Most clinical psychiatrists would agree that many but not all schizophrenic subjects show abnormalities in the field of language. Many use neologisms, i.e. new words for old referents, and some chronic patients talk in a more or less private language which at times degenerates into a word salad. The following features have been noted in the schizophrenic's verbal productions—alliteration, condensation, over-inclusiveness and the personal distortion of the symbol-referent tie. Stuart Chase said: “The point of every discussion is to find the referent. When it is found emotional factors dissolve in mutual understanding.” Psychiatrists often assume that they have identified the referent which ties in with the symbol the patient is using, but sometimes the patient uses new symbols, as “Bill” did the other week when he astonished the other group members by announcing that he was “troubled by warpations and distressed by ignorances”.

Seventy-eight psychiatric in-patients were allocated to personal illness classes by means of the Delusions-Symptoms-States Inventory (DSSI). Paper and pencil measures of psychomotor speed and scatter of tapping were administered with an immediate retest. It is suggested that from a social desirability position one would have to predict that the more personally ill (i.e. those endorsing the more socially undesirable items) would be slower and more diffuse on these measures. We found, however, such patients to be more constricted and slower. It is concluded that such a combination adds to the utility and validity of the hierarchy of classes of personal illness.

There is a fairly general opinion amongst those engaged in asylum work that the classical type of general paralysis is less frequently met with relatively than formerly. This may be due partly to an increased number of so-called atypical cases, and possibly also to cases now being diagnosed as general paralysis, either ante or post mortem, which were not formerly looked upon as such. With a view to finding out the frequency of the chief phenomena of the disease as it is now met with in asylum practice, the following data, both pathological and clinical, have been compiled. The cases examined were (1) all the male cases admitted to the West Riding Asylum, Wakefield, from January 1st, 1896, to December 31st, 1902; (2) all the male cases admitted to the London County Asylum, Horton, Epsom, from its opening in the early part of 1902 to March 31st, 1905; and (3) all the female deaths at Horton.

I fully appreciate the very great honour which has been done to me this afternoon in asking me to speak of the experience which I have had in nearly twenty years of work amongst those who are suffering from alcoholism. Of courseyou will forgive me if I speak in an altogether unscientific way. I can only say exactly the experiences I have met with, and as I now live, summer and winter, in their midst, I can give you at any rate the result of my personal experience among such people. Thirteen years ago, when we first started the colony which we have for inebriate women at Duxhurst, the Amendment to the present Inebriate Act was not in existence, that is to say, there was no means of dealing with such people other than by sending them to prison. The physical side of drunkenness was then almost entirely overlooked, and the whole question was dealt with more or less as a moral evil. When the Amendment to the Act was passed it was recognised, at any rate, that prison had proved to be a failure for these cases, and this was quite obvious, because such women were consigned for short sentences to prison, and then turnedback on the world, at the end of six weeks or a month, as the case might be, probably at the time when the craving for drink was at its height, and therefore when they had every opportunity for satisfying it outside the prison gate they did so at once. It is nowonder therefore that women were committed again and again, even to hundreds of times. When I first realised this two cases came distinctly and prominently under my notice. One was that of a woman whose name has become almost notorious in England, Miss Jane Cakebread. She had been committed to prison over 300 times. I felt certain when I first saw her in gaol that she was not in the ordinary sense an inebriate; she was an insane woman who became violent after she had given way to inebriety. She spent three months with us, and I do not think that I ever passed a more unpleasant three months in my life, because when she was sober she was as difficult to deal with-although not so violent-aswhen she was drunk. I tried to represent this to the authorities at the time, but I wassupposed to know very little on the subject, and was told that I was very certainly mistaken. I let her go for the reasons, firstly that we could not benefit her, and secondly that I wanted to prove my point. At the end of two days she was again committed to prison, and after being in prison with abstention from alcohol, which had rendered her more dangerous (hear, hear), she kicked one of the officials, and was accordingly committed to a lunatic asylum. Thus the point had been proved that a woman had been kept in prison over 300 times at the public expense during the last twenty years before being committed to a lunatic asylum. The other case, which proved to me the variations there arein the classifications of those who are dubbed “inebriates,” was a woman named Annie Adams, who was sent to me by the authorities at Holloway, and I was told she enjoyed thename of “The Terror of Holloway.” She had been over 200 times in prison, but directly she was sober a more tractable person could not be imagined. She was quite sane, but she was a true inebriate. She had spent her life in drifting in and out of prison, from prison to the street, and from the street to the prison, but when she was under the bestconditions I do not think I ever came across a more amiable woman. About that time the Amendment to the Inebriates Act was passed, and there were provisions made by which such women could be consigned to homes instead of being sent to prison. The London County Council had not then opened homes, and they asked us to take charge of their first cases. They were sent to us haphazard, without classification. There were women who were habitual inebriates, there were those who were imbecile or insane; every conceivable woman was regarded as suitable, and all were sent together. At that time I saw clearly that there would be a great failure (as was afterwards proved) in the reformatory system in this country unless there were means of separating the women who came from the same localities. That point I would like to emphasise to-day. We hear a great deal nowadays about the failure of reformatories, but unless you classify this will continue to be so.

Gentlemen,—In the name of the Irish members of our Association, I desire to greet you all with a very cordial welcome on the occasion of this your second visit to our city. Fourteen years have elapsed since you last honoured us with your presence. I hope that a careful comparison of the present state of the institutions here with their condition then will convince you that the spirit of improvement has been among us, and that we have endeavoured in some measure to keep pace with the progress apparent in other districts in this department of the healing art.

In devoting to the foundation of a memorial lectureship a portion of Dr. Maudsley's bequest, the learned Society which I have this afternoon the honour to address made an indulgent concession to the laity in prescribing that the lecture to be delivered should in alternate years be of a scientific and of a popular character. This year it is the turn of the popular lecturer—a rôle which I have assumed with some trepidation. The distinction drawn is an ominous one. It seems to suggest that to be scientific you must be unpopular, and to be popular you must be unscientific. But is there necessarily so absolute a dividing line between the two domains? I hazard the view that it is possible to be at once both popular and scientific. No doubt there is still a tendency in learned circles to deride what is known as popular science, but that is an inheritance from the days of the cheap and inaccurate manuals which used to be written by imperfectly informed persons, pretentiously professing to enlighten the masses on the truths of science. Nowadays, science has become more condescending, indeed almost affable, to democracy. The approach has come from both sides, for democracy is now better educated, and science is now more expert in the art of exposition. The advent of the internal combustion engine, of wireless telegraphy and of many other practical applications of science to daily life has created a new and widespread interest and aptitude on the part of the general public in the acquisition of accurate scientific knowledge, particularly among the younger generation. At the same time the physicist, the chemist and the biologist have found it possible and worth while to impart much of their learning to wider audiences. Science is daily entering more and more into the lives of the people, with the consequence that its social, economic and political implications are being more and more realized by its professors. The President of the Royal Society has reminded us that we live in an age when the advance and development of scientific knowledge are continually creating new social and economic problems of the utmost importance, and has emphasized the necessity of bridging the gap between the scientist and the layman by every possible means. The British Science Guild, now doing such excellent work, was founded some thirty years ago by Sir Norman Lockyer for the express purpose of promoting the application of scientific method and results to social problems and public affairs. The market-place can doubtless never supersede the laboratory, but the scientist no longer disdains to take his wares to market.

In the introductory remarks contained in the previous portion of this essay, I said that, as far as possible, I would refrain from referring to the condition of the nervous centres as seen after death, except to explain the nature of certain phenomena seen in these diseases during life. Having arrived at the second portion of my subject, I shall draw attention to the condition of the brain and spinal cord where death has been the result of an epileptic fit, or while the patient has been in what is now so well understood as the Status Epilepticus.

The question of utilising female nursing to a greater extent than formerly in the care of male patients in asylums has roused much interest of late years, and has been brought under the consideration of the Association on several occasions. In advocating the adoption of this form of nursing one is apt to give the impression that the method is something entirely new as applied to asylum patients. But that is not intended, for in reality the system has existed to some degree for a long time; and it is only the question of the advantages of extending it, and making it much more systematic and complete, that is now raised. In some places on the Continent it has been in use for a number of years, and is developed to a greater extent than is usual in this country. In April last I had an opportunity, in company with Sir John Sibbald, formerly Commissioner in Lunacy for Scotland, Dr. Fraser, Commissioner in Lunacy for Scotland, and Dr. Robertson, medical superintendent of the Stirling District Asylum, of visiting two institutions in Holland and seeing the method in practice; and I now venture to submit some notes, not by any means exhaustive, of what was observed there, and to make these, and my own further experience of the system at the Fife Asylum since 1896, when I had the privilege of reading a paper descriptive of it at the annual meeting of the Association, the basis of my remarks at this time.

Examinations of the cerebro-spinal fluid, with a view to determining its starch-splitting power, have been carried out with varying success for the past thirty years, but the results which have been recorded are meagre and unsatisfying.

Dr. Hughlings Jackson remarks that in every case of insanity there are negative lesions of the highest centres, which cause some paralysis, sensory or motor, or both (“Journal Mental Science,” October, 1888). Evidence that this is so has been brought forward by him, principally, however, in relation to the insanity of epilepsy and postepileptic states.

A relationship between malignant growths and mental disturbance has been established in a variety of ways. Some writers have approached the subject from a purely general standpoint. Thus Knapp has noted an increased liability to cancer in individuals who show signs of mental instability and has suggested a possible correlation between the two disorders which are both associated with grave metabolic changes. (1) Proceeding on similar lines, Snow instituted an inquiry which revealed a considerable difference of opinion as to the incidence of cancer in the insane, and concluded that its occurrence is relatively rare. (2)

From the earliest times in the history of medicine probably no subject has been more thought about, no subject more frequently attacked, than that of heredity, and it is therefore not without a certain amount of hesitation that that all-important subject is brought into consideration in such an article as this.