They have been so acute that, with prophetic eye, they could detect insanity in its obscurest beginnings, and could evoke from the slenderest data the direst picture of irresponsible disease; or they have been so charitable that they were ready to rush to the rescue of a criminal when insanity was but whispered, and to throw over him, with due flourish of trumnpets, the shield of their detective wisdom. Such conduct is most mischievous; it lessens the due weight of medical evidence, it obstructs justice by bringing the plea of insanity into contempt, and it too often gives pretext for the false and ignorant sneer that insanity can generally be proved, if there be money enough to prepare the defence.

But lawyers have a better reason for their tenacity than exceptional folly like this. To lower the general sense of responsibility for wrong-doing, would be a public calamity so grave, that it cannot be too carefully guarded against; and this evil could not fail to result if the plea of insanity were too lightly accepted. On the other hand, what can tend more to lessen the public respect for justice, and the public confidence in its administration, than to see a man solemnly condemned as a criminal, and afterwards practically acquitted as a lunatic, by being sent to an asylum during Her Majesty's pleasure?

The acquittal of every criminal in whom any degree of mental defect could be discovered would be both unjust and dangerous, nor is the common excuse that confinement in an asylum is the same as perpetual imprisonment, at all sound. It is untrue as regards the individual, it is unsafe as regards other intermediates who might, by his conviction, have been deterred from similar crimes; and it is a violation of the public sense of justice, when a criminal escapes merited punishment.

The suggestions made in the interest of the prisoner by the Advocate-Depute, that Tierney's power of controlling his actions had been so weakened by the previous diseases, that the jury might possibly find him guilty of culpable homicide, rather than of wilful murder, deserves attention, as one mode of solving the difficulty occasioned by intermediate criminals.

Perhaps it evades the difficulty, rather than solves it, unless, indeed, the principle were adopted that in every case the jury should consider the character and motives of the murderer, as well as the circumstances of the deed, and should specify, as in some other countries, the degree of his guilt. Whether this would not be in itself more equitable, and in every way

more satisfactory, than the utterly uncertain and irregular way in which the Royal clemency is now dispensed, is not a question for this paper.

I have suggested, as a simple way of meeting the difficulty, that when the jury cannot acquit a prisoner on the ground of insanity, and yet are satisfied that there is some mental defect, they should be able to find him "Guilty, but entitled to mercy on account of his mental condition." This finding should save the prisoner from the extreme penalty due to his crime, whatever the crime may be, and should leave it entirely to the judge to determine what mitigation of punishment the mental condition demands.

It has been said that, if the power of barring the capital sentence were in the hands of the jury, they would be too apt always to exercise it, and that the power of mitigating the sentence should be left solely with the judge, when the jury have unanimously recommended the prisoner to mercy on account of his mental condition. Possibly this would be better; but either course would put an end, in great measure, to the present uncertainty and error. It is a great and increasing evil, that the solemn sentences of public criminal courts should be continually reviewed and altered by the Secretary of State, for reasons which the public never know.

It may of course be objected that no man can accurately gauge the accountability or self-control of his fellow man, and that to adopt this suggestion would give only an approximation to justice. This is perfectly true, but it is the nearest approximation we can make. It recognises at once what is needful for society, and what is just to the individual, by awarding punishment to his crime and extending mercy to his weakness. Nor could any material wrong be occasioned, if the Judge failed to estimate with perfect accuracy the relative proportions of wickedness and weakness in the prisoner's mind. A sentence unduly severe could probably never be carried out, as the further development of insanity in prison would quickly procure the prisoner's removal to an asylum for the insane. On the other hand, even after the most lenient sentence, the liberation of the prisoner should be subject to satisfactory guarantees as to his future care. Practically then this approximation would secure substantial justice alike to society and to the individual; and what is all human justice but an approximation, but a rough endeavour after the perfect justice which Omniscience alone can render ?

Case of General Paralysis complicated with severe Unilateral Epileptiform Attacks, Temporary Hemiplegia, Aphasia, &c. Autopsy. By W. JULIUS MICKLE, M.D., Medical Superintendent, Grove Hall Asylum, London.

George H, a Quarter master-Sergeant in the 38th Regiment, was admitted into Grove Hall Asylum on the 12th of June, 1874. It was stated that the attack had then been of between one and two months' duration; that it was supposed to be aggravated, if not induced, by tropical climate; and that he had become epileptic. Previously to his admission he had been in a state of active maniacal excitement, incoherent, noisy, destructive, violent, and the subject of delusions of a grandiose character.

On Admission.-Height, 5ft. 10 in.; weight, 161lbs.; married; æt. 34. Is moderately nourished, possesses a powerful muscular development, and fine soldierly carriage; skin fair, complexion rather pale and sallow, irides bluish-grey, pupils equal, pulse varying from 108 to 120. There are no signs of constitutional syphilis. State of tongue, speech, and gait characteristic of incipient general paralysis. Sometimes he will not answer questions, or only in an angry tone; at others he replies by a furious shout. The irritability is most intense, and he makes frequent violent attacks upon attendants or patients. He declares that he "is Colonel of the Regiment, has £23,000, and is about to marry the daughter of a peer.'

Treatment had only the effect of moderating in some degree the excitement, the restlessness, the irritability, the insomnia, and the disposition to outbursts of furious threatening, and of overt violence. In fact, the maniacal symptoms were undoubtedly in part the outcome of the epileptic neurosis, which also manifested itself at this period in occasional nocturnal epileptiform attacks.

To pass rapidly over this portion of his history we need only add that subsequently he had hallucinations of hearing, declared he was in communication with the Deity, and received constant audible telegrams from heaven; that in August he became far more quiescent and tractable, and in September was able to occupy an associated dormitory. The fits were then almost in abeyance. On the morning of Oct. 14, 1874, a succession of severe epileptiform convulsions occurred. When visited he was in one of these attacks, which affected the right side, especially the right eyelids and face, the head and eyes being turned completely to the right

* This is doubtful. He was admitted into hospital on six occasions in India, between 1862 and 1870, for fever, diarrhæa, ague; and for cerebral symptoms in England, in March, 1874.

in clonic spasms; the occipito frontalis was implicated, especially on the right side, and also the right side of the neck, both sides of the abdomen (but more particularly the right); the right pectoral muscles also, but only to a slight degree. He was semi-conscious, and the pulse was small, feeble, compressible. Catheterisation and enemata relieved the loaded viscera, but were required during several days subsequently, especially the enemata. When he was again seen, an hour after the above attack, dextral hemiplegia was present; his replies were quite unintelligible, and he attempted in vain to protrude the tongue, or to raise himself up when requested to do so. The right side of the face was flattened, the right side of the mouth incompletely paralysed, as well as the right eyelids (orb. palp.), nostril, and side of tongue; the right palatine arch was the lower and narrower, and the uvula tip was curved towards the right side. He could swallow. The right arm and leg were much palsied; pupils sluggish, the right one the larger. Temperatureright axilla, 99.5°; left ditto, 99-6°. The convulsive attacks continued for several days (until the 22nd), there being several successions of severe fits every twenty-four hours, besides a number of single convulsions. Throughout he was examined frequently, and full records were made, but only the more salient points need be reproduced here. The convulsive attacks described were some of those which occurred under my own observation. On the 15th the hemiplegia continued; there was moderate conjugated deviation of the head and eyes towards the left side; the respiration was stertorous, but he could be roused from the state of semistupor; and the pupils were dilated, sluggish and equal. A fit was then witnessed the moment after it began. The right side of the mouth and face and the right eyelids were in violent convulsion, the right nostril and face drawn up, the head and eyes turned completely to the right, the occipitofrontalis was moderately affected; the right arm was strongly convulsed, the elbow bent at a right angle, and the sheet seized between the thumb and forefinger; the right leg participated to a less extent, and the abdomen and chest to a slight degree only. As the spasm died away the mouth, eyes, and fingers were still working slightly. Ten minutes later he was noticed in another fit, which was confined to the right side of the mouth and face, the eyes, right forearm and arm. Slight twitchings of these parts persisted for some time after this fit. On the fifth day there was another

attack of hemispasm under observation. It affected the right angle of the mouth more severely than any other region, and died away last at that part. The head and eyes were turned to the right, and the right pupil was the wider of the two. This attack extended to the right arm and leg. A few minutes after it had completely subsided the mouth was again suddenly and violently jerked to the right, as well as the face generally, and the eyelids and eyeballs. But the spasm did not diffuse itself beyond these parts in that instance, although it was of several minutes' duration, as usual. Again, it died away last at the mouth. Temp. 100°. On the sixth day the paralysis was diminished; it was most marked in the arm, less in the leg, and only moderately in the face and tongue. Had had no fits for several hours; the left pupil slightly the larger. Temp., right axilla, 100.9°; left ditto, 100.3°. Next day the patient was drowsy and dull, but was free from convulsion, and the hemiplegia was lessening. Temp., right axilla, 101.7°; left ditto, 101.6°. On the ninth day he was brighter, and the palsy was still disappearing. On the twelfth day he could grasp with his right hand, could walk across the room, but swayed towards the right side, and now and then would have fallen if not supported. In walking the right foot was raised high, the heel passing just above, and close to the left inner malleolus, and this foot was planted in front of the left ore, so that his course swerved constantly towards the left in progression; the gait also tended to become hurried, awkward, and confused. Slight tension of the facial muscles was now observed on the right side, and the mouth was drawn a little to the right. Temp., right axilla, 97·1°; left ditto, 97°. The hemiplegia gradually disappeared after this date, and the speechlessness was succeeded by aphasia, partly amnesic, and partly of the nature of heterophasia; the old defect of articulation, the broken, hesitating character of utterance, being also marked. Though he understood simple questions he gave no replies until he was pressed to speak, and the successive answers to the same reiterated query were very different. For example, when thrice pressed to tell his name his replies were as follows:-(1) My name is right-John." (2) "Man." (3) "Mankin." When requested to mention the number of his regiment he replied at first in an unintelligible jumble of words, and subsequently said, "fifty-eight." He was shown a pencil, and was asked what it was. He said, "What's that for,-regiment,-regiment,-is the,--belongs to you,-to

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