No.705.

[1836-37.

LECTURES

ON

MEDICAL JURISPRUDENCE,NOW IN COURSE OF DELIVERY

AT THE

UNIVERSITY OF LONDON.

BY PROFESSOR A. T. THOMSON.

LECTURE XXII.

SIMULATION OF DISEASES, (continued):—Imi-tation of Fever, Ague, Epilepsy, and Cata-lepsy. Cases of real Catalepsy. Simula-tion of Hœmoptysis, Hœmatemesis, Tympa-nitis, Insanity, and Idiotcy. Tests of theseDeceptions. Diseases when feigned by Offi-cers. Alleged bodily Disqualifications toserve on Juries. Cautions to be observedin granting Certificates of Unfitness forperforming Military and Civil Duties.GENTLEMEN :-Internal diseases are simu-

lated in two ways:-1. A temporary dis-eased state of the body may be producedby substances of various kinds taken intothe stomach, or applied to the surface ofthe body. 2. Appearances very similar tothe symptoms of diseases may be altogetherthe effect of imitation. Both modes are

not unfrequent, but the first method is

chiefly practised by soldiers and sailors.Ferers are simulated by swallowing a

mixture of soap and tobacco, which pro-duces a small rapid pulse, closely resem-bling that of continued fever, with a brownfurr on the tongue. The same state, FODEREsays, can be produced by smoking Cumminseeds. Dr. PARIS informs us that a parox-ysm of fever may be excited and kept up bythe introduction of a clove of garlic into therectum. But these deceptions are readilydetected by confining the person to bed, andclosely watching him; the symptoms, in-stead of increasing, as in real fever, entirelydisappear in a few hours. It is not moredifficult to detect the simulation of ague byold soldiers, who, Dr. HENNE informs us,are deeply versed in the history of aparoxysm of intermittent, and very skilful

in imitating the rigors, and also in givingthe febrile aspect to the tongue, by whiten-ing it with chalk. The absence of the hotand the sweating stages of the paroxysmreadily discover these imitations. Amongstsailors the rigor of ague is often admirablysimulated by mere acting. Dr. CHEYNEmentions a case of this kind, which wasdetected by throwing down the bed-clothes,and finding that the body was covered withperspiration, caused by the efforts made inthe imitation of the cold fit.

Epilepsy being a disease which recursonly at intervals, and which can be readilyassumed at the moment most convenient forthe object of an impostor, has been morefrequently and successfully simulated thanmost other general diseases. One of themost perfect cases of feigned epilepsywasperformed by the daughter of a farmer nearEdinburgh, who was such an adept in

feigning disease, that she, at different times,feigned hepatitis, amaurosis, paralysis,aphonia, gastralgia, dyspnoea, and, ulti-mately, the passing of bones from the va-gina. To give the appearance of bloodyfroth, which frequently issues from the

mouth, in real epileptic fits, in which thetongue is often wounded, blood is suckedfrom the gums, and soap is chewed. Thebest means of detecting this imposition is towait until the sleep, which is the usualtermination of the paroxysm, be imitated,and then either to drop hot sealing-wax on,or to apply a red-hot iron to, the leg of theimpostor. The true epileptic is insensibleto pain at this time, but it is rarely that theimpostor does not display sensation on beingthus tried. Dr. CHEYNE recommends tointroduce a few drops of alcohol into theeyes. This does not arouse the true epilep-tic from his sleep, but it soon discovers thedeceptive one. It is of no use to applysuch means during the continuance of thepretended convulsions, as the compressionof the nervous filaments by the voluntaryviolent contractions of the muscles reducesthe sensibility so much, that pins and nee-dles may be run into the body, and themost irritating applications made to it,without the individuals betraying the leastconsciousness. A more satisfactory method

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of detecting the deceit is to ascertain the that Dr. CULLEN, and several other medierlcontractility of the pupil, which does not writers, have considered it to be in everytake place in real epilepsy ; and, also, to instance a feigned disease. I have seen twobserve whether the face becomes livid. cases of it, in one of which no doubt could

,

Another method is the application of ster- be entertained of the reality of the disea-·: ’

nntatories to the nostrils, which have no and, in the other, no motive existed forinfluence in real epilepsy, but produce deception. I will describe to you the motsneezing in the feigned disease. DE HAEN interesting and undoubted of these cases. ;

relates the case of a girl who was brou ght I was attending, nearly twenty years aulo, fto the hospital at Vienna with epilepsy, an officer in the army, who was labourg

.

which, from occurring once or twice a-day, under phthisis, in the last stage of the di’,next occurred every hour. The resemblance ease. His hope of recovery was still, how.was good in every respect but one : during ever, kept alive in his mind and that of histhe paroxysm she did not open her eyes wife, so that his friends could not perstiadtwith a winking, but in the natural way, him either to make his will, or to sell In, -

which, along with the normal condition of commission, which was all that he had tothe pulse, and the contractility of the pupil bequeath to his wife and an only daughter. to light, led DE HAEN to suspect some At length he became sensible of his danger, deceit. He ordered her to be taken out of and drew up a petition to the commander.bed, and directed the attendants, in her in-chief, for leave to sell out, and, at thehearing, to place her erect, and if she fell to same time, he made his will. I was sentchastise her severely. She took care not to for to witness his signature to both. Har.fall, and by this display of volition the ing executed these deeds, his mind seemedfraud was detected. Among soldiers and much relieved, and I left him more happysailors this feigned disease is readily cured than he had been for many months. I had

by proposing an operation in the patient’s not, however, left the house five minutes,hearing, and to proceed as if it were to be before the servant came breathless after me.immediately performed. and required my immediate presence, as herAn excellent method of detecting this master was much worse. I returned h-

feigned disease in a beggar was practised at stantly, but my patient was dead; he hadParis. This man had excited so much com- fallen back in the bed immediately I leftpassion, that a bed of straw was prepared the house, and expired without a groan,on which he might fall without injury to His poor wife was standing by the side ofhimself. At length the fraud being sus- the bed like a statue, pale, her eyes fixed,aspected, the four corners of the bed of straw it were, on vacuity: she was insensible, eli- were set on fire, whilst he lay on it in a dently, to my entrance into the room.

paroxysm of the disease. He quickly Finding that her poor husband was past allsprang up and fled. human aid, I approached Mrs. -; she

Dr. BECK justly remarks, that " one fact seemed to take no notice of any thing: Ishould be kept in view respecting this dis- took her hand,---she felt it not. I spoke toease. The real epileptic is desirous of con- her,-my voice was unheard,—no pulsecealing his situation, and attaches to it a was perceptible at the wrist; and it waskind of false shame, whilst those who only by the dew on a mirror, approached tofeign the disease talk about it, and take no her mouth, that I was satisfied that sheprecaution to avoid publicity." breathed. It instantly occurred to me that

Catalepsy is a disease of very rare occur- it was an attack of catalepsy, and I vi as

rence, but is, nevertheless, occasionally confirmed in my opinion, by finding that thefeigned. The real disease consists in an arms and other parts of the body remaiafdinstantaneous rigidity of the trunk and fixed in any position in which they werelimbs, the suspension of the senses, and tem- placed. She was put to bed, and continuedporary interruption of the exercise of the in this state for forty-two hours, after whichintellectual faculties. The posture and ex- she suddenly seemed, as it were, to awake:pression of countenance at the moment of she was sick, and re-action soon came on,andseizure is retained by the patient, and from augmented to fever. She was two monthsits not varying, and from the fixed attitude ill, and in a most precarious condition.of the body, the person appears actually This case is a parallel to one describedlike a statue. The pupil contracts on the by the late Dr. GoocH, which I strongly re-approach of light, but the eyelids continue commend you to read; you will find it in

fixed; and the balance of power between GOOD’S Study of Medicine, rol. iii., p. 57.the flexor and extensor muscles is so equal, I will also notice another remarkable casethat any new position in which the limbs or quoted by Sir ALEXANDER CRICHTOB, fromtrunk of the body is placed by force, is the fifth volume of the Psychological Mmaintained. The return to the natural zine, and quoted in his work on insanity.state is as instantaneous as the attack of A young lady, an attendant on the Princessthe disease. It is generally the result of , after having been conimed tn hersudden and powerful shocks to the nervous bed for a great length of time, with a. violentsystem ; and the symptoms are so singular, nervous disorder, was at last, to all appear-

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ance, deprived of life ; her lips were quite to send him to Bethlem Hospital he gradn-pale, her face resembled the countenance of ally recovered.a dead person, and her body grew cold. Another case is recorded of a young sol-She was removed from the room in which dier, who resisted measures of still greatershe died, was laid in a coffin, and the day of severity; he permitted pins to be thrusther funeral was fixed on. The day arrived, under his nails, his head to be trephined,and, according to the custom of the country, and several other cruel acts to be committed,funeral songs and hymns were sung before yet he persisted in the deception until hethe door. Just as the people were about to procured his discharge, immediately afternail on the lid of the coffin, a kind of per- which he was seen in perfect health, em-spiration was observed to appear on the ployed actively in his father’s house.surface of her body. It grew greater every The following curious method ofdetec-moment, and at last a convulsive motion tion was employed by JOHN HUNTER:—Thewas observed in the hands and feet of the impostor was a young man, a patient of St.corpse. A few minutes after, during which George’s Hospital; he apparently lost everytime fresh signs of returning life appeared, power of volition and consciousness, andshe at once opened her eyes, and uttered a remained in the attitude in which he wasmost pitiable shriek. Physicians were placed. JOHN HUNTER commented on thequickly procured, and in the course of a case to the students surrounding him, whilstfew days she was considerably restored, the man stood near with his arm extendedand is probably alive at this day. The des- and a little elevated. " You see, Gentle-cription which she herself gave of her men," said Mr. HUNTER, " that the hand issituation is extremely remarkable, and supported merely in consequence of theforms a curious and authentic addition to muscles persevering in that action to whichpsychology:- volition had excited them prior to the cata-" She said that it seemed to her as if, in a leptic seizure. I wonder," continued he,

dream, she was really dead; yet she was per- " what additional weight they would sup-fectly conscious of all that happened around port;" and so saying, he slipped the nooseher in this dreadful state. She distinctly of a cord round the wrist, and hung to theheard her friends speaking and lamenting other end a small weight, which producedher death at the side of her coffin. She felt no alteration in the position of the hand.them pull on the dead-clothes, and lay her Then, after a short time, with a pair ofin them. This feeling produced a mental scissors, lie imperceptibly snipped the cord ;anxiety, which is indescribable. She tried the weight fell to the grouud, and the handto cry, but her soul was without power, was as suddenly raised in the air, by the in-and could not act on her body. She had creased effort which volition had excitedthe contradictory feeling as if she were in for the support of the increased weight,her own body, and not yet in it, at one and and at once unveiled the imposture, as thethe same time. It was equally impossible possession of both consciousness and voli-for her to stretch out her arm, or to open tion was thus demonstrated. It might beher eyes to cry, although she continually supposed that such deceptions as thisendeavoured to do so. The internal an- would readily be recognized by the state ofguish of her mind was, however, at its the pulse, but the power of the will overutmost height when the funeral hymns began even the function of the heart, which someto be sung, and when the lid of the coffin persons possess, is truly wonderful. Inwas about to be nailed on. The thought proof of this it is merely necessary to referthat she was to be buried alive was the first to the case of Colonel TOWNSHEND, related inone which gave activity to her soul, and my last lecture. The case of Colonelcaused it to operate on her corporeal TOWNSHEND may be regarded as an exampleframe." of the power which may be exerted ofThese statements are sufficient to con- feigning syncope; and another similar in-

vince you, I hope, that catalepsy is a real stance used to be noticed by Dr. CLEGHORN,disease, and from its nature it might be of Glasgow, in his lectures, in which the

thought one unlikely to be imitated; but individual had so completely the power ofit has been attempted several times, with arresting the action of the heart, that hevariable snccess. Dr. HENNEN mentions an could render the pulse imperceptible at theinstance of it in a soldier, in the Royal wrist whenever he pleased, and thus he

, African corps, of the name of DRAKE, who could feign death without any difficulty.i assumed an appearance of total insensibi- Hœmorrages are feigned, particularly

lity, and resisted every kind of severe haemoptysis, by sucking blood from thetreatment for some months, even the shower- cheeks and gums ; but this imposition isbath and electricity ; but on a proposal easily detected by the state of the pulse,being uttered in his hearing, to apply a red- which in real hemoptysis is small, irritable,hot iron, his pulse rose, and when prepara- and quick, whilst it remains natural in thetions were made, and the hot iron was ap- feigned disease. In the feigned disease,proached to his body, he displayed sum- also, there is no dyspnoea; the appearancecient signs of sensibility. On proposing of the sputa also confirms the suspicion;

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and when the mouth and fauces are ex- keep up the deception, when they supposeamined, the deception is at once unmasked. themselves alone and unwatcbed; the a’-The stethoscope, also, now affords us the sumed malady then disappears, and the im-means of readily detecting real from feigned posture is recommenced when they are u,

pulmonary diseases. the society of others. They are likewiseHanaatemesis is frequently feigned by unable to prevent sleep. If they endeavour

soldiers and negro slaves. It is effected by to imitate," continues Dr. HASLAM, " theswallowing real blood, and afterwards dis- passive forms of this malady, which is augorging it by the aid of an emetic. SAUVAGE attempt of considerable difficulty, they artmentions the case of a girl who wished to deficient in the presiding principle,the rulingescape from a convent, and for this purpose delusion, the unfounded aversions, and causefeigned hæmatemesis. She brought up less attachments, which characterise insa.several pounds of blood in the presence of nity ; they are unable to mimic the solemndifferent physicians, on several successive dignity of systematic madness, nor recur tudays. The imposition was suspected, and those associations which mark this disorder;she at length acknowledged that she had and they want the peculiarity of look whichswallowed bullock’s blood always before so strongly impresses an experienced ùu. :

the visit. The absence of the symptoms server." ’

which always accompany the vomiting of With the highest respect for the authorityblood in haematemesis readily detects this of one so conversant with the symptoms ofimposition; and the suspicion may be veri- insanity as Dr. HASLAM, I Must, nevertheless,fied by watching the patient so as to prevent differ from him as to the possibility of feignthe means of keeping up the simulation ing insanity, so as to deceive experiencedfrom being obtained. practitioners in the same line of theprofessionThe power, also, of imitating tympanitis as that which Dr. HASLAM practises. An

was well exemplified in a case under my instance of this has come within my ownown observation :-A young boy, about ten knowledge. A gentleman who had com.years of age, was apparently attacked with mitted a forgery endeavoured, to screenhim.tympanitis, which recurred at intervals of self from the penalty of the law, to feignnearly two years. He had been seen by madness,’which he accomplished so well asseveral physicians, and had been treated in completely to deceive several experiencedvarious ways, without any beneficial result, medical practitioners. He was sent to it

At the period which I have mentioned I was lunatic asylum, and continued to carryoncalled to see him, and attended him for a the deception there for several weeks; atmonth without being able to form any idea length a young medical man offered to un-of the nature of the attack. When one day, mask it, provided he could be sent as a

sitting in conversation with his mother, the lunatic to the same establishment, and conboy being opposite to me, I perceived him fined in the same sleeping apartment as themaking efforts of deglutition, and in a short supposed madman. This was accomplished,time the abdomen became distended and and by sleeping during the day so as to en-tympanitic. These circumstances led me to able him to remain awake all night he soonsuspect a fraud, and I accordingly watched detected the imposture, by witnessing thehim again, on two separate occasions, and I calm, undisturbed sleep which he nightlybecame convinced that he filled his stomach enjoyed. It is unnecessary to mention theand bowels with common air, by swallowing result.it in mouthfuls. I communicated the fact The detection of feigned madness, as youto his father, who soon cured the disease by may perceive from the story which I havegiving the young impostor a severe flogging. just told you, is frequently a matter of greatThe boy afterwards explained to me the mode judicial importance, involving the dearestin which he effected his object; and he ac- interests of individuals and families, and,knowledged that he suffered great pain from not unfrequently, the peace of society. Bntthe distension which followed, it is the extremes of madness only which canThe extent to which the proofs of feigned be feigned, furious mania and idiotcy. III

diseases might be carried would far exceed the former the impostor generally fails illthe limits of a lecture ; I will, therefore, the watchfulness which always accompa-conclude by noticing that no disease is more nies furious delirium: the very means heeasily feigned, or more difficult of detection, adopts to impose on others unveils histhan insanity, and we have instances of its knavery, by the exhaustion it causes, andbeing feigned in all ages, both for private sleep overpowers him ; whereas the realand public purposes, but particularly to de- furious maniac will be many days, even

feat the purposes of justice. It is but proper weeks, without sleep. Idiotcy is more easilyto say, that a high authority on this subject feigned. " We knew," says one of thedenies the facility of simulating insanity: writers of the article " Feigned Diseases,"" To sustain," says Dr. HASLAM, " the cha- in the Cyclopadia of Medicine, " an instanceracter of a paroxysm of active insanity would of a young player who was draughted intorequire a continuity of exertion beyond the the army, and acted the part of an idiot sopower of a sane person ; impostors cannot effectually that he procured his discharge."

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The following may be regarded as the fore, permitted to be at large. He carried aguides most likely to lead you to a correct stone on his head, and his great delight wasdiagnosis in your examination of a case of to drop it upon any unfortunate dog whichsupposed feigned insanity; in detailing them came in his zvay. One day he let his stoneit is impossible to avoid anticipating the fall upon a spaniel belonging to a cheese-view of insanity as an object of medical monger, so close to the door of the trades-

jurisprudence which is soon to occupy our man that he witnessed the transaction ; and,attention. rushing out of his shop to avenge the out-

1. In feigning madness, pretenders gene- rage on his dog, he inflicted a severe cud-rally outstrip madness? they " out-Herod gelling on the madman, at the same timeHerod,"-exhibiting themselves and the dis- exclaiming, ’ Take that for hurting myease which they are simulating in the most spaniel.’ The madman the next day ap-violent and disgusting points of view ; and peared in the streets with a stone twice asby this excess of colouring and caricature, large as the former; but instead of droppingthey ai e readily detected. it as before, he regarded every dog which

2. Real madmen, in their lucid intervals, came near him as a spaniel, merely lookingare anxious to conceal their state; and if at the animal for a few seconds, then shakingquestioned regarding it reply, that they are his head, and saying, ’ Spaniel,’ ’ Spaniel ;’not mad, nor ever have been so. Feigned but he never dropped the stone again."madmen, in the pretended lucid intervals, The most certain test of insanity is thenever desire to conceal the condition they power of supporting the whirling chair,desire to imitate. which is placed upon a spindle, so as to

3. The sleeping hours of the feigned mad- revolve on its own axis, and is whirled withman must be closely watched, for he is un- the rapidity of a fly-jack, by aid of a wheelequal to the degree of watchfulness which and crank; it causes nausea to syncope, sois a constant attendant on real insanity. that as few men can act a part after such

4. The medical practitioner should visit discipline, the impostor generally confessesthe patient at all hours, but more particu- the deceit. But persons not only feign dis-larly in the morning before he rises from eases, but actually maim themselves to ex-

bed ; for there is a peculiar animal odour cite pity. The common law says, " that

exhaled from the bodies of maniacs which, any person maiming himself to have a spe-if once smelt, can never be mistaken, and is cions pretext for asking charity, or to pre-never present but in cases of real insanity, vent his being impressed as a sailor, or en-

5. The pulse, also, forms a source of di- listed as a soldier, may be indicted, and, onagnosis : it is quicker in the grades of mad- conviction, fined and imprisoned."ness than in health ; but this admits of some Such are the modes of detecting feignedfallacy. diseases, which I have treated under the

6. Emetics scarcely act on the insane ; if head of military disqualifications rather thana common dose, therefore, of tartar emetic elsewhere, as they are most generally at-

produce a full effect, deception may be sus- tempted by soldiers and sailors. Althoughpected. If the madness attempted to be I believe that ofiicers of even great expe-feigned be melancholy madness, a drastic rience in the tricks of soldiers, have oftenpurgative may be administered, as melan- been deceived by them, yet you must recol-choly maniacs are very insensible to the in- lect that it is the business of a surgeon tofluence of drastic purgatives. a regiment, or a physician to the forces, to

7. If idiotcy be the kind of insanity feigned, know thoroughly the symptoms of disease ;something may be deduced by comparing and that the indulgence which should betheir pusillanimity and submissiveness, their readily granted to the officer cannot be ex-memory and conception of ideas, with those tended to the medical man. In the case ofof a sane person. officers feigning illness, many difficulties

8. In ordinary madness there is no hesita- present themselves ; some of the best, and ation and reflection observed in discourse ; few of the worst, feelings of our naturethe ideas succeed each other with the great- come into play, and interfere with the per-est rapidity, and the most incoherent wan- formance of strict impartiality ; but one linedering. If punishment be threatened, the of duty only should direct you,-that dic-real madman scarcely heeds it, being so tated by truth and honour.fully occupied with the phantasms of his ima- With regard to disqualifications to servegination as to be insensible either to hope or on juries, little more need be done than tofear; but real punishment has a powerful mention the diseases which uufit all indivi-effect on madmen : the feigned madman dual to sit long in court, and to undergo thedreads the threatening, but again repeats his fatigue incident to the duty of a juryman.pretended madness. I cannot avoid noticing These are-severe asthma, epilepsy, con-

to you a very admirable illustration of the sumption, aneurysm, stone in the bladder,effect of punishment on a real madman, by vertiginous affections,and infirmity from age.CERVANTLS in his preface to Dou QUIXOTRE:— The propriety of granting certificates of in-" In the city of Seville lived a madman who ability to serve, to those who labour underwas considered harmless, and was, there- such diseases, must be obvious to every one

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who is acquainted with the nature of theduty of a juryman, not only as refers to thefatigue incident to that office on every trial,but also on account of the confinement whichmay occur after the trial. " By the law ofEngland a jury, after their evidence is givenupon the issue, if they cannot agree, oughtto be kept together in some convenientplace, without meat or drinke, fire or candle,and without speech with any, unless it bethe bailife, and with him only if they beagreed." If they eat or drink at all, orhave any eatables about them, without con-sent of the court, and before the verdict hasbeen delivered, it is fineable. Now, thenecessity of a total unanimity, in the juriesin this country, renders such regulationsextremely trying to weak or aged people.The infirmity of age is too little attended

to in these cases. I had an opportunity ofwitnessing the fatal effects of a certificatebeing refused by a medical man, on theaccount of age, which obliged an old gen-tleman to attend as a juryman, when, fromfalse delicacy, having retained his urine fortwo hours longer than usual, a disease wasbrought on which terminated in his death.But this is a rare case; and, in general,practitioners, instead of refusing, are too

ready to grant certificates on the loosest in-vestigation of the case. When a certificateis required, whether to exempt from mili-tary service, or civil service as a juryman,or as a witness, or to arrest execution incriminal cases, the same honour whichshould guide an upright and high-mindedman, in the ordinary transactions of life,should regulate the conduct of the medicalpractitioner in those cases in which his skilland the correctness of his testimony are todecide. -

In cases of military service, he must lookat every avowal of disease with the eye ofsuspicion; he must investigate minutely thesymptoms under which the applicant forexemption is said to labour; and he mustinquire into the circumstances of the acces-sion of the symptoms, their progress, orderof succession, intensity, and duration. Iftheir investigation be conducted with skill,and if his examination be frequently re-peated, few of the wiles even of old impos-tors will escape the eye of experience, anddeceptions will rarely fail of being unmask-ed. But, after all, the task is extremelydifficult to execute well; and although somedisgrace must always attach to a practi-tioner who permits himself to be deceivedby a feigned disease, yet it has occasionallyhappened to the most experienced and cau-tious ; and I cannot agree in the opinion ofDr. BECK, " that nothing can be more dis-graceful to a surgeon than such a mistake."

In granting certificates to exempt from

" Haraaaee’s Coke upon Littleton, t. 3, c. 5, sec.366, b. 227.

service on juries, even more caution 18 re-quisite. You should always object to grant.ing such certificates to individuals who arenot your ordinary patients ; for the veryact of a person requiring a certificate from astranger to his ordinary habits and health,throws some suspicion upon the request.But when we have an opportunity of know.ing the state of the person requiring thecertificate, although he be not at the momentlabouring under acute disease, yet, if he beliable to attacks which can only be wardedoff by repose and freedom from fatigue andanxiety, it is our duty to grant a certi.

ficate, and to stand between every effort toenforce services which are not indispen.sable, upon the subjects of such maladies.With regard to certificates to excuse wit.

nesses from appearing in court, as morefreedom is permitted to them, in every re.

spect, than to jurymen, less tenderness isrequisite towards their ordinary ailments;and unless a witness be actually confined tobed, or labouring under some acute disease,he can hardly be regarded as excusable inabsenting himself from court, in cases theadjudication of which may materially de-pend on his evidence.

With’ respect to criminal cases, it is im.possible to suggest specific rules applicableto every case. Humanity, when it does notoppose justice, or infringe upon truth, oughtto be our guide.

OBSERVATIONS ON

IDIOPATHIC CHRONIC ARACHNITIS;WITH CASES.

MALCOLM W. HILLES,

To the Editor of THE LANCET.SIR:—The following observations relate,

to a peculiar disease, almost unnoticed bymedical writers, in the investigation of whichI have been engaged for some years. Iftheir length do not form an objection to theirinsertion, I shall feel happy if you will affordthem a place in the pages of your valuableJournal. I am, Sir, your most obedientservant, MALCOLM W. HILLES,

Lecturer on Anatomy and Physiology inthe Westminster School of Medicine.

7, Duke-street, Westminster,24th Feb. 1837.

The disease to which I would assign theterm Idiopathic Chronic Arachnitis, has beenunnoticed as an idiopathic affection, bymodern writers, although, in my estimation,it is one of great practical importance,whether we consider the structure engaged,its connection with the cerebral mass, its

insidious nature, the frequency of its occur.rence, the fatality which attends it if not

properly treated, or the liability there existsof its being confounded with other diseases.