Gentlemen,—In the first place I desire to express my thanks to the council of the medical school for the honour they have done me in asking me to give the introductory address which is customary at the opening of each of our winter sessions. That I particularly esteem the privilege will be readily appreciated when I remind you of where we are gathered, and that this is the first function which has taken place in the Bland-Sutton Institute of Pathology, which, with its laboratory, lecture theatre, and museum, will always be a monument to Sir John Bland-Sutton's princely munificence, to his affection for the hospital and medical school, to his devotion to science, and to his belief in her power to relieve suffering humanity. and who will dare attempt to gauge the direct and indirect influence of this institute? Sir John's catholicity is well known, and I feel assured of his sympathy when I venture to hope that psychiatry, which is the branch of medicine in which my interests are specially centred, will have its fair share of the blessings that doubtless will be showered from this institute.

For a long time attempts have been made to discover definite relations between external and internal stimuli occurring during sleep and coincident dreams, as also between dreams and the more or less momentous happenings preceding them during waking hours. Such attempts as have been made to prove obvious connections have mostly failed, and for reasons which for the first time are set forth by Freud. At the same time, he has demonstrated the subtile evasions and tortuous routes which pertain to the operations of stimuli on the way to dream-consciousness, whether they be sensory or purely physical, as well as the indefinite period of time over which reminiscences, which are concerned in the evolution of the dream, may extend.

Friedrich Wilhelm Nietzsche was born at Röcken, in Saxony, in 1844. His father was a Lutheran clergyman, and his grandfather held a high official position in the Lutheran Church. His grandmother Nietzsche “came of a family of pastors,” and his mother was the “daughter of a parson”. In view of the strongly antagonistic attitude which Nietzsche afterwards adopted towards the Christian scheme of morality, the marked clerical strain in his ancestry is worthy of note. According to his sister Their ancestors, paternal and maternal, were very long-lived. “Of the four pairs of great-grandparents [one] great-grandfather…reached the age of ninety, five great-grandmothers and great-grandfathers died between seventy-five and eighty-six, two only failed to reach old age. The two grandfathers attained their seventieth year, the maternal grandmother died at eighty-two, and grandmother Nietzsche at seventy-seven.” Nietzsche's mother was also long-lived; she was born in 1826, and was married, in 1843, to Pastor Nietzsche, who was then thirty years old. She died in 1897, “after having suffered ill-health for several years”. Pastor Nietzsche is described by his daughter as being an “extraordinarily sensitive man…any sign of discord, either in the parish or in his own family, was so painful to him that he would withdraw to his study, and refuse to eat or drink, or speak with anybody”. This tendency to seek solitude is worthy of note, as it reappeared in a very marked degree in his son, Friedrich. The father was short-sighted—as was Nietzsche—and, in 1848, this resulted in an accident, the consequences of which were disastrous: he tripped over an obstacle which his defective eyesight had prevented him from observing, and he suffered as a result from concussion of the brain. This shock to the nervous system initiated a train of symptoms—chiefly cerebral—which led to his death eleven months later. The fall may have been the cause of the attack; or, as another biographer says, perhaps “only hastened its approach.” The same writer informs us that Pastor Nietzsche “might have hoped for a fine career had he not suffered from headaches and nerves”. Frau Förster-Nietzsche, however, says that her father had not suffered from headaches prior to the accident. In view of Nietzsche's history, one feels inclined to agree with Halévy, more especially as, where any history of nervous or of mental symptoms of a morbid character are concerned, relatives are usually the last to admit them. Mügge says that Pastor Nietzsche “suffered either from concussion or softening of the brain…doubtless this accident hastened his death”. The youngest of the three children born to Nietzsche's parents, a boy, died just after his second birthday “from teething convulsions”. There was apparently nervous instability in the family; and Ireland says that O. Hansson “learned from a family who knew Friedrich Nietzsche from childhood that a disposition to insanity had been inherited for several generations, both on the father's and the mother's side”. This statement is not in accord with the details of family history as given by Frau Förster-Nietzsche; at the same time, it is, perhaps, no injustice to her to surmise that she was desirous of minimising the pathological aspect of the family heredity, and of laying greater stress upon the more favourable characteristics. When Nietzsche's life-history with its morbid mental vicissitudes is considered, however, it would be surprising if the family annals were found to be clear of all traces of nervous instability.

Mr. President and Gentlemen,—The subject that I propose to bring to your notice to-day—namely, the hereditary transmission of epilepsy—is one of extreme interest and importance at the present time in this country, where, owing to recent legislation, public attention has been strongly focussed on the question of transmitted defect. The results that I have obtained have been a matter of considerable surprise to me, and I am anxious to obtain the experiences of others in this matter.

The Inverness Lunacy District, which was formed after the passing of the Lunacy Act of 1857, comprises the four counties of Nairn, Inverness, Ross, and Sutherland, and is of very large extent. Its area is, roughly, one-third of the total area of Scotland, and includes the greater part of the Highlands. Its population, on the other hand, is extremely sparse, and has been steadily decreasing during the last fifty years. It is a district in which there has been much intermarriage of relatives, and which is less open and accessible than most of the rest of Scotland to the factors that have brought about such great changes in the general life of the country during the last fifty years. In recent years, however, the extension of railways, and the wide use of motor cars, have done much to diminish this degree of isolation and remoteness.

The relations between alcohol and criminality have been considered by many students of such subjects, and figures relating thereto have been worked out by more than one observer. But these figures have applied either to some large city, or to England and Wales as a whole. No statistics have been (so far as I know) compiled for such a county as Stafford. In this paper I have endeavoured to supply this omission, having had some opportunity of considering the question while serving as Medical Officer of H.M. Prison at Stafford. The county of Stafford is, in some respects, peculiar, inasmuch as the density of its population varies greatly in different districts, and its industries are very diverse. The extreme south of the county abuts on Birmingham, and considerable parts of the county area are now contained in “Greater Birmingham.” In the south and south-west of the county are the various towns and districts which make up the “Black Country.” Towards the north of the county lies the densely-populated area of the “Potteries.” Mining districts are scattered in various parts, and there are two boroughs with distinctive industries of their own—Stafford (boots and shoes), and Burton-on-Trent (the metropolis of beer). The remainder of the county consists of agricultural and grazing land.

The case I venture to bring under your notice has been a subject of much interest to me for some time past, chiefly because of its obscurity, and now, with a view to obtaining some information rather than throwing light on the subject, I will give you its main features.