sanction was given to the inauguration and subsequent gradual growth of the little colony. Its beginnings were very humble, the number of boarders very small, and even now it is only twenty-four. In this case the organizers of the experiment were the authorities of the city parish of Edinburgh, who have in various other ways successfully carried out in practice the admirable principle of "boarding out" the dependent poor. Accident determined the locality of the experiment. The authorities of the parish of Kennoway, in which the experiment has been, and is still being, made, especially Dr. Small on the one hand, and Mr. Smith (Inspector of Poor) on the other, soon took, and continue to take, a warm interest in its development; while the Commissioners in Lunacy have extended to it their fostering care and encouragement. In the cases of Balfron and Aberfoyle (Gartmore), again, the agents by whom an equally successful experiment is being gradually more and more extensively developed are the authorities of the city parish of Glasgow, and especially their medical officer, Dr. Robertson, and their inspector of poor, who harmoniously co-operate. To them is due the proper selection and supervision of the cases; upon which the success of such experiments necessarily depends. There can be no doubt that the boarding-out-the family system of treatment-of insane paupers, as practised at Kennoway or Balfron, Gartmore or Loanhead, is capable of great extension. There is no reason why equally qualified custodiers should not be found in every village in Scotland; and there is equally little reason why all parochial authorities should not take as active an interest in the boarding out of the insane poor as those of the city parishes above mentioned, who are deserving of great credit for the prominence they have taken in inaugurating a reform which, we venture to think, is destined in other countries, even more than in our own, to be one of the most important that has ever characterised the history of the treatment of the insane! The boarding-out scheme as adopted at Kennoway and other Scottish Gheels is only one development of the Gheel system of treatment, which is susceptible of many modifications. It is obvious that Baron Mundy, Professor Parigot, and Dr. Lindsay, in their advocacy of the Gheel system, had something more in view than the mere boarding-out of two or three dozen insane paupers in existing villages. Their theory of treatment -even of the poorest and most hopeless of the insane-is of a much more ambitious kind than that of the Scottish Commissioners in Lunacy. They are not content to take cottars or peasants, and their squalid homes, as they find them; but they aim at a higher kind of homes, a more cultivated class of custodiers, and a mode of life more in accordance with modern medical views as to the nature of insanity, and its proper treatment. Hence they would establish new Gheels, the first step being the purchase of sufficient areas of reclaimable waste lands. Then they would establish a colony such as that of Gheel, possessing a central village, with its hospital, churches, schools, public recreation-hall, stores, and so forth; and scattered over the domain, they would place hamlets, or isolated houses of a farm character or otherwise, all having reference to the industrial requirements of the place and the people. There is no more difficulty in constructing such a colony than in establishing a District asylum. The same elements are present; but while they are concentrated in the one case, they are diffused in the other. Of course, the foundation of a new Gheel is more expensive than the mere development of the family system in existing villages, where existing machinery is economically rendered available. But the new Gheel would be complete in its organization; and its theoretical advantages at least are very much greater than those that can attach to a mere irregular aggregation of boarders such as characterises Kennoway or Balfron. We have no desire to depreciate the humble experiments that have there been carried on (in Scotland) for the last seven years they are admirable developments of the Gheel system, so far as they go, and in the circumstances. Above all, village colonies have been proved to be practicable, which the establishment of new Gheels has not hitherto been shown, by any example, to be. But if there is any reality in the advantages the Board of Lunacy attaches to the sanitary condition of asylums; to light, air, dryness, drainage; to the features of moral or other treatment in all classes of the insane, including the reputedly incurable, [e. g. to variety of occupation and amusement; to the suitability of diet; to the requirements of each patient; to the careful medical treatment of every individual,] there can be no comparison between a Gheel constructed and organized de novo, and the old-fashioned domiciles of decayed Scotch villages! If, on the other hand, we are, with Sir James Coxe, to take private dwellings for insane paupers, "as they are and not as we might wish them to be;" if we are to regard insanity as constituting no peculiar claim on our liberality, and chronic insanity as requiring no special treatment; if we are to speak with him of "other sufferers, who frequently possess claims of much higher value, as being at once morally more deserving, and intellectually more capable of appreciating the sacrifices made for them"-doctrines, to say the least, of an extraordinary kind, proceeding from such a source-what 93-XLVII. becomes of all the ambitious arguments used by the Scotch Commissioners in Lunacy when they advocate improvement after improvement in our expensive public asylums? It is surely absurdly inconsistent, on the one hand, to regard the insane as inferior to their neighbours, or as deserving at least no better treatment; and on the other, to endow them with privileges not possessed by the sane of equal rank or status in society! What is really wanted, as regards the development to a due extent of the experiment of "boarding out" the insane poor in Scotland, is the will on the part of its parochial boards, for where the will exists the way will soon present itself. What has been achieved by the parochial authorities of Edinburgh and Glasgow might be equally accomplished by those of any county in Scotland. Convinced of the expediency and practicability of the scheme, and possessed of the necessary earnestness of purpose, parish officers will encounter no difficulties-that are not surmountable by patience, perseverance, and liberality-in carrying out for themselves an experiment of a similar kind to Kennoway and Balfron, and, it may be, on a much larger scale. There will be no real difficulty where the disposition exists to give the experiment fair play, where there is an honest and hearty cooperation of the different authorities whose interests are involved. We do not profess to be able to submit to our readers "Proofs, as clear as founts in July, when that such an experiment must in all circumstances succeed. But we have, we trust, submitted sufficient evidence to show that there is room for great development, in various forms and to various degrees, of the "Family system," as applied to the treatment of the Insane Poor in Scotland! V.-Obstetrical Tranasctions.1 THE eleventh volume of the Transactions of the London Obstetrical Society' is, like its predecessors, rich in valuable facts, and contains several memoirs of interest. Nothing is of more importance to medical science, and, we may add, to the personal reputation and security of the medical practitioner, than the placing on record of typical and extraordinary cases. Typical cases, by their accumulation and comparison, test the value of current scientific dogmas, and supply the materials for 1 The Transactions of the Obstetrical Society of London, vol. xi, 1870. The Transactions of the Edinburgh Obstetrical Society, vol. i, 1870. confirming or correcting those dogmas; and it is of the highest necessity that this double process of confirming and correcting current opinions should be constantly going on. On the other hand, extraordinary cases, apart from their value as illustrating physiological and pathological laws, have this special interest: they afford the means of explaining unexpected casualties in practice, and of removing unjust suspicions of malapraxis. We happen to know that the Obstetrical Transactions' have, in more than one instance, furnished cases which have vindicated professional character. Few greater services to medical science and to those who practise it could be rendered than to gather up into one focus, say, all the authenticated cases of ruptured uterus. No case of this kind ever occurs without throwing at least temporary doubt upon the skill of the medical man who happens to be concerned. The public and the law always look for "cases" in explanation of a particular catastrophe. They look with distrust upon mere doctrines and opinions of experts, who may be suspected of partiality. But an analogous case recorded in a book is open to no such doubt of being moulded to suit the occasion. It is often decisive. In connection with this subject we may cite two cases of ruptured uterus. The first is related by Dr. Greenhalgh, and is a very remarkable one, possibly, as the note of interrogation suggests, erroneous in diagnosis:-A woman, seven months gone, in her sixteenth pregnancy, while lifting a heavy weight, was suddenly seized with the most agonising pain in the belly, as if something had given way. Shock and collapse followed. From this she rallied. Peritonitis set in, and signs of blood infection. The membranes were ruptured by a stilet, and a large quantity of putrid, stinking liquor amnii flowed, followed by the expulsion of a fœtus far advanced in decomposition. From this time the vomiting ceased, and the patient began to recover. Another case is recorded by Mr. Mitchell :-A woman, æt. 42, pluripara; had mollities ossium, when she was delivered by forceps after great difficulty. Again pregnant; it was found when she was gone five months that the pelvic deformity had increased. It was arranged to induce labour at seven and a half months. Being about seven months gone, she was subjected to severe terror and shock by a flash of lightning. She instantly felt agonising pain in the pelvis, fainted, and on reaction felt a continuous pain in the same region. Next, hæmorrhage set in. On examination a rent was found in the uterus, three inches above the os. The fœtus was extracted footling, dead. As the knee of the child lay in juxtaposition with the rent, it is probable that the uterus was torn by the violent contraction upon this projecting portion, which occurred under the influence of fright. She died next day. No autopsy. The main interest in the case lies in the fact that mere emotion may produce rupture of the uterus. 6 Cases of extra-uterine fœtation, terminating fatally, should be collected for the same reasons as cases of rupture of the uterus. The volumes of the Transactions' now contain many valuable cases. The present one contains a case by Dr. Martyn, the preparation being reported upon by Drs. Martyn, Madge, and Phillips. They believe the case to be an example of an ovarian foetal cyst, the possibility of which has been, we think, too absolutely denied. Two cases of tubal gestation are related by Mr. Andrew Brown and Mr. Worship. A case of rapid hydramnios, with twins, is related by Dr. Graily Hewitt, and a somewhat similar case, also with twins, by Dr. Rasch. There are some curious contributions to the history of twinpregnancy. Mr. B. Curgenven gives the history of an hereditary twin-bearing family, in which the tendency to double birth was remarkably manifest. Dr. Brunton gives a paper which appears to supply evidence against the doctrine that twins contained in one amniotic sac are always of the same sex. Of ten cases in which the children were of different sexes, in nine, he says, there was only one sac. This is so directly at variance with the observations of others, that further evidence is desirable. It was remarked in discussion by Dr. Playfair that in all the cases of united twins they were of the same sac. In these cases necessarily they were contained in the same amnios. This was exemplified in a case of united twins exhibited by Dr. J. R. Rogers. The important subject of the complication of pregnancy with ovarian tumour is illustrated by several unusually valuable contributions. One case, reported by Mr. Tarn, terminated fatally by bursting of the cyst. Dr. Hall Davis related another, in which the patient was safely delivered at term by the forceps. Dr. Hicks had seen six cases which went through labour without trouble. Dr. Barnes referred to one case in which the tumour burst and caused death, and another in which the tumour became rolled over on its axis, twisting the cord and causing fatal hæmorrhage and peritonitis. He contended that these accidents might occur at any time; and as there was no security against them, it was generally best to reduce the case to its simplest expression by eliminating the pregnancy. He advised that labour should be induced in the gentlest manner; but admitted that it was in some cases preferable to act upon the tumour by tapping, or to let things go on. When ruptures of |