NUMBER OF FITS RECORDED EACH MONTH SINCE ADMISSION:

The highest number of fits in any 24 hours was eleven.

A succession of fits occurred on the night of the 31st of March, 1871, which are not included in the above table.

Remarks.-The most interesting feature in this case is the complete cessation of epileptic fits after an uninterrupted suffering for thirty-three years; and, with that, the return of mental power. Medicines cannot be accredited with this satisfactory result, nor can I point to an improved bodily condition of the patient for it. The case presents itself simply as one of metastasis-the epilepsy succumbed to rheumatism—and it is one of those forms of metastasis, alluded to by Dr. Sieveking, in his work on Epilepsy, page 219, in which a genuine blood disease" is not unfrequently followed "by a permanent cure of the epilepsy."

Throughout the case presents points worthy of notice; and to these I shall briefly refer. The combined paternal and maternal conditions appear to have produced some hereditary influence on the origin of the epilepsy, as there is a total want, in the history, of any immediate cause. That apoplexy may do so, is shewn by M. Herpin, in his table of the state of health in relatives of epileptics (Du Prognostic et du Traitement Curatif de l'Epilepsie par Th. Herpin, page 327. Paris, 1852); and the child of a phthisical mother would, perhaps, be the

least likely to withstand such influence, however slight it may be.

In the table I have compiled, exhibiting the number of fits this patient had after admission into the asylum, the varying number of attacks, both monthly and yearly, is strikingly noticeable, and is, doubtless, due to the bodily health of the patient at the time-more especially to uterine irregularities and the consequent anæmia.

Everyone associated with female epileptics has noticed an increase or decrease in the number of fits during the menstrual period; the former particularly when there is a temporary cessation, or an abnormal quantity or quality of the discharge. And this effect of functional changes leads me to the conviction that epilepsy is regarded by the profession generally within too narrow limits, when viewed as a purely organic disease, especially as there is an entire absence of any uniform pathological change.

Again: the fact is worthy of note that angular curvature of the spine appeared, or, at least, greatly increased, while the patient was in the recumbent posture, and simultaneously with the rheumatic affection. It may be doubted whether the removal of the limb for rheumatic disease of the joint was justifiable when the same affection was present in two other joints. Any attempt at resection, or even to produce anchylosis, would have been attended with too great a drain upon the system, and undoubtedly have terminated fatally. Besides which, on the principle that every case should be treated on its own merits, I submit that the result here proved the correctness of the proceeding.

The return of reason and mental vigour, with the cessation of fits, is not only satisfactory, but most interesting to the psychologist; and tends to prove conclusively that no irreparable lesion of the great nervous centres can have been produced, even after so long a period as fifteen years.

In concluding these remarks, I would express a wish that all cases in which there is a lengthened or permanent cessation of fits in epilepsy should be placed more prominently before the profession.

The good, if not curative effects, of some drugs, especially the bromide of potassium, are now generally acknowledged; and these augur well, to my mind, the probability that epilepsy will ere long be looked upon as a curable disease. But treatment should not be delayed; the disease should be combated in its

infancy, as it were.

Convulsions in childhood, from whatever cause, should be viewed with suspicion, and all efforts be made with perseverance.

A Case of Epilepsy, with Post-Mortem Examination. By Dr. THOS. HOWDEN, Haddington.

P. D., age 30. Epileptic. Admitted February, 1875; having been in confinement in this asylum five years before. For these five years, at least, he has taken the bromide of potassium pretty regularly; and during his five years' absence he has worked as a day labourer. On his last admission he was just recovering from a severe attack. Though having fits occasionally, they were never very severe till August 26th last-when, between that date and the 31st of August, he had at least twenty-six. He was able to be out of bed till the afternoon of the 29th; after which he became dull and stupid-never speaking, unless when spoken to, and scarcely then. Took the food given him readily. From the 29th August to his death, on September 2nd, he perspired profusely. His pulse was small, and very rapid; conjunctivæ much injected; pupils moderately contracted.

On September 1st, though he had no fits, there were frequent nervous twitchings of the muscles of the face, most marked on the right side, and of the right arm. Died 10 p.m. of September 2nd.

Post-mortem examination twenty-four hours after dead. Body well nourished.

Head.-Calvarium dense and hard. Dura mater very firmly adherent to bone, more especially in the occipital region. Superficial Vessels and sinuses much congested. Weight of brain 53 oz. There was no serous effusion on surface of brain. The cerebrum was moderately firm, but the cerebellum very soft.

On opening the right lateral ventricle there was an escape of fluid so sudden that much of it was lost. The ventricle was much enlarged, and its surface very white and glistening. The quantity of fluid gathered and measured from the right ventricle was 3i., 3vii., and I should think that at least an ounce must have escaped before; so that altogether there would be about three ounces of fluid in the ventricle The left ventricle was equally large with the right, but only contained two drachms of fluid. On further examination, however, this was not to be wondered at, as there was a longitudinal rent along the under surface of the septum lucidum about one inch in length.

He was never in a state of real coma. He answered when spoken to a few hours before death; and though his breathing was laboured from acutely-congested lungs, it was never stertorous.

OCCASIONAL NOTES OF THE QUARTER.

Dr. Howe on Laura Bridgman.

In the forty-third Annual Report of the Massachusetts Asylum for the Blind, Dr. Howe gives an interesting description of the method which he employed for the instruction of Laura Bridgman, who was totally blind and deaf, and who had only a very indistinct sense of smell. We quote Dr. Howe's description entire :

I found in a little village in the mountains a pretty and lively girl, about six years old, who was totally blind and deaf, and who had only a very indistinct sense of smell; so indistinct that, unlike other deafmutes, who are continually smelling at things, she did not smell even at her food. This sense afterwards developed itself a little, but was never much used or relied upon by her. She lost her senses by scarlet fever so early that she has no recollection of any exercise of them. Her father was a substantial farmer; and his wife a very intelligent woman. My proposal to try to give regular instruction to the child seemed to be a very wild one. But the mother, a woman of considerable natural ability, animated by warm love for her daughter, eagerly assented to my proposal, and in a few days little Laura was brought to my house in Boston, and placed under regular instruction by lessons improvised for the occasion.

I shall not here anticipate what I intend to write about her, further than to say that I required her by signs, which she soon came to understand, to devote several hours a day to learning to use her hands, and to acquiring command of her muscles and limbs. But my principal aim and hope was to enable her to recognise the twenty-six signs which represent the letters of the alphabet. She submitted to the process patiently, though without understanding its purpose.

I will here give a rough sketch of the means which I contrived for her mental development. I first selected short monosyllables, so that the sign which she was to learn might be as simple as possible. I placed before her, on the table, a pen and a pin, and then, making her take notice of the fingers of one of my hands, I placed them in the three positions used as signs of the manual alphabet of deaf-mutes, for the letters p e n, and made her feel them, over and over again, many times, so that they might be associated together in her mind. Í did the same with the pin, and repeated it scores of times. She at last perceived that the signs were complex, and that the middle sign of the one, that is the e, differed from the middle sign of the other, that is i. This was the first step gained. This process was repeated over and over, hundreds of times, until, finally, the association was estab

lished in her mind between the sign composed of three signs, and expressed by three positions of my fingers, and the article itself, so that when I held up the pen to her she would herself make the complex sign; and when I made the complex sign on my fingers she would triumphantly pick up the pen, and hold it up before me, as much as to say "This is what you want."

Then the same process was gone over with the pin, until the association in her mind was intimate and complete between the two articles and the complex positions of the fingers. She had thus learned two arbitrary signs, or the names of the two different things. She seemed conscious of having understood and done what I wanted, for she smiled, while I exclaimed, inwardly and triumphantly, "evρnkа! Evρnκа !" I now felt that the first step had been taken successfully, and that this was the only really difficult one, because by continuing the same process by which she had become enabled to distinguish two articles, by two arbitrary signs, she would go on and learn to express in signs two thousand, and, finally, the forty and odd thousand signs or words in the English language.

Having learned that the sign for these two articles, pin and pen, was composed of three signs, she would perceive that in order to learn the names for other things she had got to learn other signs. I went on with monosyllables, as being the simplest, and she learned gradually one sign of a letter from another, until she knew all the arbitrary, tangible twenty-six letters of the alphabet, and how to arrange them to express various objects: knife, fork, spoon, thread, and the like. Afterwards she learned the names of the ten numerals or digits; of the punctuation and exclamation and interrogation points, some forty-six in all. With these she could express the name of everything, of every thought, of every feeling, and all the numberless shades thereof. She had thus got the "open sesame" to the whole treasury of the English language. She seemed aware of the importance of the process; and worked at it earnestly and incessantly, taking up various articles, and inquiring by gestures and looks what signs upon her fingers were to be put together in order to express their names. At times she was too radiant with delight to be able to conceal her emotions.

It sometimes occurred to me that she was like a person alone and helpless in a deep, dark, still pit, and that I was letting down a cord and dangling it about, in hopes she might find it; and that finally she would seize it by chance, and, clinging to it, be drawn up by it into the light of day, and into human society. And it did so happen; and thus she, instinctively and unconsciously, aided in her happy deliverance. After she had mastered the system of arbitrary signs, made by the various positions of the fingers used by deaf-mutes and called dactylology, the next process was to teach her to recognise the same signs in types, with the outlines of the letters embossed upon their ends. Thus with types, two embossed with p, two with n, one with e,