Dr. Skae's is extolled by some on all possible occasions, and there is an undoubted danger that it may be somewhat widely adopted.

An opportunity having been afforded me, through the kindness of Mr. A. H. Garrod, of examining the brain of a fine specimen of the Chacma Baboon (cynocephalus porcarius) from the Zoological Society's Gardens, London, I purpose, in the following pages, to record, so far as I may be able, the minute structure of the convolutions in the various parts of the cerebral hemispheres. It will be my endeavour in this inquiry to study the nerve elements of the cortex step by step, and layer by layer, and thus gradually to unfold its structure; to analyse and compare the varying appearances in different situations; and finally, collecting and arranging the facts thus elicited, to place them side by side with those derived from a study of corresponding parts in the human organ, and ascertain, if possible, the relations which exist between them.

Anæmic Insanity.—This is the variety of insanity produced by exhausting discharges, loss of blood, or starvation, and takes its name from the condition of anæmia that precedes and accompanies it. Dr. Aitkin says that “any acute disease which occurs in an anæmic individual assumes a peculiar character.” Now this is precisely what occurs when such an individual becomes insane. There are two very distinct kinds of anæmic insanity, which may be called the chronic and the acute. The chronic results from anæmia produced gradually by exhausting discharges or such slow processes. Its symptoms are precisely those that Dr. Skae described as occurring in the insanity of lactation without the sexual characteristics of the latter, so that I need not occupy your time in describing them. The most important characteristics are the premonitory giddiness, flashes of light, singing in the ears, headache. The acute variety follows great and sudden losses of blood or starvation. It is most typically seen in the latter condition. At first there is a state of mental prostration, with pale and cadaverous countenance, wild and glistening eyes, severe pain in the epigastrium, and an intense thirst; then the mind becomes quite imbecile, so that the patient will make no effort for his own benefit, and after this a state of maniacal delirium, with hallucinations of the senses, comes on. The patient sees ravishingly cool and limpid streams and green fields, which if he is at sea he will at once jump overboard to reach, he tries to sing, and converses with imaginary friends. This is soon succeeded by coma or convulsions and death. But if food is given before this, the patient often remains for a long time delirious or imbecile in mind, cannot get rid of his hallucinations, and cannot exert his mind in any way.

We have seen that Simple mental weakness, the first form of weakmindedness, is neither more nor less than a want of mind, in some degree. In it the higher emotions are blunt, perception is dull, and all the processes are backward or sluggish.

I wish here to give as briefly as possible an account of the pathology of the nervous symptoms which result from syphilis. Of necessity there is considerable recapitulation from former papers I have written. For syphilis produces very different affections of the nervous system, and I have therefore had to speak of syphilis when considering Amaurosis, Epileptiform seizures, Hemiplegia, &c. It is, however, justifiable to bring together the conclusions one has arrived at about syphilitic nervous affections from the study of nervous affections in general.

Unconscious cerebration is regarded as so important a discovery that two well-known scientific men have contended for the priority of its publication, and while some people are anxious to give it fresh applications and illustrations, others proclaim it to the public as a new demonstration of science, accepted by physiologists, and stable enough to uphold new theories founded upon it. After having carefully considered the evidence upon which the theory of unconscious cerebration is supposed to rest, I am disposed to think that the facts, or assumed facts, may be explained in a simpler manner, and that the theory itself is superfluous and unproved. For an exposition of what is understood by unconscious cerebration, and on what grounds it is believed to exist, I have used a work called, “The Principles of Mental Physiology,” by Dr. Carpenter, the well known physiologist, who claims to have worked out the theory in his own mind, without knowing that any other had preceded him, and whose recognised reputation is a sufficient guarantee that the argument, in his hands, is sure of being well stated. The term itself seems far from being a happy one. Dr. Carpenter tells us that it has been found readily intelligible; he objects to “unconscious reasoning” as a contradiction in terms, and yet his own description seems either to imply unconscious reasoning, or unfelt feeling; and the difficulty of finding an appropriate term for this class of operations, is really owing to the difficulty of conceiving what these operations really are. In fact, to state them clearly, is to render the theory incredible. To call thought cerebration, may show the desire of a writer to assign thought as the product of brain action; but it is neither warranted by true philosophy, nor by the popular and scientific uses of speech. When the liver secretes bile, one does not say that it hepatates; or when a man breathes, we do not say he pulmonates.

In studying, during the last five years, the phenomena of Mind in the Lower Animals, I have encountered as great difficulty in drawing any definite or definable Psychical Line of Demarcation between Plants and the Lowest Animals as between the Higher Animals and Man. In other words, it appears to me that certain attributes of mind, as it occurs in Man, are common to Plants. The only alterative is the omission from our conceptions and definitions of Mind of certain phenomena common to plants with all classes of animals, including man—those, namely, that do not involve what we distinctively call consciousness. But the difficulties of such an elimination seem to me insuperable.

The following rough notes are compiled chiefly from the reports of the various Mission Hospitals established throughout China, and the Health Returns of the Treaty Ports, published under the auspices of the Chinese Customs' Service. It is a very wide question, and our materials are scanty.

When I saw in the last number of this journal that Dr Crichton Browne had essayed the task of criticising the system of classification of insanity devised by the late Dr. Skae, I knew the fact could not but be gratifying to Skae's friends. To have any system or theory subjected to independent criticism is very good for it. Then I could not forget that some of those who had advocated most earnestly Skae's classification had been pupils, assistants, and friends of his during life; and I was conscious, from my own experience, how much anyone in that position was inclined to look partially on his work. I felt sure that Dr. Browne, while seeing this, would not, in those circumstances, consider it a mortal sin, and would pass it gently and generously by. Indeed, I was a little afraid that he himself, as an old pupil of Skae, might be tempted to soften the stern tone befitting a critic, by something of the same pardonable feeling. He has striven to resist this impulse, and with much success. Another reason why I rejoiced that the merits of this system should be canvassed was, that I thought with, perhaps, natural partiality, that everyone must necessarily see something good in it; and that the fact of its being looked closely into by a competent and unbiased mind would produce a better understanding of Skae's point of view, and a more thorough sifting of the tares from the wheat. Not that such criticism had been wanting either at home or abroad. The system had been before the world for twelve years. The authors of all the standard books on psychological medicine and papers on classification published since that time had discussed its merits; and it did seem as if it were growing in favour. Maudsley, in each successive edition, had seemed to make more and more account of it; Blandford had assigned it a good place amongst other systems; Hack Tuke had given high praise to all the “somato-etiological” systems of looking at and classifying mental disease, and to Skae's in particular; Mitchell had declared it had taken hold of the medical mind; Thompson Dickson had said there was some good in it; and finally, that Nestor of alienists, whom Dr. Browne fitly describes as “the most illustrious representative of English medical psychology now living,” Bucknill, had given it the truest flattery of all by incorporating its nomenclature in the orders, genera, and species of that classification which is the final result of his vast experience, the generalised sum of all his thinking. All these, and more, had found it had faults; but they all speak of it and its author with much respect. Then it is a mere matter of fact that its terminology had become a part—and an essential part—of recent writings on nervous and mental disease.

In that general process of evolution by which the human ace, as well as the individual, is governed, each age appears to possess some distinguishing feature which stamps it with a special character. In all those branches of study and of speculation which, from the earliest dawn of mental cultivation, have engaged the attention of mankind—in theology, in history, in philosophy, in law, in science, and in medicine—the student, looking back upon the progressive achievements of his race, recognizes certain well-marked eras. These, although chronologically distinct, afford landmarks when reviewing the progress of the human intellect in its search after that perfect knowledge which stimulates, but ever eludes, the efforts of its votaries. To more than one period the student can point and say: These were days of deep theological disputes, and the schools of divinity attracted the best intellects of the age. of another period he may say: Historical research was here predominant. of another the remark would be true that, while it lasted, the different schools of philosophy divided the intellectual world. And again: Here was an age of great legists; at such a period constitutional and international law gradually acquired shape and recognition. At all periods, whether of intellectual progress or stagnation, the fascination of numbers has thrown its spell over some of the most gifted minds; and, in the exact science of mathematics, the student has enjoyed this singular advantage, that every theorem proved, every problem solved, has been a step gained once for all—alone among the sciences this, within its range, has been permitted to afford a convincing answer to the ever-perplexing question, “What is truth ?” As physicians, we should be ungrateful if, in the most cursory retrospective glance, we omitted to notice those votaries of science, whose patient search for the realization of the alchemist's dream led to so many discoveries in chemistry, and laid the foundations'of that modern science that has numbered among its disciples some of the most brilliant intellects of recent years. The study of medicine has passed through various gradations according to the theories that were predominant; until, in recent years, the cultivation of our art has become so interwoven with scientific investigation, so allied with strict inductive reasoning, and so associated with other and collateral branches of study, that the student of medicine may now be said to embrace in his curriculum the whole scope of scientific teaching, as well as the purely professional practice of the healing art.

The treatment of the insane in families, and the system pursued at Gheel, are generally regarded as identical. The experiment which has been going on for centuries in the little Belgian town appears to satisfy all the requirements of a crucial experiment; and it is supposed that it furnishes in its results a demonstration of the worth or worthlessness of the family system of treatment. Friends and foes have long been accustomed to investigate the matter at Gheel, and to found their respective verdicts on the system which they may have observed there.

“Look to the needle of your compass, I beseech you, good Sir Astrophel, and tell us, if yon can, whence comes this storm ?”

We now come to the consideration of the last of the three forms of weakmindedness among prisoners, viz., states of mental exaltation. We looked upon the first form, simple mental weakness, as a state of “want of mind,” a negative or irresponsive condition of mind. The second form, states of mental depression, we took as a condition in which there is general inertia of mind with a prominent activity (positive action) in the direction of painful depression.

The following case occurred at the Glasgow Circuit Court, in September, 1875, and seems well worthy of record in the “Journal of Mental Science.” It is especially important, as showing that the Crown, disregarding the formal definitions of the Judges, has practically recognised that insanity, like other diseases, varies greatly in degree, that it may modify without destroying legal responsibility, and that it may mitigate without annulling the penalty due to crime.

Moral Responsibility, although often treated from a metaphysical point of view, has seldom been regarded from a physical or physiological side, and yet it is from this source alone that we are at present able to gain any accurate information respecting the working of the mind, and it is chiefly from this basis that I purpose here regarding it. The means of observation which metaphysicians employ have been known to, and employed by, philosophers for the last two thousand years, and yet it must be admitted with but a poor result. Until physiology came to their aid, they had not arrived at a knowledge of the fact that the grey cortical matter of the brain is the seat of the mind, and that intellectual action involves definite physico-chemical changes which we are to some extent capable of estimating. The psychologists, indeed, fixing their attention solely upon subjective phenomena, resemble those fatuous fakirs, who, intent upon a particular point in their own bodies, come to believe that the umbilicus is the seat of wisdom; or, rather, they resemble the horse in a threshing floor, which, however rapidly it may seem to advance, only retraces its steps in one small unending circle. It is a simple fact that, whatever positive knowledge we possess of the mental process has been obtained by the aid of physiology, and it is equally certain that all the knowledge we are likely to attain for a long time, if not always, must be derived from the same source.

That the amount and types of insanity vary in different countries, and even in different portions of the same country, has long been a recognised fact; but my object in this short paper is, by means of an illustration drawn from one district, to show within what narrow limits, as regards locality, great differences may be observed in the distribution of insanity.

Case 1st.—H. J. M. Admitted July 29th, 1872; female; 18 years; single. Hereditary predisposition existed in family; she had at one time been excited for a day or two, and been treated at home; she had lately been subject to considerable anxiety, and had to sit up frequently at night nursing a sick relative. Ten days ago became excited, talking much incoherently; was sleepless, and took food ill. For the two days previous to admission had got worse, more excited, had attacks of hysterics, and did not sleep at night. She had not menstruated for two months.