When a great pillar is removed, the structure which it supports, if happily it does not fall, seldom escapes without a tremble; and it speaks well for the construction of the fabric if, without outward sign of damage, it can withstand its loss until a new pillar has been inserted in its stead.

Mr. President, Ladies and Gentlemen,—A new epoch in military and medical science has arisen in consequence of the employment of high explosives, combined with prolonged trench warfare, in this terrible war.

It is considerably more than a quarter of a century since I first promulgated the doctrine that madness and unsoundness of mind are not the same thing; that madness includes more than unsoundness of mind, and that unsoundness of mind very often occurs in the sane, and is, indeed, one of the most frequent disorders of the sane. This doctrine has always seemed to me as manifestly true as the doctrine of natural selection, and, like the doctrine of natural selection, needs, it appears to me, only to be stated to secure the adhesion of every reasonable mind. In fact, I have found by experience that to the immense majority of my acquaintance it does only need to be stated to secure their adherence. Nearly everyone—everyone outside the membership of this Association—to whom I have stated it, without a single exception, has, in fact, accepted as self-evident that what matters in influencing our judgment of madness or sanity is not what a man thinks or feels, but what he says or does; not his mind, but his conduct. Even within this Association the doctrine has many adherents among the younger members, for I often receive letters from them, telling me how great an assistance it has been to them; so that things are moving, and I trust that before long we shall reach the stage that I predicted in a correspondence in the British Medical Journal, when not only will the doctrine be universally admitted to be true, but also we shall all declare that we never held any other, and that any claim of mine to have originated it will be strenuously denied. However, litera scripta manet. The minute-book of the Educational Committee will show that when I urged that conduct, as being the most important factor in madness, should be systematically studied, I could not secure even a seconder. When I subsequently brought the subject forward in this Association I had not one supporter. Nor had I when I brought it before the Royal Society of Medicine three years ago. In the third edition of Dr. Craig's book on Psychological Medicine, which has just appeared, the doctrine is not so much as even mentioned, and Dr. Craig says that insanity cannot be defined. This he says in face of the fact that at the Royal Society of Medicine I showed that there are several different concepts confused under the name of insanity, and I carefully defined every one of them; nor has any one of my definitions ever been impugned. I venture to assert that if these definitions had emanated from a German source they would have been welcomed with enthusiasm and received with reverence.

Of all the consoling illusions which mankind have harboured to irradiate, hearten, seduce and dupe them in their onward way to the perfection, universal peace and brotherhood which they hope and expect to approach, if not attain—after the devastating deluge of this long war for an unknown Divine event is over—none is perhaps more wildly irrational than that of a complete regeneration of human nature, and the coming of a perfect transformation scene on the troubled earth; for all the world as if the method of vital progress which has been since the beginning of life is appointed to come abruptly to a stop, or to be reversed; with the optimistic belief, too, that life shall be thereby exalted and glorified immeasurably. Could the fatuity of egotistic optimism go farther? Was the universe specially created to be a stage on which man—equally with other species and the rest of animate nature—lives, suffers, decays, and dies, might play his transitory part? Was that the illusive goal which at its outset launched it on its transcendental aim and its mysterious career, along which it has groaned since in long protracted travail? Naturally in that matter the devotees of religion believe the most, hope the most, cry aloud the most; otherwise their faith might be rudely shaken.

Mlle. Joséfa Ioteyko in her learned articles on La Théorie Psycho-Physiologique de la Droiterie, which were published in the Revue Philosophique, June and July, 1916, and of which an epitome appears in this number of the Journal, quotes largely from the works of Mlle. V. Kipiani, an enthusiastic educational reformer, who advocates a certain method of reading and writing, the object of which is the avoidance of unnecessary eye-strain. The method, which is fully described in the epitome, is not new. It is simply the boustrophedon mode of writing employed centuries ago by the Ancient Greeks, and abandoned by them for the method which is now used by European nations.

In 1895 an unostentatious book quietly appeared in Leipzig and Vienna entitled Studies of Hysteria (Studien über Hysterie), written jointly by two authors, Dr. Josef Breuer and Dr. Sigmund Freud. There was no public ready to receive the book, it attracted little attention, and had a small sale. In England and America it remained almost unknown, so that it is now a satisfaction to the present writer to recall that almost the first full exposition in English of the views set forth in this book appeared in the first volume of his own Studies in the Psychology of Sex in 1898. Yet these studies of hysteria, as an attentive reader could scarcely fail to realise, turned over a new page in medical psychology, and the new page was of fascinating interest. A case of hysteria was no longer to be regarded as, on the psychic side, almost beneath a physician's serious attention, nor was it to be settled merely by an accurate description of the physical symptoms, after the manner of Charcot's school, to which school in the first place Freud himself had belonged. It was a mystery to be patiently investigated, a mystery to which the key often lay far back and forgotten in the patient's history, and when skilfully used, with knowledge and insight, the patient's medical history acquired not only psychological significance but something of the interest of a novel. Freud himself clearly recognised this and stated, even in this first book, that it was by a representation of psychic processes, “such as we are accustomed to receive from the poet,” that he had gained his insight into the nature of hysteria.

The large chapter of aphasia and allied conditions of psychomotor and psychosensory disturbances is still a chapter where there are great differences of opinion, and a great heterogeneity in nomenclature.

In the beginning every creature was a patriarch: it was, philosophically, not only its individual self, but also all its potential progeny. Such a creature's whole conduct was directed towards the one goal of eternal life on earth. It so happened that in very many cases the creature's best chance of success involved association with other creatures of its kind, or even of other kinds. From this arose the complication of the acquirement of tribal instincts. Tribal instincts were acquired only for patriarchal purposes, though in very many cases they proved to be the immediate cause of the creature's death. A further complication arose when certain of the creatures acquired intellect and took to thinking. Philosophically, a living thing exists only that it may produce a generation capable of producing yet another generation. A generation is important only as the cause of its next generation. Intellect often gave the creature an immediate advantage over rivals, but it glorified the individual self at the expense of the patriarchal self. This is recognised in the third chapter of Genesis, where intellect is called the serpent, and thinking is called (in Chapter II) the tree of the knowledge of good and evil. The statement that “in the day that thou eatest thereof, thou shalt surely die” declares that the race is kept going only by those who do not understand how to limit their families.