I have again ventured to trespass on your time and attention with some remarks on the pathology of epilepsy, partly in order to refer to some criticisms on my views and partly to amend them, because my most recent observations on the coagulation-rate of the blood in this disease seem to indicate that they require some modification.

In any province of experience the systematic arrangement of the facts pertaining to it is regarded as one of the most useful instruments in its comprehension and understanding, and for this reason a systematic classification of the various forms of insanity has long been accepted as one of the best signs of psychiatric progress.

Francisque Sarcey says that originality consists, not in thinking new things, but in thinking for yourself things that thousands of generations have thought before you, and that your idea will appear new because you will strongly impress upon it the turn of your mind and tinge it with the colour of your imagination. Something of this kind has occurred in the presentation of dementia præcox. Kraepelin does not even claim the term as his own invention, but refers to it as the original proposal of Pick. We have duly recognised the distinguished position attained by them both, and appreciated Kraepelin's work, especially in investigation and teaching, and his achievements in elucidating morbid mental phenomena. If one is led to differ with him in the light of observations already made in this country and years of personal experience, that difference must be expressed in terms of esteem and respect.

This paper has for its object the placing on record of a considerable number of observations made during the past eighteen months upon the blood of the insane. It was after the perusal of Dr. Lewis Bruce's work upon the clinical aspect of mental diseases that this special subject suggested itself to me as one deserving minute and extended study. Whereas Bruce deals somewhat minutely with the various constituents of theblood, I have confined my observations to the changes that occur in the number and variety of the white blood-cells, and the relationship these alterations have to the acute mental diseases in which they are found. These researches, though still in their infancy, hold out great encouragement to the belief that in such directions we may yet succeed in arriving at a true knowledge of the pathology of mental diseases, and at the same time advance at least one step in what has hitherto baffled all research-the conditions governing the mutual relations of mind and matter.

Asylum officials may be roughly divided into three groups. In the first group are included artisans and others who are paid weekly wages, have no emoluments, and live in their own homes away from the asylum, whilst in the second and much larger group are included nurses and attendants (estimated by the Commissioners in Lunacy to number in England and Wales more than ten thousand persons), laundrymaids, housemaids, kitchen-folk and others, who, in addition to their monthly paid wages, usually have the emoluments of board and lodging. In the third group are included chief officers and others who are provided with houses, cottages and apartments on the asylum estate. The weekly paid or artisan class are, as a rule, well paid, contented, and of long service. They do not lead a cloistered life, and it is not with them that this article deals. As to the second group, the public now happily recognises the unselfish labours of the large army of workers in direct attendance upon the insane throughout the country, and it is not necessary to enlarge upon their usefulness to the community. Their hours of duty are very long, their pay is not large, and the restrictions and disadvantages under which they work are very great. Probably all asylums have allowed a certain number of these officials to board and lodge off the premises. Some asylums may be more favourably situated than others, and thus have done more in this direction, but the writer thinks that at all asylums more could and should be done towards de-cloistering the staff. In an asylum constructed to meet the circumstances and placed in suitable surroundings, the sane resident population could be reduced to very moderate proportions. It is urged that when the abnormally long and trying hours of duty are over, as many officials as possible should be altogether freed from institutional restraints. The cost of the erection of asylums would be decidedly lessened if they were built to provide accommodation only for (i) the patients, (2) such members of the staff as must of necessity be boarded and lodged on the premises, and (3) such officials as must have houses provided for them on the estate. Has any asylum authority ever prepared an estimate showing the cost of the erection and upkeep of quarters, and of the provision of necessities and conveniences of every description specially made for members of the staff who do not need, for any particular reason, to be provided with lodgings on the asylum estate?

I fully appreciate the very great honour which has been done to me this afternoon in asking me to speak of the experience which I have had in nearly twenty years of work amongst those who are suffering from alcoholism. Of courseyou will forgive me if I speak in an altogether unscientific way. I can only say exactly the experiences I have met with, and as I now live, summer and winter, in their midst, I can give you at any rate the result of my personal experience among such people. Thirteen years ago, when we first started the colony which we have for inebriate women at Duxhurst, the Amendment to the present Inebriate Act was not in existence, that is to say, there was no means of dealing with such people other than by sending them to prison. The physical side of drunkenness was then almost entirely overlooked, and the whole question was dealt with more or less as a moral evil. When the Amendment to the Act was passed it was recognised, at any rate, that prison had proved to be a failure for these cases, and this was quite obvious, because such women were consigned for short sentences to prison, and then turnedback on the world, at the end of six weeks or a month, as the case might be, probably at the time when the craving for drink was at its height, and therefore when they had every opportunity for satisfying it outside the prison gate they did so at once. It is nowonder therefore that women were committed again and again, even to hundreds of times. When I first realised this two cases came distinctly and prominently under my notice. One was that of a woman whose name has become almost notorious in England, Miss Jane Cakebread. She had been committed to prison over 300 times. I felt certain when I first saw her in gaol that she was not in the ordinary sense an inebriate; she was an insane woman who became violent after she had given way to inebriety. She spent three months with us, and I do not think that I ever passed a more unpleasant three months in my life, because when she was sober she was as difficult to deal with-although not so violent-aswhen she was drunk. I tried to represent this to the authorities at the time, but I wassupposed to know very little on the subject, and was told that I was very certainly mistaken. I let her go for the reasons, firstly that we could not benefit her, and secondly that I wanted to prove my point. At the end of two days she was again committed to prison, and after being in prison with abstention from alcohol, which had rendered her more dangerous (hear, hear), she kicked one of the officials, and was accordingly committed to a lunatic asylum. Thus the point had been proved that a woman had been kept in prison over 300 times at the public expense during the last twenty years before being committed to a lunatic asylum. The other case, which proved to me the variations there arein the classifications of those who are dubbed “inebriates,” was a woman named Annie Adams, who was sent to me by the authorities at Holloway, and I was told she enjoyed thename of “The Terror of Holloway.” She had been over 200 times in prison, but directly she was sober a more tractable person could not be imagined. She was quite sane, but she was a true inebriate. She had spent her life in drifting in and out of prison, from prison to the street, and from the street to the prison, but when she was under the bestconditions I do not think I ever came across a more amiable woman. About that time the Amendment to the Inebriates Act was passed, and there were provisions made by which such women could be consigned to homes instead of being sent to prison. The London County Council had not then opened homes, and they asked us to take charge of their first cases. They were sent to us haphazard, without classification. There were women who were habitual inebriates, there were those who were imbecile or insane; every conceivable woman was regarded as suitable, and all were sent together. At that time I saw clearly that there would be a great failure (as was afterwards proved) in the reformatory system in this country unless there were means of separating the women who came from the same localities. That point I would like to emphasise to-day. We hear a great deal nowadays about the failure of reformatories, but unless you classify this will continue to be so.

Some day there may be found a medicine to cure epilepsy. After that day the treatment of the disease will be a simple affair. But for the present he who undertakes to treat an epileptic undertakes a very difficult and responsible task. He must takea broad view of the situation, and use remedies not mentioned in the British Pharmacopoeia.

I feel highly honoured in being invited to read a paper before you this afternoon on my experience in the treatment of morphia habit by the method published by Dr. McBride in April, 1904.