Although the main value of hospital statistics is administrative, in connection with planning future needs of the mentally ill, they have been used by Shepherd (1957a), Brown et al. (1961), Barr et al. (1962), and Ratcliff (1964) to study trends in the characteristics and fate of patients admitted to mental hospitals. Since the factors that govern the admission of patients to psychiatric hospitals are both complex and varied, as has been shown by Svendsen (quoted by Reid, 1960), it would be more correct to say that the studies referred to describe the end-results of a number of factors interacting with each other and changing from time to time, such as hospital policy, demands of the mentally ill, available resources, therapeutic advances, attitudes of the community to admission, the state of the law, and so on. All these factors could be expected to influence the number and characteristics of patients admitted, especially for the first time.

Amnesic aphasia has a peculiar position within the aphasic disorders, and it has always been found difficult to bring it into any aphasic scheme. The nearest to it in Head's (1926) classification of symbolic disorder is his nominal aphasia. This, however, is actually a sensory aphasia, in which the difficulty in finding words prevails; it has lost all the characteristics of the classical amnesic speech disorder. Goldstein (1926), on the other hand, while stressing the existence of the amnesic aphasia as a definite and well-circumscribed type of disorder, denies that it has anything to do with a speech defect—an opinion up to then held. According to him, it is fundamentally a defect in the thinking process in which the patients have sunk to a lower and more concrete level of behaviour. They have, according to Goldstein (1926), lost the categorical meaning and use of words; they may be able to name an object in a concrete situation, but are unable to generalize, to use the word in its class meaning. Since then this question has been critically examined by several authors (Hauptmann (1931), Isserlin (1936), von Kuenburg (1930), Lotmar (1933), Scheller (1938)) in the light of Goldstein's conception. In their conclusions, repudiating Goldstein's opinion, they reaffirmed the classical view of a basic speech disorder in the amnesic aphasia.

All the forms of insanity we have hitherto been considering have been more or less connected with the sexual organs or sexual functions and conditions, with the exception of the first and last—the epileptic and phthisical insanity. The forms which follow are mostly connected with disease of the body, affecting the brain sympathetically, or disease of the brain acting on its functions directly.

That a uniform statistical method should be generally adopted by all those connected with the insane is greatly to be desired, for though statistical researches have met the fate of all other methods (‘Annales Psychologiques,’ July, 1856), have been received with un-reflecting infatuation, or been the subject of unmerited reproach, according as they have given us useful facts or have led us into error, yet everything leads us to expect that the extension of a statistical programme, would furnish us with useful data, for the examination of some of the most important questions relative to mental alienation.

Gentlemen,—Rarely has a survey of my labours in science, and as a teacher, afforded me so much gratification as on the present occasion. It has been my good fortune to bring about for the first time the introduction into the course of our medical studies, in this place, of a clinical course on Psychiatrie, thus claiming for this branch of medicine its true position as a proper and profitable subject of study, and as one demanding alike systematic and clinical instruction. And, in the first place, it behoves me to express my thanks to all those magistrates who have furthered, in the most intelligent and effective manner, my endeavours to establish this new clinical course. It is about a year since I first mooted the question of the institution of this clinique, and I had the gratification of seeing my ideas rightly understood, and favorably received. Moreover, in the course of the previous winter, the offer was made to me by the government, to undertake the professional direction of the lunatic asylum, an offer which I readily accepted, with a view to this plan for clinical instruction in mental maladies. Hence the speedy establishment of the course. For twenty years, indeed, I have publicly claimed for Psychiatrie its recognition as a regular portion of medical education. Whilst in many other places prevailing difficulties and scruples have defeated the project, we have here speedily found the means to commence this admittedly judicious and useful work, and thereby to secure a new and valuable addition to the educational advantages of our University.

In the numbers of the Journal for January and April, 1896, I described the recent action of the Berlin authorities in placing a considerable number of the insane poor under care in private dwellings, which illustrates one of the latest ways in which this mode of providing for the insane has been organised. Having in the year 1895 revisited for the third time the well-known colony of the insane at Gheel, in Belgium, and having once in 1895 and again in 1896 visited the recently established Belgian colony at Lierneux, I now propose to describe the present position of these two colonies, which exemplify the oldest systematised method of providing for the insane in private dwellings.

A granular condition of the ventricular ependyma has long been recognised as a pathological condition in various cases of insanity, and is so common in cases of general paralysis that we are surprised when it is not present. It is, however, by no means confined to that specific class of case, but exists in others, and, although not so frequent, is sufficiently common to make one inquire into its cause and as to its bearing, if any, on insanity.

In view of the impending meetings of the Fourth International Congress on the Care of the Insane, to be held in Berlin from October 3rd to 7th, 1910, it seems desirable that the members of the Medico-Psychological Association and other readers of the Journal of Mental Science should be able to have in print a record to the present date of the proceedings of the International Committee, which was originally appointed at the Congress held at Milan in 1906 with the object of studying the causes and prophylaxis of mental disease.