As his oldest surviving friend, and one of 52 years standing, it devolves upon me to write the obituary for the Journal of Mental Science of Dr. T. Outterson Wood, President of the Royal Medico-Psychological Association, 1905–6, who died on July 19 last at his residence, Lodore, Chelston, Torquay, in his 88th year.

Although the subject of my short address is named on the agenda “After Care,” I am privileged by your chairman to touch upon the activities of social workers generally in regard to the welfare of the mentally afflicted.

Mental change in cardiac disease, though a rare complication, is a subject that can be properly and usefully discussed at a meeting of psychiatrists at which physicians are asked to take part. For while the physician may be able to assess accurately the physical defect in the circulatory apparatus, he is trained only in a rough-and-ready way to interpret different types of character, and the way in which they react to disease, and is liable to go astray in his interpretation of mental states. There is also this advantage—that in the present state of uncertainty as to the physical basis of mental disease we cannot look at the subject from too many points of view.

If I may be allowed to speak to you about the importance of functional impediments to the circulation, I would like to do so from the point of view of the anatomist. I shall not speak about the clinical and physiological observations in neuropathology and internal medicine; I want rather to begin with the deductions to which the anatomist is led by his own methods, independent of clinical facts and questions.

In 1906 Alzheimer reported the case of a woman, æt. 51, who, in addition to the expression of ideas of suspicion and jealousy, failed mentally to such an extent that she was unable to find her way about her own home. During her hospital residence she was perplexed, disoriented for time and place, and had difficulty in understanding and in expressing her thoughts. There were delirious phases, during which she was hallucinated. Her power of retention was greatly impaired. She showed paraphasia and perseveration. The illness persisted for a period of four and a half years, and at the time of her death she suffered from contractures. The post-mortem examination showed a striking alteration of the neurofibrils: “In an otherwise normal cell there appear at first one or more fibrils, which on account of increased thickness and increased stainability stand out prominently. In the further course of the alteration many neighbouring fibrils are similarly affected. These then form thick bundles, which gradually come to the surface of the cell. Finally the nucleus and cell disintegrate, and only a tangled bundle of fibrils remains to indicate the site of a former ganglion cell.” In addition, throughout the entire cortex, especially in the outer layers, there were many miliary foci or plaques.

The researches of Golla and his co-workers, Armstrong, Mann, Marsh, Scott and others on the bio-chemistry of dementia præcox suggested that it might be profitable to explore a line of treatment based upon their results.

The problem of character has long occupied the minds of philosophers, pedagogues, sociologists and psychologists, such as Socrates, Plato, Pascal, J. J. Rousseau, Kant, and later Bahnsen, Wiszniewski, A. Bain, A. Martin, Ribot, Smiles, Mill, Perez, Paulhan, Le Bon, Galton, Fourneaux, Foerster, Klages.

The writers of text-books do not give us much aid in gaining a true idea of the cause of “late” rigidity—rather the reverse, for they seem to think it necessary, always, to drag in “decerebrate” rigidity as an essential preliminary towards understanding the factors in the case.

Several fallacies may occur in the recording of the pressure of the cerebro-spinal fluid. These fallacies may be related to (1) the type of apparatus used, (2) movements of the patient, and (3) reading of the pressure.

CLOSE co-operation between psychiatry and general medicine is advocated with renewed vigour from time to time. This is a wholly desirable thing, provided that the essential differences between disorders of the individual as a whole and disorders of his several organs are kept clearly before one.

It is a well-known axiom that to know one subject thoroughly entails more than a passing acquaintance with many others. This is especially true of the field of medicine, where neglect of any one related subject may lead to an incomplete, or even to an erroneous solution of a particular problem.

Psychology was for centuries a part of philosophy, the happy, undisputed hunting-ground of the speculative metaphysician. With the beginning of the nineteenth century a new era dawned gradually for psychology. Anatomists, physiologists and physicists began to invade this reserve of the metaphysician. These early attempts of Gall and Spurzheim, Johannes Müller, E. H. Weber, Du Bois Reymond, Helmholtz, Lotze, Fechner, Thomas Young and many others are too well known to detain us. They lead up to the work of Wilhelm Wundt and the establishment of psychology as one of the natural sciences, from speculation without facts to speculation allied with experiment. However, as usually happens, the swing of the pendulum goes from one extreme to the other. For whilst the metaphysical psychologist would ignore physiology and neurology, maintaining that what is not itself a phase of consciousness cannot be used to explain consciousness, some of the physiological psychologists would overshoot the mark and attempt a psychology without consciousness. Thus we find the behaviourists (Watson) and the objective psychologists (Bechterew). Pavlov appears to belong to the latter school. But as Prof. Brett, in his History of Psychology, rightly says: “Modern psychology lies between two points: it emerges from anatomy and physiology, and terminates in a region where those sciences cease to guide.”

It is generally known that the normal ratio between serum albumen and serum globulin is altered in general paralysis.

In recent years the approach to psychiatry has become more and more biological. The point of interest is shifting from the kind of mental illness which a person has, to the kind of person who has the illness. The greatest stimulus in this direction to psychiatry in the last few years was undoubtedly the publication, in the year 1921, of Kretschmer's Körperbau und Charakter. Indeed, the stimulus was so violent that nowadays hardly any psychiatric field (not to mention other branches of the biological sciences) has escaped exploration along Kretschmer's lines; and the vast bibliography which has piled up is enough to appal the student of constitutional biology and kindred subjects. For some reason, surprisingly little work has been done on the constitution and temperament of the weak-minded. The object of this present research is to fill the lacuna in some small measure. The neglect of this field of study is surprising, for the reason that weak-mindedness is classified by Kraepelin, the father of modern psychiatry (Psychiatrische Klinik, Barth, Leipzig, 1921, Bd. i, S. 23), in the group of the congenital mental disorders; and a congenital anomaly should surely be expected to provide interesting material for biological research. The present writer, then, approached his subject without prejudice and without a thesis. It was his business to study a group of congenitally weak-minded people, and observe and record their physical and temperamental anomalies.