to season, the cases are generally more prevalent in late summer and early autumn than at other times.

The author next gives a summary of the p. m. findings in 100 cases dying at Betley Asylum at variable time, from or after an attack of dysentery, and finally gives the following summary:

1. That dysentery in this country (England) is mainly confined to lunatic asylums.

II. That it does not occur, except rarely, in other large institutions, such as prisons and workhouses.

III. That the increased precautions, etc., that have been taken during the last few years have made no appreciable difference to the incidence of, or the mortality from, this disease.

IV. That there is strong evidence in favor of the view that not one but many micro-organisms, either singly or as a mixed infection, can give rise to dysentery.

V. That disturbance of the subsoil in the neighborhood of an asylum is very liable to be followed by an outbreak of dysentery in that asylum. VI. That the evidence, deduced from the relation between the inhalation of sewage effluvia and dysentery, supports strongly the theory that asylum dysentery can be caused by some micro-organism which normally inhabits the colon and becomes pathogenic when the resisting power of the tissue is sufficiently reduced.

VII. That the occurrence of asylum dysentery in members of the staff of an asylum is probably due either to infection by a virulent form of some universal organism, or to some normal colon organism becoming pathogenic, owing to the reduction of immunity caused by the frequent breathing of an atmosphere permeated by a fæcal odor.

VIII. That there is strong evidence to support the theory that, in lunatics, the vitality and resisting power of all tissues to infection is reduced, owing to the impairment of their trophic nerve supply.

IX. That dysentery is particularly apt to occur in lunatics owing to the deterioration of nerve cells affecting the trophic nerve supply to the colon.

X. That it is far less apt to occur in congenital cases of insanity or those in whom the mental disease is stationary.

XI. That the statistical evidence is entirely against the view that dysentery is spread by the transfer of recovered cases from ward to ward. FITZGERALD.

The Early Ocular Signs of Dementia Paralytica. By WARD. A. HOLDEN. Journal of Nervous and Mental Diseases, Vol. 32, p. 713. Nov., 1905. The author briefly records his finding in a series of seventy uncomplicated cases of paresis, i. e., where tabes was not suspected.

The cases were examined as soon as a positive diagnosis of paresis was made and were almost all in the early stage of the condition.

The writer's method of examination is as follows: He directs the patient at first to look out the window for a minute or two and then to

look at the ceiling, when the pupils dilate since less light enters the eyes. The patient then looks alternately from the window to the ceiling, remaining in each position one minute.

When the pupils are sluggish he suggests that the patient first face the light and then turn his back to it, doing this with both eyes open and then with each eye closed. With this method the author claims that the reflex from the cornea does not interfere and that irregularities and inequalities in the pupils can be well defined. Also that by covering either eye with the hand and exposing the other the direct and consensual reaction can be determined. The size of each pupil is measured with a pupillometer while the other eye is closed.

To elicit sensory reaction the skin of the back of the neck is pinched several times after the pupils have come to rest. The gaze having been fixed on a certain point; waiting until hippus movements cease. The author considers this of importance because such hippus movements are frequently found in paresis.

It is noted that certain physiological variations in the size of the pupils occur, for example, larger where the irides are blue than where they are brown, large in cases of myopia, large in childhood, smaller in adults, and smallest in old age. Between the ages of 25 and 35 the pupils measure from 4.5 to 6 mm., the average being 5.25 mm., and in a series between the ages of 40 and 50 the range was from 3 mm. to 4.5 mm., the average being 3.75 mm.

The sensory reflex is usually well marked in early life and is often absent in old age. The shape of the pupil often shows variations at different ages, being regular in youth and frequently being irregular in

old age.

Inequality of the pupils is common and may have no pathological significance. Cases of alternating mydriasis are common in paresis, where the relative sizes of the two pupils change, and there may also be alterations in the sensory and light reactions during the examination.

The author in common with many other observers notes that in all his seventy cases there was not one case of optic atrophy.

Then the results are tabulated under the following heads: sex, age, vision, refraction, fundi, shape, size of pupils, sensory, light and convergence reactions. The following conclusions are arrived at: In uncomplicated cases of paresis early in the disease there is an almost constant absence of the sensory reflex. In half the cases irregularities in the outline of the pupils; in nearly half inequality of the pupils; in more than half small pupils; in one-fifth loss of light reflex; in another fifth markedly sluggish light reaction, and in a few of these a diminution of convergence reaction; lastly, while the absence of the sensory reflex, myosis and irregularity of the pupils may not be very significant late in life, they are of very considerable importance earlier in life.

FITZGERALD.

On the Pathogenesis of Some Impulsions. By PIERRE JANET. Journal of Abnormal Psychology, Vol. 1, p. 1, April, 1906.

Dr. Janet briefly discusses impulsive acts in general and then gives short abstracts, with comments, of five cases who respectively showed impulsions of dipsomania, of gluttony, of dromomania, and of self-mutilation. He draws attention to the periodicity of these impulsions and discusses the cases cited and makes frequent references to others whom he has observed, and finds that all of these cases have had a common origin in attacks of depression which the impulsions in a measure relieve. He believes that treatment of these impulsions should be directed to the prevention of these underlying attacks of depression.

W. R. D.

Pamphlets Received.

Columbus State Hospital, The Sixty-seventh Annual Report to the Governor of the State of Ohio for the fiscal year ending November 15, 1905.

Fifty-fifth Annual Report of the Managers of the Syracuse State Institution for Feeble-Minded Children for the Year 1905.

Detroit College of Medicine. Announcement for Session of 1906-1907. Medical Educational Standards.

A Case of Heteroplastic Ovarian Grafting, Followed by Pregnancy and the Delivery of a Living Child. Robert T. Morris, M. D. Reprinted from Medical Record, May 5, 1906.

Railway Brain Strain of and Brain Strain Regulation of Railway Employes. C. H. Hughes, M. D. Reprint from the Alienist and Neurologist, May, 1906.

Psychoencephalonasthenia or Cerebrasthenia Simplex, and Psychoencephalonasthenia or Cerebrasthenia Insaniens. Charles H. Hughes, M. D. Reprint from the Alienist and Neurologist, May, 1906.

Prospectus of The American Pharmacologic Society and the Working Bulletin System for the Co-operative Investigation of New Materia Medica and Food Products. F. E. Stewart, M. D.

Sixty-fourth Annual Announcement of Rush Medical College, containing the Bulletin of the Medical Courses of the University of Chicago. Georgetown University Publication. Bulletin of the School of Medicine and Dental Department. Announcement for the Session of 1906-1907. The Maryland Agricultural College Quarterly. No. 32. May, 1906. Proceedings of the American Medico-Psychological Association at the Sixty-first Annual Meeting held in San Antonio, Texas, April 18-21, 1905. College of Physicians and Surgeons of Los Angeles, California, Annual Announcement, Session of 1906-1907.

New York Post-Graduate Medical School and Hospital. Twenty-fifth Annual Announcement.

Albany Medical College. Announcement for Session 1906-1907.

Autointoxication: Its Factors, Results and Treatment. By H. C. B. Alexander, M. D. Reprinted from Medicine.

Legal Aspects of Epilepsy.

By H. C. B. Alexander, M. D. Reprint

from the Alienist and Neurologist, May, 1906.

Abbott's Alkaloidal Digest.