Reviews, abstracts, and papers concerning this subject having appeared from time to time in the Journal of Mental Science, I shall, with the exception of making a few incidental explanatory quotations, confine myself to an account, more or less brief, of some of my own cases and to the remarks suggested by them.

In the absence of all medical testimony, opinion respecting the man's mental condition during the period in question must be based upon the ordinary evidence brought forward at the inquest. And it so happens that, notwithstanding the remarkable finding of the jury, the conclusion at which most people would arrive, after perusing the evidence and the in coherent statement found in the handwriting of the deceased, insonsi-mprpolfeesseionnoaulgh, opiannidon.quitTehuws, iththine “the DeailsycoTpeeleogfrapohrd,” inaryin reference to the case, relates the circumstances and the evi dence, and then says : “After all this, it is impossible to avoid the conclusion that the assailant of Mr. Hamburger was not altogether responsible for his actions. We may even go further, and say, although the jury were of the opinion tmhiantd, thethreat wtahse nodeceevaisdeedncewatos sdheocwidedwlyhat inwsaanse” his wshtaetne hoef attempted to murder Mr. Hamburger. It is sufficient for my present purpose to affirm the correctness of the opinion here qiioted from a lay paper, without entering into such details of the evidence as might be taken either for or against that opinion.

In the previous paper on the subconscious and conscious mind it was tacitly assumed throughout that excitation processes, though capable of activating the responding organ, yet are kept within the limits of that organ's capacity to respond. In the case of the heart, however, it was definitely pointed out that the responding organ had a limited capacity to give a normal response; also that the intensity of excitation processes could exceed this capacity (1, 3).

One can arrange the determinants of Rorschach responses in the following groups, according to the sense impression which they convey:

An optic sense impression only is given by the form-, colour- and vista-responses (F, C’, FC, CF, C, FK, K, k responses).

A kinaesthetic impression is conveyed in addition to the optic one by the movement responses (M, FM, m responses).

A tactile and optic impression is conveyed by the texture responses (c, CF, FC responses).

Friedrich Wilhelm Nietzsche was born at Röcken, in Saxony, in 1844. His father was a Lutheran clergyman, and his grandfather held a high official position in the Lutheran Church. His grandmother Nietzsche “came of a family of pastors,” and his mother was the “daughter of a parson”. In view of the strongly antagonistic attitude which Nietzsche afterwards adopted towards the Christian scheme of morality, the marked clerical strain in his ancestry is worthy of note. According to his sister Their ancestors, paternal and maternal, were very long-lived. “Of the four pairs of great-grandparents [one] great-grandfather…reached the age of ninety, five great-grandmothers and great-grandfathers died between seventy-five and eighty-six, two only failed to reach old age. The two grandfathers attained their seventieth year, the maternal grandmother died at eighty-two, and grandmother Nietzsche at seventy-seven.” Nietzsche's mother was also long-lived; she was born in 1826, and was married, in 1843, to Pastor Nietzsche, who was then thirty years old. She died in 1897, “after having suffered ill-health for several years”. Pastor Nietzsche is described by his daughter as being an “extraordinarily sensitive man…any sign of discord, either in the parish or in his own family, was so painful to him that he would withdraw to his study, and refuse to eat or drink, or speak with anybody”. This tendency to seek solitude is worthy of note, as it reappeared in a very marked degree in his son, Friedrich. The father was short-sighted—as was Nietzsche—and, in 1848, this resulted in an accident, the consequences of which were disastrous: he tripped over an obstacle which his defective eyesight had prevented him from observing, and he suffered as a result from concussion of the brain. This shock to the nervous system initiated a train of symptoms—chiefly cerebral—which led to his death eleven months later. The fall may have been the cause of the attack; or, as another biographer says, perhaps “only hastened its approach.” The same writer informs us that Pastor Nietzsche “might have hoped for a fine career had he not suffered from headaches and nerves”. Frau Förster-Nietzsche, however, says that her father had not suffered from headaches prior to the accident. In view of Nietzsche's history, one feels inclined to agree with Halévy, more especially as, where any history of nervous or of mental symptoms of a morbid character are concerned, relatives are usually the last to admit them. Mügge says that Pastor Nietzsche “suffered either from concussion or softening of the brain…doubtless this accident hastened his death”. The youngest of the three children born to Nietzsche's parents, a boy, died just after his second birthday “from teething convulsions”. There was apparently nervous instability in the family; and Ireland says that O. Hansson “learned from a family who knew Friedrich Nietzsche from childhood that a disposition to insanity had been inherited for several generations, both on the father's and the mother's side”. This statement is not in accord with the details of family history as given by Frau Förster-Nietzsche; at the same time, it is, perhaps, no injustice to her to surmise that she was desirous of minimising the pathological aspect of the family heredity, and of laying greater stress upon the more favourable characteristics. When Nietzsche's life-history with its morbid mental vicissitudes is considered, however, it would be surprising if the family annals were found to be clear of all traces of nervous instability.

Earlier investigations (3, 4) have shown an abnormal glutamic acid metabolism in schizophrenic patients.

These changes are, briefly, low glutamic acid level (and high glutamine level) especially in acute cases. Glutamic acid concentrations below 1.2 milli grams per 100 ml. venous blood were ascertained in most of these patients.

From the earliest ages in the history of man, we find evidences of the existence of beings stunted in body and defective in mind, whose relations with their fellows varied through the centuries. At one epoch they were exalted almost to the level of a deity, and their symptoms were interpreted as manifestations of Divine will. At another they were looked upon with loathing and disgust, not unmingled with fear. Still later, they were either the playthings of kings or the victims of cruel jibe and blow, and their existence at the present day, and the associated conditions of insanity, crime and intemperance, constitute one of the most serious, if not the most serious problem which a civilised community is called upon to solve.

At the present time when the Mental Deficiency Bill is before Parliament a discussion on the above subject may be of some interest to the readers of the Journal of Mental Science.

The treatment of congenital syphilis, in spite of the advances in the general treatment of syphilis in the last thirty years, still leaves much to be desired. Veeder, after treating some 500 cases of congenital syphilis in St. Louis between 1912 and 1920, came to the conclusion that the results of treatment were most unsatisfactory, and that very little was to be gained by the treatment of the syphilitic child. He advocated the treatment of the parents to prevent the birth of syphilitic children. Nabarro is of opinion that the criterion of cure should be the complete cessation of any symptoms of activity and a normal blood and cerebro-spinal fluid. He has not been able to fix any limit of time after which he can regard the patient as cured. He mentions a case of his which relapsed with interstitial keratitis after having had a negative Wasser mann reaction for eight years. Ambrose King doubts whether congenital syphilis is ever really cured; he states that “cases had been seen in which manifestations of congenital syphilis appeared only after the lapse of a number of years, and others in which active lesions occurred, but with a negative Wassermann”.

The influence of slight variations in the inorganic constituents of the tissue fluids on the function of the nervous system has long been the subject of physiological investigation. Thus a disturbance of the ratio Ca/Na is known to be related to the irritability of muscular tissue (1). Ca and K are antagonistic in their action on the vegetative nervous system: Ca increases the excitability of the sympathetic system, whilst K excites the parasympathetic system (2). The influence of Ca on the excitability of the central nervous system finds a clinical illustration in tetany; and, from a pathological point of view, diminution of the serum Ca is well established in certain types of this disorder.