An account of the life and work of Dr. Bedford Pierce may suitably begin with some remarks which appear in his book, Addresses to Mental Nurses. In the course of a preface to his Lecture on “Character and Outlook” he says:

Sir David Drummond, who had been an Honorary Member of the Association since 1925, died on April 28 last. He was born in 1852, and graduated M.B., M.Ch. at Trinity College, Dublin, in 1874; he took his M.D. in 1876. He spent the greater part of his life in Newcastle-on-Tyne, and at the Royal Infirmary of that city he was elected Pathologist and Assistant Physician in 1878. Later he became Physician, and on his retirement in 1912 he was made Consulting Physician. His name was a household word in the greater part of Northumberland and Durham, in which counties he had a very large consulting practice in general medicine, always paying more attention to organic nervous disorders and to conditions arising as a sequel to syphilis. Although he never worked in a mental hospital, he was always drawn towards abnormal mental states, more especially if there was some organic basis for the mental breakdown.

My first duty is to thank you most sincerely for the great honour you have done me in electing me to the Presidential Chair of this great Association, which, in its ninety years of existence, has numbered among its Presidents so many illustrious pioneers of progress in the world of psychiatry. Fully conscious of my limita tions, .1 deeply appreciate the honour, and will endeavour, during my term of office, to fulfil to the best of my ability the responsible duties laid upon me.

In discussing this subject, “The Place of Psychiatry in Medical Education,” one needs to consider various aspects of a wide field. First there is the education of the student in the medical school in both the pre-clinical and clinical years. Next we have to deal with post-graduate education, including the value of the mental hospitals, the psychiatric clinics, and the general hospitals, etc., in this regard. Then we have to consider the education that leads to research in our field—such research, for instance, as the relation ship of the endocrine glands to the nervous system, the field of bio-chemistry, the matter of heredity and of eugenics. There is also the subject of “menta hlygiene” —a that is rather loosely applied, but should include the educational aspect of psychiatry. Lastly, there is the preventive aspect of the subject.

The physicist, in his endeavour to explain natural phenomena, has, in the course of his investigations and observations, discovered certain laws which appear to be constant and applicable to the phenomena in question. On the basis of those laws he has evolved theories which provide him with an intelligible appreciation of the mechanism involved. The law embraces and synthetizes a large number of observations, but it also serves as a point of departure for new observations. Whilst the law may be constant, the theories may undergo modification, as new facts come to light, as has occurred, for example, in the case of the atomic theory. Amongst physicists there is, however, a readiness to consider new discoveries, to put them to the test, and, if they are found to be in harmony with determined laws, to incorporate them in the theoretical scheme.

During a symposium on the psychotherapy of the psychoses held under the auspices of this Section,† I took occasion to point out that, owing to the nature of their case material, many psychoanalysts had been forced to undertake this branch of treatment, whether they liked it or not. In the case of psychiatric classification the position is somewhat different. However much the psychoanalyst may choose to procrastinate, he cannot postpone indefinitely the task of correlating psychiatric data with his own systematic formulations on mental development. The more precise and dogmatic these formulations become, the more incumbent it is on the psycho-analyst to test them in the psychiatric field. Already some ventures have been made in this direction, notably in the work of Rickman,† Schilder,§ Stärcke‖ and others. The main justification for a renewal of these attempts lies in the fact that during the past four or five years, appreciable advances have been made in the psycho-analytic understanding of early stages of ego development. A great deal has been achieved by the analysis of small children, largely under the inspired stimulus of Melanie Klein, and already this work has produced reverberations in other directions. I am constrained to make this preliminary explanation in the hope of mitigating an impression which I fear still prevails in some quarters, namely, that in its relations to psychiatry, psycho-analysis displays the dogmatic over-compensation of an ignorant and none-too-welcome parvenu. Indeed, I should like to take this opportunity of stating that psycho-analysis, if even on the barest grounds of economy of effort, looks forward to an increasingly close alliance with pure psychiatry. And I hope to be able to indicate in this paper some problems on which the co-operating energies of the two sciences might well be concentrated.

Shortly after the introduction of therapeutic malaria into this country, the Ministry of Health and the Board of Control, in consultation with the London County Council Mental Hospitals Department, established a special centre for this treatment at Horton Mental Hospital. A separate villa in the hospital grounds was set apart for the work, and, through the interest, advice and help of Col. S. P. James, M.D., F.R.S., of the Ministry of Health, a laboratory was equipped and arrangements were made for the supply of malarial infective material to all parts of Great Britain. The work was begun in April, 1925, and during the seven years that have elapsed since then, 200 cases have been treated. These cases are all women, drawn from the various London County Mental Hospitals; recently, however, an annexe has been added to the centre, and facilities are now available for treating men also.

In the course of this article it is intended to study carefully the after-history of patients treated by malarial inoculation for general paralysis since the introduction of this method of treatment into this country at Whittingham County Mental Hospital in July, 1922.

The treatment of diseased conditions by means of induced pyrexia is now so frequently carried out that it is surprising how little we know of the biological processes involved. It is not an exaggeration to say that the beneficial effects of malaria in general paralysis are as gratifying as those of liver in pernicious anæmia, and of insulin in diabetes, but we still await a satisfactory explanation of its mode of action. An attempt in this direction was made by Eddison (1), who observed a failure of leucopoiesis in untreated cases of paralytic dementia, which he attributed to degeneration in the reticulo-endothelial system. He considered that, in general, pyrexia was associated with leucocytic reactions, and that this resulted indirectly in reticulo-endothelial stimulation. It is not proposed to consider here the arguments put forward by Eddison, but he should be given credit for being the first person in this country to draw attention to a very important aspect of pyretotherapy.

Nembutal (sodium ethyl [1-methyl-butyl] barbiturate) has recently come into use in general hospitals in this country as a preliminary to and partial substitute for general anæsthesia.

A Sustained hyperglycæmia and quantitative changes in the blood cholesterol are common findings in the manic-depressive psychosis, and, since both may be dependent upon a faulty endocrine balance, parallel observations of the hyperglycæmic index and blood cholesterol have been made in 24 cases in order to determine whether any relationship exists between the two values.

In the previous contribution to this series of studies∗ we reported the scores obtained by women patients in a mental hospital when submitted to certain p-tests. Facts emerged of the kind that, relative to the scores obtained by normal non-psychotic women, maniacs obtained low p-scores, melancholic and depressive and dementing psychotics high p-scores, and that certain præcox patients obtained extremely high-p scores indeed.