ity is due: first, to social and economic factors; second, to accidental individual factors, pathological or toxic; third, to various factors, toil, law, laziness, theft. Prevention is the only cure. Following this address Dr. Deny, of Paris, and Dr. Joris, of Brussels, made a report on the Neuro-fibrillar Conducting Tracts, which was well discussed. In the afternoon the meeting was held in the Normal School, when Mlle. Dr. Ioteyko made a report on Overwork in Schools, and Mr. De Saegher, an advocate and himself blind, read a paper on The Psychology of the Blind, after which a reception was held and a visit was made to the laboratory of Mlle. Ioteyko. The next day the meeting was held at the hospital for insane, an inspection being first made. Dr. Dupre presided at this meeting and opened the discussion on Mr. De Saegher's paper. Dr. Deroubaix made a report on The Systematized Psychoses Based on Delusions of Interpretation, illustrated by a patient presented by Dr. d'Hollander, which provoked considerable discussion. Dr. Fameme reported a case of benzinomania. In the afternon Dr. Ley made a report for the committee appointed to examine nurses. As the meeting of the French Congress will be held at Brussels in 1910, it was decided that the Sixth Belgian Congress will not be held until 1911, when it will meet at Bruges. A gymnastic and dancing exhibition was then given by patients, and a banquet held in the evening closed the congress.

ANNUAL MEETING OF FRENCH ALIENISTS.-The Nineteenth Annual Meeting of Alienists and Neurologists of France and of French-speaking countries was held at Nantes, August 2-8, 1909. The usual addresses of welcome having been heard, the president, Dr. Vallon, made his address, in which he dwelt upon the necessity of hospital physicians standing up for their rights, especially in regard to advancement and retirement. After this the morning was given over to a visit to the museum, where is contained a rich collection of Spanish and French paintings of the seventeenth and eighteenth centuries. In the afternoon Dr. V. Parant made his report on Les Fugues, which was discussed by many and which is made the subject of the "Letter from France" in this number of the JOURNAL, after which the meeting adjourned. The next day MM. Granjux and Rayneau made their report on The Insane in

the Army, which provoked considerable discussion. Prof. Gilbert Ballet then read a paper on a new nomenclature for the periodic psychoses, which was also well discussed, being followed by three other papers. The next morning a visit was paid to the asylum for the insane, and in the afternoon M. Sainton made a report on The Chronic Choreas, which was illustrated by the cinematograph. A number of other interesting papers were also read at this session. The fifth of August was given over to pleasure trips and a visit to the asylum of La Grémaudiére. The next morning an excursion was made to Sucé, a small village, where the last session was held, ten papers being read. The last day was given over to pleasure, a number of trips being made. A number of recommendations were made concerning the commitment of the insane, etc., and Brussels was selected as the next meeting place.

DEATH OF DR. LOMBROSO.-Cesare Lombroso, Professor of Psychiatry in the University of Turin, died suddenly in that city October 19, 1909, aged 74 years. He was a man of great industry and collected a mass of facts, but was unfortunately too apt to be satisfied with unconvincing evidence, so that his opinions did not receive the support which they would otherwise have had. He also suffered from the enthusiasm of his pupils, who by promulgating opinions even more extreme and bizarre than his own have brought disrespect upon him. He was best known for his work on the criminal delinquents and for his study of genius.

Correspondence.

LETTER FROM FRANCE.

LES FUGUES.'

The study of ambulatory phenomena, pursued under the most diverse names, of which, in France, the most important have been: migratory insanity, ambulatory automatism, impulsive vagabondage, deambulation, dromomania, and fugues, has been the object of numerous investigations, which, if we except Foville's article upon the migratory insane, are chiefly due to the school of la Salpêtrière, represented by Charcot, J. Voisin, and Raymond, and to the school of Bordeaux, including Pitres and Régis, and have to do almost exclusively with the acts of epileptics, the hysterical, impulsive and unbalanced, designated under the name of neurasthenics, psychasthenics, and others.

For some years, sundry publications having attracted attention to fugues of widely different character, the Annual Congress of Alienists and Neurologists proposed for study the question of Fugues in Psychiatry for its session at Nantes; Professor Joffroy, in collaboration with his pupil Dupouy, immediately published a very full monograph on the subject; several articles or volumes appeared from various sources and discussions arose at the MedicoPsychological Society.

MM. Joffroy and Dupouy, who have brought to the subject a considerable contribution of personal observation, have had especially in view the construction of a general theory of psychological determinism of the diverse forms of fugues and vagabondage.

'No attempt has been made to translate the word "fugue" in this letter because the translator believes that no precise English equivalent exists in a single word. Our English "fight" approaches it closely. The word “fugue," as used by the French, means a sudden and temporary change of the personality and mode of doing things. An example would be that of an epileptic who takes a train for a certain point, without knowledge of his action, and returns to his ordinary mental state in some strange city, etc.

H. P. W.

Taking as their starting-point this statement, that the diverse functions of the brain, psychic, motor, sensory, are inter-related to the extent of becoming, in some sort, a general function, one and indivisible, they consider that, in passing from the normal state to the pathological, we should find the psychic, motor, sensory, and trophic disturbances also united. This is the consideration which had already led Professor Joffroy to his theory of the myopsychias. MM. Joffroy and Dupouy's study of this subject, les fugues, is based upon the notion of the relations existing between the intellectual and motor functions: "Even before attempting to define these acts," they remark, "we wish to show the parallelism which, in the same individual, controls the progression as well as the regression and the vitiation of these two functions, and when we have followed all the stages which lead, in the case of a child, from the reflex, by way of desire, to volition; when we have descended the slope that, in the case of the dement, leads from the normal voluntary act, by way of vesanic volition, to the automatic act; when we have characterized the different congenital anomalies of the will, its acquired enfeeblements and its deviations or transitory obnubilations, then only, understanding the importance of the part played by the idea, disordered or not, in the production of the movement, shall we be able to classify and describe vagabondage and la fugue."

And thus, starting with this controlling idea that the morbid act in question, la fugue, is an impulsion immediately depending upon an alteration of the will-power, they pass in review the different modalities which the morbid will may exhibit. La fugue, according to the case, occurs under widely varying appearances. But, they say in conclusion, in these different psychopathic conditions, it should be regarded as an impulsion, as an act more or less automatic and impersonal, terminating, when these characteristics are carried to the extreme, in what has been called ambulatory automatism.

The task assigned us to report on the question of Fugues in Psychiatry for the Congress of Nantes obliged us to look at the problem from another point of view. Leaving aside all general theories, the report has been restricted, vagabondage being outside the question, to a study of the clinical symptomatology of fugues, with accompanying medico-legal considerations and cul

minating in an attempt at definition which might enable us, in the future, to assign to the symptom fugue a definite place in the symptomatology preliminary to any nosography.

La fugue takes rank between automatism and vagabondage, with either of which, in extreme cases, it might be confounded-a fact that would hardly surprise the clinician-but from which commonly it can be clearly distinguished. Automatism tends to provoke certain movements, performed without purpose and with no direction whatever, corresponding to no psychological elaboration. Among these movements there are acts of walking: clinically the procursive phenomena of the epileptic, the ill-regulated activity of many dements are automatic acts. At the opposite extreme we have vagabondage, which far too many authors have not felt called upon to differentiate from fugue. We are not speaking here of a legal definition which, merely concerned with acts subject to punishment, takes account only of a question of fact at a given moment and might include cases of mere fugue, as well as true vagabondage. Psychologically and clinically we should distinguish between fugue and vagabondage. There are indeed individuals, some of sane mind, others unbalanced, who proceed by virtue of a voluntary act, without the intervention, even when they are unbalanced, of an actual mental disorder, non-constitutional, susceptible of interpretation as an act of irresponsibility. They are either involuntarily impelled on their way by the presence of circumstances outside themselves, or voluntarily, by virtue of a combination of tastes and aptitudes, of a temperament causing them to become professionals, meriting the name of vagabonds, the very meaning of which expresses a sort of permanence of the condition. Clinically certain cases of fugue, especially the systematized forms, might, by the duration of the fugue, take on the appearance of vagabondage; but these we include in the category of fugues in so far as the motive for the change of place is clearly insane.

Between automatism and vagabondage we find la fugue, which may be defined as any act of walking or travelling accomplished by access and brought about by a mental disturbance. We have adopted this definition, the principal terms of which are already to be found in a definition of Benon and Froissart, because we recognize in it the merit of being clear, precise, exclusively medical and clinical, and of borrowing no point of comparison nor any of its terms from elements foreign to the subject or capable of being