ance takes place in either House and is not concluded before midnight, or telegraphic despatches of grave import reach the editor long after midnight. The leader writer who deals with the debate must there and then master the news of each speaker, and write his article amidst interruptions of every kind; the writer who has to deal with the telegraphic news is expected, in an interval that is to be counted by minutes, to produce a brief essay of consummate merit, showing the bearings and importance of the latest news. Both writers work under the pressure of the consciousness that every moment is of importance. It is no easy task under these circumstances to concentrate the whole mind upon what has to be done, and to abstract the attention from the conversation going on around. Worst of all to the writers' nervous system is the sense of hurry-"it is the pace that kills,' whether the effort be across the Epsom Downs or in the field of literature. The constant recurrence of these sudden calls upon the stored energies of the leader writer renders his occupation one of an exhausting nature, and exposes him to all the bad effects of mental strain.

I began this paper with the reflection that each age appeared to be marked by the predominance of some particular branch of study. It strikes me, however, that at the present day every field of inquiry is occupied by countless labourers in the cause of progress and of knowledge; every profession thronged by ardent students, every intellectual calling, perhaps, overstocked by willing competitors. Modern civilization has even produced some callings that were formerly unknown. The spread of education has become so general that, notwithstanding the multiplicity of intellectual pursuits, the supply of those who seek to live by brain-work, rather than by the toil of their hands, exceeds the demand. This excess of supply over demand has produced a competitive system of intellectual tests-these have gradually increased in severity -and hence training for them has to be undertaken at an increasingly immature age. The claims of education are gradually and steadily infringing upon the years that formerly were devoted to exercise and school-boy's play. The shadow of future competitive examinations, which at first curtailed the sunshine enjoyed by lads in the higher forms of our public schools, next shortened the playtime in elementary schools, and now fairly darkens the threshold of the nursery. That which is encouraged as emulation in the child, deepens into competition in the boy, and ripens into fierce professional

conflict in the man. In the intellectual avocations of adult life, in commercial callings, a reckless expenditure of nervous power appears to be the rule, moderate toil and a patient expectation of the fruition of effort the rare exception. Manual labour is held somewhat too much in contempt; the artistic handicrafts that, in a less artificial condition of society, were cultivated with ardour, are now neglected; the healthgiving pastoral and agricultural pursuits, for which our colonies offer a boundless field, are considered unfit for the educated thousands who crowd the walks of professional life. Such a state of society cannot be considered healthy, and, from a psychological point of view, is not unattended with risks. How often do we observe a youthful brain, precociously brilliant in its promise, associated with a feeble frame and a halting circulation. Such an organism requires rather the care of the physician than the culture of the schoolmaster. The high pressure education and intellectual competition of the age in which we live, may perhaps be credited with much of the bodily suffering and mental anguish that spring from the various prevalent forms of nervous diseases. Beyond a doubt no system of training could be devised more radically unsound than the present when applied to the offspring of families in whose histories there lurks the taint of mental unsoundness.

Believing that no earthly rewards can compensate for the loss of health of mind and body, I have ventured to glance at some of the injurious effects of strain and overwork as they have presented themselves to my own observation. Such a note of warning, uttered before such an audience, may have the effect of inducing greater moderation on the part of those who are overstraining their mental powers in the effort too quickly to attain position, distinction, or wealth; it may persuade a thoughtful few to lead a more restful life; it may save much nervous suffering to the rising generation, who are preparing by undue mental toil to enter upon that competitive struggle in which to the few fall the prizes, while disappointment awaits the greater number. The Roman satirist, after reviewing the various hopes, ambitions, and pursuits of mankind, sums up, as the highest expression of human happiness to be sought after, in these words:"orandum est, ut sit mens sana in corpore sano❞—a truth spoken for all time.

Report of Three Cases of Short Attacks of Insanity with some Remarks on the Discharge of Recovered Patients. By J. A. CAMPBELL, M.D.

CASE 1st.-H. J. M. Admitted July 29th, 1872; female; 18 years; single. Hereditary predisposition existed in family; she had at one time been excited for a day or two, and been treated at home; she had lately been subject to considerable anxiety, and had to sit up frequently at night nursing a sick relative. Ten days ago became excited, talking much incoherently; was sleepless, and took food ill. For the two days previous to admission had got worse, more excited, had attacks of hysterics, and did not sleep at night. She had not menstruated for two months.

On admission. Was in a state of great excitement, most restless and noisy, but could speak coherently and answer questions correctly when she chose to exercise self-control.

Physically. She was a slight-built, healthy-looking girl, of average height. Temp. in axilla 99.4°; pulse 96 weak. Examination of chest showed heart and lungs to be healthy.

July 30th.-Was restless and did not sleep during the night. July 31st.-Was restless and noisy during the day, took food ill, ordered drachin doses of tr. valerian co. in water thrice daily.

August 8th. Is much improved, well-behaved, rational in conversation. Sleeps well at night; at times complains of pain in head. August 10th.-Is keeping well; was ordered an iron and aloes pill thrice a day.

August 29th.-Having kept well since last entry was to-day discharged recovered.

CASE 2.-M. McG. Admitted Jan. 28th, 1875; single, 25 years of age. Had one previous attack of insanity, for which she was for a short time under treatment in an asylum.

Little was known either about her or as to her family history, except that at menstrual periods she was excitable and irritable. She had become suddenly much excited, tearing her hair, throwing the dishes about, singing and shouting.

She had not slept for two nights, she complained of pain in the side. Menstruating sparingly; said to have caught a cold at beginning of menstrual period.

On admission. Mentally she was depressed, emotional, crying; able to answer questions correctly; for most part coherent in her remarks; memory unimpaired; no delusions could be elicited.

Physically. A tall, dark complexioned, slight-built woman. An examination of chest showed a normal condition of heart and lungs; breasts bore evidence that she had been a mother.

Temp. 97.8°; pulse, 72; weight, 125lbs; pupils equal, abnormally dilated; tongue slightly furred.

Jan. 29th.-M. t. 97°.6; e. t. 98°; m. p. 66; e. p. 96. Lay quietly during the night. Has taken food fairly since admission. Is to-day very nervous and emotional.

Jan. 30th.-Slept well last night; has taken food well, is quiet and dull.

Feb. 1st.-Is quiet and well behaved; eats and sleeps well.

Feb. 3rd.-Had slight diarrhoea to day, probably caused by change of diet.

Feb. 5th.-Quiet, civil, reasonable, industrious and cheerful, eats and sleeps well.

Feb. 11th.-Having kept well up to this date, and an informality having existed in the medical portion of her admission order which could not be rectified, she was discharged recovered.

CASE 3.-H. H., Commander R.N. Admitted August 7th, 1873; 64 years of age; had been a sober, quiet going man. Several relatives had been insane; he had once been under treatment in an asylum, and had a short attack when at home. These attacks had been of short duration, and at long intervals. He was said to have had a sunstroke when on foreign service.

He had been out of his usual health for a week, then became excited, fancied he was on board ship, broke the crockery, slept little at night, and took little food.

On admission. Mentally he was in a state of great excitement, talking incessantly in a loud voice; fancied he was on shipboard, issued orders at pitch of his voice; evidently has hallucinations of vision.

Physically. A healthy-looking, stout-built man. Temp. 990; pulse, 120; pupils equal; conjunctivæ suffused; reflex action dulled; heart and lungs normal; tongue furred, protruded straight; articulation slightly slipshod.

August 8th.-Restless most of the night; shouting orders in nautical terms. Talking in an incoherent rambling manner to-day. Did not take food well.

13th. For the last five days has been much excited and restless, has been out for a walk daily; at night is most noisy and restless, piles his bedding and sits on the top of it naked; says he is in his cabin on board ship; shouts and issues orders; won't take medicine as he is afraid of being poisoned.

14th.-Been better to-day; slept six hours last night; is more coherent in conversation; took his food well.

23rd. Since last entry this patient has slept well every night, and been daily getting better. Is now quite orderly, coherent in conversation, and apparently quite well.

Sept. 2nd. Having kept well since last entry, was to-day discharged recovered.

The first was a case of hysterical excitement in a girl whose

history showed marked hereditary predisposition to insanity. She had been excitable previously though never to such an extent as on this occasion. In all probability if treated at an earlier date for her menstrual irregularity, she might not have required asylum treatment. She was in the asylum 31 days. I saw no reason to detain her as she appeared quite well, and she has kept well ever since.

The second was a somewhat similar case; though I could not ascertain it as a fact, I have little doubt but that hereditary predisposition existed in the case. The attack was of very short duration; evidently the worst of it was past before she came under my care. An informality having existed in the medical certificate on which she was sent to the asylum, it induced me to discharge her at an earlier date than probably I would otherwise have done. She was apparently quite sane the third day that she was in the asylum. She was fourteen days in the asylum.

In the third case, the history showing a return of a very short attack of insanity, with a long interval of mental health, induced me to discharge the patient at the earliest possible date, in order to allow of his enjoying home comforts for as great a length of time as he could. I am aware that he kept well for a year. He was twenty-five days in the asylum.

I

may mention that the short remarks I am about to make in regard to the discharge of recovered cases, are mainly in the hopes of eliciting the opinions of members of this Society, whose experience must necessarily be large.

It may be considered that when a patient has arrived at the recovered stage, the medical attendant may be thankful, and not trouble himself much more about the case, but practically this is not so, many considerations of a serious aspect have to be taken into account. Of these three have principally to receive attention, viz. :

How long should the patient be kept under observation in the asylum ?

What is the probability of a recurrence of the disease, and within what time?

In what manner are the patient's home surroundings likely to affect him?

The length of time after apparent recovery for which the patient should be kept under observation, must, of course, be much modified by the nature and history of the attack of insanity. I am of opinion that it may be reduced to the shortest limits in the following forms of insanity :