This condition, after lasting more or less for two years, yielded gradually to treatment, and there has been a surprising amendment during the last year. Both at puberty and at cessation this lady became suddenly very stout.

DIPSOMANIA. Like B. de Boismont, I have several times seen, in temperate women, a craving for spirits only at the menstrual epochs, which subsided with the flow, and the same desire has been noticed in pregnant and puerperal patients. Esquirol and H. Royer Collard have met with women, in good circumstances, who all through life had been temperate, but who, at the change, were suddenly seized with an irresistible desire for brandy, which again became disagreeable to them, when the critical period was passed. This impulse is akin to the well-known longings of pregnancy, and those who yield to it know they are doing wrong, struggle against it, but are overcome. It is easy to understand how such impulses should be rife at all the periods when the ganglionic nervous system is in a state of perturbation, and when anomalous sensations at the epigastric region indicate morbid action in the ganglionic centre; they should, therefore, be considered not so much as despicable failings as complaints admitting of being cured by proper treatment.

KLEPTOMANIA. Drs. Taylor and Marc have known patients who, previous to puberty or to disordered menstruation, were conscientious respecters of the rights of property, but who, though in affluence, would steal, at all risks, at the critical periods of life. Dr. Marc mentions a rich lady who, during pregnancy, could not resist the temptation of stealing a chicken from a cook-shop. I have already alluded to a case of this description occurring at the change of life, and I believe it to happen oftener than is supposed-though, while yielding to an ungovernable impulse, the sense of acting wrongly is still present to the mind.

HOMICIDAL MANIA.-This irrepressible impulse has been admitted in English Law Courts, whether it occurs during disordered menstruation, pregnancy, or puerperal mania. I cannot cite any case where this impulse led to lamentable consequences at the change of life, but one of my patients was con

stantly troubled with the temptation to kill her grandchildren, and she feared to dine with them "because of the knives."

SUICIDAL MANIA.-Hippocrates relates that self-murder was epidemical among the young women of Miletus. It has occurred during menstrual irregularities, and B. de Boismont has observed it at puberty and at the change of life. From his extensive statistical researches respecting suicide in France, it appears that, for one woman, three men commit suicide; and, with respect to the age at which this crime is most frequent, he found that, out of 5960 suicides committed by women in the whole of France, the greatest number, 1111, took place from forty to fifty; 1026 occurred from fifty to sixty, and 992 from twenty to thirty. It appears, however, that the capitals of some countries are exceptions to the rule, for the same observer found that, out of 1380 suicides committed by women in Paris, the largest number, 343, occurred from twenty to thirty, and 241 from forty to fifty. Capitals excepted, wherein the battle of life rages with fearful fury, it is safe to conclude that women feel the greatest propensity to self-murder between forty and fifty. Many patients have told me, with inexpressible anguish, that they feel" so strange in the head, so lost, so troubled with sensations of impending horror, that they must commit suicide to prevent their going mad," and one drowned herself in a cistern.

DEMONOMANIA.-When the belief in Satanic influence had a strong hold on the popular mind, lunatics often thought themselves possessed by the devil; now they are more afraid of the policeman. The only case of demonomania that I have seen, occurred to a lady at the change of life. She attributed the distressing symptoms of uterine disease to the devil having taken up his abode in her body, and the delusion vanished when her health was restored. Dr. J. Conolly relates a similar case in his Croonian lectures; the patient was also at the turn of life: and on analyzing Esquirol's remarkable article on demonomania, I am struck by the fact, that all his cases occurred at this epoch. One patient, aged forty-six, thought the devil had placed a cord from the pubis to the sternum; another, aged forty-nine, had been troubled by cerebral symptoms ever since cessation, at forty, and thought the devil lodged in her womb. A third,

aged forty-eight, declared that he had taken up his abode in each hip-bone. A fourth, aged fifty-seven, from nervous had become insane at fifty-two, when cessation occurred, and she claimed the devil as the father of her children. A fifth, aged fifty-one, thought she had signed a contract with the devil— an illusion which originated in puerperal mania.

Impulse to deceive. It is passing strange that women should surpass men by stupendous powers of deception. When man has an object to gain, when he wants to beg, or to escape military servitude, he is clever enough at deception; but he does not, like woman, find pleasure in deceiving for deception's sake. It would take a large volume to contain the authentic accounts of deception knowingly practiced by women merely to excite interest. There was nothing at all amiss with the bodily health of most of these women; in some, menstruation was deranged, and others were hysterical. Thus admitting on the part of women a large amount of fully intended deception, there will remain a certain number of cases in which the patient is herself deceived, and has not the slightest intention to deceive others, even when making the most outrageous accusations. It is well known that irreproachable women, when suffering from puerperal insanity, have accused themselves of having had connection with one or more men they knew little or nothing of. I have known women at the change of life to do the same, and who, after having been insane for six or eight months, have learned with horror of what they had accused themselves.

APOPLEXY AND HEMIPLEGIA. Notwithstanding Dusourd's contrary assertion, women are little subject to apoplexy at the change of life. I give the following curious instance of an ataxic state of circulation leading to the simultaneous loss of blood from many parts:

CASE 36.-Hemiplegia.-Eliza C., aged forty-seven, first came to the Farringdon Dispensary, February 18th, 1853, being then forty-four. She was of average stature and size, with brown hair, hazel eyes, and flushed face. The menstrual flow came at fourteen, and continued regular, but profuse, and with unusually severe abdominal pains. She married at fifteen. The menstrual flow ceased for eight months, and then a large

blood clot came away, and for several years either the menstrual flow came every fortnight, or was absent for five or six weeks, being then followed by a voluminous clot and great flooding. She never conceived, was once flooded for three weeks, and for the last six months the menstrual flow has appeared every fortnight. Such being her state of health, without known cause, she was suddenly seized with hemiplegia of the right side. She walked to the Dispensary, dragging the right leg, the right arm was numb, often felt like pins and needles, and could be pinched without causing pain. She looks stupid, complains of headache, loss of memory, temporary loss of sight, stutters in speaking, and cannot find the words she wants. The attack of hemiplegia was accompanied by epistaxis from the right nostril. She had been already cupped at the nape of the neck, and I ordered 8 oz. more blood to be withdrawn in the same way, and gave calomel with opium, and black draught. February 21st she lost blood from the right nostril; 8 oz. blood were withdrawn, and immediately afterwards came a violent flooding, which continued until March 5th, when I ordered alum injections, antimonials, and 1 gr. of opium, with 3 of c. ext. of colocynth, to be taken at night. During the flooding, blood frequently trickled down the right nostril. Notwithstanding the quantity of blood lost by the patient, her strength seems but little impaired; she is quite conscious, and walks to the Dispensary; but the hemiplegic symptoms are as marked as ever. May 12th. She has returned from the country and is better, but still complains of numbness of the right side. She can say what she wants, but has a difficulty of utterance, and complains so much of pain on the right side of the head, that I ordered her to rub in twice a day the size of a filbert of 2 oz. of mercurial ointment, mixed with 2 drachms of ext. of belladonna, and to take the com. camph. mixture, and the aloes and myrrh pills at night. June 16th.-After having rubbed in the ointment four times, her head felt very sore, and "as if it was heavier and larger than usual." She could not see distinctly; salivation came on, but soon subsided, after which she was better in every way, the head was no longer painful, and she could use her right arm and leg, though they remained weak. I lost sight of the patient until May 31st, 1856, when she ap

peared the same as when I first saw her, except that her face, instead of being flushed, was spotted with dabs of capillary injection. Since the flooding, during her previous illness, there had been no menstrual flow, and she had suffered more or less from headache, abdominal pains, faintness, flushes, and perspirations. Lately the head has been very painful, she finds it difficult to keep awake, and cannot bear to be spoken to; the right arm and leg are almost useless; the right hand is soddened with perspiration, has pricking sensations, and scarcely feels when it is pinched. Blood has been passed in the urine, and she says that hæmaturia occurred also in her first attack. I ordered 8 oz. of blood to be withdrawn as before, calomel and opium to be taken at night, and a black draught in the morning. June 25th. She was cupped to the same amount on the 4th and 18th, the bowels had been kept freely open, antimonials had been administered, ice applied to the head, and the patient was sometimes better, sometimes worse, often bewildered, at times ungovernable, but the hemiplegic symptoms remained stationary. I again ordered the mercurial and belladonna ointment to the head; she rubbed in 2 oz.; the head seemed swollen; she felt stupefied, could not see clearly for three days, and was salivated. The head and right side then became much better, but the right hand is still powerless. She had a slight menstrual flow for three days, after an interval of as many years, and I prescribed comp. col. pills, the camph. mixt., and 15 grs. of nitre three times a day. Finding the hemiplegic symptoms somewhat worse on the 16th, I advised the posterior half of the head to be shaven, and the ointment to be again applied. This was done with decidedly good effect; and when I saw the patient on August 20th, she no longer suffered from hemiplegia, and was able to attend to her domestic duties, although suffering from debility, headache, and nervous symptoms, most likely increased by occasional fits of intemperance.

THEORY OF MENTAL DISEASE.-After recounting the facts which prove that there are morbid affections of the ganglionic centre, I sought to understand their import, before discussing their treatment; and now that the facts indicating the various forms of cerebral disturbance, induced by the change of life, have been related, I shall call attention to their probable mode