1165THE PROBLEMS OF PSYCHIATRY.

Annotations.

THE PROBLEMS OF PSYCHIATRY.

"Ne quid nimls."

WE publish this week an Address on Mental Disordersdelivered by Sir George Savage before the Section of Psychiatry of the Royal Society of Medicine last Tuesday.The address, with the expressed intention of the deliverer,went over a wide field, for the section is a new one, and no

doubt the first president felt that with such an expanse ofvirgin soil to be tilled it might be embarrassing at

the outset to put any limits to the work which

the section might do, or suggest any confines to

the value which might accrue to medicine throughits deliberations. Sir George Savage’s general message,uttered out of the fulness of long experience, is optimistic,for while he warns us that progress does not follow on the

heaping together of facts, but upon the drawing of duelessons from those facts, he shows clearly that only by theindustrious collection of material can proper guidance beobtained. Only from organised and combined work cancome the rapid revolution in attitude and designs whichis so clear a mark of the scientific medicine of the last

20 years. The value of cooperative work over a largefield and within no rigid boundaries is testified to

incidentally in Sir George Savage’s address when he

points out the risk of being led into general deductions byisolated incidents. This risk can only be minimised by steadyand often laborious inquiry, when the incidents will eitherappear as no longer isolated, or much toil will have beenspent with apparently useless results. As a matter of fact

such toil is not useless but most valuable. Even if the

incidents in question are found to be isolated and thereforeof less substantial value, only research can prove this, andthe time spent on the research must not be grudged, forthe labour that is thus saved for other people may beincalculable. Sir George Savage compares such work to

pursuing knowledge down blind alleys, and his simile maybe used to point out that an alley is not known to be blinduntil someone goes down to the bottom of it ; after whichthe alley can be charted as "No thoroughfare," and othertravellers along the main route will not lose their time invain digressions. We may expect that the deliberations of thenew section of the Royal Society of Medicine will take noteof divagations from the apparently broad path, and will

discuss their value ; and we may feel quite sure that underSir George Savage’s segis such discussions will be of highscientific character, and will not become symposia of thefanciful. Neurologists and psychologists alike will sympathisewith his view that their sciences should not be divorced.

Sir George Savage puts the position very simply when hesays that there are only a limited number of ways in

which the nervous system can express itself, and thereforesimilar symptoms will be present, whether the central

nervous system is primarily affected, or whether its func-

tions are interfered with by the misconduct of one of its

servants. A section of psychiatry may expect to have

advanced for its consideration under one division of its

labours the most advanced physiology and pathology, andunder another division the widest social questions.

THE SURGEON’S ASSISTANTS.

EVERY surgeon realises the importance of skilled assist-ance in his operations, and to none is it brought homemore vividly than to the ophthalmic surgeon. Dr.

Samuel Theobald, the veteran professor of ophthalmo-logy at the Johns Hopkins University, makes some

valuable suggestions in a paper re3,d befo.’e the American

Ophthalmological Society, and published in the Johns

Hopkins Hospital Bulletin. To the experienced t’iey mayappear to be the veriest truisms, but to those for whom

they are intended they should be of great use. Theymight with advantage be extended and amplified, thus

forming an invaluable manual for ophthalmic house surgeonsand assistants. What ophthalmic surgeon to a hospital is

there that does not dread the advent of a new house surgeon ?With what trepidation does he not watch his every move-ment at the first operation ? Is he deft with his fingers andlight of touch, or will he swab an eye as though it was

an amputation wound? Often the surgeon will dispense withassistance rather than run the greater risk. It is some-

times wiser to leave a speculum to its own devices thanhave it pressed upon the eye or pulled out altogether by aninexpert assistant. There are, however, some operations inwhich the part of the skilled assistant is at one stage oranother as important as that of the chief, and not infre-

quently in some complicated case intelligent cooperationmay save an eye otherwise irretrievably lost. Perhaps it is acataract extraction ; the patient squeezes and vitreous appearsin the wound ; everything may depend upon the assistanteasing the speculum and quieting the patient, whilst the

surgeon delivers the lens with a spoon or vectis. Dr.

Theobald has also some words of wisdom for the nurse and

pharmacist, not to speak of the manufacturing optician. Hewaxes poetical over the instrument maker.

Shrine of the mighty, can it beThat this is all remains of thee?

he quotes from Byron apropos of the cataract knife whichhas been ground instead of being sharpened on the oil-stone.

AN ANTHROPOLOGICAL SURVEY OF PRISONERS.

Ix the recently issued annual report of the Commissionersof Prisons for the year ended March 31st, 1912,1 it is

mentioned that the anthropological investigation whichhas been proceeding in the convict prisons during the

past ten years has now been completed. A large amountof statistical material bearing on the physical and mentalcharacters of some 3000 convicts has been collected,and has been analysed and tabulated by Dr. Charles

Goring (one of the medical officers of Parkhurst Prison)in the Galton Eugenics Laboratory of University College,London, under the supervision of Professor Karl Pearson.The Commissioners promise that the statistics and reportwill shortly be published in full, and meanwhile theyindicate briefly the main results of the investigation. The

general conclusion arrived at by Dr. Goring is, they state,that criminals are not differentiated from the rest of the

community by any physical or mental anomalies, thoughthey appear as a class to be below the average of the

population at large in height, body weight, and generalintelligence. The only distinctive character which is im-puted to them is that ’’ they manifest a constitutional

incapacity due to weakness of will or want of power, result-ing in an incapacity to live up to the required social

standard, thus bringing them within the meshes of thecriminal law." It is not made quite clear whether the exist-ence of this constitutional incapacity has been establishedby some special psychological examination directed to thatparticular point, or whether it has been merely inferredfrom the fact that the individuals dealt with were con-victed criminals. In the latter case the terms usedwould appear to involve some rather large assumptions,amounting, indeed, to a begging of the whole question.Apart from this point, it will be seen that Dr. Goring’sresearch fully confirms the conclusions of other investigatorswho, approaching the subject on similar lines, have also

1 THE LANCET, Oct. 19th, 1912, p. 1090.