274 PROCEEDINGS OF THE SECTIONS. 
symptom, and lead to violence in a large number of cases. 
In addition to the symptom or facts above noted, attention 
should be directed to— 
4th. The condition of the memory. 
5th. Change in the higher emotions, and 
6th. Other abnormalities. ; 
The following, which I have taken with some alterations from 
an admirable article on this subject by Dr. Brushfield in the 
Lancet for May, 1880, is suggested as a form for medical certificates, 
and brings all the essential points under notice :— mee 
ppearance, especially facial aspect, attitude, peculiarities 0 
dress. 
Conduct and general demeanour, restlessness, excitement, 
violence, exaltation, or depression. : 
Condition of the habits and propensities, especially as to 
change. | 
Delusions; if any, describe them. 
Hallucinations, do., 0. 
Coherence or incoherence, volubility, obscenity. 
Condition of the memory. 
Change in the higher emotions. 
Other abnormalities. 
The second series of facts in the certificate are those aa 
municated by others, and I may here call attention to the necessity 
of stating the name or connection with the patient, as ier 
nurse, attendant, &c. of the person from whom this infor a 
u 
of hospitals, and in some cases the facts are of the wag 
importance, being the prominent feature of the certificate, a 
dwarfing altogether those observed by the medical practii0 
_ himself. In some cases of epilepsy the medical saupeege = pene es 
the patient between the paroxysms can testify only to a dul ive 
expression and some loss of memory, whilst the friends can 8 
