Gentlemen,–The coveted position of President of this Association, which is to-day celebrating its sixty-fifth anniversary, is one to which many may aspire but few may reach, and I recognise to the full that the honour of being selected by you as worthy of this office–the highest compliment in your power to bestow–is not due to any distinction or merit in me, but arises from the fact that as your Secretary–holding an office which at least requires assiduity and patience–I have been closely associated for a longer period than has fallen to the lot of any of my predecessors with the interests and objects for which our Association has existed, viz., the promotion and cultivation of science in relation to mental disorder and improvement in the treatment of the insane.

The subject of fatigue, rest, and sleep cannot be approached without reference to the theory which has revolutionised our ideas of cerebral activity-the neuron theory of Waldeyer and Ramon y Cajal. This theory is certainly “in the air,” and despite the adverse views of notable histologists such as Apathy, Bethe, Dogiel, Donnagio, and Hill as regards its universal applicability, it has, I think, come to stay with us, as have the cycle, motor, submarine, and probably we may shortly say the aeroplane. Arguments, pro and con., are scarcely called for here, but there are a few points which I cannot omit reference to.

So much has been written on this subject, that I trust it will not be considered disrespectful to previous observers if I refer more particularly to my own experience and observations. As out-patient physician to Charing Cross Hospital, and latterly physician in charge of wards, I have had a considerable experience in seeing the effects of alcohol in the production of bodily diseases; but as Pathologist to the London County Asylums I have had a much larger experience in seeing the effects of alcohol in the production of mental diseases. I can safely say that in quite one fourth of the male cases which come under my observation at Charing Cross Hospital, and in a considerable proportion of the female cases, alcohol has been an efficient cause in the disease, or a very important coefficient. In conjunction with venereal disease, especially syphilis, it is responsible for many degenerative processes, which will be alluded to. My house-physician, Mr. Reade has kindly made a tabulated statement referring to the influence of alcohol in the medical cases admitted during the year 1905, which is appended.

The description of the varieties of dementia which is contained in the present section is based on the clinical classification of 728 cases of mental disease referred to in Part I of the present paper (Journal of Mental Science, April 1905).

Although the world will never again see anything like the great crusades of the middle ages, these events may be traced to causes which, though now of less force, still influence the human mind, appealing to the simplest and deepest cravings of our common nature.

The enormous increase in the number of registered lunatics and the correspondingly heavy burden cast on the taxpayers has at length caught on to the attention of the general public. This desirable end has been attained, not so much by the efforts of responsible officials as through the irresponsible editors who cater for the sensationalism which the satiety of modern life so eagerly demands for its renewed gratification. Blue books are peculiarly unattractive and inaccessible to the man in the street, who, however, finds the highly-flavoured information always at hand in the columns of the daily press much more to his taste. Yet his opinion, which, after all, when sound constitutes that most valuable national asset, healthy “public opinion,” is formed on the information so palatably administered and so readily absorbed. From this we learn that the seeds of knowledge carefully saved in special cultivated fields of labour are scattered broadcast in loose and general terms. That they fructify, however, is certain, and it then behoves us to cultivate the harvest of opinion in order that we may turn it to good account in the public weal. We must, however, weed out all accidental stuff, and take care that the golden grain alone is digested by the public. Now, if this new knowledge of the incubus of insanity is to be turned to any good account it would seem that while it still germinates it should be most carefully handled by those best qualified to deal with its useful application: a consensus of skilled professional opinion on a purely professional matter should, if possible, be formulated and submitted to those whose duty it is avowedly to safeguard the national public health. In this consideration the first point which naturally arises is whether or not the prophylaxis of lunacy comes within the purview and scope of practical politics. Such a consideration fortunately admits of little debate, for while one hesitates to place full belief in the specific cure of ills by means of Acts of Parliament, yet it must be thankfully admitted that, in every case where the State interfered in the interest of the public health, much has been done for the arrest of bodily ailments; the insidious rot of chronic disease has been checked, and the violent invasions of epidemic plagues have been circumscribed in area, reduced in intensity, and rendered less harmful in their results. A great practical national benefit has resulted in every instance. But so far as lunacy is concerned, the function of the State has been chiefly confined hitherto to the preservation of the unfit; little has been attempted to stem their increase. The fact is that the problem of dealing with insanity is so vast, so complex, so far-reaching, in all its relations to social and economic life that it is to be feared that no Government, even one with such a heterogeneous majority as that now in power, would tackle it as a matter of choice, and yet the inevitable cannot be always shirked. The enemy is closing in, and, to those who can estimate the extent of the decay of the mental stability of the country, the time is not far distant when the passive tactics of the present defence against lunacy must be changed to a more active crusade. We must not be content to retreat into asylum fortresses-we must shell the enemy in position and shell the position to prevent occupation by the enemy; we must not be content to contend with the cases of occurring insanity, but we must safeguard the coming generations against further disastrous and increasing casualties. We must fight, not only the existing insanity of our own time, but we must safeguard the interests of posterity by legislating for the protection of those who have to carry on the evergrowing “white man's burden.”

Two papers have recently appeared in the Journal indicating a causal relationship between indoxyluria, alimentary toxæmia, and melancholia. One paper, published by Arthur A. D. Townsend in January, 1905 (Journal of Mental Science, 1905, p. 51), is entitled “Mental Depression and Melancholia, considered in regard to Auto-intoxication, with Special Reference to the Presence of Indoxyl in the Urine and its Clinical Significance”; the other paper, published by Lewis C. Bruce in July, 1906 (Journal of Mental Science, 1906, p. 501), bears the title “The Clinical Significance of Indoxyl in the Urine.”