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hemisphere controls language by signs as it does all other forms of language. The sign language is closely related to pan- tomime. The latter may be defined as the nat- ural mode of expressing thought, ideas, and emo- tions, by muscular action other than that of the vocal apparatus. Gestures on the other hand ex- press emotion only and not thought. Pantomime and gesture are natural and inherent. The sign language is an artificial and elaborate system which must be learned to be understood. In ac- tual life deaf mutes always use natural pantomime to help them in expressing ideas. Disorders of pantomime — amimia and para- mimia — have not received as much careful study as speech aphasia. Bastian is of the opinion that amimia varies in the same ratio as the intelligence of the individual affected. In his opinion it does not occur in subcortical lesions and after a lesion in Broca's convolution the disability may be onh' slight. If on the other hand the auditory word centre is involved and still Mesterolone Online more the visual word centre there is more and more mental degradation and a corresponding diminution in the individual's power to use and understand pantomime. Charles K. Mills, who has given much time to the sub- ject, states that in true motor aphasia even when complete the patient sometimes shows marked preservation of pantomime, whereas in word deafness and word blindness pantomime is most disturbed on the sensory or receptive side. In mixed sensorimotor aphasii pantomime may be uncertain. In none of the patients I have examined have I found complete amimia associated with pure motor aphasia. In some patients the ability to use pantomime was remarkable. On the other hand, I can not recall a case of sensory aphasia in which the visual speech centre was diseased in iioS ROIVE: PREVENTION OF INSANITY. which there was not either total amimia or, and this more frequently, paramimia, the pantomime being so confused and contradictory as to be in- comprehensible. The same condition is found in sensorimotor aphasia. Further, in pure motor aphasia the patient imdei-stands Buy Mesterolone pantomime well, whereas in sensory or mixed aphasia he either does not understand at all or only incompletely and with difficulty. Since the sign language is only a highly developed form of pantomime it is probable that the same laws control both and that disease affecting pantomime in a person having the power of speech would aflfect the sign lan- guage in deaf mutes. The sign language is of course learned by vision, and it is probable that in deaf mutes a lesion of the visual centre always causes its loss. Whether there can occur a purely motor disturbance of the sign language, the re- tention of the ability to comprehend (a normal Mesterolone Tablets visual centre) , with a loss of the ability to express thought by signs on account of a lesion making it impossible to recall muscular movements neces- sary to be made is, I believe, unknown. A pure motor amimia in persons who are not deaf mutes, unassociated with any form of verbal aphasia, has never been described. 1327 Spruce Street. THE Generic Mesterolone PREVENTION OF INSANITY IN ITS INCUBATION BY THE GENERAL PRACTITIONER.* By J. T. W. ROWE, M. D,, NEW YORK, FIRST ASSISTANT PHYSICIAN, MANHATTAN STATE HOSPITAL, EAST, ward's ISLAND. Within the limitation of a six column paper I shall attempt to express my views on a subject that alienists and psychopathologists have for many years striven to shed light upon, viz., a means or method for preventing the occurrence of insanity. I expect to be received with due acclaim by super- intendents of overcrowded institutions whose great- est efforts are in the direction of keeping out the ■incoming patients and getting rid of those on their hands, and by industrious students of asylum finan- cial budgets. Constantly renewed volumes of psychiatry have not aided us in the least. The annual reports of superintendents only deplore the steady increase of insanity with no relief in sight. The ratio of recoveries is no better, and assigned

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