to write her biography as that of the most wonderful woman he had ever come across-this being a decent middle-class man, who by his honest industry had made a small fortune, and had lost £3000 of it through her. And he was counted sane and she insane!

THE INSANE DIATHESIS.

A description of the general symptomatological forms of mental disorders would not be complete without reference to a condition of mentalisation which has been called the insane diathesis. Maudsley, in this country, and Morel, in France, have described it better than any other authors. The great difficulty about its description is that we find few cases of this condition alike, and its special manifestations in different cases are as multiform as the human faculties, and as complex as different combinations of unusual developments of those faculties can make it. There are certain human beings characterised through life by striking peculiarities, eccentricities, originalities in useless ways, oddities, disproportionate developments, and nonconformities to rule, these things not amounting to mental disease in any correct sense, and yet being usually by heredity closely allied to it, or by evolution ending in it at last. The children of insane parents, or some of the members of families who have developed many neuroses, are most apt to exhibit the symptoms of the insane diathesis. Its symptoms are so various that they cannot be briefly described. One has merely to read the works of the modern psychological novelist to find the type of person I refer to in abundance. No one has lived long in the world without meeting in the flesh many examples of it.

And there have been enough examples of it in the real lives recorded in biographies, ranging from the inspired idiots to the inspired geniuses among mankind. We may safely reckon Chatterton, De Quincy, Cowper, Turner, Tasso, Lamb, and Goldsmith, to take a few men of genius, as having had in some degree the insane temperament. We find some such persons strikingly

original, but not reasonable; different from other men in their motives, in their likings, in their ways of thinking and acting to such an extent that human society would at once come to an end were all others like any one of them. They are all in the highest degree "impracticable" and "unwise" in the conventional senses of those words. Some are abnormally sensitive and receptive, others abnormally reactive. Some are subject to influences and motives that are absolutely unfelt by ordinary men, such as hypnotism, sympathy with animals, &c. Most of the spiritualists, thought-readers, and clairvoyants who are honest, as well as many "Bohemians," are of this class. The actions of most of them may be described as instinctive. They do not find their way to lunatic asylums, but their friends often have to consult our profession about them, especially in youth. And fortunate would it be for many of them if the doctor had the direction of their upbringing on physiological and medicopsychological principles, instead of the schoolmaster on doctrinaire and purely mental ideas. How much unhappiness might have been saved in the world had this been done! For if there is any distinguishing feature of many of them, it is the capacity to be miserable. Nothing reconciles one so to the abundance of commonplaceness and stupidity in the world as a study of the lives of some of these persons. And surely our profession will in the future be able to apply its knowledge of brain function and development and the laws of heredity towards making the most of such lives, strengthening the weak points without forcing down the strong ones, saving from misery and ruin without depriving humanity of their originality and intenseness. I have one case in the asylum that may be counted as of the insane temperament. F. M., the son of an eccentric father, who could not get on as a student, because he would insist on studying, not what was prescribed, but what he liked, whose knowledge is prodigious on all subjects, -the only man whom I ever knew who had read through the Encyclopædia Britannica, and lived, but whose common sense is infinitesimal. I never saw any man, sane or insane, who could

"make such a fool of himself," in an ordinary company of ladies and gentlemen. He has most original ideas as to the future politics of Europe, founded on a profound study of the mental characteristics and capacities of the races who inhabit it. Yet he will get up and sing "My Pretty Jane" in a large company, out of tune and out of time, and so ridiculously that there is scarcely a dement in the asylum who will not laugh at him, and call him "daft." He is totally unfitted to "get on" in the world in any way. I presume it was this that drove his friends, after many trials elsewhere, to send him to a lunatic asylum, as the only place fitted to receive such a being.

Do not suppose for a moment that all persons of the insane diathesis are geniuses or talented. Nothing could be further from the truth. Most of them are, on the contrary, very poor creatures indeed, a nuisance to their friends, and no good to the world at large.

The insane diathesis differs essentially from the German Primare Verükheit. The latter is an insanity naturally evolved in early life from the original constitution of a brain which may have been at first without peculiarity, but gradually, inevitably, and without any other cause than its own natural evolution, an unsound state of mind is developed without preliminary explosion of brain-storm in the shape of an attack of mania or melancholia.

LECTURE X.

GENERAL PARALYSIS.

PARALYTIC INSANITY.

GENERAL PARALYSIS is not only a variety of insanity, but a true cerebral disease, as distinct from any other disease as small-pox is from scarlatina. It is a disease of extraordinary interest physiologically, pathologically, and psychologically. Its study has somatised and definitised the study of all mental diseases, and has added, and will add still more, to our knowledge of the connection of mind with body, and of mental and motor disturbances. What we knew of its symptoms and pathology ought to have led to the conclusion that the cerebral convolutions have motor functions long before Hughlings Jackson, Hitzig, and Ferrier arrived at their generalisations on the subject. Being a distinct disease, clinically and pathologically, it can be defined, and I should give its definition thus :-A disease of the cortical part of the brain, characterised by progression, by the combined presence of mental and motor symptoms, the former always including mental enfeeblement and mental facility, and often delusions of grandeur and ideas of morbid expansion or self-satisfaction; the motor deficiencies always including a peculiar defective articulation of words, and always passing through the stages of fibrillar convulsion, inco-ordination, paresis, and paralysis; the diseased process spreading to the whole of the nerve tissues in the body; being as yet incurable, and fatal in a few

years.

The disease, for convenience sake, has been divided into three stages, the first of which is that of fibrillar tremblings and slight inco-ordination of the muscles of speech and facial expression, and of mental exaltation with excitement; the second that of

muscular inco-ordination and paresis with mental enfeeblement ; and the third that of advanced paresis, or no power of progression, almost inarticulate speech, and at last paralysis with mental extinction. Those stages form a convenient basis for the study of the disease.

Let us look at a case in the first stage of the disease.

F. Y., a fine strong handsome man of thirty-five, without any known hereditary predisposition to insanity, who had enjoyed good health up to the time of his present attack. His temperament is sanguine, diathesis neuro-arthritic, and his disposition frank, unsuspicious, boastful, and hasty. He always had a high opinion of himself, and showed it; was of an imaginative turn, and had a physiological tendency to exaggeration. His feeling of bien être was always above the average; his habits had been industrious, and at times he had worked very hard indeed. He had not been dissipated in the worst sense, but he had lived freely, taking lots of alcoholic stimulants habitually, eating much, sleeping generally too little, and, above all, exceeding greatly in regard to sexual intercourse, both before his marriage and since he had been married for three years. He had never had syphilis that I could make out, and certainly has no evidence of the disease on his body. For a few months his friends have noticed that he "has not been the same." Six months ago he was "not in good spirits," and complained of flying pains in the head; then he was a little forgetful, wanting in application to his work, restless, doing some "unaccountable things" in business, e.g., forgetting to claim money due to him. He was irritable at home, a thing unusual with him. A month ago he began to express an exaggerated sense of well-being, saying he never was so well in his life, that his strength was "something wonderful"; he could not settle down to his daily work, his natural high opinion of himself was more openly expressed to comparative strangers, one of whom remarked after seeing him, "what a conceited fool that man is." This state went on without any other absolute signs of insanity, and without awakening the suspicions of his friends that he was mentally