The Scottish Division entered upon an important discussion at their spring meeting. It has been evident for some time that the trend of opinion in the advanced school of pathology has been towards a theory of toxic causation of insanity. Indeed, it is inevitable that the extension of such a theory, pushed to its furthest limits, should permeate all departments of medicine and find enthusiastic supporters in our own specialty. Toxic causes, established in such diseases as diphtheria and tuberculosis, have eluded observation in cancerous affections, although the search has been skilful and prolonged. A poisoning of the system, which we now call toxæmia, has been recognised in the domain of psychiatry for many years. Schroeder van der Kolk was so assured of his opinion that he based his treatment of insanity upon the theory of a common causation in the overloaded, disordered condition of the great intestine; and, even at the dawn of medical science, the toxic effects of black bile were denominated melancholia, and described at interminable length. At any rate, these theoretical ideas were useful in drawing attention to the physical basis of mind, and in offering indications for the treatment of its disorders. Of late years, however, there has been a remarkable advance in the strictly scientific knowledge of the physiology and pathology of living organisms. The science of biology has been rapidly evolved, and it is a real struggle to keep pace with the more important conclusions formulated by the great army of workers. In our own particular sphere of interest, we could not but expect the moment when the toxæmic stalking-horse should be advanced to occupy territory hitherto held strongly by the old guard of a less materialistic psychology. Therefore the battle-field at Glasgow could occasion no surprise—it was as inevitable as the great Boer war. Not that the Old Guard were inactive in defending the positions in which they have been so long entrenched, or that they have entirely lost their scalps in the fray. It would rather seem as if they were ready to establish a zone of neutral territory—ground common to both, which may yet be extended by diligent sapping and mining on the part of the aggressors. So the day ended.
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