Prof. Robertson died, after a somewhat prolonged illness, at his residence, Tipperlinn House, Morningside, Edinburgh, on March 28 of this year. As a boy he had contracted rheumatic fever, which left behind it a valvular lesion of the heart, and his last illness appears to have been complicated by this cardiac condition.

The literature on the subject of biochemical research in the psychoses is a vast one, and most of the problems met with in the study of mental diseases are still to be solved. It is evident, however, that these problems must be tackled from the physiogenic as well as from the psychogenic point of view; and it was with the object of examining the patient as thoroughly as possible from the physical standpoint that these investigations were carried out.

An account of the life and work of Dr. Bedford Pierce may suitably begin with some remarks which appear in his book, Addresses to Mental Nurses. In the course of a preface to his Lecture on “Character and Outlook” he says:

James Greig Soutar was a man whose value to his day and generation and real eminence in his profession can in no way be estimated from his conspicuousness outside the area where his work lay and the circle of those who were fortunate enough to know him well. He passed away as quietly as he lived, having characteristically continued in harness as long as it was humanly possible.

The subject of this thesis is the outcome of what might be termed a hereditary interest in the complex problem of the relationship of chronic infections to the psychoses and allied mental disorders. Circumstances enabled me, while still a student, to undertake very humbly the continuation of my father's researches in the Scottish Asylums' Laboratory at a point where his illness and death might have proved the closing of a long and arduous chapter. That this would have been so is, as far as I know, borne out by the fact that up to the present no work directly bearing on his later bacteriological studies has been published. The researches I have undertaken during the past six years have been an attempt to elucidate more clearly what exactly are the bacteriological factors at work, and, further, in what manner they attack the economy generally, and with what result. In my endeavour to verify and extend Ford-Robertson's views I have been singularly fortunate.

Sir David Drummond, who had been an Honorary Member of the Association since 1925, died on April 28 last. He was born in 1852, and graduated M.B., M.Ch. at Trinity College, Dublin, in 1874; he took his M.D. in 1876. He spent the greater part of his life in Newcastle-on-Tyne, and at the Royal Infirmary of that city he was elected Pathologist and Assistant Physician in 1878. Later he became Physician, and on his retirement in 1912 he was made Consulting Physician. His name was a household word in the greater part of Northumberland and Durham, in which counties he had a very large consulting practice in general medicine, always paying more attention to organic nervous disorders and to conditions arising as a sequel to syphilis. Although he never worked in a mental hospital, he was always drawn towards abnormal mental states, more especially if there was some organic basis for the mental breakdown.

McCowan and Quastel (5) have shown, in recent work carried out in this hospital, that a close relationship exists between variations in the affective state of psychotic subjects and abnormalities in the glucose tolerance curves. So marked is the parallelism between these two that it has been found possible to make use of an index, known as the hyperglycæmic index (H.I.), which furnishes a valuable guide to the degree of emotional tension experienced by the subject. The method of determining the index is fully described in their paper; but it may be briefly stated that it is zero when the glucose tolerance curve is normal, and varies up to 100, depending upon the degree of sustained hyperglycæmia present. The affectivity of the patient was determined clinically, and, in order to test the validity of their thesis that the emotional tension and H.I. varied pari passu, it was considered that objective evidence of the patient's affectivity would be of value.

The object of this contribution is to draw attention to a hitherto imperfectly recognized type of septic infection, which has provided new fields of research, and has shown the way to a fuller appreciation of the ütiological relationship of sepsis and mental disorder.

My first duty is to thank you most sincerely for the great honour you have done me in electing me to the Presidential Chair of this great Association, which, in its ninety years of existence, has numbered among its Presidents so many illustrious pioneers of progress in the world of psychiatry. Fully conscious of my limita tions, .1 deeply appreciate the honour, and will endeavour, during my term of office, to fulfil to the best of my ability the responsible duties laid upon me.

The diagnosis of syphilis, and especially of latent syphilis, has become a matter of increasing importance in mental hospital practice. The great difficulty hitherto experienced has been in connection with the adoption of some routine laboratory test. As long as the Wassermann was the only serological test available, many institutions were confronted with the task of undertaking a test that was too complex and difficult for all but the best equipped laboratories. This is now so well recognized that it has been very definitely recommended that no hospital should carry out the Wassermann reaction unless it has a well-trained laboratory staff headed by an experienced pathologist, and that even then results should not be relied upon unless the number of tests done each week is sufficient to ensure a continuity of technical practice (82, 83, 107). Furthermore, it has been felt that the Wassermann, good though it may be, is yet liable to error, especially in treated cases (45, 72). A search has therefore been instituted for tests that would be simpler, quicker, and, if possible, more sensitive than the Wassermann. As a result a number of flocculation tests have been devised, and these have been extensively tried by syphilologists and others (1, 5, 20, 23, 62, 88, 97, 99, 102, 114, 134). More recently, these flocculation tests have slowly found their way into mental hospitals, and whereas in the Board of Control Report for 1925 no mention is made of any of these tests, in 1930 no less than six of them were reported upon, one of them apparently having been used in five different hospitals (15, 16, 20, 21, 25, 30, 31, 34-36, 40, 42, 43, 48, 49, 100, 112, 113, 132, 133).

Pick's disease and Alzheimer's disease are well-defined, if rare, groups of cases which have been differentiated from the main bulk of the dementing psychoses occurring at and around the presenile period. Although these two sub-groups have much in common on the clinical side, their histopathological features are so strikingly different that many authorities consider them to be separate disease-entities.

In the tenth Maudsley Lecture a plan was put forward by Prof. Spearman for conducting a large-scale research in psychiatry. The proposal was that many mental hospitals might co-operate in a joint experiment. Psychiatrists would give their psychiatrical and physiological accounts of selected patients; and psychologists would apply specially prepared clinical mental tests to these same patients. The mass material from many hospitals was to be collocated in order to see, as Prof. Spearman says, “what goes with what, and what follows what.”

Studies on the leucocytes in various forms of mental disorder have appeared at various times in the literature, and will continue to do so, as long as newer methods of staining, etc., are introduced.

In discussing this subject, “The Place of Psychiatry in Medical Education,” one needs to consider various aspects of a wide field. First there is the education of the student in the medical school in both the pre-clinical and clinical years. Next we have to deal with post-graduate education, including the value of the mental hospitals, the psychiatric clinics, and the general hospitals, etc., in this regard. Then we have to consider the education that leads to research in our field—such research, for instance, as the relation ship of the endocrine glands to the nervous system, the field of bio-chemistry, the matter of heredity and of eugenics. There is also the subject of “menta hlygiene” —a that is rather loosely applied, but should include the educational aspect of psychiatry. Lastly, there is the preventive aspect of the subject.

The mouth and throat being normally and inevitably septic regions, it is useless to regard the mere presence of septic organisms and saprophytes as indicative of disease, though the finding of certain abnormal pathogenic organisms in smears and cultures, such as the Klebs-Loeffler bacillus, cannot be disregarded.

The theory of hæmoclasia, which was first propounded by Widal, rests on the assumption that, during the digestion of proteins, a leucocytosis normally occurs in the blood. When the liver is diseased, proteose substances find their way into the systemic circulation, and produce a series of manifestations characterized by lowering of the blood-pressure, hypercoagulability, leucopenia, decreased refractive index of the blood and fewer blood-platelets. From this discovery a clinical test was evolved, which was at one time believed to be of considerable assistance in estimating the functional efficiency of the liver. In the performance of this test the number of white blood-corpuscles in the circulation is alone taken as a criterion of the presence or absence of hæmoclasia, the other phenomena, e.g., raised blood-pressure, hypercoagulability, etc., not being usually investigated. A white blood-count is performed on a fasting patient, who is then given 200 grm. of milk. Further leucocytic estimations are thereafter made at intervals of twenty and forty minutes, and if a leucocytosis fails to appear, or a leucopenia occurs, the patient is said to exhibit an hæmoclastic crisis.

The physicist, in his endeavour to explain natural phenomena, has, in the course of his investigations and observations, discovered certain laws which appear to be constant and applicable to the phenomena in question. On the basis of those laws he has evolved theories which provide him with an intelligible appreciation of the mechanism involved. The law embraces and synthetizes a large number of observations, but it also serves as a point of departure for new observations. Whilst the law may be constant, the theories may undergo modification, as new facts come to light, as has occurred, for example, in the case of the atomic theory. Amongst physicists there is, however, a readiness to consider new discoveries, to put them to the test, and, if they are found to be in harmony with determined laws, to incorporate them in the theoretical scheme.

In view of the present situation in India, it seems advisable to place on record a short general review of the position of psychiatry there, and of the difficulties that have delayed improvement during the twenty years of my own experience. Having joined the Department in 1906, and having served in it since then, as Medical Superintendent, in succession, of the Punjab Asylum, Lahore, the Burma Asylum, Rangoon, and the Central Hospital for Mental Diseases, Yeravda, Poona (the last since 1912), I feel qualified to criticize it now. From 1912 until my retirement in 1926 I was the Senior Officer of the Department. By the term “Alienist Department of India” I refer to the system of asylums and mental hospitals “established” or “licensed” by the Provincial Governments for the treatment of mental disorders under the Indian Lunacy Act of 1912, and to the small group of specialists who have managed them, both before and since the coming of that Act into force. Only those institutions “established” by Government need be considered, because, as far as I am aware, no private “licensed” hospitals exist. This fact alone indicates the degree of interest that the more educated Indians take in the treatment of mental disease. The Parsis, however, have, in my experience, done a good deal to ameliorate the condition of the insane in Bombay, but this race is a small one, numbering only some 101,000.