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general paralytics, have laid before the Académiedes Sciences the important conclusion that thetreponema of general paralysis belongs probably toa different race from that which causes the otherlesions of syphilis. The incubation period of generalparalysis is much longer than that of ordinarysyphilis, and the appearance of its lesions differssensibly from that of other manifestations thereof.Syphilis particularly causes deep ulcerative lesions.In general paralysis superficial lesions and erosionscovered with scales are found. Physicians havelong noted, moreover, that general paralysis super-venes especially in syphilis when the onset has

appeared benign, and this fact has been usuallyattributed to the benignity having induced a certainlaxity in following up treatment. M. Marie and M.Levaditi consider that this benignity of the primaryand secondary lesions is a constant character ofthe nerve treponema. Observations favouringthe initial specificity of this treponema alsoexist. The history is well known in medical circlesof men who in their youth had been internesin the same hospital, and had contracted

syphilis from the same source, all of whom at theend of a varying number of years have succumbedto general paralysis. The virus of syphilis appearsmore vigorous, for in thej,aboratory, notwithstand-ing numerous transmissions, it always inducedsyphilis. Accidental laboratory contamination evenhas been known in man from cultures. On theother hand, the virus obtained by culture of thetreponema of general paralysis has appearedincapable of infecting the lower monkeys, chim-panzees, or rabbits. Dr. Roux, in presenting thiscommunication to the Academy, observed that thevirus of general paralysis did not confer anyimmunity in regard to the virus of syphilis,and that many cases were known in which

general paralytics had subsequently contractedsyphilis. The one virus, therefore, secures no

immunity against the other. From this it wouldseem that there are two varieties of treponema, thefirst of which attacks the mucous membranes andthe visceral parenchyma, while the other has aparticular affinity for nervous tissue, a kind ofspecificity of which other microbes, such as thebacillus of tetanus, meningococci, and the virus ofrabies, furnish examples. Salvarsan acts equallywell on both races, and if it frequently fails in

. treating general paralysis, this is because of thegreater difficulty encountered by the drug in

reaching the infected cerebral tissues.

A Hie1’opagus Monster.Some months back a xiphopagus monster was

shown at the Académie de Medecine, and was sub-sequently operated on, quâ operation, successfully,although one of the two individuals succumbedsome days later. On May 22nd a monster was bornin a little town in the Cote d’Or from a familyin which all preceding children were entirelynormal. It consisted of two females united backto back by a sacral bridge. This bridge ismade principally of cutaneous tissue, and owingto its relative elasticity allows the two children torecline obliquely with a certain freedom of move-ment. Palpation discloses inside this bridge a chainof soft ossicles corresponding to the union of thelast sacral vertebrae. The chief malformation con-sists of a single anus communicating with a cloacainto which the two recta discharge. This is theonly complication Dr. Mignot expects to encounterwhen he operates in two or three weeks’ time. It

will not be difficult to provide a separate anus foreach child, though it is by no means certain that indefault of a complete sphincter for each child3theanus will be continent.June 22nd.

Obtuary.SIR HENRY WILLIAM NEWTON, L.F.P.S. GLASG.,

,

LATE MAYOR OF NEWCASTLE.

THE death occurred on June 21st of Sir Henry W.Newton, the " father " of the Newcastle city council.He was born in 1842 at Newcastle, and was the

son of the late William Newton, physician andsurgeon, who in the early " fifties " took a leadingpart in public affairs. The son adopted his father’sprofession, and commenced practice in the sixties."In addition to private practice he held variouspublic appointments, including those of factorycertifying surgeon and public vaccinator, but not-withstanding the heavy claims on him he found timefor much public work of diverse character. Forclose on half a century municipal matters receivedunremitting attention at his hands. He entered thecity council in 1866; in 1877 he filled the officeof sheriff, and proceeded to the mayoralty in 1883.Sir Henry Newton was mayor for the second timein 1901-02, and again filled the office to the satis-faction of his fellow citizens. While his publicwork was of a general character, his chiefinterests were in the direction of the publiclibraries and public parks, and to him must beascribed chiefly Newcastle’s enviable position inthese respects. Much might be written abouthis labours on behalf of sanitation and publichealth. No more striking proof of his earnest-ness in these matters could be desired thanthat represented by the fact that in the year1907 he, with Mr. H. E. Armstrong, the formermedical officer of health for the city, promoted aunion of public health authorities, which subse-quently developed into a national organisation withSir Henry Newton as its first president. Throughother channels Sir Henry Newton gave the com-munity the benefit of his wide knowledge and

experience. Thus he was chairman of many im-

portant local committees, and he was chieflyinstrumental in establishing the NorthumberlandCounties School of Cookery and Domestic Economy.Some eight years ago he received the freedom ofthe city, and in 1909 he was knighted. Much

sympathy will be felt with Lady Newton, who isherself a devoted public servant, in the loss whichshe has sustained.

____

JAMES NEIL, M.D., C.M.ABERD.,LATE MEDICAL SUPERINTENDENT, WARNEFORD MENTAL HOSPITAL.

Dr. James Neil, for 17 years medical super-intendent of the Warneford Asylum, Oxford, diedon June 20th. He was the son of the Rev. RobertNeil, and was born at Glengairn in 1848. He enteredthe Faculty of Medicine in the University ofAberdeen in 1873, graduating M.B. and C.M. withhonours in 1877, and proceeding to the M.D. degreein 1881. In 1877 he was appointed assistantphysician of the Royal Asylum, Aberdeen; from1878 to 1883 he was assistant medical officer of theCheshire County Asylum at Macclesfield ; in 1883he became assistant medical officer of the BoroughAsylum at Portsmouth, and went in 1887 as assistant

1847

medical officer at the Warneford Mental Hospital.In 1897 the medical practitioners of Oxford gavehim a testimonial, and the position of medicalsuperintendent having become vacant, the staff andofficials of the institution presented a petition tothe governors praying for his appointment. Manyimprovements in the asylum were carried out

during Dr. Neil’s term of office.Mr. Charles Williams sends the following appre-

ciation of his work and character: " Dr. Neilwas an exceptionally good as well as cleverman, and as an administrator, business man,and master of method I never met his equal. Byhis unceasing energy and untiring devotion to itsinterests he brought the institution over which hepresided to the highest pitch of perfection in everydepartment, and his loss is a most serious one, andon account of his constant thought for the comfortand happiness of those around him, is deplored byall connected with it. By no one, however, is itmore deeply deplored than by the writer of theselines who was closely associated with him for thelast 12 months of his working life, and who not onlylearnt much from him but who learnt to love himfor his genial, kindly nature, and especially forhis numerous acts of personal consideration andkindness."

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JOSEPH HAY KEAY, M.D., C.M. EDIN.AFTER a long and painful illness, borne with great

fortitude, Dr. J. Hay Keay passed away at hisresidence, Greenwich-road, on June 17th, in hissixty-fifth year. He was born at Forneth, nearBlairgowrie, on Nov. 13th, 1849, and received hisearly education at Perth Academy, afterwards enter-ing the University of Edinburgh, where he graduatedM.A. at the age of 18, winning many prizes andscholarships. For four years he studied theology, ’,eventually becoming a licentiate of the UnitedPresbyterian Church of Scotland. Later he turnedhis attention to medicine and graduated M.B., C.M.at the University in 1876, proceeding to the M.D.degree in 1892. After studying at Leipzig he enteredon general practice at Crook, co. Durham, sub-sequently going to Blairgowrie, where he was ingeneral practice for seven years. Later he went toColne, in Lancashire, where he stayed for ten

years and took a prominent interest in the buildingof a cottage hospital and in other municipal affairs.In 1899 he went to Greenwich and was appointeda member of the Greenwich board of guardians.He was an active member of the British MedicalAssociation, and frequently represented the Green-wich division at the annual Representative meet-ings. He was a keen student t of the various

systems of State insurance against sickness in

operation on the continent, and took an active partin endeavouring to allay professional anxiety inconnexion with the introduction of medical benefitsin this country. He was the chairman of the firstcommittee formed to represent the panel practi-tioners in London, a post which he was compelled torelinquish owing to his failing strength, and thebreakdown in his health was no doubt largely due tohis devotion of his time and energies to public affairs.Dr. Keay was the author of many pamphlets andarticles on medical and allied subjects, and showedmuch thought and acumen in the presentation ofhis ideas. In 1906 he read a paper before theWest Kent Medico-Chirurgical Society, of which hewas an ex-President, on Medical Attendance on the

1 THE LANCET, vol. ii., 1906, p. 15.

Working Classes, in which he contemplated a

possible extension of the principle of the Educa-tion Acts to illness, and a provision of free medicaltreatment for the sick at the expense of publicfunds, either local or imperial. The paper was ashrewd prophecy of much that has since happened.

Dr. Keay married Anna Laura, eldest daughter ofMr. Candler, of Crook, whom he leaves a widowwith a son and two daughters.

Correspondence.II Audi alteram partem."

THE WORKING OF THE MENTALDEFICIENCY ACT.

To the Editor of THE LANCET.

SIR,-The letter of Sir H. Bryan Donkin in THELANCET of June 20th regarding the position ofdefective criminals under the Mental DeficiencyAct raises a point of very great interest and import-ance. Without entering into any discussion as tothe meaning to be attached to the words " feeble-minded" and "defective," as used in the terms ofreference of the Royal Commission, I think mostpersons will agree with Sir Bryan Donkin that it isregrettable that the labours and careful inquiries ofthis Commission were not utilised to construct a con-solidated Act which should deal,- not merely withone variety of mental abnormality, but with thewhole class, whether due to arrested develop-ment (amentia), perversion (insanity), or decay(dementia). The law regarding the responsibilityof two of these classes is admittedly very unsatis-factory and in need of amendment. In particularthere are many persons suffering from milddementia who commit offences for which theyare not fully responsible, and who need care andcontrol and not punishment. I quite agree withthe statement that many of these cannot in actualpractice be certified and detained under the

Lunacy Act (as was formerly the case with themildest grade of aments), and it would undoubtedlyhave helped to remedy this if "mentally infirmpersons " had been included in the Act of 1913. Asit is, it is most important for physicians and

lawyers to realise that this Act deals with amentsonly-that is, with persons defective from birth orfrom an early age.With regard to the difficulty in dealing under

this Act with criminal aments in whose case

sufficient history is not forthcoming to show thatthe defect has existed from birth or from an earlyage, which I take to be Sir Bryan Donkin’smeaning, I am not quite in agreement. The Actdefines four classes of defectives-namely, idiots,imbeciles, feeble-minded, and moral imbeciles.Presumably such persons should come under thelast category. Moral imbeciles are defined as

" persons who from an early age display some

permanent mental defect coupled with strongvicious or criminal propensities on which punish-ment has had little or no deterrent effect," andfrom this it would certainly appear that in theabsence of a previous record the person whocommits a crime, even though he is shown at thetime to be suffering from mental abnormality,cannot be dealt with under this heading. But mayhe not be dealt with as an idiot, imbecile, or feeble-minded person ? The definitions of each of these