During the past eight months he has had four fits. The first in bed early in the morning: he lost his senses; was much convulsed; bit his tongue; the attack lasting for from fifteen to twenty minutes. The next two fits, of the same character, occurred one week after the first. The fourth took place a week after Christmas. Four months ago, he says, his left eye gradually turned outward, and he saw double. Fourteen days ago he complained of great pain at top of head, and could not sleep for three nights. His left eye closed. His wife says he became very stupid, lost his memory, and has been getting gradually worse, so that now he is almost imbecile, requiring even to be dressed. He is deaf with the left ear, and, so far as can be gathered, the sight of the left eye is defective; its pupil is dilated and sluggish. He can whistle, and can close both eyes equally well, but there is ptosis of the left eyelid. His appetite is bad, and he is long in eating his food, which is retained for some time in his mouth ere he swallows it. The left arm is wasted to the elbow, and painful. For a month or two after his first visit to the hospital it was not possible to obtain reliable information from him as regards syphilitic infection, which was strongly suspected. His mind was so vacuous that he only gave contradictory answers. However, he was at once treated upon this view. Ten grains of iodide of potassium were given three times a day for a fortnight; then fifteen grains for another fortnight, and a blister applied to the back of his neck. On March 3d his wife reported that he wandered a good deal every day, fancying himself a boy again. On this day one drachm of the solution of bichloride of mercury was given in infusion of rhubarb twice a day, and the iodide discontinued. This treatment was continued until June 23d. About the beginning of April he began to improve a good deal, especially in the condition of his mind; and it was then gathered from him that he had buboes at twenty-three years of age. He denied ever having had a chancre. He had suffered much from "rheumatics" in the arms and legs; worst at night. In June he had two fits for the first time since December. On June 23d a return was made to iodide of potassium, which was given in ten-grain doses three times a day; and this has been regularly taken ever since. In August it is noted that he has lost all wandering; but is suffering pain in the head. In October, "There is now no strabismus, nor ptosis." When we last saw him, a few days ago, he walked into the room with tolerable firmness, and with a bright, rather ani mated, expression of countenance. There was no sign of paralysis to be noted, and his mental condition was surprisingly changed from what it was when he came under treatment. The case is an interesting one, both as showing the value of specific treatment and as a lesson in the fact, often unrecognized, that unusually great patience is necessary in the treatment of syphilitic diseases of the nervous system, improvement being often much delayed. The man has been attending the hospital regulartly for fourteen months, and with constantly increasing advantage.-The Lancet. Treatment of Neuralgia by Veratrum.-M. Bertrand has published eight cases of facial neuralgia, and of neuralgic headache, in which quinine and blisters had been tried without success, and which yielded promptly to an ointment made as follows: The painful parts are to be rubbed with this ointment, preferably when the paroxysms are at their height, and as often as they recur. Two or three frictions suffice in the majority of cases.—Bulletin Général de Thérapeutique. Long Lethargy complicated with Catalepsy.-The subject of this case was a young girl aged ten years and seven months, who had been recently attacked with scarlatina. Suddenly, she was seized with a severe pain which lasted five weeks, and during which sleep was almost impossible. At the end of this period, the cephalalgia disappeared, and was succeeded by an extreme fatigue of all her limbs. Finally, one day, at about two o'clock in the afternoon, she fell into a very sound sleep, from which her mother could only arouse her partially, and then with great difficulty. The child ate a little food, coughed, and soon went back to bed, and did not again awake. Repeated applications of electricity were made, each time to the extent of causing cries and movements, but as soon as the current was interrupted, the sleep became as profound as before. Warm salt baths, sulphuret of antimony, calomel, injections of valerian, camomile, and tobacco, and tincture of opium, were used, but produced no effect. Paroxysms of catalepsy occurred three or four times a day, and lasted five or six minutes each. It was only after the lapse of two months that the lethargy appeared to become less profound. A month subsequently the faculty of speech returned, and she soon afterward entirely recovered her health.-La Revue Médicale Française et Etrangère. II. MEDICAL JURISPRUDENCE. Suggestions for rendering Medico-Mental Science available to the better Administration of Justice and the more effectual Prevention of Lunacy and Crime. By T. LAYCOCK, M.D., etc., etc., Professor of the Practice of Medicine, of Clinical Medicine, and of Medical Psychology and Mental Diseases in the University of Edinburgh.' THAT medico-mental science is often at variance with the doctrines and decisions of the courts of law is a fact too well known and too generally admitted to need formal proof. It is almost as generally assumed that the scandalous failures of justice, which too often result, must be attributed to the defective education and knowledge of the profession. It is alleged that, as a body, we are for the most part ignorant and theoretical in matters relating to insanity, and if not ignorant, then presuming, and often using the little knowledge we possess, rather with the intent to rescue thieves and murderers from the legal consequences of their crimes than to help the administration of justice. It is certainly a fact which many of us lament, that the corporate bodies of the profession generally, including the general medical council, ignore the subject as a distinct department of medical education; and consequently medical practitioners, not being duly trained, do sometimes appear to great disadvantage in courts of law. Medical shortcomings are not, however, the subject of my paper, but certain fundamental defects in the principles and procedures of the law which render medico-mental science sometimes even worse than useless, and always less useful to the commonweal than it might be, if rightly adapted to the needs of modern society. Nor would it be difficult to show that some of the crime and folly which occupies our courts and fills our reformatories, prisons, workhouses and lunatic asylums, is capable of prevention by a well-devised use of medico-mental science. As these matters are wholly beyond, the powers of the profession, I shall ask leave to move at the close of the discussion that a committee be appointed, with power to take such steps as may be thought necessary to secure a thorough inquiry by the Government into the relations of medical science to the administration of the law in. Read at the Annual Meeting of the Medico-Psychological Association, held at the Royal College of Physicians, August 4, 1868. regard to all persons mentally disordered or defective, with a view to such improvements as may be practicable. I do not presume to controvert the legal dictum that in this department, as in others, law in the abstract is the perfection of reason and common-sense, but the contrary. The principle of the law is perfectly just and reasonable, namely, that both the legal responsibilities and the rights of an individual may be either limited or wholly abolished, provided that it be proved that he is mentally incapacitated for his duties or for the use of his rights by either bodily disorder or defect. So that in any trial, thus involving either the responsibilities or rights of an individual, two distinct questions arise: firstly, whether the individual is or was mentally incapable; and, secondly, whether the incapacity is or was due to bodily cause, and not to ignorance and vice. The first is a question for a jury, to be established only by evidence of the conduct of the individual; the second can only be determined according to the rules of medical art, and by those versed in the kind of facts which constitute evidence of bodily disorder and defect. It is obviously in recognition of this principle that the opinions of medical practitioners are held to be necessary to the administration of the law in these cases. Existing defects are not, therefore, due to error in the fundamental principles of the law, so much as to imperfect interpretation and application of those principles; and I shall show that these are imperfect, partly because guided by obsolete medical doctrines, and partly because of defects in legal and medico-legal procedures. Some of these doctrines, indeed, so far from being in harmony with modern science, have really no ground in the common-sense and experience of mankind. The legal responsibilities and rights of the young, termed infants in legal phrase, may serve as an illustration. The law in the abstract justly and rightly affirms that the young members of society are legally incapable and irresponsible in proportion to the incompleteness of their development, whether it be of body or of mind. Marriage is one of the first and most important of social duties, and the law therefore rightly undertakes to fix the age at which young persons are sufficiently developed to procreate and duly bring up children. This question, which is strictly within the domain of physiology and medical psychology as well as common-sense, is thus settled by the law as to females In Ireland, a woman cannot marry without consent until she is eighteen years old; in England, she may marry at sixteen; but in Scotland, a girl of twelve and a boy of fourteen can enter legally upon this duty. Now, puberty, even in the South of Europe, is not attained so early, and is still later in Scotland, so that such a law, if prepared now for the first time, would be at once repudiated, as only applicable to other races of men in other climes. If we inquire how this strange notion came to be part of the law of Scotland, we find it was transmitted from ancient Rome; further inquiry shows that Rome received the law from more ancient Greece, the great source of Latin literature and law; and, going still deeper into antiquity, it seems probable that Greece received it from more ancient Egypt, or else from the great and still more ancient Aryan source of Westtern language and customs. The question of mental incapacity from disease or defect entered into and regulated all the proceedings as to person and property of the ancient Roman law. This principle has also been preserved to a great extent in Scotland as to property. But in England, while a person, equally as in Scotland, ceases to be a minor or an incapable at twenty-one, if he be at that age imbecile, foolishly prodigal, facile in temper, and weak in judgment, because undeveloped in brain and intellect, the ancient common-sense distinction between idiocy as defect and insanity as disease is not merely lost sight of, but repudiated. Lord Westbury said approvingly in the House of Lords, "Originally there was a difference, but it has long since disappeared." And Lord Chelmsford said, on the same occasion (viz., the discussion of the Lunacy Regulation Bill, March 12, 1862), "Under the existing law no person, however extravagant, foolish, or prodigal, could be made the subject of a commission of lunacy unless his acts were such as to lead a jury to the conclusion that he was of unsound mind, and a verdict founded on imbecility or weakness of mind would be set aside as contrary to law." In short, the courts, abandoning the true principle of law, proceed to discuss the metaphysical questions of a man's sanity or insanity. Milton has represented the fallen angels as sitting apart in hell, and discussing insoluble metaphysical questions like those raised in the courts, and a witty friend of mine affirms that the great poet did this to show that evil spirits were tormented, even in their recreations, by their bad propensities, and that their appropriate punishment was to be "in wandering mazes lost." So, in truth, too often is the course of things in our courts when insanity is the question discussed. Adults are subject to disorder and decline of the faculties which place them in the same position in regard to property as infants and minors. Senile dementia-that "second childhood" which surely comes to every man and woman that lives long enough-may come on at an early age. In Scotland, the same sound principles apply to these cases as to the others; but in England, there must be the inquiry, not into incapacity, but into in |