"V. Illusions (vertigo of sensation, &c.). "C. Excessive motility. "VI. Vertigo of motion (rotatory movements). "VII. Co-ordinated spasm (muscular tic). "VIII. Chorea. "IX. Tremor (paralysis agitans)." The diagnosis of hypochondriasis from melancholia, says the author, "is based upon the hypochondriac's constant self-regard, and the habitual reference of his delusions to the corporeal sphere." "The predominance of motor disturbance" in hysteria "will generally serve to distinguish" it from hypochondriasis. By "hallucinations," the author means those which are unconnected with insanity; so that the subject of them, "although his phantasms may have the appearance of reality, does not believe in their objective existence." A somewhat similar distinction should be drawn between the illusions of the sane and insane. Muscæ and tinnitus aurium are illusions common to every one, and the result of a real impression on the sensory nerve; but where the muscæ, on the one hand, are firmly believed to be furies or devils, or the ringing in the ears, on the other, is transformed into "voices," then the mind is insane. The same thing holds good in reference to optical illusions, as spectra; the sane mind can by experiment convince itself of their real nature, whereas no process of reasoning will ever unseat the delusive impressions of the insane. "The most important chronic diseases of the brain, and nervous system generally, present a combination of exaggerated activity in some portions and diminished function in others.' Those so characterized are as follow:- "I. Hysteria, and allied affections, catalepsy, &c. "II. Epilepsy, 'le haut' and 'le petit mal." "III. Tumour of the meninges, cerebrum, and cerebellum. “2. Tuberculous, } sometimes separable. "3. Aneurismal, fibroid, hydatid, &c., not separable. "IV. Chronic meningitis. "V. Chronic softening. "VI. Induration of the brain. "1. In the adult (from epilepsy, lead poisoning, &c.) "VII. Chronic hydrocephalus. "VIII. Urinæmia." There is nothing pathognomonic in the symptoms of specific tumours. The tuberculous and carcinomatous are inferred by the presence of the cachexia; the aneurismal by the existence of arterial disease elsewhere; while the other varieties may be guessed at from the discovery of similar growths in other parts of the body. As indications of the "special locality" of a tumour, the following are valuable. "Pain is most commonly situated on the same side as that in which the tumour exists." "Motor phenomena (both spas modic and paralytic) are observed almost invariably on the opposite side." 66 "Convulsions are most frequent in tumours of the cerebellum." 'Amaurosis, on the other hand, is most common in tumours of the anterior cerebral lobes." "The implication of the special senses generally (but not exclusively) indicates a location near the base." A suggestion of Romberg's, confirmed by one case observed by Dr. Reynolds, will form a valuable means of diagnosis, if more extended observation proves it to be trustworthy; namely, that when the tumour is situated on the upper surface of the encephalon, a "forced expiration increases the pain;" whereas when affecting the base, "this effect is produced only by inspiration." Paraplegia rarely occurs from encephalic tumour, unless the cere bellum is its seat." "When softening has observed a chronic course throughout, its most difficult differentiation is from tumour and meningitis. The three may, however, be distinguished in many cases by the following characters. "A. Tumour,-intense, locally limited, paroxysmal pain; anæsthesia of special senses; local paralyses; epileptoid convulsions without paralyses; unimpaired intelligence; coma at close of life. "B. Chronic meningitis,-pain, not very severe, not limited; mental and emotional excitement; disorderly spasms and paralyses; with frequent, but irregular accessions of fever. "C. Chronic softening,-oppressive, not intense pain; with gradual failure of intelligence, motility, and sensibility." The nervous symptoms of urinæmia may resemble those of these three affections, but then "the pain is rarely acute; there is drowsi ness, or a peculiar coma and stertor, and the extrinsic symptoms furnish the means by which a diagnosis may be established.” The third part of the book is devoted to diseases of the spinal cord. With regard to the special locality-the cervical, dorsal, or lumbar regions may be affected. When the lumbar or lower dorsal portions of the cord are the seats of disease, the "lower limbs are alone implicated." "The bladder and rectum are paralyzed." If the upper dorsal region be affected, "respiration is impeded;" "unless the lesion extends above the second dorsal vertebra, the upper limbs retain their function." "Affections of the cord opposite the first dorsal, or the last two cervical vertebræ, implicate the movements of the arms." "If the disease extends no higher than the sixth cervical, the arms retain their movements at the shoulders;" if above the sixth or fifth, "and the phrenic nerve is implicated, the dyspnoea is most urgent." "If the lesion exists higher than the fourth or third vertebra, death is extremely rapid, owing to asphyxia from paralysis of the respiratory muscles." "The locality of disease may be discovered by the existence of spontaneous pain, or tenderness, at a particular point of the vertebral column; and the latter may be estimated by pressure, concussion of the spinous processes, or the application of heat (by means of a sponge or cloth wrung out of hot water)." "Where motility is at first exclusively affected, the anterior and antero-lateral columns are most probably diseased; and vice versâ, when sensibility is primarily deranged, the probability is, that the posterior, or postero-lateral columns are principally affected." "Acute diseases of the spinal cord and its meninges" are as follows: "I. Plethora spinalis, or congestion. "II. Meningitis. "III. Myelitis (acute softening). "IV. Meningo-myelitis. "V. Tetanus (idiopathic). "VI. Hydrophobia. "VII. Hæmorrhage, meningeal and spinal. "1. Into the spinal cord. "2. Into the tuber annulare. "VIII. Concussion of the cord." Spinal meningitis is ushered in by "highly marked fever," and is accompanied by "pain referred to the spine, at first slight, but rapidly increasing in severity, and becoming almost intolerably violent." Tonic spasm is the chief motorial symptom. Myelitis, on the other hand, is denoted by "peripheral pain, or anæsthesia, and paralysis;" it is "commonly hyper-acute, and terminates in a few days; but if this is not the case, sloughing of the inte guments occurs, and hastens the prostration of the patient to a final issue." Meningo-myelitis "is more common than either of its elements in an isolated form." The chronic diseases of the spinal cord are "I. Chronic myelitis (or softening). "II. Chronic meningitis. “III. Induration and hypertrophy. "IV. Tumours. "1. Diathetic-e. g., tubercle, carcinoma. "V. Idiopathic paraplegia (dynamic)." In the fourth and last part of this work, Dr. Reynolds considers the diseases of the nerves. The diagnosis of the particular nerve affected " can be arrived at only by a knowledge of the anatomical distribution," "and physiological functions of each division." The functions of a nerve may be modified by "I. Excessive activity. "A. Of sensation or sensibility. "B. Of motility. "II. Diminished activity, or complete loss of function. "A. Of sensation, or rather of impressibility. "B. Of motility." The special diseases of the nerves are thus arranged :- "a. Painful subcutaneous tubercle. "B. Inorganic or functional. "III. Neuralgia, considering specially, 66 a. Facial. Neuralgia of the fifth nerve. "b. Ischiatic. Sciatica. "c. Dorso-intercostal. "IV. Hypercineses, or spasms, considering specially,"a. Facial-spasmodic tic. "b. Oculo-motor. Strabismus. "c. Laryngeal. Laryngismus stridulus. "V. Anæsthesiæ, especially of the fifth nerve. "VI. Acineses, or paralyses, and especially that of the facial nerve (portio dura of the seventh)." Part Third. FOREIGN PSYCHOLOGICAL LITERATURE. Medico-Legal Consultation on a Case of Monomania. THE parents of M. M—, who died in the Charenton, 10th Jan. 1851, consulted M. Dubois as to whether deceased was in a sound state of mind at the time of making his will, in June, 1848. The confinement in Charenton dated from Nov. 1850, when he was in a state of dementia and general paralysis. The question to be determined was, whether the mental affection was of recent origin in 1848, or was the last stage of a much older affection existing at the time of the execution of the testament. This was to be answered-1st, by certain writings of deceased; and 2ndly, by the statements of the medical attendants of M. M-. In July, 1846, M. M-addressed a letter to the "Constitutionnel," giving notice that the police had directions to check the machinations of his enemies. In 1847 he also complained to the procureur du roi that he was annoyed by anonymous letters, and by the culpable designs of certain persons to terrify him, and alterer son intelligence. A note was also found, written by himself five days before the will was made, and which purported to contain a receipt for an antidote to poison, that had been, it stated, administered to him by a garde mobile. The antidote consisted of vanille and milk. Among the papers belonging to deceased was a list of his enemies written by himself. The medical attendant of the deceased, Dr. Delente, stated that M. M— had suffered an attack of apoplexy in 1841, the traces of which were visible after death. Dr. Delente had regarded M. M- as a monomaniac, being under the impression that his heirs had conspired to poison him. From these and other circumstances, M. Dubois gave it as his opinion that the deceased was a monomaniac in 1846; that the mental affection continued; and, that at the date of the execution of the will he was not in a sound state of mind.—“Annales Médico-Psychologiques." Juillet. On the Identity of Dreaming with Insanity. By M. MOREAU, of Tours. M. MOREAU holds, as a fundamental point in the explanation of the phenomena of insanity, the essential identity of the state of dreaming with insanity. This proposition he regards as the corner-stone of the edifice of the science of psychology. This conviction M. Moreau has arrived at from researches long conducted by himself, and from the study of other writers upon psychology. The following extracts will illustrate the principal arguments of M. Moreau on this question. In refuting certain objections taken by M. Delasiauve, M. Moreau observes "No dream can be called spontaneous, we do not of our own accord, and according to our own good pleasure, plunge into the state of dreaming; we may prepare all the conditions, we may drive away all the obstacles to sleep, but we cannot dream voluntarily; that is altogether another matter. At the very moment that these conditions for which we have arranged promise the desired result, at that instant we cease to be ourselves; with the inner consciousness our spontaneity of action is lost, the ego is transformed; another individuality, that of the dreamer, takes the place of the awake. We see then here that nothing takes place but that which occurs in delirium, in a dream— one is delirious. In the former it is so in obedience to a physiological cause unknown; in the second, in obedience to an unknown pathological cause in spontaneous insanity), or well known (in the madness of intoxication). The result in both cases being the extinction, the slow or sudden annihilation of intellectual spontaneity-a metamorphosis of the ego-a dream. "The state of dreaming has in all ages attracted the attention of physiologists, but has it been sufficiently studied in itself, independently of the organic conditions in which it is produced? Are we not too much accustomed to regard these conditions as indispensable to its development? Has it been ascertained whether it may not be met with in very different pathological and physiological conditions? In other words, must we recognise in the dream a particular manifestation of the thinking faculty, determinable by essentially different causes? "a. We have elsewhere said, that what we call absence of mind, is in reality but incomplete dreaming, an intermediate state between waking and sleeping, and received more with reference to the intellectual than to the properly organic conditions of sleep. We speak indifferently of reverie and absence of mind as an intense mental pre-occupation, which absorbs our attention to things around Here, then, common language bears us out in our views. us. "It may be said that, in this case, the phenomena of dreaming are produced under normal conditions, the intellect not being vitiated by any morbid intlu |