were clubbed, the right more than the left, and both legs were withered to the knee. The right leg was shorter than That the deformity was congenital is shown by the fact that John Hunter observed it at Byron's birth. It was undoubtedly double congenital talipes equino-varus; the deformity being worse in the right foot. Jeafferson's claim. that the right alone was deformed and that the left became so by walking on the toes to accommodate the gait to the deformity, is untenable since the right leg was shorter than the left, and toe-walking on the left would have increased the difference in length and of necessity the lameness. Moreover, it would have swelled the calf muscles into goodly size, whereas Trelawney explicitly states that both legs were withered. The deformity of Sir Walter Scott was clearly due to anterior poliomyelitis, leaving a group of muscles in one leg paralyzed. This disease usually attacks healthy children. Good health and cheerfulness in after life are usually preserved, except in very extreme cases. Congenital club-foot unquestionably arises from different causes. It is so frequently an accompaniment of severe forms of mal-development and of congenital brain defects, that there can be no doubt that imperfect constitutional development is one of its causes. That the deformity, with the many limitations to a well-rounded life, that it involves, may tend to create morbidness to a certain degree, is perfectly true, but extreme morbidness is far more likely to be an additional symptom of the degeneracy which in certain cases is the underlying cause for the deformity.

Under Dr. Coolidge's analysis and from the standpoint of the alienist, the student of Byron's career is compelled to take into account, therefore, the possibility of an underlying state due to degeneracy. The question arises in what particular neuroses did the degeneracy existent in Byron find such expression as to lead to suspicional irritability. As I have elsewhere shown,* vanity and jealous suspiciousness are exceedingly common in degenerate children. The mental life swings between periods of exaltation and depression alternating with brief epochs of healthy indifference. Psychic pain arises from the most trivial cause and finds expression in emotional outbursts. The child is peculiarly liable to the ordinary fears of childhood intensified by the degenerate state. If in addition to these fears, there be

*ALIENIST AND NEUROLOGIST, July, 1897.

some tangible physical defect around which they may be centered, then that physical defect renders them a fixed idea which would not otherwise occur. This condition is further intensified through injudicious brutal reference to the defect by those in whom the child's natural instinct of refuge taking cause it to confide. A healthy mental background would throw off these morbid fears. A sound maternal care would destroy them. In Byron's case not only was the last absent, but its very reverse was present. The brutality with which Mrs. Byron referred to her son's lameness could not but be echoed by her inferiors. Although May Gray to no mean extent supplied the proper refuge, I still this could not offset the maternal influence. In addition to these factors another element has to be taken into account. The evidence of the co-existence of a special neurosis producing a suspicional irritability was decades ago thus summed up by Madden:*

Whether Byron's epileptic diathesis was hereditary or not, the question of its existence is beyond dispute. He had no regular recurrence of its paroxysms like those that belong to a confirmed case of the primary form of this disease, his seizures were generally slight, occasioned by mental emotion or constitutional debility, induced by the alternate extremes of intemperance and abstemiousness. In boyhood, the most trivial accident was capable of producing sudden deprivation of sense and motion. On one occasion a cut on the head produced what he calls a "downright swoon." A similar effect was the consequence of a tumble in the snow at another time. In later life the same constitutional tendency is to be observed. One evening on the lake of Geneva with Mr. Hobhouse an oar striking his shin caused another of those 'downright swoons;" he calls the sensation a very odd one, a sort of grey giddiness first, then nothingness and a total loss of memory.' At Bologna in 1829, he thus describes one of those attacks in one of his letters: "Last night I went to the representation of Alfieri's Mirra, the last two acts of which threw me into convulsions; I do not mean by that word a lady's hysterics, but an agony of reluctant tears, and the shocking shudder which I do not often undergo for fiction." This attack appears to have been of graver nature than the description of it implies, for a fortnight after we find him complaining

66

*Infirmities of Genius, Vol. II, p 91.

of its effects. He was seized with a similar fit at witnessing Kean in Sir Charles Overreach and was carried out o the theater in strong convulsions. At Ravenna in 1821, in some occasions of annoyance, he says he flew into a paroxysm of rage which had all but caused him to faint. And the same year complaining of the effects of indigestion he says, "I remarked in my illness a complete inaction and destruction of my chief mental faculties. I tried to rouse them, but could not, and this is the soul. I should believe that it was married to the body, if they did not sympathize so much with each other."

Ellis, the American artist, alludes to a convulsive and tremulous manner of drawing in a long breath as one of Byron's peculiarities; and we are informed by Lody Blessington whose accurate observation of Byron's character we have reason to place great dependence upon, that any casual annoyauce gave not only his face, but his whole frame a convulsive epileptic character.

In all cases of degeneracy, the environment especially during childhood is of peculiar interest to the student. May Gray, Byron's nurse, with that intense altruism and deep sense of justice (frequently miscalled charity) so often present in Scottish Calvinistic women, even of the lower class (which is so akin in its predestinarian spirit to the similar justice of the determinism of evolution) saw at once the source, and the causes of the intensification, of the hereditary defect of her nursing for whom, she always cherished the deepest affections. In the cant of plutocracy, which to-day echoes the law and order cant of the Stuarts, Bourbons and George the III (the most crazy and meanly trickiest of the Hanoverians), it is too often forgotten that the personal liberty principles of the Americans of the Revolution came to them not merely from the Puritans, the republican Hollanders and Huguenots, but largely from the Scottish Republicans, whether resident in the lowlands of Scotland or the North of Ireland whose spirit glows in the verse of Burns:

The rank is but the guinea stamp,

The man's the gowd for a' that.

The influence of Mrs. Byron's republicanism on the poet would have been feeble but for the sterner, deeper republicanism of May Gray, which was of the type that

founding the United States expressed its ideal in Emerson's vision:

To May

"When the church is moral worth,
When the statehouse is the hearth,

Then the perfect state is come,

The republican at home."

Gray's training intensified by his mother's

vehemence is due Byron's deep-seated sense that while:

"The name of commonwealth is past and gone,
Still one great clime in full and free defiance
Yet rears her crest unconquered and sublime.
Above the far Atlantic-she has taught

Her Esau-brethren that the haughty flag,

The floating fence of Albion's feebler crag,

May strike to these whose red right hand has bought
Rights cheaply earned with blood."

I have dealt at much length with the source of republicanism in Byron as Byron's republicanism has been considered a cant like that of Caligua, and hence among his mental stigmata of degeneracy. In Great Britain and Ireland, however, it should be remembered that the hereditary nobility of the Continent does not exist; good family does not mean ennoblement, and descendants from noble families are often not merely commoners but often fall into very inferior social status. This fact has been excellently utilized by Hardy in the family history of the milkmaids of his dramatic "Tess of the Dubervilles." The same condition is illustrated in the fact that next to Tennyson, the poet, the nearest legitimate collateral descendant of the Plantagenets was a sexton at Wapping named Plant, who with the poet had therefore a greater hereditary claim to the British throne than Queen Victoria or the idol of the modern Stuart hysterics, Princess Mary of Modena. Byron's republicanism, was therefore a healthy outcome of early environment.

(To be Continued.)

HISTORY OF SOUTHERN HOSPITALS

FOR THE INSANE.*

1

By T. O. POWELL, M.D.

Medical Superintendent, State Lunatic Asylum, Milledgeville, Georgia.

VIRGINIA now has four asylums for the insane-three

VIRG

for whites and one for colored. The names of these asylums were changed in 1894 to State Hospitals.

In 1769 the House of Burgesses in the colony of Virginia provided for a building for the insane at Williamsburg, the capital of the colony. The institution was officially called "The Hospital for the Reception af Idiots, Lunatics, and Persons of Insane and Disordered Minds." It was in dimensions 100 feet by 38 feet. At a meeting of the Court of Directors September 14, 1773, the hospital was examined and found finished. Mr. James Galt was appointed keeper, and "after he agreed to accept the said office, the court delivered the charge of the said hospital to the said James Galt." The keeper had entire charge of the hospital, subject only to the Court of Directors-as the superintendent now has. He attended to all the business, expended all money, and the visiting physician was sent for only when the keeper ordered that he should be.

Mr. Jomes Galt, the son of Mr. Samuel Galt, was born in 1741, probably at "Strawberry Banks," a farm near Old Point Comfort owned by his father. He had had the advantages of education and travel, and was noted for his integrity, and later for his patriotism. He held the position of keeper until the hospital was suspended from lack

of funds during the revolutionary war, and when the insti

*Being a section of Presidential Address before the fifty-third annual meeting of the Medico-Psychological Association at Baltimore, Maryland, May, 1897.