spinal nervous system, and upon which this mental disturbance is simply dependent.

DR. N. R. MORSE: I think there is a point of difference which may be reconciled between our friends who are now on opposite sides. It seems to me that some of the cases mentioned as insanity are not insanity. The case related by Dr. McManus was not a case of insanity. I remember a similar case which occurred when I was a boy about seventeen years of age. A man who weighed two hundred and fifty pounds did not dare to be in a room with a man that weighed less than one hundred and twenty-five pounds, simply because he had taken two quarts of hot drops in Mead, in the course of eight or nine hours. He was perfectly wild and wishing that he could have more, and yet I could control him and I was a mere boy of seventeen, simply by agreeing with him. It was not a case of insanity. I have seen many cases of men who were temporarily, as you may say, , insane. They were excited by this congestion and hyperemic condition of the brain. Now that is not insanity, but if the condition continues without any relief, and he becomes permanently anæmic, then we get the want of co-ordination, which is a very fortunate term on the part of our friend Dr. Korndorfer; and then we have insanity, permanent, or more or less permanent. It is not temporary, Some of the cases pronounced by the old school physicians to be insane and which are confined in an insane asylum, reach that point finally. We all know that in typhoid fever we have this hyperæmic condition, but it would be a mistake to say that the hyperæmic condition in typhoid fever was insanity, when it is not, truly speaking, insanity. I like the definition-that is I think my friend comes nearer to the point than Dr. Owens, when he says it is a want of co-ordination with a perverted understanding.

DR. W. H. JENNEY: It seems to me that there has not yet been a true definition made of insanity, although there have been attempts enough made to define it. I have cases of insanity to treat almost every day. If the cases related here are insanity, I think that there is a great range between insanity and functional disturbance. For instance such as we have in every dyspeptic. Now I have a case at present where a lady is constantly in fear of being deranged. Now, referring to the definition given here to-night by many of the gentlemen, that would be considered insanity; but it seems to me that insanity is more of a pathological state, and the discussions on that subject would be much more beneficial if they were based on that ground instead of upon a mere aberration from functional disturbance.

DR. S. R. BECKWITH: I beg your pardon for rising again. The flippant

manner in which we settle this question which has occupied the attention of the psychological members of the old school for many, many years, and they have not been able yet to settle it, is certainly very pleasant, to say the least of it. It does show to me that the question has been discussed from the standpoint of the pathologist almost entirely. We have had several definitions from pathologists given to-night. It seems to me we had better confine ourselves to the treatment of the insane, and a better style of management, than in dealing quite so hastily with these subjects. I think that perhaps we go beyond our reach, and if we very carefully compare the opinions of men who have had a life experience in it, we may find that we have made some statements that we can hardly bear out. Much as I respect this definition given by my friend, I would merely say that I would not like to give an opinion so hastily. I believe no psychologist who has ever written or spoken on this subject has attempted to define what insanity is.

DR. FISHER, Montreal, Canada: I will relate a case that came under my own notice, that of the wife of Sir Hugh Lynn, President of the Lynn Line of Steamers, who died two days before my leaving. She had been suffering from insanity for some time before her death. Her sickness began, I believe, with puerperal mania, taking the form of melancholy. This condition continued for some time. She had everything done for her that money could procure; her surroundings were supposed to be the best; she had the best advice that could be obtained. However, she did not get any better and eventually she became uncontrollable, and died under these circumstances. I mention her case because I consider it typical of a form of mania which has been common of late and which I thought of when the President was speaking of mania, a mania which we find in the rich and luxurious. In all these cases it seems to me it is exceedingly difficult to remove the cause. Those people who have been obliged to earn a living at the wash tub seldom become mad, or if they do become so are very easily cured. Now I want to hear if anybody has anything to say of that particular kind of case, arising with the wealthy and luxurious.

DR. BROWN: Now gentlemen, this idea or thought, as it is urged, ought to be fully understood, if we can understand it. Of course we can only think of forms of motion with that particular power, we would not say power, that particular faculty of co-ordinating or understanding the rationale of a chair sitting on the floor. We have, when we think of that, to co-ordinate the floor with the chair, that is the natural fact. If it was ten feet above the floor without anything to hold it, and we should get it

into that place and tell anybody about it, they would call us insane. If a person made that statement to you would you call him sane or insane? We can go on asking these questions, and you can give your definition of insanity, telling us what is necessary to constitute insanity and what is not, and in what state the mind co-ordinates and in what state it does not co-ordinate, but would we not send a man to the insane asylum who was constantly lying and making misstatements? Suppose a brain is in a certain state, having just such an amount of blood, arterial blood, and the circulation is in a perfect state, pulse 72 to the minute, your patient has had all the physiological relations he could have, born of healthy parents in the first place, and himself healthy, would you think that that man could possibly be insane? You change that condition of the circulation, let the blood vessels be broken up and the deposits be made according to the waste of the brain, or the waste of any part of the body, and when you have this going on you will soon see things differently from what they are. The brain is in that peculiar state in which you cannot see clearly, a state similar to the state of mind of a person afflicted with color blindness, or any of those peculiarities that appear to others if you are insane. For this reason Dr. Beckwith may seem insane to you and you are insane to him, but still you are unable to put your finger on the spot and declare what part of the brain is affected. We know that there is fat in the brain, we have heard about that, we have seen it and know that it is true, but how about our impressions, pleasant or otherwise? Have we a right to call one friend's actions sanity and the other insanity? There must be a perfect balance; the work must be all carried forward together; the brain must be kept in that condition. There is no difference in the states of sanity and it cannot be said that I am more sane than you are, or that are more sane than I am. There must be just such a relation between the arterial and venous circulation, and then the vein does not waste faster at one time than at another or increase in size faster. The same is true in regard to natural functions. There must be so many hours given for sleep, there must be a certain amount of exercise every day, and when all these things are done naturally, like the majority of people, then we call a man sane. Why? Simply because he does a thing like the majority of people counted sane. That is the reason I said in my paper, that it was insane not to care for the health of the majority; that is the reason I said the physical change in the brain dependent on the blood or any great event, produced insanity, or to that effect. So order, regulate, and govern the whole; first a healthy parent, then a healthy way of living. You can find people insane from liquor, from opium, from loss of sleep, from various

you

causes, but when you come to that individual state where they become extremely mad, then you call them insane, then you get a physician and he gives his testimony that the man is insane. Then we have to state particularly what kind of insanity it is, which he does to the jury or judge before he sends him to the asylum. Now every man that does not coordinate, if you use those words, is insane. To state the facts of the case, I am insane if I have not stated the exact relation between the blood and the brain, what it does and what it does not do. Of course you may take my statement or may refuse it; if you take my statement, you will have to rest on that until you find a better one.