As effects of excitement may be noted—(a) those which are transitory, occurring during the excitement, and (b) those which persist. As transitory effects there may be an apparently general hypermnesia, in which there is a marked freshening of all memories, or there may be a selective hypermnesia, where certain rather narrow lines of association are followed. The lasting effects may be hypermnesia, hypomnesia, or total amnesia for events experienced during the excitement. The following lasting effects may also be noted upon experiences that have occurred before the emotion: (1) The well-known retro-active amnesia; (2) The opposite, retro-active hypermnesia to which little attention has formerly been paid; (3) a combination of both these effects; for the same person the stretch preceding the critical event may show vivid recollections followed by a period of utter blank. The retro-active hypermnesia in the author's cases rarely goes beyond the events of the day preceding the excitement. It occurred in 25 out of 225 cases. The antecedent events are unusually vivid—more vivid than any other of the patients' memories. The vividness is not confined to visual images, although these are more frequent; sounds, the mood, the general state of the mind may be clearly represented. There is some indication that women experience it more frequently than men. In some cases the effect has come at some crisis at early childhood, in others at a later date. The quality of the emotion seems of less importance than the intensity of the shock. Fear, or fearless surprise, or pleasurable surprise may be the cause. If the intensity be exceeded the experiences connected with it are in some degree suppressed; while if it be not reached the experiences are lost probably by a mere failure to gather up the events into the mesh of interest. Emotion facilitates the recall of whatever is noticed during the excitement, and it seems probable that memory images may be treated by the emotional onrush in the same way as perceptive images. The experiences of the preceding day, however, probably do not exist as actual images at the time of the emotion but as psycho-physical dispositions or traces, so that where there is retro-active hypermnesia the emotion would seem to have the power to strengthen these dispositions and the connections by which they may be called into life. The author gives illustrative cases.

The author gives the results of his control measurements of sections from various cortical areas. He used a special block-holder, equipped with a scale, and rotatable, so that from one block of cortex seven or eight planes of section could be made, cutting the cortex at as many different angles. All the measurements were made at the apex of convolutions, where the axes of the majority of nerve-cells pass vertically into the white matter. The depth increments referable to obliquity are tabulated as percentages of the shortest measurement. He concludes that, using sections cut and mounted with extreme care to avoid undue obliquity, one may expect an error of something under 6 per cent., of which almost one half is due to difficulty in determining the line of demarcation between cortex and white matter. The fixing of this line is somewhat arbitrary, owing to the rather gradual and straggling manner in which the spindle-cells of the lowest cortical layer disappear as the white matter is reached.

Metropolitan Asylums Board.—The report for 1918 is very attenuated, and only a brief paragraph is devoted to each of the public services which come within the scope of the Board's many activities. Among these services not the least important is that which deals with the imbecile and feeble-minded.

A married woman, æt. 40, began to have difficulty in doing her work, complaining of headaches, which gradually became more severe. Her memory gradually failed for both recent and remote events. After about seven years walking became difficult, and finally she was bedridden, being unable to stand. A tremor of the hands developed, and it was necessary to feed, dress, and care for her. No syphilitic evidences; Wassermann negative in blood and spinal fluid. No sclerosis of peripheral arteries. Blood-pressure 160–80. Pupils irregular, the right dilated; reaction to light slow, to accommodation nil. Tactile appreciation slightly impaired; inability to localise readily for touch or space; wincing to pin-pricks. Knee-jerks exaggerated. Right ankle clonus. No Babinski. Marked tremor of hands, tongue and lips. Speech retarded and slurring. The clinical condition much resembled general paralysis, except for its protracted course and the negative Wassermann. Diagnosis, “cerebral tumour?” Died comatose at the age of 48.

This prolific writer here surveys the diverse opinions of authors respecting the significance of injury in the ætiology of general paralysis, since the first description of the disease by Bayle in 1822, and gives eighty-four references. He considers that injury can act neither as a determining nor as a predisposing cause, and that it is very doubtful whether it can act even as an occasioning cause. Injury can, of course, accelerate or aggravate a pre-existing general paralysis, but it is not certain that it can give rise to the disease, even in a syphilitic subject. On this point, scientifically, an attitude of the greatest reserve is necessary, but for medico-legal purposes it is often right that an injured person should have the benefit of the doubt. The writer sets forth the differential diagnosis between traumatic dementia (strictly so-called) and post-traumatic general paralysis. His account of the medico-legal aspects of the question is mainly of French interest.

The writers consider that many diagnostic mistakes were made in war psychoses owing to the tendency to crowd cases into one of the two great pigeon-holes, manic-depressive insanity or dementia præcox, and that in many instances little attempt was made to understand the cases as reactions in terms of personality, conflicts and wishes. Many cases showing symptoms of these psychoses occurred in unadaptable individuals and the disorder readily cleared up upon removal to hospital. Many illustrative cases are given which enable the writers to conclude that: (1) affective disorders were frequently mistaken for dementia præcox; (2) psychoses showing typical schizophrenic development had recognisable benign features; (3) acute confusional hallucinatory psychoses with fear were incorrectly diagnosed as dementia præcox; (4) acute paranoia was a relatively common psychosis; (5) the distinction between psychosis and psychoneurosis is untenable.