With perhaps the exception of the youngest in our ranks, there can be no member of the Association or, indeed, of our branch of Medicine, who learnt of the death of Sir Frederick Needham without realizing that an important link was thereby severed in the sequence of those who, in our time and in their respective spheres of action, have rendered great service to psychological medicine, especially in bringing about the many improvements that have taken place during the past three-quarters of a century in the conditions under which insane patients are housed and treated.

The object of our investigations has been to find out if carbohydrate metabolism is disordered in the different forms of insanity.

To this end we have determined the sugar tolerance of 100 insane patients by observing the variations in the blood-sugar content after the ingestion of a known amount of glucose.

Numerous articles have appeared within the last few months in both Continental and English literature describing the value of the malarial treatment in cases of general paralysis. Thus Yorke and Macfie state that out of 84 general paralytics treated with malaria, 23 (or 27.4 per cent.) had been, or were about to be, discharged, at the time of writing, from the mental hospitals. Weygandt in 50 cases obtained good remissions in 48 per cent., and Kirschbaum in 51 in 58.8 per cent. Scripture states that in Wagner-Jauregg's clinic complete remissions were obtained in 44 per cent, out of 141 cases treated. This percentage of complete remissions is still being maintained, Gerstmann reporting recently that 40 per cent, show complete remissions with ability to work, 30 per cent, improvement, and 30 per cent, no improvement. If only early cases are treated Wagner-Jauregg states that nearly 100 per cent. of cures can be obtained. These figures compare very favourably with the percentage of spontaneous remissions recorded by Kirschbaum. This writer found that spontaneous remissions occurred in only 11.4 per cent. of untreated general paralytics. At present it is too early to make any definite statement with regard to the permanence of the remissions, although the three oldest successful cases in Wagner-Jauregg's clinic have now shown complete remissions for years.

The problem of delinquency has a peculiar interest for the alienist as well as the social reformer, for it is now accepted that intelligence and mental disorder have a close relationship with antisocial conduct.

The antiquity of psychotherapy is in great measure responsible for the difficulties which involve this branch of medicine at the present time. For it comes to us trailing clouds of superstition, pervaded by implications of the most unscientific order.

The time for a discussion of occupation as a means of cure or betterment in cases of mental disorder has long been overdue, and needs no apology. The papers which have been read deal with its practical aspect, and relate in a convincing way what has actually been accomplished. My aim is twofold. In the first place, I wish to give a short historical résumé of occupation as it has affected Gartnavel, and in the second place, to discuss its importance and value.

America has lately been the scene of a murder, and a consequent trial, both of which were remarkable even for that land of sensations. The circumstances of the crime were quite out of the ordinary. The questions discussed at the trial were of the utmost psychological and medico-legal importance. The local newspaper reports, together with many other details, were sent to us through the kindness of Mr. Stephen M. Reynolds, of Chicago. We thus have information which few, if any, in this country possess. The actual trial lasted thirty-two days. The mere reading of the reports was a heavy task. We then had to separate from the mass of journalism those points in the evidence which might be taken as established. And we think that a summary thereof may be of general interest.

The following paper presents the results obtained from the investigation of enteric fever at Cane Hill Mental Hospital. For some time past there has been a persistent incidence of enteric fever on the female side of this institution. The cases have been sporadic, and as ail circumstances pointed to the existence of “carriers” as the cause, it was deemed advisable to conduct an extensive bacteriological examination on all possible sources of infection.

The word “unconscious” is used in Freud's sense; the word “suggestion” is used more in the general sense of the presentation of an idea to the mind than perhaps in the more technical sense of McDougall.

According to the late Sir William Bayliss, a leading physiologist, the vitamins, which the plant alone knows how to manufacture, are a kind of chemical messengers (hormones). “They are obtained from the plant, and are particularly abundant in fresh green vegetables and fruit.” … “Their precise mode of action is still unknown, but in their absence normal growth and function is impossible and certain diseases make their appearance.” Hence the normal growth of the animals depends upon stimulations and influences directly derived from the plant kingdom. The evolution of the animal is in large part directed by the plant, which is also saying that it is cosmically directed, in virtue of those terrestrial and solar influences which the plant purveys. But it is also saying, in a most important sense, that all organic evolution is directed by the amount of mutuality existing between the kingdoms and what this involves in bio-sociality. If the vitamins are, in Sir William's words, “obviously a kind of chemical messengers,” then we must consider them as the hormones of symbiosis, as “messengers” of health—the diametric opposites of the alkaloids, the vegetable poisons which are of appalling efficacy in the physiological economy of the animal. By symbiosis I mean not parasitism, not commensalism, but definite, almost deliberate, mutual adaptation for the purpose of mutual service, on the part of living things, nearly always of different orders of creation, broadly, that is, between the plant and the animal (“Norm-symbiosis”).

Luminal has been used in the treatment of insane epileptics in a number of patients at Claybury Mental Hospital during the last three years. A perusal of the results obtained shows that this drug would appear to have a definite value in diminishing the number of seizures, but that it hardly deserves the encomiums showered upon it in some quarters, e.g., it does not reduce fits to the level of “rare occurrences,” and in some cases the fit-incidence is increased during its administration.

A. B—, æt. 42, governess, of a neurotic family. Had been in France and England with an American family, and consulted several doctors for some vague illness, sciatica, etc.