Nyasaland is a narrow strip of land 40,000 square miles in extent. It lies approximately between latitude S. 9’ 45” and 17’ 15”, and longitude E. 33’ and 36’. It is bounded on the North by Tanganyika Territory, on the East by Lake Nyasa and Portuguese East Africa, and on the West by Northern Rhodesia and Portuguese East Africa.

The sensory material which provides the essential data for conscious activity is conveyed to the higher functional levels of the brain by impulses which stream up the olfactory tracts, the optic tracts, and the tracts of the brain-stem and spinal cord. With the exception only of the olfactory impulses, all these sensory impulses are filtered through the thalamic region of the brain, or diencephalon, before they can be relayed to the cerebral cortex which forms the anatomical substratum of the more elaborate mental processes. It is an interesting fact that, while the functional localization in the cerebral cortex and the functional localization in regard to the numerous fibre tracts in the brain-stem and spinal cord have been established in quite considerable detail by anatomical, physiological and clinical studies extending over many years, the localization and the connections of the various relay mechanisms in the diencephalon still remain obscure. Since the nature of the sensory material which is delivered to the cerebral cortex depends ultimately on the influences and modifications which may be imposed on the afferent impulses during their passage through the diencephalon, it becomes a matter of extreme importance, from the point of view of the study of the physiology of sensation and of psychological interpretation of sensory experience, that attention should be concentrated on this diencephalic mechanism. The minute anatomy of the diencephalon has recently been worked out in great detail, and it is now the task of the anatomist, physiologist and clinician to discover the functional significance of the numerous cell groups and fibre tracts which have been defined.

When one compares the present state of psychiatric research with that of neurological research, one finds, in the former, an astonishing confusion of contradictory viewpoints. This confusion would, I believe, be resolved if research workers in psychiatry embodied in their creed certain of the principles which Hughlings Jackson unceasingly laboured to establish.

Progress in general medicine is brought about by clinical observation or carefully controlled experimental research. In psychiatry there is little opportunity for the latter approach. One of the few methods available at the present time is the use of intoxicating drugs. It was Kraepelin who first emphasized the importance of studying psychological changes produced by drugs. Following his lead many observers have tested their action on various psychic faculties. Copious data have been collected about such agents as alcohol, caffeine, hyoscine and cocaine. But the value of these observations in bringing about an understanding of the psycho-pathology of the major psychoses is limited, since it is rarely possible to produce the picture of a true psychosis without giving the drug in amounts sufficient to bring about dangerous or chronic intoxication.

Since the time of Ferrier and Hitzig, the effort to localize functions in the cortex has been elaborated until at one time there was thought to be a veritable mosaic of centres in the brain. This line of development has repeatedly been interrupted by investigators who denied the possibility of localization. In this paper we shall refer more particularly to the work of Goldstein, who in numerous papers, and in his new book, Der Aufbau des Organismus, has launched an attack on localization, which by virtue of its systematic approach outdoes all previous attempts of the kind. The chief objects of his scrutiny are the theoretical and philosophical principles of cerebral localization. Two of the ideas stressed by him may be anticipated here; the need for defining what is meant by “symptoms” in cerebral pathology, and the importance of observing the general behaviour of patients with cerebral lesions. These ideas are well in conformity with the general methods of psychiatry.

In the consideration of sinus sepsis in mental disorder it is first necessary to define in our own minds what we understand by the terms used, and their joint significance. A short summary of work already done is therefore given.

My first duty is to thank you for the honour you have conferred on me in electing me President, and to welcome you all on your visit to East Kent and Folkestone for, I think, the first time in the history of the Association.

Present-day medicine tends, where the ætiology of a disease is obscure, to rely too much on the wholesale suspicion of several viscera. It is, therefore, necessary to consider those factors which lead us to the supposition that the liver is at fault in epilepsy.

The material to be presented in this paper is based on the association-motor records of 100 normal controls and 297 psychiatric cases examined by this method during the past three and a half years. The procedure introduced by Luria (1) in 1932, and subsequently modified and adapted by us to meet the expediencies of everyday clinical practice, consists of Jung's word-association technique combined with motor activity.