J. T., a cabinet-maker, was brought to the Asylum from Stirling by two policemen, on the 29th July, about 7 p.m. A certificate of emergency had alone been granted, and there was no further information regarding his case in the form of admission. He was about 30 years of age. He looked in bad health, exhausted, and miserable, and his head was bound up with a handkerchief. He asked the attendant to be careful in removing this, as there was a frightful gash underneath it. When it was undone, however, there was no wound to be seen. There was a large black mark over the right side of his face and ear, which looked as if produced by gunpowder, mixed with a little blood. There was a drop of serous fluid in the ear. The patient answered questions intelligently, though in a languid, dejected manner. He put out his tongue freely when asked. It was foul. Pulse was about 80. The policemen stated that they had been informed he had attempted to shoot himself with a double-barrelled pistol, and that the police-surgeon who had seen him thought the pistol could only have been charged with powder. The patient denied this, however, and said that the pistol had been loaded with bullets. The policemen further stated that after apparently firing both barrels of the pistol at his head early on the morning of the 28th, he had attempted to drown himself in the river Forth. As there was no external wound, nor any symptoms of injury to the brain, and as it was about 40 hours since he had attempted to shoot himself, I concluded that he had missed his aim, and caused nothing more serious than a gunpowder mark on his face. He walked along with an attendant to one of the wards. He there conversed a little with the attendants, as he had been doing in the waiting-room before I saw him, and told them a little about his history. He mentioned that he was married; that he and his wife did not agree; that he had been living away from her for some time; and that he had been drinking pretty freely. He complained of thirst, and said he had a headache. He drank a good deal of water. I saw him again in about half-an-hour, and talked with him a little about himself. He looked ill and wretched, and complained of a tremendous headache. At eight o'clock he walked up stairs with the other patients, undressed himself, and went to bed in a dormitory. After going to bed he became very restless, kicked the clothes about, talked incoherently, and shouted for “John” (apparently his brother). About 10.30 he was removed to a single room. He walked quietly along, and got into his new bed. When visited about an hour afterwards, he was lying in bed, but talking nonsense. At six in the morning the attendant went into his room to waken him. He was lying dead on a mattress on the floor, with his face downwards, his mouth and nose being firmly pressed against the mattress. I saw him almost immediately. He had all the appearance of a person who had died from suffocation, and probably in a convulsion. The face and neck were livid and swollen. The tongue was protruded between the teeth; bloody mucus was on the sheet, and seemed to have come from his mouth and nose. A post-mortem examination was made at the instance of the Procurator Fiscal, by Dr. Moffat, of Falkirk, and myself, at 5 p.m., of which the following is a report:—
On the casuistry of progressive paralysis (several cases with acute and prolonged course)