In his book on Psychological Principles the late Prof. James Ward defines “character” as “nothing but Nature modified by circumstance”, Apart, however, from the fact that much depends upon the meaning which we attach to the terms here employed, this generalization raises many questions which are worthy of consideration, and a discussion of its validity is not without interest.

Now that our Association, by a gracious act of our Sovereign, has been granted a Royal Charter—a signal recognition of its achievements and of the humane principles and aspirations of which it is an expression; a change, too, which is emblematic of the growth of its activities and influence—it is not inappropriate that I should address you on some aspects of the practice of psychiatry, especially in regard to possibilities and lines of progress in the future, and as to how the Association might better assist their materialization. The aspect I wish particularly to dwell upon is that which is the title of my address.

Camillo Golgi was born of humble parentage at Corteno (Valcamonica) on July 9, 1843, and died at Pavia on January 21, 1926. At 22 years of age he completed his medical studies in the University of Pavia, and subsequently acted as Assistant in various cliniques of the Faculty of Medicine there. He was most assiduous in his attendance at the Laboratory of Experimental Pathology, at that time under the direction of Bizzozero, the discoverer of the blood-plates. He had, for financial reasons, to leave Pavia for a time and take charge of a hospital for chronic patients, but he allowed no difficulties to discourage him, and, even in apparently uncongenial surroundings, carried on his researches. In 1873 he discovered the famous Black Reaction, which, in the practice of histology, has since borne the name of the “reaction of Golgi.”

By the death of Dr. Henry Rayner our Association has lost one of its oldest and most esteemed members, who had done great service to it and to the cause of the insane.

To believers in portents the circumstances surrounding the evolution of a great personality are ever of interest, and to such the birth of the promulgator of the myth of the unconscious mind must especially appeal, surrounded as it is by features of a truly extraordinary character.

My first duty is to express my thanks to the members of the Royal Medico-Psychological Association for the great honour they have conferred on me in asking me to deliver the Maudsley Lecture.

Of all the physical phenomena which interest philosophers and psychiatrists there are none more interesting than hallucinations. Psycho-sensory disorder is a complex aggregate in which the psyche in its entirety is mingled with organic disorders, an association which is still a mystery to us. The study of the affective states in the hallucinated is, therefore, of the highest importance, since it allows us to bring psychic and physiological disorders together in their reciprocal relations. “The hallucination,” says Hesnard, “which has always for the patient a personal affective significance more or less distinct, is only the symbolical translation, in comparison with a normal perception, of an interior positive psychic fact, of an affective productivity.”

Discussing experimental psychiatry Kraepelin observes that lack of comprehension of the experimental test, lack of ability to execute it, lack of interest, of co-operation, and of endurance, all conspire to increase the task of the experimenter and to modify the value of the results. The consequent demand for trustworthy experimental methods, which without too complicated technique and too unusual demands on the patient shall yield information of significant variations from the normal in quantitative terms, voices at once the need and the embarrassment of the experimental psychiatrist. The determination of the electrical conductivity of the skin is undoubtedly one valuable method of approach in this search after quantitative information, and this paper is the result of some months' investigation which I carried out at the Maudsley Hospital, when, through the kindness of the Medical Superintendent, Dr. E. Mapother, I had put at my disposal cases of psycho-neuroses and early psychoses.

In 1910 I was holding the appointment of Medical Officer and Magistrate at Anguilla in the St. Kits presidency of the Leeward Islands, British West Indies, when the Administrator one day handed me a cable, asking if I would accept the Medical Superintendency of the “CentralLunatic Asylum,” Tanjong Rambutan, Perak, Federated Malay States. Fortunately the cable explained that Tanjong Rambutan was in the Federated Malay States, as neither he nor I had the slightest idea where it was.

Many French psychiatrists have described a particular variety of visual hallucination to which M. Leroy has given the name “Lilliputian.“ They are found in many types of insanity and also have been known to occur in normal people. Their character does not vary in that the patient sees everything in miniature. Little men, little horses indeed little animals of all kinds, sometimes not any larger than one's finger, disport themselves under his gaze, all relatively proportioned, perfectly made little people who seem to him to belong to a world of their own, and to have stepped out of it into this big one of ours. There is a condition known as micropsia, in which the patient sees objects around him several sizes smaller than they are in reality, but this must not be confused—as easily it might—with true Lilliputian hallucinations. It might be put into the category of illusion, for there is a perception of an actual object, seen very much reduced in size, like the reflection in a convex mirror.

Wagner-Jauregg was led to adopt the treatment of general paralysis by malaria, following the preliminary observations he had made in 1887. He and many other investigators had noticed the tendency of paretics to improve after intercurrent affections, and he finally decided to use benign tertian malaria because he had satisfied himself that it could be controlled whenever desired. The publication of his results and those of Gerstmann, Weygandt, Kirschbaum, Delgado and others attracted considerable attention, and an increasing amount of literature on the subject is accumulating. Observations on this subject are being made in most European countries, in America and in this country. So far the treatment has been empirical; no one has been able to prove why infection with malaria should produce such striking results. Jahnel and Weichbrodt have shown the destructive influence of high temperature as such on the spirochætes, and it may be the case that the intermittent waves of high temperature may be more destructive to the spirochætes than a continuous temperature to which the organisms might have a better chance to adjust. Again it may be that spirochætes under these conditions would be more readily killed when arsenic is given. Muelilens and Kirschbaum hold the view that there is a great impoverishment of the blood following inoculation, and that the subsequent regeneration leads to a reactivation of the immunity process. In this connection it may be noted that some authorities, e.g., Brown and Pearce, believe that success in the treatment of neuro-syphilis by chemical preparations, e.g., tryparsamide, is due, not to the germicidal properties of the chemicals in question, but to the fact that these chemicals confer some form of protective reaction on the tissue cells which enables them to exercise a destructive effect on the spirochætes. Moore has pointed out that the relative infrequency of clinical neuro-syphilis in women as compared with men may be due to the incidence of pregnancy. It is known that pregnancy modifies the reaction to syphilitic infection, and it may be that the physiological process in pregnancy tends to prevent the disease.

The parallel between the phantasies and delusions of the individual and the myths and religious beliefs of the race is very close and extensive. In both cases we can trace the same “scotomata” to reality, the same logical inconsistency, and the same attempts to compensate for these defects (which of course are not acknowledged as such) by rationalization, by mystical interpretations, by appeals to blind faith, and by the denial of the capacity of human understanding to criticize or even to comprehend these “mysteries.”

This work was carried out mainly with financial assistance from the Medical Research Council, to whom the results have been com municated, and to whom our thanks are due.

Having regard to the paucity of information on the subject of the phosphorus and calcium-content of blood and cerebro-spinal fluid in the psychoses, and to the consideration that at this mental hospital a research laboratory in chemistry is available, it seemed desirable to investigate these matters.