wards, the heaviest brain in the one series being 60 oz. 8 dr., and the heaviest in the other being 62 oz. 12 dr. It will also be seen that, with two exceptions, the superiority in weight was among the brains of the sane in each of the quinquennial or decennial periods into which they are classified. Whether this justifies the inference that persons having large brains are less frequently the subject of mental derangement than others, I shall not venture to say; but the fact is a striking one when contrasted with the results derived from a comparison of the average weight of the entire number of cases, where it appears that the average weight is increased in persons dying insane. The average weight in the insane from fifteen to ninety years of age being 50 oz. 2 dr., and in the sane 49 oz. 14 dr.

Different results are derived from a comparison of the weights of the brains of the females; here, in one exceptional case, the brain weighed 614 ounces in a female who died insane, but in a majority of cases the greatest weight was on the side of the sane. On taking the average of all the cases, the weight of the brain in the insane was 44 oz. only, and in the sane 44 oz. 5 dr.

The comparison, however, establishes, I think, a strong presumption that the absolute weight of the brain is increased in the insane, when we reflect that in many cases of insanity, the absolute size of the brain must be materially dimi nished by the large quantity of serous effusion found in the ventricles, arachnoid sac, and sub-arachnoid tissue.

On

This increase in weight, however, appears to depend chiefly upon an increase in the weight of the cerebellum; for, on comparing the weight of the cerebra in the two series of cases, it will be found that the difference is inconsiderable, and indeed in the case of the females that it is in favour of the sane. comparing, however, the columns showing the weight of the cerebellum (with the pons and medulla) in the two classes, it will be found that there is almost a uniform preponderance in the weights of those of the insane. The average weight in all the cases of the insane males exceeds that of the sane by 4 drachms, and in the females by 5 drachms.

In a Table the ratio between the cerebellum (with the pons and medulla) and the cerebrum is given at the different ages distinguished. Here the same fact is very clearly brought out; in almost every instance the cerebellum in the insane being heavier in relation to the cerebrum than it is in the sane. From the average of the entire number, the cerebellum was found in the males to be as 1 to 6.748 in the insane, and as 1 to 7:06 in the sane; and in the females as 1 to 664 in the insane, and only 1 to 7 in the sane. The cerebellum therefore is considerably heavier in relation to the cerebrum in the insane.

This mode of estimating the results appears to me to be free from the source of fallacy arising from the small number of cases compared; when we compare the absolute weights together, as here, on examining all the cases separately, we find, in almost every instance, the cerebellum of each brain heavier in relation to its own cerebrum in the insane than in the sane.

Further inquiries, and a larger number of data, may modify these results; but, I think, from those which I have thus collected, it may be regarded as highly probable that there is an increase in the weight of the cerebellum in persons dying insane.

In mania, the average weight of the encephalon in males was 53 oz. 134 dr.; in monomania, 52 oz. 119 dr.; in dementia, 49 oz. 11, dr.; and in general paralysis 46 oz. 61 dr.; the weight being greatest in mania, and least in general paralysis. In comparing the average weights of the cerebella, &c., however, in the same series, while they are found to follow the same decrease from mania, the highest, through monomania to dementia, the weights being respectively 6 oz. 12 dr., 6 oz. 11 dr., and 6 oz. 9 dr.; the cases of general paralysis present

the highest average, the average weight being 6 oz. 13 dr. From the fact that in general paralysis the morbid appearances are most constant and most distinctly marked, this result might perhaps be anticipated, if we assume what I have endeavoured to show, that the relative weight of the cerebellum to the cerebrum is increased by insanity, and that the cerebellum is the organ principally affected. This increase, too, would appear from a review of the history of the case to bear a constant relation to the form of the disease, and to be greatest in more protracted and gravest cases. On comparing the average weight of the cerebellum to that of the cerebrum in the cases classified as above, it was found in males to be as 1 to 6-9735, 67549, 6-5625, and 6-2511, in mania, monomania, dementia, and general paralysis respectively. Excepting mania, the same gradual increase in the relative weight of the cerebellum was found to obtain in the females, the cerebellum being to the cerebrum in them as 1 to 6.5338, 6:412, 6·5943, and 60435 in same class of cases respectively.

It appears, therefore, that in cases of comparatively short duration, there is the smallest amount of increase in the relative weight of the cerebellum, and that in general paralysis the greatest increase takes place.

In reflecting upon these results, the impaired control over the voluntary movements, which forms so marked a feature of general paralysis, and the very constant increase of the relative weight of the cerebellum in this disease, must at once be viewed as very interesting and important facts in connexion with the functions ascribed to the cerebellum by Fleurens and other physiologists.

May it not be asked-supposing it to be established by an extended series of observations, that there is uniformly an increase in the relative weight (and specific gravity, as we shall presently see,) of the cerebellum as compared with the cerebrum in all forms of insanity-whether it may not be inferred that the cerebellum is the organ through which we exercise self-control,-control over the volitions and successions of our thoughts, as well as over the voluntary muscular movements;-a perturbed volition or a loss of self-control, being of all other symptoms the most essential characteristic and pathognomonic feature of insanity?

The specific gravity of the grey and white substance of the brain was taken in 80 cases, of which 39 were males and 41 females.

The specific gravity in the cases of insanity was almost uniformly higher, and this observation applies to both the grey and white matter.

In Dr. Sankey's cases, the lowest specific gravity of the grey matter was 1028, in the Asylum ones the lowest was 1030; the highest in Dr. Sankey's cases was 1046, in mine 1049; while the average specific gravity in all the cases of both sexes was in the former 1034, and in the latter 1038, showing an increase in the specific gravity in the cases of insanity.

The lowest specific gravity of the medullary substance in the healthy brains was 1032, in the diseased 1032; the highest in the healthy was 1048, in the diseased 1053; the mean of all the cases was 10411 in the sane, and 1·0429 in the insane, showing an increase in the specific gravity of the white matter of the brain in cases of insanity.

These results are corroborative of those obtained by Dr. Sankey in his observations at the London Fever Hospital, where in all the cases complicated with cerebral symptoms of a grave character preceding death, such as convulsions, strabismus, paralysis, and utter unconsciousness, the specific gravity was high, averaging both in the grey and white matter 1041. He makes two exceptions in regard to the white matter, in both of which the specific gravity was below the mean; these were both cases of children of eight and ten years of age, and both of tubercular meningitis. Deducting these cases, the average specific

gravity of the white matter in his series of cases, complicated with cerebral symptoms, was 1043.

On examining my cases in detail, I find that in most of those cases where the specific gravity of the grey matter was considerably below the mean, the patients had died of phthisis, and in other instances of exhaustion occurring at an advanced age. Where exceptions to this general inference were met with, it was found that either the symptoms immediately preceding death were of a grave character, or that the morbid appearance found in the membrane indicated chronic inflammatory action.

I have also taken the specific gravity of the grey and white matter of the cerebellum in forty-three cases. I have placed on the table the averages at different ages. The number of observations is too few to warrant more than a presumption that the specific gravity of the cerebellum is higher than that of the cerebrum. The difference is much more apparent when, instead of comparing averages, the specific gravity of the cerebellum is compared with that of the cerebrum to which it belonged.

I have not been able as yet to obtain a sufficient number of data showing the specific gravity of the cerebellum in the sane to furnish comparisons with the observations I have made. Dr. Sankey has kindly furnished me with a number of observations made by him; but as he has not separated the grey from the white matter, but has taken his specific gravity from a portion of brain containing both, I cannot compare my observations with his directly. I may state, however, that they tend to the same general conclusion, that the specific gravity of the cerebellum is higher than that of the cerebrum, and that it is so in healthy brains as well as in diseased ones, although probably in

a smaller ratio.

Through the kindness of Dr. Haldane, I have been enabled to make a few observations on the specific gravity of the grey and white matter of the cerebellum in persons dying in the Royal Infirmary. The number of cases suitable for a comparison of this kind of cases dying without any cerebral symptoms, has as yet been rather too small to merit a special record. I may, however, state that in a series of five cases of males dying without cerebral symptoms, the average specific gravity of the grey substances of the cerebellum was 1042, that of the cerebrum being 1041. In the cases of the insane examined by me, the average was 1040 for the cerebellum, and 1035 only for the cerebrum, showing a much greater increase in the ratio in the insane than in the sane, although the absolute specific gravity was less in these particular cases.

The white substance of the cerebellum in the five cases referred to, had an average specific gravity of 10443, while that of the cerebrum was 1.0430. In the cases examined in the Asylum, the average specific gravity of the white substance of the cerebellum was 1044, while that of the white substance of the cerebrum in the same cases was 1.039 only-thus showing a small increase in the absolute specific gravity of the white substance of the cerebellum in the insane in the cases compared, and a very considerable increase in the relative specific gravity to that of the cerebrum in the case of the insane.

From these data, although limited, I infer that the specific gravity of the cerebellum is increased in insanity, and attains a greater increase in relation to that of the cerebrum than it does in persons dying sane.

In comparing the specific gravity in the different forms of mental disease, and taking the average of all the cases of each kind, I find the lowest specific gravity of the grey matter to occur in cases of dementia, where, however, it is still 0003 above the average in the sane. The next highest specific gravity occurs in cases of melancholy and monomania, the next in general paralysis, the next in mania, and the highest in epilepsy.

Of the white substance, the lowest average of specific gravity occurred in

cases of mania, 1040; the next in dementia, 1041; the next highest in general paralysis, the next in monomania, 1044; and the highest also in epilepsy, being I 0458.

The results of the preceding observations are curious and interesting. They are inferences certainly from a comparatively limited number of data; but they are, I think, sufficient to prove that more extended observations of a similar kind may probably lead to some satisfactory and important deductions regarding the pathology of insanity and the functions of the brain.

In conclusion, I think it right to state, that the specific gravity of the central substance was taken exactly in the same manner as that followed by Dr. Sankey. A number of jars were prepared with solutions of common salt, the density of which was determined by the urinometer. A series was prepared, ranging from 1030 up to 1050. Small portions of cerebral matter were dropped into these solutions, until a jar was found in which the portion so dropped floated midway, at the point of which it sank. This fluid gave the specific gravity, and to insure accuracy, and avoid fallacies arising from the spontaneous evaporation of the fluid, the specific of the fluid was in every experiment tested afresh by the urinometer at the time of the observation. The temperature of the room was 60° F. It is right to repeat the precaution pointed out by Dr. Sankey, namely, to take the first effect of the experiment, and that only; as by allowing the portion of brain to remain a few minutes only in the solution, its specific gravity rapidly alters by endosmose, and it will soon sink even in the strongest solutions. From not attending to this precaution, it is, I presume, to be explained why, in the pathological report lately published of a Metropolitan Asylum, the brain is stated in many cases to have had a specific gravity of 1·090 and upwards!

PRIVATE LUNATIC ASYLUMS IN IRELAND.*

THE number of private asylums in operation at present is the same as mentioned in our last Report; the lunatics, however, have increased by thirty-six, a circumstance corroborative of a fact which our experience in public institu tions fully bears out, that insanity is not on the decline in this country, proportionate with the reduction in the general population.

The improvements observable from year to year, since the passing of the Act, afford the strongest proof of the foresight and wisdom of the Legislature in thus particularizing the duties of the inspectors, and giving them the authority of an Act of Parliament to enter into details, and the mode of conducting these establishments, as also to correct any abuses or irregularities they may find to

exist in them.

At the date of our First Annual Report, which was made in the year 1843, twelve months after the passing of the 5th and 6th Victoria, the patients confined in private licensed asylums amounted to 373, of whom 161 were males, and 212 females. From that period up to the present they have been annually increasing, there being under treatment on the 1st January, 1855, 459, viz., 252 males, and 207 females; showing an increase of eighty-six lunatics, or twenty-three per cent. on the number under treatment a year after the Act had come into operation.

The most remarkable feature in the above statement is the variation in the proportion of the sexes, the females having exceeded the males in 1843 by fifty-one, and the males exceeding the females in 1854 by forty-five. This

* From the "Seventh Report of the Inspectors of Irish Asylums for the

Insane."

variation we find, by reference to the registry kept in our office, is owing to the circumstance that immediately after the passing of the Act, a far greater number of aged females, labouring under chronic lunacy, than of males, were sent to the various private asylums, their friends being desirous, when an opportunity occurred, to place them in establishments where more comfort and attention could be secured to them than in their own houses.

In the course of ten years, as might be reasonably expected, many of these parties died, and hence the present comparative diminution in the numbers of that sex.

Of the 459 patients under treatment at the date of our returns, 132 are set down as curable, and 281, exclusive of forty-six idiots and epileptics, as probably incurable. Of those, however, designated in their certificates of admission as probably incurable," we have found by experience, from the improved system of treatment now adopted-mildness and judicious management (with constant care and vigilance on the part of the attendants) having superseded mechanical restraint and a less solicitous regard to the feelings and comforts of these afflicted persons-that many become so far relieved as to be enabled to return to their families, and although with impaired understandings, yet capable, to a certain extent, of enjoying the pleasures of their domestic circles, a degree of recovery that scarcely ever was attained under the old system by the class of lunatics in question.

The idiotic and epileptic patients bear but a small proportion to the aggregate numbers in private asylums, the former being only thirty-six, viz., twentytwo males, and fourteen females; the latter ten, of whom one only is a female. Having investigated into the history of lunacy as regards certain families, from our personal knowledge of the members affected by it in asylums, we would refer to continued intermarriages, and direct hereditary predisposition, no inconsiderable amount of the cases that have come under our observation, the malady frequently developing itself in the third and fourth generation, and, what may appear extraordinary, leaving the second unaffected.

Generally speaking, when such predisposition exists amongst the immediate or exciting causes, whether physical or moral, none will be found more prevalent than intemperance and dissipation; so intimately, indeed, in many cases, is a love of drinking associated with insanity, that it often becomes most difficult to decide whether it be a symptom or merely a result of the disorder. The official management of patients labouring under depraved moral affections is attended with difficulty, and needs much discretion on our part, from the plausibility of the arguments they adduce when under restraint, and the injustice of which they complain at being unnecessarily deprived of liberty, or more truly speaking, of the opportunity to indulge in a reckless dissipation. A majority of the relapsed cases sent to private asylums, and composed of the classes in question, is for the most part carried off by repeated attacks of paralysis.

Of those under treatment on the 1st of January, nearly one half223 patients were of mature age, or from forty to sixty years; 152 from twenty to forty; and only five persons under twenty; the remainder being all advanced in life, or over sixty. With reference to this return, it may be stated that early in life, and more particularly when curative treatment is had recourse to on the first appearance of the malady, the mental faculties are more susceptible, and yield more easily to moral and medical influences; so that it frequently happens, under these favourable circumstances, that a few months are sufficient, if not to establish a cure, to afford, at least, well-founded anticipations of ultimate recovery. On the other hand, when the friends of lunatics, from mistaken kindness and motives of delicacy neglect for a long time to place them in an asylum, or to pursue a judicious line of management in their regard, or, above all, when insanity is developed late in life, the probability of recovery becomes slight indeed; the mental, like the cor