"The supply of water is ample, the heating is uniform and of the proper temperature, the wards and rooms are flooded with light, and the ventilation is such that all of the air capacity of the ward buildings can be changed every twenty minutes, while the air space allowed each patient is about 4,000 cubic feet. "The drainage and sewerage of the build ings are good, the dietary is arranged with reference to affording the proper variety and amount of nutritive material, while cleanliness and regularity of life are enforced.

"All things conduce to healthfulness and comfort to a degree to which life in an ordinary household bears no comparison.

"In attention to these details, this asylum is not an exception. The general freedom from acute forms of disease, which have their origin in neglect of hygienic law, and the small death rate annually of the insane in public institutions, point to the success at tained in establishing conditions favorable to health.

"The same fact is also shown in the prolonged life of the insane, an appreciable factor in the present large number of this de. pendent class."-Assem. Doc. No. 10.

At a recent meeting of the Académie des Sciences, M. Marey read a physiological communication from M. Mendelssohn, who had proved that the electro-motor power of the axial current of a nerve-fragment increases with the length of that fragment, though not proportionally with it. If the trunk of the nerve be gradually shortened, it is seen that the direction of the axial current ceases after a certain limit to conform to the rule which the author had already mentioned, viz., that the direction of the axial nervous current is always in opposition to the direction or course of the physiological function of the nerve. The electro-motor power of the axial current increases with the area of the transverse sectoin of the nerve. This correlation disappears when two different nerves are compared in

the same animal or analogous nerves belonging to animals of different species. The electro-motor force of the axial current decreases with the exhaustion of the nerve which is induced by prolonged tetanization. This exhaustion may even completely destroy the axial current. Desiccation of the nerve, and especially of its sectional surface, rapidly lowers the electro-motor force of the axial current. All these facts show that this current possesses essentially the same physical and physiological properties that M. DuboisReymond has described as existing in other nervous currents. Philadelphia Medical Times.

TOBACCO ASTHMA.

Russo Gilberti reported to the Societa d' Igiene numerous cases of functional disorders caused by tobacco,among which is the following: A young man twenty-four years of age, well developed and nourished, but of an erethistic temperament and a hereditary tendency to convulsions, was seized with severe attacks of asthma which he attributed to smoking. His physician advised him to discontinue the use of tobacco and avoid rooms where there was tobacco smoke, and for more than a year he has not had the slightest attack of asthma.

This case confirms the opinion of Peter, who considers tobacco a true poison to the pneumogastric, and may, even in small doses, injure those who are especially susceptible to its influence. (Le Sperimentale).— Buffalo Medical and Surgical Journal.

DIABETES AND TABES.

The New York Medical Abstract gives the epitomized conclusions of MM. Pierre Marie and Georges Guinon from (Rev. de Méd.) as follows: knee-jerk absent in three cases of diabetes; and some cases of diabetes approach so near some forms of tabes as to be distinguished only by the excretion of sugar. A case might be one of tabes or diabetes, with complete loss of knee-jerk, lightning pains,

unsteadiness with the eyes shut, etc. The presence of sugar in the urine would, how ever, determine the diagnosis, as the writers have not found sugar in the urine of any case of tabes at the Salpêtrière. M. Jendràssik says the knee-jerk can be revived in cases of neurasthenia and diabetes, where it has sunk to almost nothing, by making the patient attempt a muscular effort with his body and arms while the knee reflex is under examination.

PERIPHERAL NEURITIS.

The favorite journal of the lamented Jewell, the Neurological Review, which with its gifted editor, died too soon for the good of Neurological Medicine, contained the following condensation, from Revue de Médecine of MM. Pitres and Vaillard's interesting memoir on this subject.

anesthetic spots in the skin, localized trophic disease of the skin and its dependencies, certain localized motor paralyses, accompanied or not by muscular atrophy, isolated joint affections, visceral crises, etc.

On this subject Dr. Charles F. Folsom, M. D. physician to Boston City Hospital in the Boston Med. and Surg. Jour., May 26, 1887 also discusses as follows, giving his own and leading German opinion. So far as I am able to learn, post-mortem examinations in cases of primary multiple neuritis have not thus far shown disease of the brain or spinal cord, which has not been acknowledged to be insufficient to produce the symptoms, and in

most cases there has been no central lesion found; the evidence being that the disease is primarily an interstitial peripheral neuritis, that in mild cases the disease goes no farther, and that in severe cases there is also parenchymatous inflammation, and more or less de

2. The neuritis of tabetic patients does not differ in any essential respect from other forms of the non-traumatic affection.

3. Their topographical distribution in the body is variable, for the neuritis may attack the sensitive and mixed nerves and the visceral.

4. In the majority of cases, but not always, the disease begins at the outer extremity of the nerve.

5. Their extent and gravity have no constant relation in respect to age, or the extension or depth of the medullary regions of the locomotor ataxia.

6. It is probable they do not play any part in the production of the specific symptoms of tabes, such as the lightning pain, incoordination of movements, abolition of patellar reflex, disorders of the muscular sense, etc. These latter symptoms depend rather upon the condition of the posterior columns of the cord.

7. Certain inconstant symptoms, however, which are added to or complicate the symp. tomatology of tabes, appear to depend upon the peripheral neuritis; such, for example, as

are capable, in time, of a great degree of regeneration, or, at least, of restoration of function. The distinct sensory symptoms with which the disease is commonly ushered in usually soon nearly disappear, except pain and marked anesthesia is a rare exception in the disease. We are driven, therefore, to suppose (1) that there is an undiscovered central lesion; (2) that there is a functional central disease giving rise to the neuritis, as Erb holds; (3) that Leyden and Oppenheim are right that the central lesions thus far observed result from ascending neuritis, or form a part of the morbid process in the nerves, without giving rise in themselves to any special symptoms; or finally (4), with Struempell, that primary multiple neuritis affects chiefly the motor fibres-a supposition analogous to Westphal's theory that the motor fibers or cells in the cord may be sensibly diseased without affecting those governing nu trition of the muscles.

Alcohol has an affinity, so to speak, whether from a common micro-organism or not, for the brain and spinal cord, as well as for the nerves.

The Alienist and Neurologist has the following editorial discussion of this subject: Dr. Arthur Wynn Foot, in a recent article in the Dublin Journal of Medical Science, describes a case and suggests the term "hypnolepsy" for the narcolepsy of M. Gelineau, which, by the way, was described by Graves, as Wynn makes note, under the familiar term "lethargy."

He thinks "hypnolepsy" would be a more expressive term. In narcolepsy the word vapy means a becoming stiff-numbness, deadness, such as would be caused by palsy, frost, fright-and can only indirectly have the secondary meaning of quiescence from sleep whereas the word no conveys only the idea of ordinary sleep.

Wynn regards hypnolepsy as quite a different affection from the sleeping sickness (maladie du sommeil) of the tropics, and which is almost endemic on the western coast of Africa; for this latter is almost invariably fatal, exclusively attacks the black population, and is usually associated with glandular swellings in the neck; "and from epilepsy, to which at first sight it may seem to be related, it has remarkable points of difference, in there being neither tonic spasms nor clonic movements, in the preservation of common sensation, and in the consciousness, to a certain degree, of what is going on around. It is also noteworthy, in reference to this point, that neither picrotoxin nor the inhalation of nitrite of amyl has proved of any more serIvice in this affection than has caffein."

But a malarial epileptoid neurosis might possess all these features.

Graves' case of hypnolepsy is introduced in the same article by Dr. Wynn in the following words:

Under the heading "Lethargy," Dr. Graves describes a case of this affection which is not included in the fourteen cases M. Gélineau has been able to collect. Dr. Graves writes: "I know a gentleman advanced in life and of plethoric habit, who has been for several years affected with lethargic symptoms, but with

out any headache, tendency to paralysis, or impairment of his general mental energies. He is frequently attacked, however, even at his meals, with unconquerable sleepiness, and it is surprising how suddenly it comes on. Thus he will be sitting, talking quite cheerfully, and unexpectedly he drops into a sleep, which lasts for about half a minute or a minute, and then he rouses himself and continues awake for a few minutes longer. This happens so often that he cannot venture to go into company. At one meal he has broken three or four glasses by becoming unconscious while raising them to his mouth. He was consequently obliged to have an attendant to watch him going to bed, lest he might fall asleep and endanger the house by allowing the candle to fall."

Narcolepsy, or hypnolepsy, therefore, is an other "Graves' disease."

NEW FORMS AND SYMPTOMATIC PHASes of INSANITY.

The Alienist and Neurologist thus discusses the new forms and symptomatic phases of insanity:

Within the domain of psychological research there appear, sometimes, morbid and rational psychical phenomena so aggregated in an individual as not to conform to our preconceptions of any typical form of mental disease, yet presenting such blended features of rational and irrational conduct as to impress the mind of the discerning and unbiased alienist as incompatible with a perfectly sane state of mind.

Cases like that of the Pocassett letter-carrier, Freeman, the "Second adventist" fanatic who, though a kind and temperate father, discharging his daily duty and excit ing no suspicion of insanity, in a moment of religious fervor and folly, deliberately drives a dagger into his little child's heart, under the mistaken belief that his hand, as was Abraham's of old, would be stayed, because of his faith, and who still believed that God would restore the life of his child long after its little heart had ceased to beat. Though

the insanity of Freeman was neither discernible nor suspected in the community in which he had lived and daily labored up to the time of the commission of the awful crime, he was found, on his trial, to have been insane, and sent to an asylum in New Jersey.

Cases similar in character but not precisely like that of Bernard Cangley and Michael Trimbur, reported by Dr. Ray, those sudden outbreaks of latent mental disease described by Jarvis, or the aberrations of the moral faculties first described by Prichard, and the obscure displays of epilepsia and the unclassified monomanias, now and then appear to excite anew our wonder at the deep mysterious ways of mind unhinged, and stimulate our curiosity to psychically fathom its singular workings.

Thus mania without delirium before Pinel, and paretic insanity before Arnold and Bayle, were non-existent as insanity in the professional mind, and primaire verruecktheit went unrecognized till demonstrated by that scientific interest which prompts the student of anatomy and pathology to make unwearied search when apparent organic anomalies are within possible reach of his knife, and throws about a new phase of mental derangement a fascination that charms to indefatigable study, even though the unfortunate victim be destined for the gallows. For it is from their study as from new phases of physical disorder that, if we investigate them aright, may be gained the most knowledge. "Their existence, however infrequent, must necessarily modify the conclusions that might be drawn from the more common forms of mental disease," said the great Ray. Psychiatry is not a completed science, and the wise man therein will hear and will increase learning. The laws of aberrant mental display are not yet all definitely established. Irrevocable rules of action for minds diseased have not been unalterably determined. As many exceptional phases yet undescribed of insanity probably still remain to be described and named by the observant student of psychiatry as were unnamed a few years ago, before the profession became familiar with manie sans delire, manie

raisonante, moral and emotional insanity, manie transitoria, general paralysis, folie circulaire and certain of the partial insanities.

Predicating the statement upon what thus far has been revealed to us of the varied displays of deranged mind, it would be as unreasonable to limit our comprehension of diseases in which mind is involved, to forms embraced within our present nomenclature, as to ignore the existence of new diseases revealed in derangement of other functions of other organs than the brain, because we cannot precisely name them. New diseases and new forms of old diseases appear before they are categoried. We cannot have a nomenclature ready made, in which to include every new form of mental disease.

VALUE OF Urethran as A HYPNOTIC.

Dr. J. B. Andrews, of Buffalo, reports the following valuable experimental clinical conclusions;

"The first experiment was made on the 8th of May, when I took thirty grains of urethran at three P. M. Before taking, the pulse stood at eighty, in fifteen minutes it had fallen to seventy; and at forty minutes was substantially the same. I fell asleep while sitting in my chair about half an hour after taking the medicine. The sleep was natural without any unpleasant sensations, without disturbance of respiration or the pupils of the eye. It was not prolonged, but was interrupted by the taking of a sphygmographic trace. After this interruption no further opportunity was given for sleep as I got up and walked about.

"On May 14 a second experiment was made. I took fifty grains of urethan at 8:25 P. M. The pulse before taking stood at eighty-eight. In fifteen minutes the pulse was reduced to eighty-two, and in an hour after taking, to eighty. At nine o'clock, thirty-five minutes after taking the drug, I fell asleep. At 9:20 tracing was taken; at 9:35 I was awakened by a report from the night-watch regarding patients which demanded my attention. This aroused me so fully that I did not sleep again. The character of the sleep and the effects of