ROYAL MEDICAL BENEVOLENT FUND.

291 and moody. It was impossible to predict his behaviour from day to day. The fit was a regressive phenomenon. of the dissolution of function in the nervous system. In the treatment of epilepsy it was of the first importAccording to this, every case presented a dual sym- ance to study the personality of the patient, who was ptomatology-negative or defect symptoms, and essentially a mal-adjusted individual, and to help positiveor release symptoms. These two groups, with him to adjust himself to his environment. Treatment on these lines was full of possibilities, while the a third small group of irritative symptoms, were commonly considered to include all manifestations of customary routine bromide treatment had little to disease. Head and Rivers had added a phylogenetic be said in its favour. factor to this hypothesis. They believed that the Dr. DouGLAS ADAMS (Glasgow) read a paper on " lower levels of evolution " remaining after some The Early Diagmosis and Treatment of Disseminated destructive lesion represented what had been normal Sclerosis. activities of the nervous system at an early stage of Thus " protopathic The colloidal gold reaction in the cerebro-spinal fluid its phylogenetic development. sensibility " and the " mass reflex " were to be regarded I, was a test of early organic nervous disease of the as approximating to the normal sensori-motor reac- !, greatest value. Disseminated sclerosis gave constantly " In ’, a tions of some hypothetical primitive animal. paretic " curve. In the treatment of the disease he had obtained favourable results in some cases by general, phylogenetic hypotheses were entirely specu- I lative, and the view prevalent among continental I the administration of novarsenobillon and by mercurial neurologists that abnormal reflex reactions were inunction, though as the observations were of less reversions to arboreal activities of pre-human ancestors than a year’s duration the possibility of remission met with a not unexpected reply in Prof. Karl Pearson’s apart from treatment could not be excluded. No illview that our forebears were never arboreal in habit. effects followed this antisyphilitic treatment. He had The view that almost all bodily ailments were psychical conducted some successful inoculation experiments in origin vied with the phylogenetic school of thought in the sense that animals inoculated with material in present popularity. The confusion of psychological from human cases of disseminated sclerosis developed and physiological categories by those who sought to I paralytic symptoms. However, no histological invesestablish psychogenesis as the solution of all our tigation of the lesions underlying the paralyses in the difficulties often led to grotesque conclusions, such as experimental animals had so far been conducted. In a short discussion following this paper, Dr. that of Jelliffe who stated that the overflow of psychical " energy " into the " somatic pathways" of the FARQUHAR BUZZARD stated that he favoured antinervous system led immediately to the lesions of syphilitic lines of treatment, especially in respect of disseminated sclerosis. In general, it might be urged arsenical compounds, for disseminated sclerosis. It that before we had recourse to the exclusively verbal was important that treatment should be long persisted in. In the matter of experimentally produced pararesources of the psychologist in the attempt to determine the causes of disordered function in the lyses in inoculation animals, he thought that unless the specific lesion of disseminated sclerosis could be nervous system, physiological factors should first be demonstrated no conclusions could be drawn from excluded. As an example of the importance of physiological the clinical observation alone.-Dr. J. CRUICKSHANK factors, the psychical and neurological symptomato- (Aberdeen) stated that in a somewhat extensive he had never logy of anoxaemia were described. The sensitiveness experience of the colloidal gold reaction of the nervecell and synapse to oxygen deprivation found a positive result except in neuro-syphilis and had long been known, but had never been seriously disseminated sclerosis. To differentiate the two a considered by the neurologist as an important factor Wassermann test must also be carried out. in the production of disordered nervous activity. Physiological experiment, confirmed by clinical experiROYAL MEDICAL BENEVOLENT FUND. ence, showed that the initial reaction of the nervous system to minimal grades of anoxaemia was the development of an increased excitability. Clinically, AT the last of the Committee held on July 12th so-called " irritative " symptoms were often manifes- 20 cases weremeeting considered, and £244 voted to 16 of the tations of this condition. A symptom-complex closely applicants. The following is a summary of some of the cases resembling that of tetany was readily produced in relieved :the normal individual by a short period of forced Widow, aged 70, of L.R.C.P. Edin. who practised in Somerset breathing, which resulted in a relative anoxaemia. The and died in 1917. Applicant was left quite unprovided for on the death of her husband, and was helped by a brother-in-law, mass reflex of spinal man was considered as a phenomebut he is now dead. She has been living on her savings, and non possibly dependent upon this cause, and it was they are now exhausted. Two sisters allow her £36 per annum, pointed out that reflex responses could be obtained and board and lodging cost 25s. per week. Voted £18 in 12 in the spinal animal under suitable grades of anoxæmia, instalments. S. Edin. who practised in Daughter, aged 61, of L.R.C.P. & which appeared identical with the mass reflex of and died in 1895. Applicant lost all her belongings In conclusion, it was urged that neurologists, Filey man. through a fraudulent solicitor. She used to earn a little as a but cannot get work now and appeals to the Fund despite the clamant exhortations of the psychogenetic journalist, to her. Rent and rates 33 per annum. Voted £18 in school, could not afford to neglect physiological 12 help instalments. to causes factors when attempting determine the L.R.C.P. & S. Fdin., aged 70, who practised in London and underlying disease of the nervous system, in favour Cheshire, but now unable to work owing to paralysis agitans. of the allegories and verbal researches of clinical He is dependent on his wife, who earns £35s. per week as a clerk. They are living with applicant’s father-in-law, who has a pension psychology. and who is also helpless, and pay .82 per week for their board Dr. CARVER read a paper on and lodgings. Voted £26 in 12 instalments. Widow, aged 68, of M.R.C.S. Eng. who practised at Southam Epilepsy from the Psychological Standpoint. and died in 1882. Owing to chest and heart trouble applicant Our views on epilepsy had within recent years under- has not been able to earn anything for the last five years. For the past two years she has been living on proceeds of the sale gone considerable widening. Epilepsy was a syndrome of the furniture ; these have now gone, and applicant asks the rather than a disease, and the convulsion of epilepsy Fund to help her. She has been living with a married daughter, but cannot do so any longer, and her son allows her £12 per was no longer allowed to dominate our conception of the condition. The study of the epileptic personality ’, annum. Voted £26 in 12 instalments. aged 41, of M.B. Irel. who practised at Enfield had afforded much new and important knowledge and andWidow, died in 1920. Applicant left with four children, ages 5 to 16. had shown that the epileptic might be recognised at The second boy, aged 14, provided for by uncle. The eldest an early stage of his malady before any convulsion son, aged 16, is consumptive, and has just returned home from Applicant has sold her furniture, and is now had occurred. In the causation of epilepsy, psycho- a sanatorium. living in rooms. Since September, 1920, she has received £114 logical, physiological, anatomical, and other factors from investments. Voted 918 in three instalments. had all to be considered. The views of Pierce Clark Subscriptions may be sent to the hon. treasurer, Sir were then discussed. The personality of the epileptic Charters J. Symonds, at 11, Chandos-street, Cavendishwas characteristic. He was egocentric, selfish, erratic, square, London, W. 1.

becoming traditions. Among the guiding principles was undoubtedly

most fruitful of Jackson’s theory