Possibly the title superscribed to this short article may prove misleading; if so, I must crave your indulgence, as the subject to which perhaps such a title is more applicable could scarcely be done justice to within the short limits of time allotted us. I merely wish to skim over the surface of this question of alcoholism and indicate some special features which have appealed to my interest in this connection, prefacing my remarks on the geographical distribution of alcoholism and insanity with a cursory review of the physiological action of alcohol upon heatformation and its effects on those centres presumably operant in muscular sense discrimination.

The present and final division of this paper contains a description of those types of mental disease which are classed by the writer under the heading “Dementia.” Under this term he includes all cases which agree, from the psychic aspect, in the possession of a decreased or decreasing mental capacity, and from the physical, in the existence of a distinct and permanent loss of cortical substance in those regions of the cerebrum which especially serve as a physical basis for the carrying on of (voluntary) psychic processes.

The difficulty of informing the relatives of patients suffering from dementia paralytica on the probable duration of the disease led the writer to inquire into those symptoms and signs which appeared to be of value in prognosis.

Gentlemen,—I need offer no apology for once more bringing this subject before you, as its importance demands our immediate and careful consideration. More especially is this the case at the present time, because since I last alluded to it (at our annual meeting in July, 1905) the Select Committee of the House upon the State Registration of Nurses, has given to our nurses the stamp of official recognition, by inserting in their report the following opinion:—“The claims for Registration of Mental or Asylum Nurses have been laid before your Committee. They are of opinion that a separate Register of Registered Asylum Nurses should be kept by the Central Body, to which should be admitted the names of Nurses who have served for not less than three years (in not more than two Asylums) and who have received the certificate of the Medico-Psychological Association and can produce satisfactory certificates of good character.”

Since October, 1902, there has been in operation at the Metropolitan Asylum, Leavesden, a system of promotion for nurses and attendants.

The term “dysentery” includes many diseases which, though clinically and pathologically similar, are widely different in their etiological and epidemiological characters.