lusions and excitement followed later by an indolent, stupid, emotionally indifferent, catatonic state. Physically, he showed a large thyroid tumor, more marked upon the right side, dyspnoea and metallic voice. Operated upon August 12, 1908, by Dr. Rowan; on the 24th, the stitches were removed and the patient had improved physically; September, 1908, he showed marked improvement mentally, the hallucinations disappeared and thought process became clear; September 16, 1908, he was paroled to his mother; three days later went to work; he was returned to the institution August 5, 1909, in a mute catatonic condition.

CASE II.-A. E., male, age 28, clerk. Family and personal history negative. Present illness dates back to 1906, when he became listless and delusional, but continued to work until 1908; admitted to the institution April, 1908, when he was stupid, indolent, had some hallucinations of hearing and showed lack of voluntary activity. He continued in this state and upon examination, December, 1908, showed physically all somatic signs of catatonia, cyanosis of extremities, increased reflexes and dilated pupils; psychically was a dull, indolent catatonic with marked negativism. Operated upon February 1, uneventful recovery from operation; has remained in the same condition since the operation.

Pathology of Gland.-Gross weight 15 gm., moderately vascular, small hard mass the size of a pea palpable in gland. Microscopical diagnosis: Struma parenchymatosa. The alveoli are markedly enlarged, the colloid markedly increased. Alveoli are lined with several layers of epithelial cells and islands of parenchyma cells are irregularly arranged between the alveoli. The vessels are slightly distended with blood and hemorrhages have occurred into the stroma extensively. In a few places blood is noted filling the alveoli. The stroma is slightly oedematous. In some places the contents of the alveoli are of a serous nature not staining deeply, but for the most part they take the stains well. Some few show no contents. CASE III.-W. T., age 28, R. R. employe, male. Family history negative. Personal history; has always been rather unruly and drunk alcohol excessively. Previous illnesses; diphtheria and syphilis. Present illness dates back to June, 1907, when he became careless as to appearance, in January, 1908, he became delusional, and showed marked fabrication. Admitted to the institution January, 1908, when he presented the appearance of a paranoid dementia præcox with physical findings of cyanosis of the extremities, dermographism and hyperidrosis; he ran a course presenting foolish, unsystematized delusions, foolish behavior, grimacing and at times mutism to a degree. January, 1909, was in good physical condition, blood pressure, sys. 130, dias. 100, red cells 4,500,000, whites 8000. Blood clots in four minutes. Operated upon February 1, 1909; uneventful recovery from the operation. Escaped from the institution February 19, was returned in the same conditon as existed before the operation, and has since then remained the same.

Pathology-Weight 25 gm., moderately vascular, normal in size and color, small fat-like body removed, found to be parathyroid. Microscopical diagnosis: Struma colloides. The majority of the alveoli are markedly distended with colloid. The interstitial tissue is slightly cedematous;

here and there small islands of parenchyma cells are found in the interstitial tissue; blood vessels are normal and no hemorrhages present, contents stain well in practically every part. In one alveolus is noted a marked cauliflower growth.

CASE IV.-E. K., male, age 28, draughtsman. Family and personal history negative. Of previous illnesses had diphtheria as a child. Present illness commenced 10 years ago, when he became excited, following an altercation with his father. After this developed hallucinations of sight and delusions of persecution, became retarded in action and was emotionally indifferent. Five years ago he became catatonic, showing cerea flexibilitas and mutism; with the exception of one remission lasting two months, he has remained in this condition (January, 1909). Examination revealed: Physically cyanosis of the extremities, cold, clammy skin, increased reflexes, etc. Blood pressure, sys. 125, dias. 90; blood clots in four minutes, red 6,000,000; whites 10,000. Psychically an extreme example of catatonia. Operated upon February 8, 1909, has remained in the same condition since the operation.

Pathology.-Thyroid paler, but not larger than normal; weight 17.33 gm.; microscopical diagnosis: Moderate struma colloides. The alveoli are markedly distended and lined with a flattened epithelium. There is some interstitial parenchyma hyperplasia. A few of the acini are lined with several layers of cells; there is is no oedema of the interstitial tissue although slight hemorrhage is noted throughout.

CASE V.-F. W., male, age 20, laborer. Family and personal history negative. No previous illnesses. Present illness: When 16, was always depressed and of a retiring disposition, two years ago became careless in appearance, apathetic and indolent. Admitted to the institution April 12, 1908. Physically in good condition, psychically indolent, and careless; mute to a degree; January, 1909, showed physically cyanosis, hyperidrosis, dilated pupils and increased reflexes; blood pressure, sys. 150; dias. 100; red 6,000,000; whites 8000. Psychically remains as before. Operated upon February 1, 1909; remains the same as before operation, although for a short time he took a more active interest in his surroundings.

Pathology.-Weight 39 gm. Microscopical diagnosis: The structure is found to be normal except for a few hemorrhages between the alveoli and distention of a few alveoli, showing flattened epithelium and an increased amount of colloid; the lining epithelium contains but one layer

of cells.

CASE VI.-R. F., male, age 23, teamster. Father died insane at the age of 35. Personal history negative. Of previous illnesses had scarlet fever as a child. Present illness began April 19, 1908, with worry, then the development of mutism, had vague delusions of persecution, admitted to the institution May, 1908, in a catatonic condition, staring stolidly before him, answering all questions with "I don't know-I couldn't say." An examination in January, 1909, showed physically, somatic signs of catatonia, blood pressure, sys. 125; dias. 90; red 6,000,000; whites 11,500 Psychically showed some delusions of persecution, great emotional deterioration, attention very difficult to obtain and interest very slight; re

mains mute at times except when hard pressed. Operated upon February 8, 1909. February 15, showed slight improvement, wants to work. February 22, is up working about the ward, taking interest in his surroundings. March 1, patient markedly improved, wants to be interviewed to prove that he is well, wrote a letter to the physician telling of his improvement, an act of volition certainly not present before the operation. May 8, has begun to re-develop delusions of persecution with onset of carelessness in his appearance, reluctance in answering questions; there is no hypertrophy of the thyroid gland. After having been paroled and returned in a few weeks in the same condition as existed previous to the operation he has so remained.

Pathology.-Same as in case V.

CASE VII.-J. U., age 19, male, laborer. Family and personal history negative. Present illness dates back to February, 1909, when he became reclusive, constantly examined his face, developed hallucinations of hearing; admitted to the institution, October, 1907, in a catatonic condition. Examination, January, 1909, shows physically the signs of catatonia; psychically mutism, some negativism, emotional deterioration and filthiness. Blood pressure, sys. 120; dias. 80. Operated upon February 8, 1909, he has remained in the same condition as existed before the operation,

Pathology-Weight 18.75 gm. Normal gland markedly hyperamic, interstitial stroma is not oedematous but there are many hemorrhages, slight increase of connective tissue between the alveoli.

CASE VIII.-J. L., male, 25. Family and personal history negative. Previous illnesses: Typhoid fever when 2 years old, measles at 6, developed pulmonary tuberculosis at 18. At that time present illness began; he became delusional, acted in a peculiar manner and was admitted into the institution July, 1905; when he presented the picture of a negativistic mute catatonic. Examination, February, 1908, showed physically, besides the signs of catatonia, blood pressure, sys. 130; dias. 90; red 6,000,000; whites 8000. Psychically a mute catatonic. Operated upon February 15, 1909, has remained in the condition present previous to the operation. Pathology.-Moderate struma colloides. Microscopical examination: Large alveoli in patches with moderate degree of hyperæmia with extensive hemorrhages in the interstitial tissue. The epithelial lining is thinned. CASE IX.-H. H., male, age 19, schoolboy. Family and personal history negative. Present illness dates back to 5 years ago, when he refused to eat and became very irritable, admitted to the institution November, 1907, paroled January, 1908. Readmitted July, 1908, examination January, 1909, showed psychically a very foolish hebephrenic, having numerous mannerisms and grimaces; physically negative; blood pressure, sys. 120; dias. 80; red 5,500,000; whites 8000; blood clots in four minutes. Operated upon February 15; remains in no way improved.

Pathology.-Moderate struma colloides. Microscopical examination: Alveoli are distended in islands and lined with low flattened epithelial cells. Here and there are islands of epithelial cells in the interstitial stroma and lining some of the alveoli are several layers of cells; hyperæmia is marked. Moderate degree of interstitial hemorrhage.

CASE X.-R. E., male, age 28, machinist. Family and personal history negative. Admitted to the institution September, 1906, when he showed verbigeration, decreased volitional impulses, was indolent, later developed marked negativism, became mute and refused food. Examination January, 1908, showed marked cyanosis, etc., blood pressure, sys. 130, dias. 105; red 6,000,000; whites 8500; blood clots in five minutes. Psychically, an extremely negativistic, mute catatonic with great emotional deterioration. Operated upon February 15, has remained in the same condition as existed previous to the operation.

Pathology.-Moderate struma parenchymatosa, with atrophic thyroid. Microscopical examination: Alveoli are not increased in size; the interstitital connective tissue is slightly increased, the organ is markedly hyperæmic and a moderate degree of hemorrhage present. The epithelial tissue is markedly increased in the alveoli in places.

CASE XI.-F. T., female, age 25, clothing cutter. Family history negative. Personal history: She was always neurotic, and would be annoyed at trifles; at 17 commenced to worry over religion; continued in this way until 1907, when she developed attacks in which she would throw herself around for a long period of time; in November she became delusional and was admitted to the institution December, 1907. Physically showed cyanosis of extremities, otherwise negative. Psychically, hallucinations of hearing, poor attention, emotionally depressed and fearful, conduct very foolish, continuing she became mute, listless and careless in appearance. Examination January, 1909, she showed physically marked dermographism and cold, clammy skin; psychically in the same condition as above described. Blood pressure, sys. 140, dias. 100; blood clots in four minutes, red 5,000,000; whites 9000. Operated upon February 15, 1909, has remained in the same condition since operation.

Pathology.-Struma colloides, et hemorrhagica. Microscopical examination: Many of the alveoli are distended with colloid; the epithelium is thinned out and the cells flattened, in other places it is normal; there is marked hyperæmia and extensive hemorrhages into the interstitial tissue and alveoli; no cedema is found in the interstitial tissue; there are a few islands of parenchyma cells, a small parathyroid was noted.

CASE XII.-C. H., age 23. Personal and family history negative; previous illness: Syphilis when 19. Admitted to the institution February, 1909. Physically in good condition; psychically very confused; showed marked emotional deterioration, took a long time to answer questions. He ran a course developing mutism, some negativism and became extremely careless as to appearance. The course was intercepted by numerous remissions lasting from a few minutes to several hours. Examination May 1, 1909, mentally in the state described above, physically showed cold, clammy skin, increased reflexes, blood pressure, sys. 130, dias. 80; blood clots in four minutes, reds 6,000,000; whites 10,000. Operated upon May 15. For the week following the operation he showed numerous remissions lasting several hours, since then he has reverted into his former condition of mutism and so continues.

WAS KING EDWARD THE SECOND A DEGENERATE? A CONSIDERATION OF HIS REIGN FROM THAT POINT OF VIEW.

BY CHALFANT ROBINSON, PH. D.

1

"A greater ninny than Edward the Second never lived" is the opening sentence of Mackinnon's Life of Edward the Third. Bishop Stubbs in speaking of the death of the king, says: "Thus ended a reign full of tragedy, a life that may be pitied, but [which] affords no ground for sympathy. Strange infatuation, unbridled vindictiveness, recklessness beyond belief, the breach of all natural affection, of love, of honor, and of loyalty are here; but there is none who stands forth a hero." Again, he describes the reign, outside the great crises, as exceedingly dreary. "There is," he says, "a miserable level of political selfishness which marks without exception every public man; there is an absence of sincere feeling except in the shape of hatred and revenge." Accurate and dispassionate as his estimate is, there still seems to be lacking a needed element to account satisfactorily for the life of the king, and to explain what gave to his reign its peculiar character. This needed element is the diseased brain of the king himself.

2

It is the purpose of the following article to interpret the reign of Edward the Second from this new point of view. For it is one which neither the chroniclers nor modern writers have considered. Indeed, when we adopt Edward's pathological condition as an hypothesis, many apparently trivial, as well as many plainly significant incidents, related by the chroniclers, assume a scientific character, and in them Bishop Stubbs' estimate of the reign finds an unsuspected explanation. If the annals of the reign are dreary, it is the dreariness of paralysis. If contemptible men are in power, it is because of the impaired vigor of the king's judgment in putting them there. For the head is sick and the whole body is full of misery.

p. LXXV.

1 Stubbs, Early Plantagenets, p. 288. Introd. to Chron. Edw. I & II, Vol. II, 'Indignos quoque et ineptos ad gradus ecclesiasticos promovit, quod post modum sudes in occulos et lancea in latere sibi fuit. Higden's Polychronicon, Vol. VII, p. 298.