interfere with their thoughts, reply to or comment upon them, continually say ridiculous, abusive, or obscene things, and perhaps make offensive accusations against them; they see insults in innocent gestures, and imagine that people make grimaces at them in the streets; they have strange morbid bodily feelings which, caused really by their enervating vice, they ascribe to mesmeric, electric, or other mysterious agency; and some of them fall from time to time into a sort of trance or ecstasy, a quasi-cataleptic state in which they see visions that are perhaps of a religious character. Homicidal and suicidal impulses are not at all uncommon, and are the cause of much mental distress; for they arise in the patient's mind against his will, and although he is quite aware of their nature, he is terrified by them and fearful that he may some day succumb to them. It is seldom, however, that patients of this class do yield to such impulses ; they are for the most part too fearful of pain to hurt themselves, and too wanting in resolution to hurt others.

When, degeneration going on, they reach the last and worst stage of degradation, they sink into an apathetic state of moody and morose self-absorption with extreme loss of mental power. They sit or lie all day, or saunter lazily about, muttering or smiling to themselves, lost to all healthy feeling and human interests, slovenly and dirty; if they enter into any conversation, they probably reveal delusions of a suspicious or obscene nature. They believe that they are subjected to strange influences which sap their vigour, especially during the night, and perhaps declare that persons get into their rooms while they are asleep, and indecently assault them or perpetrate unnatural offences upon them; their perverted sexual passion still gives the colour to their thoughts. So they linger on, pitiable wrecks of degradation, from year to year, becoming weaker in mind and body, until they die from complete nervous prostration or from some intercurrent disease to which they fall easy victims at last.

Such is the natural history of the physical and mental degeneracy which is produced in men of a certain neurotic temperament by solitary vice. Certainly it is a sad picture which I have painted, but the colours are not exaggerated. Let

it be noted once more that there must be the temperament as well as the vice in order to have this characteristic degeneracy produced. In another sort of temperament the vice is the exciting cause of an attack of ordinary acute mania or melancholia, and it is certainly sometimes practised for a long time without any mental ill effects. It must be confessed that there is little to be done for persons whose minds have once become seriously affected. If they can be constrained by any means to relinquish the vicious habit at the beginning of their troubles there is good hope for them; but if not, they will not eschew it at a later period, for with the decay of mind they have less and less desire and power to overcome an ever-present temptation which has become stronger through habitual indulgence. Again and again I have known the best considered means, moral and mechanical, which anxious ingenuity could devise and the most patient care apply, to be brought to bear upon cases of this kind in order to rescue them from themselves, but seldom with a success that was worth the pains. Were it legitimate in any case to entertain or express the feeling that the sooner a degraded being becomes the nothing that he was the better for himself and for the world which is well rid of him, it would be so here. But the worst wrecks of humanity have these uses at any rate that they teach a scientific lesson by their study, and nurture humane feeling by the care which they exact.

It is not certain that the vice in women produces a form of mental disorder so characteristically featured as in men, or that it is so injurious to them. But I cannot doubt the existence of a variety of mental disease in them, having some special features, which owes much of its origin to sexual causes and is usually accompanied by this vice. A young lady begins to lose her interest in her accustomed occupations and amusements, which she abandons; is depressed and weeps at times without apparent cause, and is uncertain and capricious in her behaviour; complains of strange and distressing bodily sensations; ceases to exhibit affection or consideration for her parents and others near and dear to her, whom she afflicts by her perverse moods, her capricious temper, and her self-will; perhaps she forsakes their society in order to spend a great deal of time in

her bedroom, where she occupies herself for long periods without weariness in doing nothing or in doing very trifling things; or she pertly insists upon pursuing an independent course of action which is not befitting her sex and position. The state of matters is oftentimes worse during the menstrual periods. Nothing more than this painful change of disposition and caprice of conduct may be noticed at the outset, but in the end morbid fancies of some kind are evinced: she imagines perhaps that her hands are soiled whenever she touches anything, and must be continually washing them, or has a tormenting fear that her clothes are infected with insects and must be all day inspecting and brushing them; she gets some peculiar word or ridiculous thought into her mind and is distressed because she cannot get rid of it, and fancies that it has some indecent hidden meaning; she declares that she cannot do some very simple thing, and that she suffers agonies in consequence of her inability; she believes that some gentleman whom she has met, but who has hardly even spoken to her, is in love with her, and has been hindered by her friends or others from proposing to her, and accordingly throws herself in his way or even writes him affectionate letters. Perhaps the morbid idea is that she is followed and watched by persons who say offensive things of her and call her improper names; and that they have contrived some extraordinary seeing or hearing apparatus by which they can watch or listen to all that goes on in her room. Patients of this class are apt to make unfounded charges of attempts upon their virtue, and have sometimes written secretly with diabolical cunning a series of letters containing the most abominable accusations against innocent persons. Sometimes the patient gets the delusion that her soul is lost because of her wickedness, and has paroxysms of weeping and seeming despair; but it is noticed that the misery is not of that deep, genuine, and continuous kind which usually accompanies that delusion. it is inconstant and is mixed up with a great deal of hysterical caprice and waywardness of conduct, which perhaps also discovers an erotic flavour. In the midst of what would seem to be the most acute distress, when she is so prostrate with grief as to appear to notice nothing or is sobbing as if her heart must

break, she will take quick perception of the situation by a sharp glance or will look up quite calmly and make a suitable answer. She does no work, is extremely irritable and passionate, uses bad language, perhaps threatens her mother, and speaks of suicidal ideas. Anomalous sensations or actual pains in the head, side, or other parts of the body are complained of, and lead to all sorts of strange doings for their alleviation. Whilst her daily conduct is such that those who live with her and see her from hour to hour have not the least doubt that she is downright insane, persons who see her only for a short time or receive quite sensible letters from her may not notice anything wrong. As matters get worse, there are more paroxysms of greater excitement, which may be accompanied by much screaming, more wilful perversity of conduct, less and less evidence of natural feelings, increasing weakness of mind, and perhaps a delusion that she has had a baby or has been accused of having had one.

If these patients are taken in hand by suitable persons and firmly handled at the beginning of their illness, they may be restored to health of mind. But it is necessary to remove them without delay from among their relations, whom they can affect by their tears, distress by their caprices, frighten by their threats, master by their self-will, to the care of strangers who will exercise a watchful supervision and a firm control over them, strive with patient insistence to engage them in work of some kind and in interests outside themselves, and systematically oppose to their wayward moods and morbid caprices the surroundings of a healthy tone of thought and feeling and an orderly activity of life. If they are placed where they perceive that their peculiarities stir no commotion and are not permitted to disturb the quiet order of the household, and where there is everything about them to arouse and foster healthy feeling and activity, they are infected slowly by the surrounding tone, and the inclination to indulge their morbid feelings and whims decreases gradually until it becomes a greater pain than pleasure to do so. If, however, they are not taken firmly in hand, but, being thought to be only hysterical, are suffered to go on at home from week to week and month to month without proper control, as commonly

happens, they slide by an easy descent into incurable dementia; the real gravity and ominous import of the symptoms being out of all proportion to their seeming insignificance. Were mindslaughter an indictable offence, many a too affectionate parent would have to stand his trial for an unwise indulgence of feeling against the stifled convictions of judgment.

Although I have described this form of mental derangement in women under the head of insanity of self-abuse, inasmuch as the vice certainly prevails in most cases, I should be loth to say that a similar mental breakdown does not happen sometimes when there is not sufficient reason to suspect its existence, as the effect of a developing and unfulfilled sexual life upon a certain nervous temperament whose stability it overthrows. These cases in women differ from the corresponding cases in men in this-that while the latter seem to care not for women and shyly avoid them, being satisfied with secret selfindulgence, the former evince often by their feelings and conduct a desire for men. But the difference is not so real as it appears on the surface. Sinners of the male sex shrink from female society not so much because they actually dislike it, as from an extreme shyness and self-distrust; they have not the courage to pay attentions to a woman whom in their hearts they would like to address; instinctively they feel themselves to be unmanned; their vicious indulgence has deprived them of the source of energy and manliness which emboldens the male to a confident address. On the other hand, female sinners who show an inclination towards men sometimes exhibit quite an opposite feeling when they have become engaged or have been married; they may break off the engagement or display an acute repugnance to sexual intercourse, which they refuse, or fall into melancholy or mania; and a marriage which was perhaps schemed and made with infinite cunning as a means of cure serves only to make plain their sad state.

Hysterical Insanity.

Without doubt hysterical symptoms sometimes run on by degrees into actual insanity, but considering how common a disease hysteria is, it must be confessed that this issue is rare.