Numerous workers have experimented with thyroid treatment in mental disorder ever since this drug was first introduced into therapeutics. While some of them have reported success in a small proportion of their cases, others have remained quite unconvinced of its efficacy, except in mental disorder secondary to recognizable myxódema, and have attributed the changes observed to the known tendency of psychotic patients to periodic fluctuations or spontaneous recovery. Thyroid has been used in a variety of ways. Doses ranging from 1 gr. up to 70 gr. of the thyroideum siccum a day have been prescribed, and as a result it has been found that many schizophrenic patients have an abnormal tolerance for thyroid. For instance, Hoskins (1929) reported the administration of 48 gr. of thyroideum siccum a day for six months to a schizophrenic patient who showed apparent improvement and no toxic effects; but he has pointed out that not all schizophrenics can tolerate these enormous dosages without being intoxicated and made worse. It has, however, been the deliberate aim of some workers in the past to produce an intoxication, but this method has now largely been abandoned.

Since the appearance of von Baer's work on animal development in 1828 (1), the mode of origin and development of the nerves has been continuously under discussion. A vast number of observations has been made concerning the visible evidences presented by fixed and sectioned material, and very many experiments have been performed to elucidate the nature of the processes at work. Yet no account of nerve development has so far received general assent, and for some time the advantages ensuing from the adoption of an agreed opinion appear to have been allowed to work in favour of its acceptance. These advantages have been found to be academic rather than real. While the formulation of hypotheses is not a proceeding which can be stigmatized as unscientific or unsound, in the absence of useful developments their retention discourages inquiry. This discouragement is the more likely to occur when, as in neurology, more than a century of effort by many workers has not succeeded in establishing beyond question facts which are of fundamental importance. It is a reason why the central problems of neurogenesis have come to occupy a field not wholly favourable to fruitful discussion.

Psychiatry, during the past fifty years, has had a phenomenal but in some respects a rather unfortunate growth. Long in what Auguste Comte called the mystical state of the evolution of a science, psychiatry rapidly entered into its taxonomic phase when, as one of the later repercussions of the romantic reaction to eighteenth century materialism, the rightful place of psychiatry among the sciences of the humanities began to be appreciated. Almost simultaneously, however, premature efforts began to be made by students in the field to achieve higher levels of scientific development, with the result that the facts of psychiatry soon became almost lost in rigid and increasingly complex systems of classification. Fortunately, in recent years there has arisen a salutary tendency among psychiatrists to review the data of their discipline, and to re-examine the pragmatic and heuristic validity of certain formulations that too readily, perhaps, had been taken for granted. Among these attempts at re-orientation may be mentioned: as to ætiology and psychopathology, the work of Freud and the psycho-analytic school; as to a valid nosology, the statistical researches of T. V. Moore and others; and as to clinical application, the objective, critical studies of the results of various methods of diagnosis and therapy appearing with increasing frequency in the recent literature. We hope that the present work will be a contribution to the movement of fundamental reorganization now evident in psychiatry and its related fields of study.

In 1927 Parsons published his Introduction to the Theory of Perception with a view to formulating a working hypothesis. This book has played a large part in moulding my outlook upon psychological matters, and I should like to take this opportunity of making a few observations, even although they may not be wholly in accord with Parsons's opinions. But before going on to consider his view-point, perhaps it would be best if we started off by considering what is stated in a standard psychiatry text-book upon the subject of perception.

I. Males.

(i) Object of the Inquiry.

This paper gives some first results of an investigation into types of physique and into the alleged relation between physique and temperament. The problem here is to try to discover a method of measuring the tendencies to a particular bodily build that may be present in certain individuals.

When you did me the very great honour of calling on me to deliver the Maudsley Lecture, I was told that it had been decided that these lectures should be devoted alternately to scientific psychiatry and to subjects of general popular interest, and that the subject of my lecture was to be scientific. I decided that with a year's notice the active preparation of the lecture might well be postponed for eleven months, and that during this gestation period I might hope to fix on one of the many aspects of pathological or physiological science of sufficient interest to justify a not too technical exposition to a mainly clinical audience.

Of fundamental importance in the problem of symptom-formation in schizophrenia is the question of the relationship of given symptoms to specific aspects of the personality. The present paper bears on this question in that it is concerned with the investigation of the imagery of the schizophrenic, and the relationship of certain symptoms to specific imagery characteristics. More specifically stated, interest here is in the questions of (1) whether or not the imagery of schizophrenics is different from that of normal individuals, and of (2) the relationships of the imagery of schizophrenics to such symptoms as hallucinations, delusions, and activity disturbances. It is believed that these observations may serve the psychiatrist in understanding the nature of the schizophrenic process by its indication of the importance of imagery in schizophrenic symptom-formation.

Society's attitude towards those who commit crime is undergoing a fundamental change. Interest in criminals has changed from the moral and legal to the psychological and sociological aspects, with the result that the criminal to-day has acquired a new importance. In the old days the community set out to punish the criminal and did so with considerable severity. The Law still continues to keep as its first consideration the protection of the community, and the claims of society are considered greater than those of the individual. Nevertheless, intensive study of individual offenders is essential if we hope to be able to advise society as to the best methods of dealing with those members who will not or cannot obey its rules.

In this paper an account is given of the results of investigation of the use of the Columbian group test in a series of 10,000 male adolescent prisoners between the ages of sixteen and twenty-two years.

The hereditary aspect of mental disease is at the present time a preferential topic of research, and the importance of constitutional factors in the causation of neuroses and psychoses is generally admitted. In many instances the term “constitution” is merely a hypothetical “X” introduced because of the absence of other facts which could account for clinical symptoms. Constitution is given a positive meaning only if it is identified with hereditary equipment, which has to be assessed by the careful analysis of the clinical aspect of the disease as a whole, including its hereditary and familial aspects, as well as environmental and other exogenous causal factors. Unfortunately, psychiatric illnesses as a whole do not lend themselves readily to this type of investigation. It is usual, therefore, to apply the results of studies of heredity in non-psychiatric conditions to psychiatric illnesses themselves. As neurological conditions are the most closely allied to psychiatric ones, they are most commonly used. One of the most convenient types of illness to study from this point of view is Huntington's chorea, not only because of its psychiatric aspects, but also because of its striking symptomatology and course.

In availing myself of the invitation kindly extended to me by the Institute for the Scientific Treatment of Delinquency of speaking to you on “The Treatment of Mental Disorders and Mental Deficiency in Continental Criminal Law “, I have no intention to abuse this privilege by criticizing the corresponding English law or by making suggestions for its improvement. For the latter task I feel myself neither competent nor authorized, as I am only too well aware that every important legal change is dependent upon many considerations which the foreign observer—though possibly conversant with the external facts—can appreciate only inadequately. What I may safely do, however, is to summarize some outstanding features of modern continental law and to add a few personal experiences concerning the legal system under which I worked for nearly a quarter of a century. I intend to deal first with problems of insanity (including temporary insanity caused by drunkenness), secondly with other forms of mental disorders and with mental deficiency.

In a previous paper (1) the iron, copper and manganese content of the human brain were recorded, with special reference to the G.P.I. cortex, which in certain cases contained an excess of both total and “available” (i.e., non-hæmatin) iron.

My problem is to give you a short review of some investigations we have undertaken at Dikemark Mental Hospital on the disturbances of somatic functions in catatonia with a periodic course (1).

Among the mental symptoms associated with head injury the psychiatrist rarely happens to see those immediately following the trauma; he is principally concerned with those mental sequelæ that follow recovery of consciousness (E. Mapother). Neither is the neurologist much interested in “cases of simple concussion in which the concussion is usually of brief duration and there is no indication that the brain has been organically injured” (J. P. Martin). Thus they are generally only observed by surgeons, who are usually more interested in other aspects than the psychological or neurophysiological one. Yet these mental symptoms cannot be disregarded if a general view of the disintegration or re-integration of the nervous function after the traumatic impairment is to be formed.