when their nomination belongs to the bishop, he alone can remove them; in any case a reasonable cause is necessary, at least for the lawfulness of the act, and the assistant who believes that he has been wronged may have recourse to higher authorities, as mentioned above with regard to movable pastors. Their office, however, does not cease with the death of the priest or bishop who appointed them, unless this was clearly expressed in the letters of appointment. For the recent legislation regarding the removal of parishpriests, see PARISH, Section II, 2.

BAART, Legal Formulary (4th ed., New York), nn. 86-113; BOUIX, De Parocho (3rd ed., Paris, 1889); FERRARIS, Bibliotheca Canonica etc. (Rome, 1885-99); NARDI, Dei Parrochi (Pesaro, 1829-60); SANTI, Prælectiones juris canonici (New York, 1905); SCHERER, Handbuch des Kirchenrechts (Graz, 1886), xciiiii; SMITH, Elements of Ecclesiastical Law, I (9th ed., New York, 1893), nn. 639-70; WERNZ, Jus Decretalium (Rome, 1899), tit. xxxix; RAYMUNDI ANTONII EPISCOPI, Instructio Pastoralis (5th ed., Freiburg, 1902); AICHNER, Compendium juris eccl. (6th ed., Brixen, 1887), 426-41; CRONIN, The New Matrimonial Legislation (Rome, 1908). HECTOR PAPI.

Pastoral Letters. See LETTERS, ECCLESIASTICAL.
Pastoral Staff. See CROSIER.
Pastoral Theology. See THEOLOGY.

Pastoureaux, CRUSADE OF THE, one of the most curious of the popular movements inspired by a desire to deliver the Holy Land. St. Louis, King of France, had gone on the Crusade (1248), leaving the regency to his mother, Blanche of Castile. Defeated at the battle of Mansourah (8 Feb., 1250) and taken prisoner, he regained his freedom by surrendering Damietta, embarked for Saint-Jean d'Acre, and sent his brothers to France to obtain relief. But Blanche of Castile endeavoured in vain to send him reinforcements, neither nobles nor clergy showing good will in this respect. At this juncture the shepherds and labourers rose up, announcing that they would go to the king's rescue. About Easter (16 April), 1251, a mysterious person whose real name is unknown but who was soon called the "Master of Hungary", began to preach the Crusade in the name of the Blessed Virgin to the shepherds in the north of France. He was sixty years of age and aroused wonder by his long beard, his thin face, and his always-closed hand, which held, it was said, the map given to him by the Blessed Virgin. He drew crowds by his eloquence, and distributed the Cross among them without authorization from the Church.

The movement spread rapidly-from Picardy to Flanders, then to Brabant, Hainault, Lorraine, and Burgundy. Soon an army of 30,000 men was formed, carrying a banner on which was depicted the Blessed Virgin appearing to the Master of Hungary. The movement was equally successful in the towns, and the citizens of Amiens furnished provisions to the army. However the Pastoureaux soon showed themselves hostile to the clergy, especially to the Friars Preachers, whom they accused of having induced St. Louis to go to Palestine. Moreover, a host of idlers, robbers, cut-throats, and fallen women joined their ranks, and thenceforth with growing audacity they slew clerics and preached against the bishops and even the pope. Blanche of Castile seems to have imagined that she could send the Pastoureaux to the relief of St. Louis, and summoning the master to her she questioned him and dismissed him with gifts.

Emboldened by this reception the Pastoureaux entered Paris, and the grand-master, wearing a mitre, preached from the pulpit of St. Eustache. Clerics and monks were hunted, slain, and thrown into the Seine, the Bishop of Paris was insulted, and the University of Paris was compelled in its own defence to close the Petit-Pont between the Cité and the left bank of the Seine. The Pastoureaux then left Paris and divided into several armies which spread terror everywhere. At Rouen the archbishop and his clergy were expelled from the cathedral (4 June, 1251). At

Orléans a large number of university clerics were killed and thrown into the Loire (11 June). At Tours the Pastoureaux took by storm the convent of the Dominicans and desecrated the churches. The credulous populace regarded them as saints and brought them the sick to be cured. At last Blanche of Castile realized that she had been mistaken and commanded the royal officers to arrest and destroy them. When they reached Bourges the clerics and priests had fled, whereupon they seized the possessions of the Jews, sacked the synagogues, and pillaged the city. An attempt was made to imprison them, but they broke down the gates. A troop of citizens pursued and halted them near Villeneuve-sur-Cher. The Master of Hungary was slain, together with a large number of his followers. Some reached the valley of the Rhône and even Marseilles; others went to Bordeaux, whence they were driven by Simon de Montfort, Earl of Leicester and Governor of Guienne in the name of the King of England, who caused their leader to be thrown into the Gironde.

Another leader went to England and assembled some shepherds who, learning that the Pastoureaux were excommunicated, killed him. Henry II ordered the Lord Warden of the Cinque Ports to take measures to prevent their invasion of his kingdom. Some of them submitted, and after having received the Cross at the hands of clerics set out for the Holy Land. Ecclesiastical chroniclers assert that the Pastoureaux had concluded with the sultan a secret treaty to subject Christianity to Mohammedanism. "It is said that they have resolved first to exterminate the clergy from the face of the earth, then to suppress the religious, and finally to fall upon the knights and nobles in order that the country thus deprived of defence may more easily be delivered up to the errors and incursions of the pagans" (Letter from the Guardian of the Paris Friars Minor to his brethren at Oxford; Chartularium Univ. Parisiensis, Paris, 1889, I, 225). This is obviously a fable, but as a matter of fact this popular movement, sincere and somewhat mystical in origin, soon acquired an anarchistic character.

The same is true of the second movement of the Pastoureaux in 1320 during the reign of Philip V. In the north of France a suspended priest and unfrocked monk preached the Crusade to a band of peasants, thundering against the indifference of the king and the nobles with regard to the deliverance of Palestine. As in 1251, the ignorant mystics were soon joined by ruffians of every description whose object was to profit by their simplicity. Clad in rags and armed with sticks and knives they marched on Paris, liberated the prisoners in the Châtelet, and defied the king, who merely intrenched himself in the palace of the Cité and in the Louvre. From Paris they went to Berry, thence to Saintonge and Aquitaine to the number of 40,000, pillaging as they went. At Verdun-sur-Garonne five hundred Jews imprisoned in a dungeon strangled one. another so as not to fall into their hands. They were often aided by the people of the cities and even the middle-class citizens applauded the massacre of the Jews. In reply to the papal excommunication they marched to Avignon, and then resolved to embark like St. Louis at Aigues-Moretes. But the Seneschal of Carcassonne assembled his men at arms, closed the gates of the city against them, and drove them into the neighbouring marshes, where hunger dispersed them. The soldiers then organized hunting parties which resulted in the hanging of thousands of the Pastoureaux, but for a long time a number of their bands continued to lay waste the south of France.

Chroniques de St. Denis in Hist. de Fr., XXI, 115 sq.; BERGER, Hist. de Blanche de Castille (Paris, 1895), 392-402; BEMONT, Simon de Montfort, Comte de Leicester (Paris, 1884); RÖHRICHT, Die Pastorellen in Zeit. für Kirchengesch. (1884), 290-96; VIDAL, L'émeute des Pastoureaux en 1320 in Annales de St. Louis des Français (1899), 121-74; LEHUGUEUR, Hist. de Philippe le Long (Paris, 1897), 417-21. LOUIS BRÉHIER.

Patagonia is the name given to the southernmost extremity of South America. Its boundary on the north is about 44° S. lat., and on the south the Straits of Magellan. On the west it extends to the Cordilleras and Chile, and on the east to the South Atlantic. It has an area of about 300,000 square miles. It was discovered by Magellan in 1520, although as early as 1428 a map of the world described by Antonio Galvao showed the Straits of Magellan under the title of the Dragon's Tail. Magellan is supposed to have called the inhabitants "Patagoas" on account of the large ness of their feet. To this day they wear coltskin shoes which project far beyond their toes, which accounts for their size and his mistake.

The surface of the country is very varied. Trackless pampas (plains) rise in gently graduated terraces to the lofty ranges of the Andes, between which there is a mighty network of lakes and lagoons. From the south to the Sierra Nevada stretch these pampas in ever-rolling waves of tussock grass, thorn bushes, guanacos, and mirages. On the western rim the Cordilleras rise against the sky, holding in their jagged bosoms glaciers and icy blue lakes. On the flanks of these mountains are to be found thousands of square miles of shaggy, primeval forests, only the bare edges of which have up to the present been explored. On the eastern coast the Chubut, the Deseado, the Southern Chico (which joins the Santa Cruz in a wide estuary before emptying its waters into the South Atlantic), and the Gallegos, are the only really important rivers. In general it may be said that the eastern part of Patagonia is level and treeless, with few bays, whilst the west, really the Chilian seaboard, is everywhere pierced with fiords, and has many headlands covered with dark, thick forests, jutting out into the sea.

The climate in the north of Patagonia is not so severe as in the south. Very little ice is seen there, except in the mountains, and snow seldom remains long on the ground. In the south it is very cold, the ground being covered with snow in winter, and the lakes and rivers choked with ice. For at least six months in the year there are strong gales of wind, and rain is prevalent all over the country. In the south there is practically no summer, whilst in the north there is a mild season which lasts for several months. The principal settlements are: Gallegos, 3000 inhabitants, on the Gallegos River; Punta Arenas, 11,000 inhabitants; and the smaller Welsh ones at Trelew, Rawson, Gaimon Colhaupi near Lake Musters, and Chubut. The original inhabitants are all descended from the Araucanian race. They are mostly tall and muscular, averaging at least six feet, and are splendidly developed. In the interior are to be found the Pampas Indians and the tribes of the Tehuelches. The latter are very lazy, and amongst those whom the missionaries have not yet evangelized; It is said that wives are still bought and sold. There is the tribe of the Alacalufe in the south, and the warlike Onas who inhabit Tierra del Fuego. The natives are nomadic in their habits, and live principally on the products of the chase. They hunt the pampa fox, the ostrich (rhea Darwini), the guanaco or wild llama, and the puma. Some of the tribes, however, are not sufficiently civilized to understand the use of the bow and arrow. They live in toldos, or tents made of raw hide. Agriculture is unknown among them. They are ruled by military governors from Chili or Argentina, according to the territory in which they live. These governors reside in the larger settlements, such as Punta Arenas, Gallegos, and Chubut. They are each at the head of a small military force, to be used if necessary. in punitive expeditions.

Their religion is the crudest form of Dualism. They believe in a bad spirit called Gualicho, and in an inferior good spirit. The latter is much neglected, whilst the former, with his attendant devils, requires a great deal of propitiation. Their notion of Heaven is a very

elementary one, and consists in a kind of happy hunting ground. Their language is guttural and harsh. It is very deficient in words, one sound having frequently to do duty for a large number of ideas. Owing, however, to their intercourse with the whites, many of them have acquired a sufficient knowledge of Spanish to make themselves understood. Ancient remains have been discovered in the country, at about 44° S. lat. Skulls and flint arrow-heads and knives have been found, also the mummy of a female, which has been presented to the Smithsonian Institute. There is no industry to be found in Patagonia, except among the European settlers. They are largely engaged in sheep breeding, and in cattle and horse raising.

The government of the Catholic Church in Patagonia is divided into two parts, northern and southern. The Vicariate of Northern Patagonia was founded in 1883, and canonically approved by Decree on 20 Jan., 1902. Monsignor Giovanni Cagliero, S.C., titular Archbishop of Sebaste, and Apostolic Delegate of Costa Rica, is at its head, with the Very Rev. Father Stefano Pagliere, S.C., as his vicar-general for the missions. The entire vicariate is under the control and direction of the Salesian Congregation. There are now in it about fifty priests and a large number of brothers, engaged in mission work and in the various institutes and schools. In the beginning the pioneer work was done by Monsignor Cagliero, Fathers Fagnano, Costamagna, Rabagliati, and Espinosa, who formed a small band of missionaries, carefully trained under the eye of the founder of the congregation, Don Bosco. So far there has been no synod, the special conditions of the situation rendering it unnecessary. Besides the priests who are sent on the mission from Europe, there are many undergoing training in the institutes and houses established in the vicariate. Each house is a centre from which the natives are visited in their settlements. There are at present nineteen centres, which are situated as follows:The Institute of Don Bosco of the Holy Family, the parish church of Our Lady of Mercy, and the subordinate church and Institute of Our Lady of Pity, all in the same settlement of Bahia Blanca; the Mission of the Sacred Heart of Jesus, at Choele-Choel; the parish church of Our Lady Immaculate, at Chosmalal; the church and Institute of St. Lawrence, at Conesa-Sur; the Institute of St. Peter, at Fortin Mercedes; the parish and Institute of Mary Immaculate, at General Acha; the parish of St. Rose of Toay, at Guardia Pringles; the parish and Institute of Our Lady of Snow, at Junin de los Andes; the parish of Our Lady of Carmel and the Institute of St. Joseph, at Patagones; the parish and Institute of St. Michael, and St. Joseph's School of Agriculture, at Roca; the parish and Institute of Mary Help of Christians, at Victorica; the parish of Our Lady of Mercy, and the Institute of Arts and Trades, dedicated to St. Francis de Sales, at Viedma; the Michael Rua Institute and the Mission of the Sacred Heart of Jesus, at Puerto Madryn, Chubut; the parish and Institute of Our Lady of Sorrows, at Rawson; and St. Dominic's Institute, at Trelew.

The Prefecture of Southern Patagonia was founded in 1883, and received canonical approval by Decree dated 20 Jan., 1902. The prefect Apostolic is Monsignor Fagnano, S.C. This prefecture is also under the control of the Salesian Congregation, all its missions and institutes being in the hands of its members. There are about twenty-four priests engaged in mission and teaching work, and there are also many brothers being prepared for the same field of labour. In this southern part of Patagonia the pioneer work was done by Monsignor Fagnano, with Fathers Beauvoir, Borgatello, and Diamond; the latter afterwards founded the Mission of Our Lady Star of the Sea, at Port Stanley, Falkland Islands, in 1888.

There are at present ten centres, which are situated as follows:-The Mission of Our Lady of Candelaria, at Cabo Peña; the Mission of St. Agnes, at Cabo Santa Ines; the Mission of the Good Shepherd, and that of St. Raphael, on Dawson Island; the parish and Institute of Our Lady of Lujin, Gallegos, on the River Gallegos; the church and Institute of Our Lady Star of the Sea, at Port Stanley, Falkland Islands; the Institute of St. Joseph, at Punta Arenas, and the dependent parish of St. Francis de Sales at Porvenir; the parish and Institute of the Holy Cross, at Santa Cruz; and the Church of Our Lady of Mercy, at Ushaia, Tierra del Fuego.

In both Northern and Southern Patagonia the entire religious and educational work is in the hands of the Salesian Congregation, and the Sisters of Mary Help of Christians. There is no other religious order at present in Patagonia, and no native missionaries. Many Indian youths have been received as students, but so far not one has been raised to the dignity of the priesthood.

The principal work of the Sisters of Mary Help of Christians is the care of children, especially during the winter time. In fact this is the only period of the year when the children can be instructed in the Catholic religion, as during the summer months they are away with their parents on their nomadic excursions. The children in the institutes, which are attached to nearly every one of the Salesian Missions, are fed, clothed, and taught by the nuns. A few of the girls have been admitted into the order, where they are working for their compatriots.

The Sodality of the Children of Mary, among the girls, the Guild of St. Aloysius, among the boys, and the Confraternity of the Sacred Heart among the adults, are in a flourishing condition. Slowly and steadily, as far as it can be done, the Catholic parochial system and life are being introduced and developed among these poor and uncivilized natives.

REID, Patagonian Antiquities; PRITCHARD, Through the Heart of Patagonia (London, 1902); DARWIN, Origin of Species (London, 1888), xi, xii; IDEM, The Voyage of the Beagle (London, 1839-); SNOW, A Two Years' Cruise off. Patagonia; MUSTERS, At Home with the Patagonians (London, 1873); CUNNINGHAM, Natural History of the Strait of Magellan (Edinburgh, 1878); MOREÑO, Viage á la Patagonia; LISTA, Mis esploraciones gonia (Buenos Ayres, 1880); Bove, Patagonia, Tierra del Fuego; ONELLI, A travers les Andes, The Salesian Bulletin; Catalogue of the Salesian Congregation (1910). ERNEST MARSH.

en la Pata

Patara, titular see of Lycia, suffragan of Myra, formerly a large commercial town, opposite Rhodes. Founded perhaps by the Phoenicians, it received later a Dorian colony from Crete; a legend traces its foundation to Patarus, son of Apollo. Renowned for its wealth, it was more so for its temple of Apollo where the oracles of the god were rendered during the winter. Ptolemy Philadelphus extended it, naming it Arsinoe. On his third missionary journey St. Paul embarked from here for Tyre (Acts, xxi, 1-3). The "Notitia Episcopatuum" mention it among the suffragans of Myra as late as the thirteenth century. Le Quien (Oriens christianus, I, 977) names seven bishops: St. Methodius, more probably Bishop of Olympus; Eudemus, at Nicæa, 325; Eutychianus, at Seleucia, 359; Eudemus, at Constantinople, 381; Cyrinus, at Chalcedon, 451, signed the letter of the bishops of Lycia to Emperor Leo, 458; Licinius, at Constantinople, 536; Theodulus, at the Photian Council of Constantinople, 879. Its ruins are still visible near Djelemish, vilayet of Koniah; they consist of the remains of a theatre built by Antoninus Pius, public baths of the time of Vespasian, temples, and tombs. The port

is choked with sand.

SMITH, Dict. of Greek and Roman Geog., s. v.; BEAUFORT, Karamania, II, 6; FELLOWS, An account of Discoveries in Lycia (London, 1841), 222; SPRATT AND FORBES, Travels in Lycia (London, 1847), I, 30, II, 189; BENNDORF AND NIEMANN, Reisen in Lykien und Karien (Vienna, 1884), I, 114 sq., II, 118; HILL, Catalogue of the Greek Coins of Lycia, 25-27. S. PÉTRIDES.

Paten. The eucharistic vessel known as the paten is a small shallow plate or disc of precious metal upon which the element of bread is offered to God at the Offertory of the Mass, and upon which the consecrated Host is again placed after the Fraction. The word paten comes from a Latin form patina or patena, evidently imitated from the Greek warán. It seems from the beginning to have been used to denote a flat open vessel of the nature of a plate or dish. Such vessels in the first centuries were used in the service of the altar, and probably served to collect the offerings of bread made by the faithful and also to distribute the consecrated fragments which, after the loaf had been broken by the celebrant, were brought down to the communicants, who in their own hands received each a portion from the patina. It should be noted, however, that Duchesne, arguing from the language of the earliest Ordines Romani (q. v.), believes that at Rome white linen bags were used for this purpose (Duchesne, "Lib. Pont.", I, introduct., p. cxliv). We have, however, positive evidence that silver dishes were in use, which were called patina ministeriales, and which seem to be closely connected with the calices ministeriales in which the consecrated wine was brought to the people. Some of these patinæ, as we learn from the inventories of church plate in the "Liber Pontificalis" (I, pp. 202, 271 etc.), weighed twenty or thirty pounds and must have been of large size. In the earliest times the patens, like the chalices, were probably constructed of glass, wood, and copper, as well as of gold and silver; in fact the "Liber Pontificalis" (I, 61 and 139) speaks of glass patens in its notice of Pope Zephyrinus (A. D. 198-217).

When towards the ninth century the zeal of the faithful regarding the frequent reception of Holy Communion very much declined, the system of consecrating the bread offered by the faithful and of distributing Communion from the patina seems gradually to have changed, and the use of the large and proportionately deep patina ministeriales fell into abeyance. It was probably about the same time that the custom grew up for the priest himself to use a paten at the altar to contain the sacred Host, and obviate the danger of scattered particles after the Fraction. This paten, however, was of much smaller size and resembled those with which we are now familiar. Some rather doubtful specimens of the old ministerial patens are preserved in modern times. The best authenticated seems to be one discovered in Siberia in 1867 (see de Rossi in "Boll. di Archeol. Crist.", 1871, 153), but this measures less than seven inches in diameter. Another, of gold, of oblong form, was found at Gourdon. There is also what is believed to be a Byzantine paten of alabaster in the treasury of St. Mark's at Venice. Some of these patens are highly decorated, and this is what we should expect from the accounts preserved in the "Liber Pontificalis". In the altar patens of the medieval period we usually find a more marked central depression than is now customary. This well or depression is usually set round with ornamental lobes, seven, ten, or more in number. At the present day hardly any ornament is used or permitted.

The paten, like the bowl of the chalice, must be of gold or silver gilt, and it cannot be used before it has been consecrated with chrism by a bishop. The formula employed speaks of the vessel as blessed "for the administration of the Eucharist of Jesus Christ, that the Body of our Lord may be broken upon it", and also as "the new sepulchre of the Body and Blood of Jesus Christ". In the Oriental liturgies there is placed upon the altar a vessel called the discus, analogous to the paten, but it is of considerably larger size.

KRULL in KRAUS, Realencyclopädie fr. christ. Alt.; DE FLEURY, La Messe, IV (Paris, 1887), 155-67, with the plates thereto belonging, which supply the best available collection of illustrations; OTTE, Handb. der Kirch. Kunst-Archäologie, I (Leipzig,

Patenson, WILLIAM, VENERABLE, English martyr, b. in Yorkshire or Durham; d. at Tyburn, 22 January, 1591-2. Admitted to the English College, Reims, 1 May, 1584, he was ordained priest September, 1587, and left for the English mission 17 January, 1588-9. On the third Sunday of Advent, 1591, he said Mass in the house of Mr. Lawrence Mompesson at Clerkenwell, and while dining with another priest, James Young, the priest-catchers surprised them. Young found a hiding-place, but Patenson was arrested and condemned at the Old Bailey after Christmas. According to Young, while in prison he converted and reconciled three or four thieves before their death. According to Richard Verstegan, he converted, the night before his martyrdom, six out of seven felons, who occupied the condemned cell with him. On this account he was cut down while still conscious.

POLLEN, Acts of the English Martyrs (London, 1891), 115-7; English Martyrs 1584-1603 (London, 1908), 208, 292; CHALLONER, Missionary Priests, I, no. 94; KNOx, Douay Diaries (London, 1878), 201, 217, 222.

JOHN B. WAINEWRIGHT.

Pathology, MENTAL.-I. LOCALIZATION OF MENTAL FACULTIES.-In the cerebral cortex-that is, the thin covering which envelopes the entire surface of the brain-are distinguished various areas, connected by long nerve tracts with the organs of sense, the skin, the muscles, and in fact with the entire surface of the body. These connexions constitute what is known as the Projection System. There are other areas which are not connected with the outer world, but are related in the closest manner by numerous nerve fibres one with another, and with the areas of the projection system. These constitute the Association System. In the former, definite elementary psycho-physiological functions are accurately localized. There are sharply defined centres for the movements of the individual members (the tongue etc.), for the sensations (taste etc.), for hearing, sight etc. In the left cerebral hemisphere (in the right for left-handed persons), there is a specifically human centre, that for speech; destruction of this definite portion of the brain cortex causes a loss of the power of speech and of the understanding of spoken words, even though there be no deafness, paralysis of the tongue, mental disorder, or anything of this order.

The higher and specifically psychical functions, and indeed all psychical processes (attention, mental moods, will, etc.) are localized in the association centres, the entire massive frontal lobes serving exclusively as such. Modern attempts to localize the individual mental faculties are as little successful as Gall's endeavours to deduce scientifically defects or developments from the formation of the skull.

The external forms of normal psychical conduct have a normally functionating foundation-a healthy brain cortex; unhealthy changes in this latter disturb the normal psychical processes, that is, they lead to mental disease.

II. CAUSES OF MENTAL DISTURBANCES.-The normal mechanism of the cerebral cortex may be impaired in a variety of ways. Impairment may result from the originally insufficient or defective construction of the entire brain (as in congenital dementia, idiocy), or by the destruction of extensive portions of the normally developed brain by injury, inflammation, softening, malignant new growths etc. In very many cases it is due to the action of poisons, which either temporarily or permanently affect the activities of the sound and well-proportioned elements of the cortex. The number and variety of such active poisons is extremely

great; among them are alcohol, morphine, cocaine, hashish, lead, poison products of microscopically small organisms or bacteria (fever deliria), abnormal products of metabolism coming from the gastro-intestinal tract (gastro-intestinal auto-intoxication-hallucinatory confused states), syphilis (in general paresis), poisons from the disturbance of important glandular organs (e. g. disease of the thyroid glands in the dementia of cretinism). In other cases, a disease process of the blood-vessel system affects also the blood vessels of the brain, and thus injures the cerebral cortex (mental diseases due to the calcification of the blood vessels, arterio-scelerotic psychosis).

One and the same poisonous agent (e. g. alcohol) may be taken within definite limits and withstood by one individual, whereas another individual's reaction to the drug may occasion a nervous or mental disease. The personal predisposition plays an important causative factor. This individual constitution (i. e. inferiority, lower capacity for resistance) of the central nervous system is for the most part congenital and hereditary, just as temperament, talent etc. Mental diseases due to alcoholism or nervousness are doubly severe in persons to whom a corresponding taint has been transmitted by their ancestors. In some instances this inferiority may be induced in previously healthy and normally constituted nervous systems by sunstroke, concussion of the brain etc. Injuries to the head, especially those accompanied by concussion of the brain, cause not only an increased disposition to mental disease, but are not infrequently its direct cause. A chronic state of exhaustion produces psychoses, severe and protracted hæmorrhages, weakness due to chronic purulent disease, malignant new growths, etc. Occasionally the mental disturbance bears a direct relation to phases of the female sexual life (menstruation, pregnancy, labour, suckling, change of life).

In some markedly predisposed individuals, very intense bodily pain or continuous physical irritations may occasion attacks of mental disturbance (confused states in migraine, toothache, polypi in the ear, worms in the intestines etc.). In very many instances we are entirely ignorant of any direct cause, and can only interpret the unstable disposition as due to a strong hereditary taint. In many forms of mental disease we know absolutely nothing concerning the causes. It is striking that psychical factors themselves (worry, care, shock etc.) as sole and direct causes of mental disease play a very minor rôle a fact in striking contrast to the popular notion. Only in extremely hysterical individuals, i. e. those already disposed to disease, do violent psychical emotions frequently give rise to rapidly-passing attacks of mental disorder. Furthermore, long-continued excitement, trouble, and the like, work only indirectly in the etiology of the psychoses-e. g. by reducing the power of resistance of the central nervous system, that is, by giving rise to an increased disposition to nervous and mental disease, which itself is transmissible to posterity. Alcoholics make up a third, paretics almost two-thirds of all the mentally diseased. If the teachings of Christianity were to be generally followed, there would very rarely be a paretic, since for the most part syphilis is acquired only from illegitimate intercourse; there would be no alcoholism; and the untold distress caused by mental disturbance would be spared mankind.

With reference to the question whether one may through one's own fault bring on psychoses [as was expressly taught by the Protestant psychiatrist Heinroth (d.1843)], modern psychiatry teaches as follows: as has been said above, there are many purely bodily causes of mental disease, in connexion with which there can be no question raised as to personal responsibility. In the case of alcoholism the matter is not so simple. While it is certain that the abuse of alcohol is one of

the most important causes of mental disease, it is also certain that a great proportion, even the majority, of habitual drinkers are severely burdened by heredity, and start as psychopathic inferiors. They are not degenerate because they drink, but they drink because they are degenerate, and alcoholism merely destroys an already ailing nervous system. The true cause of drunkenness lies primarily in the individual's constitution, and may frequently be traced to the ancestors. The sins of the fathers are visited upon the sons, even to the third and fourth generation. În so far as illegitimate intercourse is a sin, syphilis and its attendant paresis may be regarded as one's own fault. It should not, however, be forgotten that syphilis can be acquired in other ways (e. g. by drinking from an infected glass). One finds the accusations of conscience and self-reproach in wholly irresponsible melancholic patients, and unrepentant criminals often live a long life without developing insanity. In short, the question whether the soul through its passions or burdens can make itself diseased must in general, according to modern experience, be answered negatively, or the possibility of such causative combinations may be acknowledged only with important reservations and the greatest restrictions.

III. VARIETIES OF INSANITY.-The forms that mental disease may assume, according to their symptoms, their course, and their results, are extraordinarily complex. Only those of most importance will be touched upon.

(1) Melancholia.-The most important feature here s a primary (sc. not induced by external events), sad, and anxious depression, with retardation of the thought processes. The patients feel themselves deeply unhappy, are tired of life, and overwhelm themselves with self-reproaches that they are unable to work, are lazy, stupid, wicked, or unamiable. In many cases the patients themselves can give no reason for their depression; they often cite in explanation long-forgotten sins of youth, all kinds of more or less unimportant occurrences and circumstances, the cares of daily life which are treated as a matter of course in times of health, or the very symptoms of their illness. Because they take no pleasure in anything, in prayer or in the presence of their families, they accuse themselves of impiety and want of affection. In other instances pure delusions arise. The patients accuse themselves of crimes which they have never committed: they have made everybody unhappy, have desecrated the Host, and have given themselves up to the Devil. Many cases of dæmonomania of the Middle Ages and of the times of the Reformation belong to this category, as was clearly recognized by many ecclesiastics. Regino, Abbot of Prüm (892-99), Gregory VII (1074) etc. protested energetically against the execution of witches; the Jesuit Friedrich von Spee (d. 1675), in his "Cautio criminalis", condemned the trying of witches as an institution opposed to humanity, science, and the Catholic Church.

The patients often feel a terrible anxiety, fear a cruel martyrdom; sleep suffers, bodily nutrition fails, and painful centres of pressure are often found in different nerve tracts. The danger of suicide is extremely great. The greater number of all suicides occurs as a result of recognized melancholia; other conditions, such as an intense state of anxiety, may often render such patients dangerous also to others. The selfaccusations are uninfluenced by any words of comfort; a hundred times confessed, they return again and again. The severest cases end in a condition of inability to speak or to move (stupor).

(2) Mania.-By this we understand a primary (i.e. nct caused by external influences), happy, elated mood subject to very rapid variations, especially to impulsive, wrathful emotions. Self-consciousness is increased, the flow of ideas is precipitate and rambling; there is over-talkativeness and excessive

restlessness. The severest cases end in flighty ideas, confusion, and frenzy. But even the mild cases are disastrous for the patients and for their surroundings. Abnormal sensuality shows itself; individuals of previously high moral standards give themselves up to violent alcoholic excesses, and practise all kinds of sexual crimes. The patients are senselessly lavish, are guilty of deceits and thefts, and, by reason of their irritability, quarrel with their associates, superiors etc., insult them, and disturb the public peace, commit violence, are arrogant, quarrelsome, contentious, and delight in intolerable hair-splitting. Sleep is badly broken, the eyes shine, the play of the countenance is full of expression and vivacious; many patients resemble persons slightly intoxicated. Very frequently maniacal and melancholic states occur with characteristically regular alternations, and repeat themselves in one and the same individual, who during the intervals is mentally normal (circular insanity with lucid intervals).

(3) General Paresis.-This disease leads with gradually increasing mental and physical decay to dementia, paralysis, and death. Frequently, in the early stages maniacal states, antecedent to severe dementia, are already observable. The patients are not only distracted and forgetful, but above all irritable, sleepless, brutal, shameless, sensual, lavish, extravagant etc., exactly like true maniacs, only in a still more coarse and unrestrained fashion, because of the simultaneously appearing dementia. Very often one finds the most grotesque and changeable ideas of grandeur (megalomania); the patients believe themselves immeasurably rich, are emperors, operasingers, even God Himself; they have discovered perpetual motion, know all languages, have thousands of wives, etc. In other cases there are hypochondriacal delusions (the patients complain they are dead, or putrescent, etc.). Not infrequently the delusions are permanent, and the patients simply grow less rational from day to day. On the physical side, one observes most frequently a characteristic difficulty in speech; the speech becomes stuttering, uncertain, and finally an unintelligible babble. The pupils of the eyes lose their circular form, are often unequal (e. g. the right narrow, the left very wide), and do not contract on exposure to light (Argyll-Robertson pupil). Very frequently transitory apoplectic or epileptic attacks occur. In the last stages the patients are quite insane, prostrated, confined to bed, and pass their excretions involuntarily until death intervenes. In the earlier stages, almost at any stage in fact, marked and continued improvement and stationary periods may take place at any moment.

(4) Juvenile Insanity (Dementia præcox).-This disease process usually sets in after the years of puberty, and gradually leads to a condition of dementia. Quite frequently only the ethical side of the psyche is at first affected. Boys and girls who have been active will suddenly develop a dislike to work, become irritable and headstrong, give themselves up to coarse excesses, go about in bad company, lose every family sense, etc. After a year or more the loss of intelligence becomes unmistakable. At times the initial stages take on a hypochondriacal colouring. Natures previously healthy and full of the joy of life begin to observe themselves with anxiety, go from physician to physician, have recourse to quacks, etc. They found their complaints on all kinds of foolish notions; there must be an animal, or a sore, in their stomachs, etc. Very frequently in the further course of the disease (occasionally at the beginning), hallucinations of hearing and of sight occur. Conditions of confusion, delusions of persecution, of poisoning, of megalomania of varying types occur. Peculiar socalled catatonic states of muscular tension develop, in which the patients remain expressionless and motion