I have long felt that the relationship of Dr. Jackson's teaching in reference to nervous disorders has not been sufficiently considered from the psychiatric side. I fear that I shall not be able to do justice to the subject, yet I believe it to be almost a duty for me to attempt it.

In insanity hallucinations are frequently present. This is no recent observation and has been duly noted in the literature since the dawn of medicine. Hippocrates, Asclepiades, and Celsus make mention of them in their writings.

It is an acknowledged fact that in the whole annals of mankind the most eventful period of a nation's psychology is that during which its people is passing through the crisis of war, and the history of nations, from the earliest dawn of society, presents continuous records of warlike operations. The present war, which has already lasted over two and a half years and which is without any immediate prospect of cessation, has disturbed the mind and altered the course of life of whole continents; yet all of us are agreed that it should never be possible for this “malady of princes” to occur again, and it is with the view of preventing its recurrence that civilisation (which means the united culture of all the Allies as well as of the “benevolent” neutrals) is now making a final and intense effort.

Confusion is a hallmark of the effects of toxin upon the cerebrum. When very slight, special tests are required to elicit it. Interference with neuronal conductivity is the chief pathogenetic factor. The topical incidence of this is one of the determinants of the form taken by the psychosis, whether hallucinatory, disorientative, depressive, delusional, or what not. Another factor is the state of the body secretions as affected by the toxins; a third factor is the patient's psychological status, as determined by the capacity and the opportunity for experience.

There is nothing new in the symptoms comprising the syndromes—generically dubbed “shell-shock”—arising from the circumstances of battle. But to those of us who have had large numbers of these cases passing through our hands, new ideas have been suggested, or the confirmation of old theories brought home.