It was with a deep sense of responsibility and of gratitude alike that I accepted the invitation to address you as your fourteenth Maudsley Lecturer; a sense of responsibility through the thought that, in a way, I come as a representative of American psychiatry; a sense of sincere gratitude for an opportunity to acknowledge a real personal indebtedness to British science and British medicine and British psychiatry, partly for what I received myself in the long years since my early post-graduate work in this country forty-three years ago, and partly for the influence British thought and work and practice has had upon certain developments, for which it is a pleasure to express our indebtedness and appreciation. Some of these relations and connections are little realized and little appreciated, and yet very illuminating and by no means only personal.