1574 MEDICO-PSYCHOLOGICAL ASSOCIATION.

DR. RUBERT WILLIAM BoYCE, Assistant Professor of

Pathology in University College, London, and Dr. AndrewMelville Patterson, Professor of Anatomy in UniversityCollege, Dundee, have been unanimously recommended bythe Council of University College, Liverpool (VictoriaUniversity), for the "George Holt" Professorship of Patho-logy, and the "Derby" Professorship of Anatomy in thatCollege respectively.

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ON Saturday last, Urbino, the native town of FrancescoPaccinotti (the celebrated author of the "Storia della

Medicina," and classed by historians of medicine as beinghimself one of the foremost physicians of the nineteenth

century), held a commemoration of her distinguished son.The orator of the occasion was Filippo Mariotti, ex-

Minister of Public Instruction, who unveiled a monumentof the "illustre scienziato." Tuscany, in whose medicalschool Paccinotti’s best work was performed, was worthilyrepresented on the occasion.

AN exhibition of pictures on behalf of the building fundof the Dental Hospital of London will be held in the

galleries of the Royal Institution of Painters in Water

Colours, Prince’s Hall, Piccadilly, from Monday, June 25th,to Monday, July 2nd. The exhibition will be opened at3 P.M. on Monday, June 25th, by their Royal and ImperialHighnesses the Duke and Duchess of Saxe-Coburg and Gotha.

MEDICO - PSYCHOLOGICAL ASSOCIATIONOF GREAT BRITAIN AND IRELAND.

TUESDAY, JUNE 12TH.THE fifty-third annual meeting of this association was I

held in Dublin last week. The council met at 9.15 A.M.,and the general meeting for the election of officers, fiscalbusiness, &c., took place at 11 A.M. The chair was occupiedby Dr. James Murray Lindsay, the outgoing President.After a complimentary reference to Sir John C. Bucknill’srecent knighthood, Mr. Conolly Norman, the President forthe year, delivered his address.

THE PRESIDENT’S ADDRESS.Mr. Conolly Norman, after thanking the association for

the honour they had done him in electing him their President,and congratulating the meeting on its size and steadygrowth, proceeded to define what he thought should be thescope and aim of their work. This, he held, should be asremote as possible from those of a trades union. They couldtake, and ought to take, a much higher ground. Theirassociation consisted of men who practised a highlyspecialised and very important branch of medicine, importanton account of its social bearings and the wide-reachingcharity with the organisation of which it was concernedno less than from its position in the medical hierarchy.Dealing as it does with the latest acquired and themost complex of the human functions, psychiatry hasbeen one of the last of the specialities to obtain a distinctfooting. No branches of medicine, anatomy, and physiologyattract more attention or better workers at present than thosedealing with the nervous system, and, although they awaitthe fullest development of their speciality, the further pro-gress of normal and pathological anatomy and physiology,sciences in strict logical order subordinate to theirs, yet theycan even now claim to follow one of the most scientificbranches of medicine. In one striking point they noted anadvance for which their association might largely claimcredit. When they last met in Dublin the President, in his

address, expressed regret that the experiment of clinicalteaching which had been attempted at the Richmond

Asylum had failed. Now clinical instruction in mentaldisease is a necessary portion of the medical curriculumthroughout the United Kingdom. They should press uponasylum authorities that no medical officer should be per-manently appointed to an assistancy who had not, within alimited period of probationary service, passed a special qualify-ing examination in psychiatry. After referring briefly to theimportance of pathology and the increasing interest that was

ow taken in pathological work by alienists, Dr. Normanassed to the important question of asylum accommodation,nd said that certain developments in the care of the insane?hich have taken place of recent years on the Continent hadardly received the attention which they merit, instancing the’reat asylum of Alt Scherbitz, near Leipzig, which he con-idered would be the type of the model asylum of the future.’ Here," he said, I I the modern principles of dealing with anasylum population are carried out to the fullest extent.:nstead of vast buildings modelled on a prison, a barrack, ormonastery ; instead even of semi-detached buildings con-

iected by passages, the entire institution consists of groups)f houses entirely detached and every one surrounded by its)wn garden. Farm work forms the chief feature of theabours carried on ; but all kinds of workshops are pro-dded." Dr. Norman concluded by narrating the facts con-nected with a recent large and successful experiment in the)oarding out of lunatics in Berlin. The method adoptedwas somewhat similar to the Scotch boarding out system, onwhich, however, it was a great improvement, for the boarded-3ut patient remained under the supervision of an asylumphysician, and no certification or legal formality was requiredEor readmission.Dr. F. A. Elkins read a paper on Twenty-eight Cases of

Adult Female General Paralysis admitted to the RoyalEdinburgh Asylum from 1889 to 1893.1

Dr. Nicolson proposed and Dr. Whitcombe seconded avote of thanks to the President for his address, which wasadopted amid applause. The President expressed his acknow-ledgments, and stated that the mr-mbers were invited by Mr.Molony to visit Swift’s Asylum and by Mr. Pim to visit theStewart Institution. Dr. Gordon invited them to breakfaston Saturday morning at the Zoological Gardens. He (thePresident) was endeavouring to organise an excursion toBray and Greystones for that day. Mr. Frazer gave a lanterndemonstration, and the proceedings terminated for that day.

WEDNESDAY, JUNE 13TH.Dr. Renas Semelaigne read a paper on The Forms of

Delusion in Persecutory Insanity, in which he adduced casesof persons whose insanity took the form of believing thattheir lives were threatened by others, natural or spiritual.

Dr. Drapes read a paper on the Alleged Increase of In-sanity in Ireland. It was alleged that whilst in othercountries insanity had increased along with an increasingpopulation, or in a higher rate than that of the increase inthe population, Ireland presented a continuous increase inthe number of cases of insanity, along with a continuouslydecreasing population. Statistics, however, showed that theincrease was apparent rather than real. The number ofinsane persons under care had largely increased both in

England and Ireland, but proportionately to population to amuch larger extent in Ireland ; but this was due mainly to agreater accumulation in Irish than in English asylums owingto a lower death-rate amongst lunatics in Ireland than inEngland, while the discharged rate of unrecovered patientswas higher in England than in Ireland. Dr. Drapes couldnot help thinking, however, that the Celtic temperament lentitself more easily to insanity than the temperaments of othernationalities.

Dr. Hack Tuke read a paper on the same subject.Dr. Oscar Woods, Dr. Atkins, Dr. Andriezen, and thePresident also spoke.Dr. Clouston read a paper on Rest and Exercise in theTreatment of Acute Insanity.In the afternoon a meeting was held at the School of

Physic, Trinity College, at which Dr. Hack Tuke presided.The Rev. Dr. Haughton, F.R.S., said he was instructed

by the Provost and Senior Fellows of Trinity College, theGoverning Body of the University of Dublin, to give theassociation a hearty welcome. He did so not merely ongeneral grounds, but for two other reasons also, one personalto himsely-namely, that when they last honoured Dublinwith a visit they selected him-he did not know for whatcause-for honorary membership of their body.The Chairman said he was certain they would all join in

asking Dr. Haughton to convey to the Provost and SeniorFellows of the University their appreciation of their kind-ness.

Dr. Andriezen gave a demonstration on Some of theNewer Aspects of the Pathology of Insanity.

Professor Cunningham spoke on Development of theCerebral Sulci of the Human Brain.

1 Reported in full in THE LANCET, June 16th.

1575SANITARY REPORT OF INDIA FOR 1892.

The annual dinner was held the same evening at the RoyalCollege of Physicians.

THURSDAY, JUNE 14TH.Dr. Bond, in the unavoidable absence of the writer, read

a paper on the subject of Cerebral Pressure, written byDr. Claye Shaw. In dealing with the advisability of surgicaloperations, such as trephining or opening of the skull, Dr.Claye Shaw considered the great question to decide waswhether there was pressure on the brain in the earlier stagesof insanity and general paralysis. If there were, could anymore direct means be taken to relieve it than the opening ofthe skill He believed he was right in saying that in acuteinsanity the specific gravity of the brain was increased, andsurgical operations should only be resorted to after allother measures had failed ; but on the failure of all othermeasures he would recommend the performing of the opera-tion before dementia set in.Dr. MacPherson also contributed a paper on the same

subject, and defined generally the symptoms of cerebralpressure.Dr. Thornley Stoker said he had for a long time been

engaged in operating on the cranium, and was prepared toassert that where it could be shown that cranial pressureexisted the operation of trephining was a justifiable opera-tion.-Dr. Andriezen said they had not certain indicators toshow that in the insanity of these countries there was anincrease of cranial pressure.-Dr. Mercier found the condi-tions of the pupil as laid down in the text-book absolutelyvalueless for the indication of cranial pressure.-Dr. Swanzypointed out that a small, rapidly-growing tumour on thebrain was most likely to bring about optic neuritis.Mr. Nolan read a paper on the subject of the Insane in

Irish Workhouses, in the course of which he said they werehappily on the eve of legislative measures for the establish-ment of a new and better system of treatment of those

unhappy people. Idiots, epileptics, the demented andhalf-witted, the melancholic and the raving maniac, thefeeble, the dying, and the strong, he said, all met in thecommon goal, and the workhouse lunatic was honoured inthe most public of public institutions, a burden on the rate-payers. There was no suitable accommodation, with skilledcare, for these persons. Mr. Nolan then referred at lengthto the report of the Inspectors of Lunatics in this country,who had noticed, amongst other things, the want of propersanitary accommodation, classification, and nursing. Lunaticscould not be properly treated in workhouses, and should besent to asylums. In concluding, Mr. Nolan recommendedthat idiots and epileptic idiots should be provided for in oneor more suitable establishments, and that for the simple andepileptic lunatics there should be distinct asylums, wherethey could receive the accommodation and care they require.

Dr. Eustace, testified to the evils attending the presentsystem of treating the insane in workhouses.Mr. J. E. Kenny, M.P., said when he was medical officer

the evils of the present system were brought forcibly beforehim. There was the system of no separation between theinsane and casual inmates, and, without imputing the leastdegree of inhumanity to the authorities, he knew that theinsane persons became butts of those sane persons with whomthey intermixed. He thought the housing of the lunaticswas a matter of international importance. He would ask theGovernment if they could see their way to invite the coöpera-tion of the other Governments to arrange an internationalcommission to look into the subject.

Dr. Andriezen read an interesting communication on thesubject of Insanity and Race Decay. He considered thatenvironment had much to do with the causes of criminalityand insanity, and as an instance of hereditary insanity andcriminality, referred to the famous case of the "Duke"family which lived near New York and intermarried. The headof the family, "Max Duke," was a confirmed drunkard, andamongst his descendants there were 200 thieves and mur-derers, and 280 persons afflicted with blindness, idiocy, and- consumption ; 300 degraded women, and 90 children bornprematurely. In the ultimate stage the descendants of thisfamily became sterile, and nature therefore triumphed, butnot until it had cost the State more than$1,000,000.The afternoon meeting was held at the School of Physic,

Trinity College, when a demonstration was given by Drs.Clouston, Middlemass, and Robertson, upon the Chief Patho-logical Changes found in the Brain in Insanity.-Dr. BattyTuke also gave an interesting demonstration and referred tothe effects of fatigue on the cerebral cells of the honey bee ;

Professor Cunningham and Dr. Telford Smith demonstratedon the Brains of three Microcephalic Idiots.

FRIDAY, JUNE 15TH.On the suggestion of Mr. Conolly Norman, who occupied

the chair, the discussion on the question of "Lunatics inWorkhouses " was postponed till the next general meeting.Mr. Curwen (America) read a paper dealing with the treat-

ment of the insane and with the education of the young. Heconsidered that every physician in charge of a hospital forthe insane should do everything in his power to aid theadvancement of mental physiology, mental pathology, andpsychology. The better these processes were studied themore satisfactory would be the treatment and progress of thepatient.

Dr. Jules Morel, of Ghent, and Inspector of Asylums inBelgium, read a paper on the need of special accommodationfor those individuals whose mental faculties had not beensatisfactorily developed before or after birth. By placingsuch individuals in institutions other than asylums, reforma-tories, or prisons those who were slightly degenerate mightbe saved from further degeneracy. These, such as inebriates,might be discharged when improved, and the most degenerateshould be kept and might contribute by their own earnings tothe State.

Dr. Hack Tuke had been unable, after careful examinationof a number of persons, to decide whether they were honestmen or criminally inclined. Until they could arrive at adefinite conclusion they could not ask the Government tosequester persons who had not committed any crime, and whowere not insane to such an extent as would warrant theirbeing detained in asylums.

Professor Benedikt read a contribution on Moral Insanity,and said it was a great progress in psychology to have reco-gnised that many criminal and vicious acts have their offspringfrom congenital qualities.

Dr. Burke said his long experience enabled him to testify tothe effect which the fact that they were considered irrespon-sible for their actions had upon the conduct of insane persons.A vote of thanks having been accorded to the President

and Fellows of the Royal College of Physicians for placingtheir rooms at the service of the Association, the annualproceedings terminated.

THE REPORT OF THE SANITARY COM-MISSIONER WITH THE GOVERN-MENT OF INDIA FOR 1892.

[THIRD NOTICE.] ]BEFORE concluding our remarks in connexion with the

European army in India we may advert to a few interestingpoints such as the effects of a tour of Indian service upon thestrength of a corps. Out of 920 men who went to India inthe 2nd Battalion King’s Liverpool Regiment, only 4 returnedwith the regiment after fifteen years’ service in that country.Of the 916 to be accounted for 312 were lost to the regimentby death (147) and invaliding (165)-about 339 per 1000 ofthe original strength-and 604 from other causes. The

number of women and children in India has, of course,declined greatly since the introduction of the short-servicesystem ; the ratios of sickness and mortality rose to anunusual height among the former in 1892, while among thelatter (children) the sickness was greater, but the mortalitywas somewhat less during the same year-it amounted to48 ’59 per 1000. We may incidentally note the absence ofcholera among infants of less than a year old and the absenceof small-pox among infants and children up to fifteen yearsand upwards, showing the protective effect of vaccination ina country where small-pox is very prevalent.The year 1892 was an eminently unhealthy year in India as

a whole, but especially so in Bengal and in the Punjab;indeed, the public health was worse in the Punjab, and thedeath-rate the highest that has probably ever been recorded-49 48 per 1000. Epidemic cholera was especially prevalentin India during that year, but the unhealthiness was notexhibited in respect of cholera only, for there was an in-creased prevalence and mortality from various other diseasesalso.The gaol population of India, amounting to an annual