ness. But even in this case he might be in error, for intemperance, or ill health, and fatty degeneration might coexist without being related as cause and effect ; and, besides, fatty degeneration, at least of the liver, is not always to be regarded as a sufficient cause of death. When it occurs as widely diffused as in this instance it must be looked upon as presumptive evidence of poisoning. The presumption would be much stronger if the history of the case excluded other rapidly acting

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... like acute infective diseases. Therefore, in all cases, fatty degeneration should cause augmented suspicion of poisoning, and lead the medical examiner to continue his search. He should not rest satisfied with an examination of the stomach and organs manifestly affected, but extend his explorations even to the brain and other parts not usually submitted to the chemist. I close with the following summary of conclusions : -(1.) It is an established fact that arsenic, in common with phosphorus, antimony, and other poisons, will cause fatty degeneration of the liver, kidneys, gastric glands, heart, and other organs. (2.) It acts after absorption, probably by its direct irritant power, causing parenchymatous inflammation, the final stage of which is fatty degeneration. (3.) This effect may be produced in a fewcertainly in tenhours after the ingestion of the poison. (4.) Arsenic cannot always be detected by chemical tests in tissues which have experienced its extreme effects. (5.) Fatty degeneration is a frequent result of arsenical poisoning. Probably either it or the preceding condition of granular degeneration always exists. (6.) The discovery of fatty degeneration post mortem, especially if widely diffused, should be regarded as presumptive evidence of poisoning, and as warranting a thorough chemical examination. My patient, an unmarried man, twenty-nine years of age, was admitted to the McLean Asylum April 6, 1876. The family history records insanity in a sister and two aunts, one on the father's and one on the mother's side. Ten years before entrance he had suffered from depression of spirits, due to a love affair, and had traveled widely in the hope of regaining his former cheerfulness, but had not wholly succeeded when he returned from Europe and settled in the West. He became connected with a