sanity. An act performed in the heat of passion is prompted by an emotion, which, for the time being, controls the will, the intellect not being called into action; hence it is an act performed without reflection. The emotions are under the control of the will; were it not so, a person would be wholly irresponsible for acts committed in the heat of passion; hence no amount of passional excitement can be justified; it may mitigate the crime, but cannot form any excuse.

Volitional Insanity consists in an inability to control the volitions in accordance with the intellect, and, if uncomplicated, no delusion attends it. Many cases of morbid impulse are instances of volitional insanity. For instance, an idea may suddenly flash across the mind and be immediately carried out, although the intellect and emotions are strongly exerted against it. A person under such circumstances feels a morbid influence to commit murder or some other criminal act, and yields, notwithstanding all the efforts he makes. Cases of kleptomania, dipsomania, pynomania, etc., are often the result of volitional insanity.

General Paralysis is a disease of more than ordinary interest. Unlike other forms of insanity, it selects its victims from the higher walks of life, confining itself almost exclusively to the male sex, and scarcely ever occurring, except between the ages of thirty and sixty. It is caused mostly by alcoholic and sexual excesses, or from severe or prolonged mental labor. Its duration is variable, lasting from a few months to three or four years; but whether progressing slow or fast, it is ever downwards, and in most cases, sooner or later, death will ensue. From the fact that there is a paralysis of all the organs of the body and brain, it is the most dreadful and incurable of all forms of insanity.-From Munual Medical Jurisprudence.

(To be continued.)

TREATMENT OF SYPHILIS WITHOUT MERCURY. BY DR. J. P. H. BOILEAU, B. A., F. R. C. S. I.

Surgeon Major, Assistant Professor of Pathology, Army Medical School, Netley.

It is believed by not a few, that no wise man would attempt to dispute the efficacy of mercury as an antidote to syphilis. Many hold that the disease cannot be eradicated from the system without

the use of the mineral. With my experience, I cannot but hesitate to accept such views.

My position is briefly this. In May, 1865, I was gazetted to a regiment about to proceed abroad. I served with it in the Mediterranean, in Canada, in the West Indies and at home; and left it in October, 1876. For ten years of that period, I was most closely associated with the regiment, and had many facilities for prosecuting inquiries into the results of the treatment of disease, and, by observations, continued year after year, for satisfying myself as to the state of my patients, long after they had been the subjects of my treatment, and so I am in a position to-day to bring to your notice, not only cases of syphilis treated without mercury, but, I believe, cases of syphilis cured (by natural processes, or otherwise) without

mercury.

The principle which in the main guided me in the treatment of syphilis was the principle of avoiding mercury as much as possible; and, in carrying out this principle, I treated most of the cases without prescribing any form of that remedy. Rarely did I resort to fumigation or inunction; and I now believe that it would have been better had I discarded all local remedies having mer cury in their composition. As a rule, I did not use such applications. I tried the internal administration of mercury in some cases, without being at all satisfied concerning its alleged antidotal or curative powers.

My general principle is well attested by a gentleman (now a commissioned officer, and occupying one of the most responsible positions in connection with the army hospital corps) who for eight years as hospital sergeant and compounder carried out my instructions. In reply to questions I have sent him, he writes: "As regards your treatment of syphilis, I know you were always averse to ordering mercury for the disease; indeed, I am quite certain of this, as you invariably marked the venereal register— NO MERCURY. And he adds: "As well as I can recollect now, all the men treated by you made good recoveries. And I don't remember a single man who was invalided, excepting L. " Such are the indisputable facts of the case. For several years I treated syphilis, in the majority of cases, without the use of mercury internally or externally; and in all such cases, without

any exception, the ulterior results were most highly satisfactory; even the man L., who was invalided, returned to his duty in good health, and served for some years afterward.

The following cases illustrate the general mode of treatment and its results.

Case 1.-A. M., aged 32, had a solitary sore in grizzly induration. The occipital and inguinal glands were much enlarged. He had roseola and rheumatoid pains. He was treated in September, 1867, locally, by fuming with nitric acid, and water dressing. The chancre healed in twenty-three days. Internally, he had iodide of potassium, nitrate of potash, compound ipecacuanha powder, and liquor opii sedativus. In February, 1868, he was looking well, and at duty. In March, 1871, he was in excellent health, and he continued so until he was discharged the service.

Case 2.-B. T., aged 20, had an indurated sore, roseolar and papular rash, psoriasis of the arms, and very severe ulceration of the tonsils. He was treated October, 1867, locally, by nitrate of silver and sulphate of copper. Internally he had iodide of potassium, cinchona, and compound ipecacuanha powder. In May, 1868, he was in excellent health, and remained in good health until transferred to another regiment in February, 1873. I heard in 1877 that he was in good health.

Case 3.-C. J., aged 25, had an indurated sore, indurated glands in both groins, and roseolar and papular eruption, very marked and widely spread. He was treated in December, 1867. He was in very good health when he took his discharge in 1871, and also by accounts lately received. The only local application was cold water; and the chancre healed readily, although the induration was very persistent. Iodide of potassium was administered in decoctum cinchonæ, and he had the usual hot baths.

I must state, that all my cases of syphilis were treated by hot baths. Whatever variety there may have been in the use of other remedies, there was none in this. Hot baths were the standing order for all cases of syphilis. And for the most part, the men were strictly confined to bed, often notwithstanding their entreaties to be allowed to get up. The most scrupulous attention was paid to the cleanliness of their linen.

Case 4.-D. W., aged 25, seven weeks previously to his ad

mission for true Hunterian chancre, was under treatment for phagedænic ulceration of the prepuce. With the hard sore, he had indurated inguinal glands. The initiatory fever of second aries soon appeared, and with it a dusky purplish papular rash, having a pustular tendency. The nates became covered with condylomata, and the scrotum before long looked like a piece of raw beef, dotted with little patches of oyster shell. He was treated in December, 1877, locally, by sulphate of copper. Internally, he had iodide of potassium, cinchona, and Dover's powder. In May, 1868, his temperature was 98°, tongue clean, skin perfectly clear; there was not a trace of any rash, pimple or sore. The scrotum was perfectly healthy looking. He was in robust health, and he continued so until he deserted some years afterward.

Case 5.-E. D., aged 25, had a circular indurated ulcer, enlarged and indurated glands in the right groin, roseola, and a papular rash. He was treated in July, 1868, locally, with cold water only by day, and by night, unguentum simplex. Internally, he took chlorate of potash, quinine, and Dover's powder. In October, 1868, he was in good health. In March, 1871, he was in excellent health. In 1878, he was in good health, and still in the service.

Case 6.-F. G., aged 26, was twenty-six days in hospital for primary sore, with inflamed glands, which did not suppurate. He had a papular eruption over the whole body, and ulceration of the tonsils. He lost all the hair on his head and face. He was treated in September, 1868. In May, 1869, there was no trace whatever of the disease. He was in good health when discharged the service in 1871; his hair had all grown again. Chlorate of potash and Dover's powder were the remedies employed.

Case 7.-G. C., aged 20, had Hunterian chancre, with indurated glands on both sides, and roseola and papular rash. He was treated in August, 1868, for phymosis, complicated to such an extent that circumcision was necessitated. Alum and carbolic acid were used locally, and iodide of potassium and Dover's powder internally. In December, 1868, his health was good. In June, 1869, he had not a trace of the disease about him. In March, 1871, he was in excellent health. There was a very fine white cicatricial line on the prepuce.

Case 8.-H. C., aged 26, was treated in November, 1869. He

was in good health, in Jamaica, in 1871. In 1878, I was informed that he was married and the father of two healthy children.

Case 9.-I. J., aged 22, was treated in December, 1869. In January, 1871, his health was fair. In May, 1871, his health was good. In 1878, he was in good health, and the father of two healthy children.

Case 10.-J. R., aged 19, was treated in January, 1869. In January, 1870, his health was good. In March, 1871, he was in good health, and was so when discharged the service.

The foregoing are examples of cases treated without mercury. Many others of a similar character passed through my hands; but it is my desire that not only such, but examples of a number in which mercury was locally applied, should be given; because my position is sustained not only by several individual cases such as these narrated, but by the very satisfactory eventual results of all the cases treated by me between 1865 and 1876; and, in order that I may be justified in bringing forward this tout ensemble of my practice, as a proof of the curability of syphilis without mercury, I am bound to give examples of those cases in which the mineral was locally applied.

Case 11.-N. G., aged 26, had extensive ulceration in, and surrounded by cartilaginous induration. The inguinal glands were enlarged. He had roseolar and pharyngeal ulceration. Lotio nigra was used in this case. He was treated in October, 1868. March, 1869, he was in good health. In April, 1870, he had remittent fever, but was discharged in good health, in May. In March, 1871, he was in excellent health; and in 1877 was still in the service and in good health.

Case 12.-O. C., aged 23, had a circular solitary indurated ulcer, enlarged inguinal glands, roseolar and papular rash over the whole body, and mucous tubercles on the inside of the thighs; the scrotum was covered by an eruption of papules. On several parts of the body, small gangrenous ulcers appeared; and he had pharyngeal ulceration. The only mercurial preparation used was lotio nigra, and that only for a period not exceeding seven days. He was treated in October, 1867. In March, 1868, he was in fair health. In May, 1868, he looked well and felt so. Not a trace of disease was manifest, excepting some slight coppery patches on