The enormous increase in the number of registered lunatics and the correspondingly heavy burden cast on the taxpayers has at length caught on to the attention of the general public. This desirable end has been attained, not so much by the efforts of responsible officials as through the irresponsible editors who cater for the sensationalism which the satiety of modern life so eagerly demands for its renewed gratification. Blue books are peculiarly unattractive and inaccessible to the man in the street, who, however, finds the highly-flavoured information always at hand in the columns of the daily press much more to his taste. Yet his opinion, which, after all, when sound constitutes that most valuable national asset, healthy “public opinion,” is formed on the information so palatably administered and so readily absorbed. From this we learn that the seeds of knowledge carefully saved in special cultivated fields of labour are scattered broadcast in loose and general terms. That they fructify, however, is certain, and it then behoves us to cultivate the harvest of opinion in order that we may turn it to good account in the public weal. We must, however, weed out all accidental stuff, and take care that the golden grain alone is digested by the public. Now, if this new knowledge of the incubus of insanity is to be turned to any good account it would seem that while it still germinates it should be most carefully handled by those best qualified to deal with its useful application: a consensus of skilled professional opinion on a purely professional matter should, if possible, be formulated and submitted to those whose duty it is avowedly to safeguard the national public health. In this consideration the first point which naturally arises is whether or not the prophylaxis of lunacy comes within the purview and scope of practical politics. Such a consideration fortunately admits of little debate, for while one hesitates to place full belief in the specific cure of ills by means of Acts of Parliament, yet it must be thankfully admitted that, in every case where the State interfered in the interest of the public health, much has been done for the arrest of bodily ailments; the insidious rot of chronic disease has been checked, and the violent invasions of epidemic plagues have been circumscribed in area, reduced in intensity, and rendered less harmful in their results. A great practical national benefit has resulted in every instance. But so far as lunacy is concerned, the function of the State has been chiefly confined hitherto to the preservation of the unfit; little has been attempted to stem their increase. The fact is that the problem of dealing with insanity is so vast, so complex, so far-reaching, in all its relations to social and economic life that it is to be feared that no Government, even one with such a heterogeneous majority as that now in power, would tackle it as a matter of choice, and yet the inevitable cannot be always shirked. The enemy is closing in, and, to those who can estimate the extent of the decay of the mental stability of the country, the time is not far distant when the passive tactics of the present defence against lunacy must be changed to a more active crusade. We must not be content to retreat into asylum fortresses-we must shell the enemy in position and shell the position to prevent occupation by the enemy; we must not be content to contend with the cases of occurring insanity, but we must safeguard the coming generations against further disastrous and increasing casualties. We must fight, not only the existing insanity of our own time, but we must safeguard the interests of posterity by legislating for the protection of those who have to carry on the evergrowing “white man's burden.”

In any department of knowledge worthy of the name of science I think it will be admitted that one of the most important elements is terminology. The accurate (and adequate) expression of facts by appropriate words is a prime essential in the advancement of knowledge; the absence or imperfection of such is one of the greatest hindrances to progress. And perhaps no more forcible example of this can be adduced than the case of psychiatry, that sphere of knowledge in which all who are members of this Association are supposed to be more or less expert students. I doubt if any branch of science has suffered more than our own from the disability of an imperfect terminology, a point which it is hardly necessary to argue. I may, however, by way of illustration remind you of the numerous schemes of classification of insanity which have from time to time appeared, a matter with respect to which every writer on the subject seems to have done that which was right in his own eyes. But what would be thought of any science—say botany, chemistry, or zoology—if a new system of classification, and even new terms for genera and species, were to be brought out with the same frequency, or anything like the same frequency, as in the case of insanity? Can anything be more bewildering to anyone commencing the study of insanity than to take up book after book and find each writer adopting a different classification, and grouping cases under one heading or category which the next authority he takes up places under another and quite different one? Surely there ought to be, in the first place, agreement amongst authorities as to the meanings of terms, and in the next place at least some permanent basis of classification which all can accept, capable, no doubt, of expansion and modification with the advance of knowledge, but not liable to continual changes, not to say upheavals, in its fundamental structure.

Among the characteristics which we agree with Kraepelin in regarding as the essential mental features of the personality, varying degrees of capacity for acquiring skill by practice and of liability to fatigue are by far the most important. The effects of practice and fatigue on the course of mental work are such as absolutely to determine the amount that can be done and the mental capacity for work. They differ, however, in their relation to the amount of work done, not only in the antagonistic direction of their effects, but also in other features which clearly show their kinship with the corresponding pheno mena on the physiological side. While the effect of practice hardly ever extends beyond the sphere of the work that has been practised, and acts on other functions, even of a simular nature, only in a limited degree, fatigue has a far more exten sive effect and reduces the general mental capacity for work. There is much in the common experience of daily life which seems to contradict this statement. Thus, change of work seems to have a favourable influence on our working capacity when we are fatigued. This appearance has led even eminent physiologists to assume that fatigue acts within the same narrow limits as practice. Thus, Mosso says, in his book on Fatigue, “Apparently fatigue is localised in a particular region of the brain, for we often see that people who have become incapable of thinking over a certain subject, or considering a particular piece of business, find relief in thinking about some thing else, or free themselves from the sense of dulness in their heads by fixing their attention intently on other and different things-for instance, on a game of chess.” Richter, too, ascribes a restorative effect to change of work in education, and thinks that he has thus discovered why school children do not show more fatigue.

Since October, 1902, there has been in operation at the Metropolitan Asylum, Leavesden, a system of promotion for nurses and attendants.

Two papers have recently appeared in the Journal indicating a causal relationship between indoxyluria, alimentary toxæmia, and melancholia. One paper, published by Arthur A. D. Townsend in January, 1905 (Journal of Mental Science, 1905, p. 51), is entitled “Mental Depression and Melancholia, considered in regard to Auto-intoxication, with Special Reference to the Presence of Indoxyl in the Urine and its Clinical Significance”; the other paper, published by Lewis C. Bruce in July, 1906 (Journal of Mental Science, 1906, p. 501), bears the title “The Clinical Significance of Indoxyl in the Urine.”

The following cases of gross cerebral lesion occurred in epileptic idiots:

CASE 1.—S. J— was admitted to Leavesden Asylum in December, 1897, ret. 17. He was then noted to be a confirmed epileptic idiot. He died in March, 1904, of ulcerative colitis. During his residence there he had frequent severe fits.

The term “dysentery” includes many diseases which, though clinically and pathologically similar, are widely different in their etiological and epidemiological characters.

The David Lewis Colony is one of the latest results of the sympathy for the epileptic spread, if not originated, by Pastor von Bodelschwingh, of Bielefeld.

It is the prevalent opinion that phthisis is the scourge of our English lunatic asylums, and that these institutions are, literally speaking, hotbeds for the growth and distribution of the tubercle bacillus. In the Irish asylums, where the death-rate from phthisis alone amounts to nearly 30 per cent. of all causes of death, there seems to be just grounds for this belief. In the English asylums, however, the mortality is much lower, and is but little, if any, greater than that amongst the general population. This can be verified by examination of the Registrar-General's Report, from which it appears that phthisis accounts approximately for one in twelve of all deaths. These figures probably represent less than the true proportion of deaths from phthisis, since post-mortem examinations in the majority of cases are not made, and thus, doubtless, many cases of pulmonary tuberculosis are overlooked.

The new Lord Chancellor does not seem to be able to increase the Lunacy Commission, although apparently the need for an increase in its strength is becoming daily more apparent, and is acknowledged on all sides.

The few remarks which I have to make in dealing with the subject of this paper are only fragmentary, and are intended merely to direct your attention to the subject, and to elicit a resolution embodying your views which can be sent on to the authorities responsible for the government of Ireland.

The disability of Medico-Psychologists connected with private asylums, from being appointed as Lunacy Commis sioners within a year of such connection, is in a fair way to be abolished. This is due to the initiative of Dr. Mercier, resulting in a deputation to the Lord Chancellor, consisting of Dr. Mercier and other members of this Association, whose repre sentations were very favourably received.

This system of care rests on the solid foundation of a principle of human nature—the mothering instinct in women. This is not restricted in its operation to a woman's own offspring, but extends in a certain degree to all children as well, and often manifests itself in the most striking manner in those women who have no children of their own. Nor is it reserved for the helplessness of childhood alone, but it includes within the scope of its action the weakness of the sick person and the infirmity of the aged. As a consequence of this, a liking exists on the part of most women for sick-nursing, which in some amounts to an instinctive craving which must be gratified, and almost all for the same reason possess a natural aptitude in picking up the practical details of nursing and care which amounts in not a few to a species of genius. If we exclude the care of insane men from our view, it can be said that wherever we have weakness and suffering and the need of personal care, there women find an opportunity for the exercise of what is a natural vocation, there we find them acting as “ministering angels.”

This new addition to the periodical literature on abnormal psychology, made its first appearance on April ist last, and is to be published bi-monthly. The Editor-in-Chief is Dr. Morton Prince, Professor of Nervous Diseases, assisted by Dr. Hugo Münsterberg, of Harvard, Dr. C. L. Dana, of Cornell, Dr. I. I. Putnam, of Boston, and Dr. Adolf Meyer.