Gentlemen,—My first duty, which is also a pleasure, is that of thanking you, as I do most warmly, for the honour you have conferred upon me in electing me to preside for a season over this great Association, a position which may well be called the blue ribbon of our department of medicine, rendered illustrious as it is by the names of great men who have held the office in the past. My only regret has been that in accepting it I replace one whom we should all gladly have seen in this chair, one whose enforced retirement cannot be alluded to without a feeling of loss, though we rejoice that his health is so far restored as to enable him to be amongst us to-day. For the rest, I am happy to echo the sentiment expressed by Dr. Macpherson a year ago, and to welcome my election as a token that the interests, aims and aspirations of the departments which preside over the lunacy administration of these countries are recognised as identical with those of all the other members of this Association—that, in fact, we all form one great body, united by devotion to as lofty an object as can animate the members of any merely human society.

I feel that some kind of apology is due for my venturing to bring before a society which concerns itself mainly with practical questions what I fear will be regarded as a decidedly unpractical paper. Still, it may not be without advantage once in a way to step aside from the more arduous path of observational or experimental investigation in the region of psychiatry with its exacting conditions, and view things from a more general standpoint. And, while confessedly it may lead to no practical outcome, if by challenging some acknowledged views, and raising a breeze of controversy, however gentle, which may ruffle the quiescent surface of the pool of accepted opinion, it should at least suggest some grounds for a reconsideration of certain important questions connected with psychology and psychiatry, the object of the writer will be achieved.

In discussing this theme before a scientific assembly it is needless for me to say that I make no claim to be the bearer of a new revelation, or the creator of a revolutionary therapeutic. My function is much more modest; it is to raise some questions that may lead to profitable argument, questions which have excited great attention in psychological circles in France, Germany and America, and yet which have scarcely stirred a ripple of interest amongst ourselves. Men of international reputation assure us that they have applied with singular success these psychical methods in the treatment of certain forms of mental disturbance, and our excellent English textbooks in psychiatry either ignore the whole subject or put the reader off with a few superficial remarks that afford no practical insight into the matter. Such men as Freud, Jung and Prince may publish their refined and delicate analyses and we continue to repeat our well-worn formulas, never dreaming for a moment that these men may have something to teach us. Their theories may be right or wrong, but their therapeutic successes are not open to question. Surely here, in Ireland, amid a population peculiarly amenable to psychic influence, it is for us of especial moment to learn how such influence may be exercised and by what methods it can be brought to bear upon disordered personalities. My purpose, then, is to make clear what these methods are, to indicate their strength and their weakness, and to show their bearing on mental hygiene.

At this time and place it would be presumptuous of me and disrespectful to your knowledge and experience were I to claim any startling originality for this short paper.

The two subjects that I wish to bring to your notice to-day are sudden death during an epileptic fit, and the present treatment of confirmed epilepsy.

Mental symptoms almost constantly accompany choreiform movements whatever the origin of the latter, and cases exhibiting such movements are fairly common in asylums.

With the ever-increasing number of processes proved to be due to the action of micro-organisms, bacterial and protozoal, it is natural that a similar line of research should be suggested in the study of the psychoses. It has long been realised that the classification and differentiation of the various conditions by mental signs alone is confusing and unscientific. Gradually more importance has come to be placed on general clinical observations as indicating broadly the primary disturbances in the economy of the body, secondary consideration being given to mental symptoms as showing the change effected in the individual nervous system by the general disturbance.

The examination of the mental condition of children in elementary schools presents many difficulties, the foremost being lack of time, owing to the large number of routine physical inspections which have to be completed within the limit of school hours, rarely allowing so much as ten minutes for each child; however, in the smaller rural schools, when it is impossible to get to another school within the same session, owing to distance, there often is sufficient time to enable one to make a detailed examination of some of the mentally defective, and dull and backward children.

The word “epilepsy” is used to describe a group of signs and symptoms which are associated with a disease that primarily affects the nervous system. We find grouped together under this name several diseased conditions which, so far as their clinical manifestations are concerned, bear a common relationship, but differ in regard to their exciting causes.