The prevention of the propagation of degenerates, more especially of the insane, is a matter of almost daily discussion among those interested in insanity, and it is also discussed and as a rule advocated in medical journals, asylum medical superintendents' reports, and even in the daily press.

If there is one fact which stands out more plainly than any other when one considers the life and work of Emanuel Swedenborg it is this—that whatever value may be attached to the writings of the later or visionary period of his life, there is no doubt they have served to obscure his eminence as a clear-sighted scientific investigator during the earlier part of his existence. That this is so can hardly be denied even by the most enthusiastic Swedenborgian, for if the average person be asked what associations the name of Swedenborg conjures up, he will at once reply that he was a man who saw visions and dreamed dreams, who said that he saw the heavens opened unto him, and who wrote an account of the same in a work entitled Heaven and Hell. A further effort of association will perchance link his name with those of Jacob Boehme, of St. Theresa, of Mahomet, and of others who have exhibited similar symptoms; but, except in rare instances, any conception of his scientific attainments even in the most meagre degree is almost non-existent. He is passed over practically without comment by most of the historians of philosophy or of psychology; and his fate has for the most part been to suffer from the uncritical eulogies of enthusiastic disciples, or from the criticism of those whose knowledge of him is limited to the later period of his life with which his mystical writings are associated. In both cases he has suffered—and the term is used advisedly even in the first instance—because scientific men have been repelled from studying one whom they have conceived as immersed in the business of describing visions of the hereafter and consequently as hardly being likely to have given much time to the concrete realities with which science should deal. Most of the discussions as to Swedenborg's place in the history of thought have centred round the later period of his life; and the mental trouble which came upon him in the midst of his scientific activities and altered the whole course of his intellectual career, sore affliction as it was during his lifetime, has not yet ceased to cling to his name, and to militate against his recognition as one of the clearest thinkers of his time, or indeed of any time. Rational psychology owes a great debt to him; like many debts it has remained long unpaid. This, too, whilst many an inferior thinker has had his wares cried in the market-place, making of real obscurity an appearance of profoundity. It is not proposed herein to deal with Swedenborg in a more comprehensive way than as a psychologist; to do more would necessitate such an acquaintance with science and with technology as but few possess. For it was Swedenborg who “introduced the calculus into Sweden. … He began the science of crystallography. He reasoned out before Franklin the identity of lightning and electricity. He anticipated Laplace in the discovery that planets and planetary motion are derived from the sun. He discovered the animation of the brain. The law of the conservation of energy seems to have been anticipated in his doctrine of action and reaction equal and necessary to life.” So says a writer in a recent authoritative work (1); and even if the claims be debatable, it is obvious than any discussion of them would but serve to obscure our more immediate purpose, which is to deal with Swedenborg as an exponent of psychology.

The important part played by heredity in the causation of insanity has long been recognised. Much has been written on the subject and investigations have frequently been made to show its influence. Owing to the complexity, variability and general indefinite character of insanity these inquiries have been mainly statistical. It is recognised that no form of insanity is of such definite and simple nature as to be readily available for study in its hereditary aspect by Mendelian methods. As has been repeatedly stated by various writers on the subject, it is not insanity, recognisable as such, that is inherited, but an abnormal nervous system liable to the development of the various conditions included in the term “insanity.”

In Dr. Turner's paper on the classification of insanity in the January number of the Journal occurs this passage: “It is from cases of this class” (epileptic insanity, psychasthenia, morbid obsessions, and impulse) “that subtle dialecticians seek to prove there may be disorder of conduct without disorder of mind.” As I am the only person who has ever made any distinction between disorder of conduct and disorder of mind, or has ever said that the one may be disordered without disorder of the other, it is manifest that I am the subtle dialecticians referred to by Dr. Turner, and I must express to him my obligation for justifying me in the future use of the royal We. We must point out to him, however, that after the manner and habit of members of this Association, he attributes to Us views that We have never expressed and never held. We have, indeed, taught for many years, and iterated and reiterated, that disorder of mind may exist without disorder of conduct, and this view is again expressed in Our paper published in this Journal in October, 1910, but We have never expressed the opinion, subtle dialecticians though We may be, that disorder of conduct ever exists apart from disorder of mind. Perhaps Dr. Turner will be so good another time as to verify his references.

In bringing forward some evidence which would point to the biological course followed by some forms of nervous disease to be considered, I would first of all accept as a working hypothesis two generalisations which apply to all forms of disease. The first of these generalisations is that there is essentially no difference in kind between a physiological and a pathological process. The distinction is an arbitrary one; the course of disease is distinguished from that of health only in so far as it tends to compromise the continuation of a more or less perfect adaptation between the organism and its surroundings. There is no tendency in Nature either to kill or to cure; she is absolutely impartial as to the result of a conflict between organisms and a host; and it is a matter of complete indifference to her as to whether toxins are eliminated or not. In the same way diseases of the mind are the manifestation of a perfectly natural relation of the organism, such as it is, to the environment. If the mental processes are abnormal, it goes without saying that the brain must be acting abnormally whether the stimuli to abnormal action originate in the brain itself or in some other part of the body. For example, if a child with pneumonia be suffering from delirium and hallucinations, as is not infrequently the case, this must be considered a perfectly natural outcome of the relation of the brain to its environmental stimuli outside and inside the organism. The actual stimuli may originate in the intestine from masses of undigested food and the stimuli may play on the brain rendered hypersensitive by the toxins from the lungs; the process and its manifestations, as well as the final outcome, are matters in which nature plays an impartial part. It cannot be admitted that there is any form of nervous disease which does not come under this generalisation. It has been argued by some authorities that because insidious forms of insanity are marked only by the slightest variation from the normal course of mental life, and that because the mental abnormalities are only modifications, and often easily explainable modifications, of normal mental processes, that the so-called insanity originates in these processes, and not in the material substratum of the organism. The fallacy of such an interpretation is obvious; it is tantamount to saying that slight albuminuria is the cause underlying early disease of the kidneys, or that a slight ódema may have something to do with the origin of circulatory disease. It is only natural that in the milder forms of mental disease the abnormal manifestations of brain activity should resemble normal mental processes; and even in the most advanced forms of mental disease there must be a close resemblance between abnormal ideation and conduct and perfectly normal ideation and behaviour. Even in advanced cases of Bright's disease the urinary elimination is more normal than abnormal; the abnormal constituents do not differ so much in kind as in degree from those of urine from healthy kidneys. It is not to be expected that in kidney disease bile or some other substance foreign to the organ would be the chief constituent of the eliminated fluid. The signs of insanity in any given case are the natural products of normal brain action mingled with the products of abnormal action. This does not, of course, preclude the possibility that under certain circumstances these abnormal products, such as delusions, hallucinations and perverted conduct, may not themselves be the direct stimuli to further abnormalities. The suicidal character of pathological processes is well seen in other organs of the body. A diseased heart, for example, is its own worst enemy; it not only fails to supply sufficient nutrition to the rest of the organism, but it starves itself by its inability to contract and expand properly, thereby increasing its own weakness. In the same way, certain phenomena of abnormal brain processes are in all probability due to the recoil on the brain of its own abnormal products in the matter of ideation and conduct.

The investigations recorded in the following paper were undertaken to determine the reason for the discrepancy in the results when applying the Wassermann reaction to the cerebro-spinal fluid and blood-serum of general paralytics. The experiments have yielded results significant in other directions which are of some interest.

The question of how far insanity can be pleaded in extenuation of, or as an explanation for, the committal of an indictable offence is one that possesses for me unusual interest.

The following case presents some important features from a diagnostic point of view, owing to its unusual onset and course, and the relative absence of initial symptoms indicative of the actual character of the psychosis.

We are apt to consider that, as the object of medical examination of school-children is the improvement of the national physique, such an object is already brought much nearer by the adoption of medical inspection. That it can only be reached through the individual and that these individuals are not responsible for their condition is apt to be overlooked, as is also the necessity for educating that part of the population responsible for the children in the various factors concerned in deterioration. At present the majority of children have parents uninterested in the means adopted in their education—they are at school, ergo, they will be educated; they have a physical instructor, a hygiene teacher, and now a school doctor, ergo, they will be made healthy or kept healthy.