states were much less favorable prognostically. Dr. Hoch had always found that cases in which the disorder of behavior was out of proportion compared with the flight of ideas and the intellectual disorder in general, were prognostically also more unfavorable. Such cases were apt to have long attacks or many attacks. The prognosis in cases in which a delusional element was strikingly out of proportion to the flight of ideas was also more doubtful than in the simple classical mania. In other words, the cases of mania in which there were strong discrepancies in the intensity of the different symptoms were those which presented a less favorable outlook than those in which there existed a certain harmony in the intensity.

At a meeting of the New York Psychiatrical Society, held Jan. 2, 1907, the following memorial notice of the death of Dr. Alexander E. Macdonald was presented by Drs. Carlos F. MacDonald and William Mabon, a committee appointed for the purpose, was unanimously adopted and ordered to be spread upon the minutes of the Society and a copy of the same to be sent to the family of the deceased:

Alexander E. Macdonald, LL. B., M. D., a member of the New York Psychiatrical Society, died December 10, 1906.

For thirty-five years Dr. Macdonald had been intimately associated with the insane. He commenced the study of medicine at Toronto University and graduated M. D., Medical Department, New York University, 1870; LL. B., Law School, New York University, 1881. He was lecturer upon Medical Jurisprudence in 1874; subsequently, Professor of Medical Jurisprudence, and Professor of Psychological Medicine and Medical Jurisprudence, and was Emeritus Professor at the time of his death. He was house physician at the Hospital for Epileptics and Paralytics, Blackwell's Island, 1870; chief of staff, Charity and Allied Hospitals, Blackwell's Island, 1871. Resident physician, New York City Asylum for the Insane, Ward's Island, 1874. Medical superintendent of the same from 1875 to 1904, the title of the asylum having been changed in the meantime to Manhattan State Hospital, East, Ward's Island.

In 1901 he established the tent treatment of the tuberculous insane, removing them from all communication with any un

affected patients. The principles underlying this undertaking are now universally accepted by the medical profession here and abroad.

An article on this subject was published by the Charity Organization of New York City and the National Association for the Study and Prevention of Tuberculosis.

Dr. Macdonald was a delegate from the American MedicoPsychological Association to the Fourteenth International Medical Congress at Madrid in 1903, and to the Fifteenth Congress, at Lisbon, in 1906; President of the American Medico-Psychological Association in 1904; member of the executive committee of the Congress of American Physicians and Surgeons, to be held in Washington in 1907; honorary member of the MedicoPsychological Association of Great Britain and Ireland, and of other continental medical associations.

His splendid administrative abilities made him familiar with every detail in the care of the insane, seven thousand at one time being under his direction. He possessed the rare gift of attracting to himself experienced, trusty and loyal officers and friends.

Dr. Macdonald was one of the most distinguished alienists of this country, and a man of striking force of character. He had a hatred of cant and pretense. His far-seeing powers, his unswerving integrity and great executive ability qualified him in an extraordinary degree for his responsibilities. At all prominent medical meetings his activities were conspicuous. His commanding presence and lofty sense of duty will always be remembered by those who had the privilege to be acquainted with him, and his pupils in all parts of the country will pay many tributes to his memory.

Dr. Macdonald was a cultured man of affairs, who wrote in a convincing and agreeable style, and enjoyed a well-earned reputation as an after-dinner speaker. He was a member of the Lotus Club and a Mason of Holland Lodge, New York City.

Our sincere condolences go out to the wife and children of our fellow member in their affliction.

The Psychiatrical Society desires to spread upon the minutes this tribute to the memory of their late associate. C. MACFIE CAMPBELL, M. B.,

Secretary.

Correspondence.

LETTER FROM FRANCE.

From time to time public opinion is stirred to its depths, in many countries, over the question of the insane. In both America and France the question comes periodically to the surface, only varying as regards the subject. In France for the past thirty years the press has waged a dozen or more campaigns against so-called arbitrary confinement: complaints of the persecuted, rancour of alcoholics, family quarrels, journalists' bugaboos, have troubled the good sense of the public by denunciatory allegations whose inanity is shown oftenest only when they had upheld the robe of justice or stirred up administrative departments not easily moved. The truth, once recognized, made less stir than the error, and the denial of the journal passed unperceived on the third page, while the pseudo-scandal had filled columns of the first.

In America, it seems, preoccupations of another sort have agitated public opinion: are the medico-legal expert reports well made, are they even useful, how reform them? These are the questions which are treated somewhat cursorily by the editors or the correspondents of the New York Times, which Dr. Alder Blumer sends me with an invitation to "explain the French system and to criticise that of Great Britain and America." I do it very gladly because among us the method of expert reporting, even if it is not perfected, renders actually incontestable service, because on the other hand so many of the problems up for discussion in America seem to us to have been settled here almost fifty years ago; however, on the contrary, we are able to profit by American experience in the matter of contradictory expert testimony.

I. I shall first name the processes and rules of criminal medico-legal expert testimony. We shall be concerned only about this kind, the testimony in civil cases not provoking the same objections.

In France, experts in criminal matters are named according to the following rules: At the beginning of each judicial year the courts of appeal, in the council chamber, the procurator general included, name from the lists proposed by the tribunes of first instance within their jurisdiction, doctors of medicine on whom they confer the title of "court experts." In order to be named one must have practised medicine at least five years or hold a diploma for medico-legal studies.

Expert physicians named on these conditions by the court are, in principle, the only ones to whom an expert report can be entrusted.

An expert so appointed is an auxiliary of justice, which gives to him the following characteristics: he illumines justice, but he does not judge and cannot impose his opinion. If he has to appear in court he is considered a witness. He is not allowed to receive any gift for his services; and he is, on the other hand, protected by the law against the slanders or the attacks which are directed towards him in his official capacity.

Every one who has committed a violation of the law which appears to be the result of insanity, or whose conduct inspires doubts, may be subjected to an expert examination by some sort of repressive tribunal. In practice it is rare to see a mere police court busy itself with the mental condition of the individual who has committed an offence; they hardly ever call in experts except for misdemeanors or for criminal cases. If the offence is flagrant the bar may, if it thinks well, name at once an expert who has to report the case to the magistrate; but oftenest it is the magistrate who has to choose the experts, either because the lawyer has asked him to do so, or because he himself feels the need of having light on the case.

It is rare in our day that the magistrate disagrees with the expert when the case lends itself to mental examination, and usually he conforms to the opinion handed down by him, without, however, being in any way obliged to do so. When the culprit is pronounced insane, the judge gives a ruling of non-suit; criminal action ends, and the patient is ordinarily placed at the disposition of the prefect magistrate belonging to the executive power, who has him officially confined; in some cases he is al