Footnotes:

[292] Presidential Address, delivered at the Annual Meeting of the Medico-Psychological Association, held at University College, London, August 2, 1881.

[293] I here do homage to the dead. Calmeil, Baillarger, and Brierre de Boismont still live, at an advanced age. (Since this address was given, the last named has died. See eloquent tribute to his memory by M. Motet, in Journal of Mental Science, April, 1882.)

[294] As will be seen by the history of lunacy reform contained in this volume, Lord Shaftesbury's interest in the movement extends back as far as 1828.

[295] American Journal of Insanity, April, 1855.

[296] 9 Geo. IV., c. 40.

[297] Amended by 18 and 19 Vict., c. 105 (1855). Acts referring to Lunacy Commissions and Chancery Patients, 16 and 17 Vict., c. 70; 25 and 26 Vict., c. 86 (1862).

[298] If parts of workhouses, etc., be included, 166. See [p. 211].

[299] I should find it difficult to point to a more striking illustration of these remarks than the good work being done at the Lenzie Asylum by Dr. Rutherford.

[300] "On the Construction, Organization, etc., of Hospitals for the Insane," by Thomas S. Kirkbride, M.D., LL.D. (Philadelphia, 1880), p. 300.

[301] On the large degree to which patients, as shown by the experience of the Chancery Visitors, can be treated satisfactorily outside asylums, see pp. [261] and [286]; also Dr. Bucknill's trenchant little book, "Care of the Insane and their Legal Control," 1880.

[302] "Ideal Characters of the Officers of a Hospital for the Insane," by I. Ray, M.D. Philadelphia, 1873.

[303] See Dr. Baker's Annual Reports of the York Retreat, and Dr. Rees Philipps's last Report of the Wonford Asylum, Exeter, etc., etc.

[304] "A Treatise on the Nervous Diseases of Women," by Thomas Laycock, M.D., 1840, chapter ix. p. 107.

[305] British and Foreign Medical Review, January, 1845, p. 311.

[306] "Remarks on Insanity, its Nature and Treatment," p. 14.

[307] "I agree with Mr. Martineau in repudiating the materialistic hypothesis as utterly futile."—Herbert Spencer, Contemporary Review, June, 1872.

[308] "Die Freiheit der Wissenschaft im Modernen Staat," by Rudolf Virchow. Berlin, 1877.

[309] Preface to his work on Mental Alienation, p. 20.

[310] "General Paralysis of the Insane," by Wm. Julius Mickle, M.D., M.R.C.P. London, 1880.

[311] Among the groups of cases in which they were more decidedly present is that comprising many due to syphilis; that in which degenerative changes follow upon hæmorrhagic softening, and another in which they succeed to occlusion of vessels and its immediate results. In another, degeneration and atrophy follow, the brain state conditioning acute insanity; and in another they are secondary to brain injury, not to mention many other groups.

[312] In the same department the services of another American alienist, Dr. Edward Jarvis, ought not to be forgotten. Among other works, his Report on the Idiotic and Insane in Massachusetts, 1854, was of great value.

[313] It is a remarkable fact, showing the mass of incurable cases which have accumulated, that the number of curable cases now is only about 1000 more than it was in 1844 (2519).