The following is an account of the cases of schizophrenia admitted to Broadmoor from 1900 till 1931.

The use of the term “schizophrenia” in place of “dementia præcox” has rendered the classification of these cases more accurate than would have been possible with the older name, and also made possible the inclusion of several cases which otherwise would have had to be left out.

In this university the study of medical psychology and mental diseases is wholly voluntary. None of the faculties require candidates for degrees to attend the course I deliver, or examine them in the subjects discussed. Doubtless the faculties of arts, theology, and law, might reasonably object to so great an encroachment upon vested interests and established traditions; but it is different with the faculty of medicine, because moral philosophy has only been added to the curriculum of medical studies since I commenced to deliver this course. I have therefore thought it would be expedient (and suggested it, indeed) to permit students of medicine going up for their degrees to choose between medical psychology and moral philosophy; nevertheless the course is still without even this modified recognition. Nor do any of the other medical boards of examiners of the United Kingdom require it. The Senate of the University of London has, however, very lately recommended the practical study of mental diseases to candidates for medical degrees; but valuable and important as this step is, yet, inasmuch as it excludes medical psychology, it falls very far short of what must ultimately be required in the interests of society of all students seeking general culture or to enter any of the learned professions. I entertain a deep-rooted conviction that mental science, in the modern and practical sense of the term, will sooner or later be forced on the attention of political economists and statesmen as one of the needs of the time; and I am equally convinced that no such science is possible except by the observation and study of morbid mental states. I therefore propose on this occasion to plead for the general study of medical psychology or mental science developed according to this method in this classroom, and although I may not hope to be successful in my pleading, I trust I shall at least encourage you who engage in the study voluntarily to pursue it ardently, as offering its own full reward for any labour you may bestow upon it.

If I fix a square peg into an oblong hole, the fact that they do not fit is instantly perceptible; but it is manifest that the. several percepts of the peg and of the hole must precede the perception of the relation of non-adjustment subsisting between them. Furthermore, if I want to determine how much the peg lacks in size, I must measure separately both the peg and the hole before I can calculate the amount of the hiatus between them. What is true of this simple case of adjustment is true of the complex case of the adjustment of the organism to its environment. However rapid and apparently immediate may be the cognition that a patient is insane—is unadjusted to his environment—yet that cognition must be preceded by a previous knowledge both of the organism itself and of the environment with which his adjustment has failed. The truth of this statement, which is involved in the definition of Insanity, may not be at once apparent, but a little consideration will render it clear. It is manifest that before pronouncing a man insane, we must first know something about him, but that we must also take into account his environment is, perhaps, not so self-evident.

In a very large number of cases of non-syphilitic mental disorder examination of the upper alimentary and respiratory tracts has shown the presence of diseased conditions of septic origin affecting the teeth and their sockets, the gums, the tonsils and the mucosæ of the mouth, pharynx, nasal passages, nasal sinuses and ears, including the diverticula contained in the mastoid.

There is a type of social psychology which finds the explanation of man's social behaviour in a hypothetical “disposition” of his mind. This motive-complex is conceived as specialized for the function of adapting conduct to social life, and as being in itself relatively closely integrated, developing and functioning as a whole. Of this hypothetical “gregarious instinct” McDougall goes so far as to say: “For it is highly probable that instinctive dispositions are Mendelian units” (Journ of Abn. Psych, and Soc. Psych., vol. xvi, p. 316). This plainly suggests that the unity of the social disposition (its existence as a discrete factor in development) is to be regarded as antedating experience—that it is an ultimate datum for psychology not susceptible to analysis, and is not a derivative of any other known motive such as “love,” “fear,” or “hope of reward.” This “instinct” interpretation of social behaviour has been criticized on many grounds (as unfruitful for psychology and incompatible with biological fact); but of course the demonstration of a Mendelian transmission of the social disposition would compel us to regard it as an element of character. Our conception of mental development and of the “socialization” of the individual, of the relative significance of upbringing as compared with organic endowment and our whole psycho-pathology depend upon our acceptance or rejection of McDougall's view. If he is right in regard to the germinal “unit” determination of the social disposition, criminological studies should offer verification. I propose, therefore, to consider how far we are justified in regarding moral insanity and moral imbecility as true “morbid entities.”

That it would be impossible for anyone in a single paper to adequately treat of the mental symptoms occurring in bodily diseases is self-evident. For it must be remembered, as Maudsley says, “that it is impossible to be out of sorts physically without being out of sorts mentally,” so that the subject includes not only the slight emotional changes found in various diseases, but also the actual insanities produced by or accompanying them. All that I propose to do in this communication is to give a short account of the mental changes which I have noticed during a four years' residence in the Manchester Royal Infirmary, and during a longer experience as visiting physician to the Manchester Workhouse Infirmary, where I have charge of over 800 medical beds.

More than two years have elapsed since the Szondi test material became available on the home market, but it seems that the widespread use of the test has been considerably delayed by the lack of a translation of Dr. Szondi's books (1, 2). Susan Deri's Introduction to the Szondi Test (3), which appeared last year, may, however, have enabled some who felt attracted by the test to acquaint themselves with it. The purpose of Deri's book is to give some guidance for the clinical handling of the test and for its interpretation. For the rationale she refers to Szondi's own books.

In connection with the malarial treatment of general paralysis of the insanein thishospital, we have endeavouredto producea secondseriesof malarialrigorsin such casesas had not shown sufficient mental or physical benefit after a first infection terminated six or more months ago.

This case has shown so great an improvement by symptomatic treatment with parasympathetic stimulants and a sympathetic depressant that it seems worthy of record for its own value, apart from the interesting investigations to which it leads.