Although much has been written upon porencephaly, yet detailed descriptions of the resulting alterations in the constituent neurons of the cerebro-spinal axis are few in number. As a further contribution in this direction the present case has been studied, and the changes found have been recorded as far as possible graphically. No attempt has been made to collect together the literature, largely clinical, of porencephaly, as it has been felt that this cannot be profitably done until the minute anatomy of the central nervous system has been placed on record in a much larger number of cases than is at present available

A Large amount of both experimental and clinical work has now accumulated around this subject. I need only briefly mention the main results of the former, as they have been so often referred to by others that they are now probably familiar to all workers in this field.

The feature of Jacksonian epilepsy to which I wish to call attention is the periodicity of the discharge. Whether we regard the lesion as “irritative” or “discharging,” it is, at all events, chronic; and whether we regard the discharges as going direct from the cortex to the efferent nerve-cells, or as causing convulsions in a more roundabout way through subcortical systems, they are, at all events periodic. How, then, do chronic lesions cause periodic discharges ? The answer which I wish to put forward is suggested by certain passages in Mercier's Psychology, Normal and Morbid, p. 283, which run as follows: —Speaking of how organic bodies may contain a store of motion which can be liberated by the impress of motion from without, and after likening this property to that of animals and their power of movement, the author continues, “But animal organisms have a further property which most inorganic bodies have not. They are continually adding to their stores of motion, and by these continual additions their store at length becomes surcharged. The tension of the contained motion reaches such a pitch that the containing resistance is no longer sufficient to keep it in bond, and it breaks out, possibly without the provocation of added motion, certainly with minimal provocation.’’ Later on, when discussing “Will and Desire,” the same author writes of nervous mechanisms, “There are many machines used in the arts, which depend for their actuation on the gradual filling of a vessel with water. The vessel is of such a shape and so supported that, as it fills, the centre of gravity shifts, until, at a certain degree of fulness, the vertical at the centre of gravity falls without the base; the vessel then capsizes, empties its contents, regains its previous distribution of weights, rights itself, and begins to fill once more.”

Following up my observations made upon the blood of patients suffering from acute continuous mania read before this Association at the autumn meeting, I have been able to observe three cases of acute continuous mania in adults which relapsed while in the asylum. The results of the first series of observations were that in every case of acute continuous mania there existed a leucocytosis which persisted after recovery indefinitely. I advanced the theory that this leucocytosis was a protective leucocytosis. In the three patients who relapsed the leucocytosis was found to have fallen to below 13,000 per c.mm. of blood, instead of being nearer 20,000 per c.mm. of blood, which is characteristic of the recovered cases of mania. The polymorphonuclear leucocytes averaged 60 per cent, in two of these patients, and 47 per cent, in the third. In one of these patients the attack passed off in two days, and the leucocytosis at once rose to 25,000 per c.mm. of blood. The other two patients passed into a definite second attack, and their leucocytes averaged 15,000 to 16,000 per c.mm. of blood, with a polymorphonuclear percentage of 60 or below 60. The fact that the leucocytosis fell in each patient at the commencement of the attack, and rose at once in the patient who recovered from the relapse, strengthens the hypothesis that acute continuous mania is an infective disorder, and that immunity from maniacal attacks rests upon the resistive power of the individual patient. This hypothesis receives further support from the fact that there exists in the blood of patients suffering from acute mania a specific agglutinin. During the month of November a patient suffering from acute mania was admitted to Murthly. The patient was so ill that I did not think she would live many days. I isolated from the blood a very small coccus, which was a pure growth, but, as the patient was exhausted, I regarded the organism as a terminal infection. The patient improved, however, and three weeks later I tested the agglutinative power of her serum upon this organism in a dilution of 1 in 30. Agglutination was complete in three hours, while the serum of a member of the staff in a dilution of 1 in 20 produced no action in twenty hours. Since then I have made fifty agglutination tests with this organism. Only ten of these cases, however, have been pure cases of continuous mania. Eight gave a decided definite agglutination, one was doubtful, and the tenth—one of the patients above noted, who relapsed—gave no reaction. No “control” serum ever gave a reaction, nor did the serum of these patients suffering from mania agglutinate other organisms. The agglutinin in the blood was therefore a specific agglutinin.

Gentlemen,—It is now some eight years since I had the pleasure of receiving the South-Western Branch at this Institution, and I take this opportunity of expressing the pleasure it gives me to see you here to-day.

The theories by which it has been endeavoured to explain the existence of hallucinations are manifold. In this field, as in so many others where we watch the play of mental phenomena, our point of view varies from time to time, so that the explanations which were once deemed more or less satisfactory become unmeaning when the problem to be solved has itself shifted ground.

Dr. Carlyle Johnstone, introducing the discussion, said: It is several years since any active steps have been taken by the Scottish Division, or by the Association itself, to obtain retiring allowances for the officers and servants of Scottish district and parochial asylums. Nothing has been done in the interval by the State or the local authorities to satisfy our reasonable claims or to remove the special injustice under which Scotland suffers. A memorial on this subject was presented to the Lord Advocate by the Scottish Division in 1877, and a similar memorial was presented to the Secretary for Scotland, Lord Lothian, in 1887. The representations of the Division were politely received, but no practical results have followed. It may be considered that it would be futile to send in a third petition; but the present Secretary for Scotland has never been approached by our body, and he may fairly consider that if we do not ask for pensions we do not want them. There is reason to believe that at any moment a Bill for the amendment of the Scottish Lunacy Acts may be introduced into the House of Commons. We should leave no stone unturned in order to secure that in this Bill provision shall be made for the granting of superannuation allowances in all Scottish public asylums. I have brought this question before the Asylum Workers' Association and the Parliamentary Committee of the Medico-Psychological Association, and both of these bodies have now memorialised Lord Balfour on behalf of the Scottish asylum workers. In my opinion our Scottish Division should do the same. The conditions of service in Scotland are so anomalous, so grossly unfair as compared with those in England and Ireland, that, if only we keep on protesting and agitating the matter, we may reasonably expect by our continual importunity to obtain justice sooner or later. At each General Election we ought to approach every candidate for Parliamentary honours, lay our case before them, and obtain from them individually, if possible, an expression of their sympathy with our claim and a promise to vote for a Bill which shall satisfy this claim. This is what we ought to have done at the last General Election. I hope that this meeting will resolve that this shall be done at the next one. It does not appear to me to be opportune to approach Members of Parliament at this moment. In a decaying House, with a dwindling majority on the side of the Government and many Members proposing to go into retirement at the dissolution, we can scarcely expect Members to pledge themselves to vote for what cannot be regarded as a “popular” or “economical” measure. But we ought, I think, to get into touch with Lord Balfour at once, and make plans for bringing pressure to bear on all Scottish candidates at the General Election, which may possibly occur at an early date.

A granular condition of the ventricular ependyma has long been recognised as a pathological condition in various cases of insanity, and is so common in cases of general paralysis that we are surprised when it is not present. It is, however, by no means confined to that specific class of case, but exists in others, and, although not so frequent, is sufficiently common to make one inquire into its cause and as to its bearing, if any, on insanity.

The report of a special committee to the Glasgow Parish Lunacy Board shows that in the year ending May 15th, 1902, no less than 259 cases of mental disorder of alcoholic origin had been admitted to the two asylums and the observation wards, one third (33 per cent.) of the whole admissions of the year being directly due to alcoholic excess.

The extension of the voluntary boarder system to the county and borough asylums has long been felt to be a necessity by all who are interested in promoting the early treatment of the insane. It is, moreover, only just that a provision of the law which is found to be good for the well-to-do classes should be extended to the poor. Dr. Ernest White has done good service in again giving prominence to this great need of the poor, in the recent discussion on the treatment of incipient insanity.

Lunacy legislation in the present Parliament is again conspicuous by its absence, but before this reaches the eyes of our readers there will probably have been some discussion in the House on the insufficient number of medical men on the Lunacy Commission.

That officers and servants of the Scottish district and parochial asylums should be utterly shut out from all superannuation allowances is an almost incredible anomaly. Public servants throughout Great Britain are generally provided for in this way, and very few of them can claim it on the ground of having duties that are in any respect so anxious, responsible, or dangerous. Asylum workers should be the first and not the last to be thus provided for.

The report of the first year's work of the pavilion (F) for mental diseases at the Albany Hospital is now to hand, and appears to offer every encouragement for the extension of the hospital treatment of mental diseases.

The laying of the foundation stone of the Winsley Sanatorium for Consumptives was an opportunity for the expression, by those connected with, it of their recognition of the valuable services of a member of our Association, Dr. Lionel Weatherly.