The work mentioned hereunder was commenced with a view to investigating the alterations in the sugar content of the blood and urine which have been observed in the insane, and to consider whether they are necessarily pathological, or whether they are merely normal sympathetic reactions to an abnormal extra-sympathetic stimulus.

The history of general paralysis records undoubted cases where the disease has for some reason or other seemed for a time actually cured so that the patients could return to work. Although such cases after a short time showed relapse whereby the disease then followed its usual course, this fact is sufficient to indicate the possi bility of stopping the progressive paralysis in some way.

In spite of the great amount of attention that has been devoted to that protean condition termed “dementia præcox,” it is not yet possible to say that any sort of agreement has been attained regarding its aetiology, pathology, or even its distinctiveness as a clinical entity. Opinion has wavered between the two extremes of the psychogenic and the physiogenic views, and extravagant speculation has risen from a limited foundation of fact. It is interesting to note Freud's (1) remarks in his recently published Introductory Lectures on Psycho-analysis, in which he says—“The edifice of psycho-analytic doctrine which we have erected is in reality but a superstructure which will have to be set on its organic foundation at some time or other.” A pronouncement of such a kind and from such a source gives one furiously to think, and invites a thorough scrutiny of our present position with regard to the problem of dementia praecox. The biological conception of mental disorders is capable of wide application, and has the additional advantage of linking psychiatry with other better established sciences. Already the study of reaction types has proved most helpful in explaining much that was hitherto obscure. Also, in the field of pathology, although it is too soon to judge of the exact significance of Sir F. Mott's (2) work on the changes found in the gonads of cases of dementia praecox and other psychoses, it is nevertheless quite clear that the conception of an inborn germinal defect has opened a new vista for research. Endocrinology, that somewhat precocious offspring of medicine, has not been neglected by psychiatrists. Langdon Brown (3) made a most helpful simile when he compared the vital process to a projectile travelling with a constantly diminishing velocity, but supplied with certain regulators capable of exerting a considerable measure of control upon this velocity. These regulators are the endocrine glands and the autonomic nervous system. He supposes that a deficient equipment of endocrines, especially the gonads, may explain the infantile outlook of the dementia praecox patient, as well as such abnormalities in bodily structure as the atavistic, monkey-like hands. He quotes Stragnell as saying, “No endocrine inferiority can be present without a psychological change, a retreat or a compensation.” It will be remembered that Adler considered that the symptoms of dementia praecox were largely the results of a sort of consciousness of organ inferiority, and that they are really methods or attempts at compensation, though ineffective, vain and misdirected. Centuries ago Lucretius (4) pointed out that the “mind is begotten with the body, grows up together with it, and becomes old along with it.” “The psyche,” says Kempf (5), “is not something which has been added in the course of evolution, its history is that of the history of the body.”

As students of psychiatry we must remember that the human being is merely a biological unit always to be studied and considered by the quality of its reaction to the environmental impositions made upon it by the social body to which it belongs.

The case I am about to describe seems of sufficient importance to bring to your notice, as it presents many points of interest.

In this lecture it is my intention to illustrate the usefulness of the psychological conception of psychical disturbances by saying some thing about the psychology of epilepsy.

This infection, which is mostly met with in those past middle age, the neurotic, and especially in those with intestinal atony, is particularly prevalent in mental hospitals and causes a high mortality. Although many so-called cases of colitis occurring in these institutions were in reality bacillary dysentery of the Flexner, Shiga and allied types, particularly so in former years, when sanitation was more defective, yet the relation of the normal colon bacilli, as causative organisms, to this disease must not be overlooked, and with a view to studying this relationship a short account of the B. coli will here be given.

Symbiosis is systematic biological co-operation, and, whether we view it in a narrow, morphological, or in a wider yet more definite socio-physiological sense, it is a phenomenon of first-rate importance, deserving widest attention. Botany, zoology, physiology, pathology, agriculture, sociology are all vitally concerned in symbiosis.

In dealing with the surface tension peculiarities of the anxiety states I will only dwell very shortly on the physical aspects of the problem. If two bodies are brought into proximity, then each body attracts the other with a force which was shown by Mitchell and Cavendish to be identical with the force of gravity.

In the treatment of epilepsy numerous drugs have been acclaimed from time to time by different observers as sovereign remedies, and with few exceptions each in its turn has been discarded as of little or no value. Borax (sodium biborate) has been advocated repeatedly, and results reported by some have been remarkably satisfactory, while others have not found it worth while to persist in its use. Can these wide divergencies of opinion be explained? It would seem that as regards borax an explanation can be found from an analysis of the following results.

A. B. C., æt. 62, widow, was admitted to the Sunderland Mental Hospital on October 10, 1922, suffering from confusional insanity.

Lead poisoning as a factor in the aetiology of insanity has of late years become rare as a result of improved hygienic conditions among workers.

This case was tried at the Central Criminal Court, before Mr. Justice Roche, on October 13th. The prisoner pleaded guilty to a charge of assaulting a Mrs. Bles, with intent to do grievous bodily harm. The facts were that Mrs. Bles was walking in Hyde Park, on September 18th, when the prisoner, who was a stranger, suddenly attacked her, and wounded her with a knife. A police constable pursued and overtook the prisoner, who turned upon him and inflicted three wounds. Mrs. Bles was carrying a bag containing 4, and this had disappeared, but whether the prisoner had taken it was uncertain. This point is of importance, in view of the plea of epilepsy which was set up. For, apart from robbery, there was no apparent motive for the crime.

The report of the Committee appointed in December, 1921, by the Minister of Health “to investigate and report on the charges made by Dr. Lomax in his book (The Experiences of an Asylum Doctor) and to make recommendations as to any medical or administrative improvements, etc.,” was published in August of this year. It is a document of considerable interest and has been widely read and discussed, especially by governing bodies of the public mental hospitals.