RELATIONS TO OTHER SCIENCES 259 



metabolism, which leads to the breaking-up of the lecithin, the 

 important fat constituent of the nervous substance, into poisonous 

 by-products, neurin and cholin. These circulate in the lymphatics 

 and blood-vessels and irritate and further poison the nerve-centres. 

 So that when the brain actively degenerates, it produces a poison. 

 This poison reacts on the nervous centres, causing new symptoms, 

 and thus a vicious cycle is set up. Some of the crises of paresis and 

 the dementias may have this origin. 



The function of the lower bowel seems to have some close relation 

 with the functioning of the nervous centres, and an autotoxemia is 

 perhaps an important element in both depressive and maniacal 

 states. Indeed the appearance of mania especially suggests an auto- 

 intoxication. One cannot observe the apparently causeless recur- 

 rence of mania and melancholia without the conviction that behind 

 it all is a disorder of metabolism leading to a toxic state. 



We may expect, therefore, much from the further studies of the 

 physiologic chemist. Such studies will include the activity of the 

 ductless glands, the adrenals and thyroid, and in particular of kidney. 



We cannot, it is true, expect to find any objective explanation of 

 the tendency which the alienated possesses to pass repeatedly into 

 states of mania. But we may find the nature of the nutritional change 

 that excited it, and by proper methods we may be able to keep off 

 recurrence of insanity. 



This it seems to me is a hopeful field of therapeutics which is now 

 presented to alienists. 



The clinical pathology of the blood has as yet been of little help in 

 psychiatry. The examinations throw no light on the cause or type 

 of a psychosis. Nor do clinical pathologists promise us much here. 

 If we could find and cultivate the germ of syphilis, a field would be 

 opened. At present there are no biologic blood-tests that help us. 

 It seems as if the ingenuity of the investigator would some day in 

 some way show us objectively some blood-changes, for example in 

 acute mania or delirium yet it has not been done. 



Pathologic anatomy is a subject of more academic than practical 

 interest to the psychiatrist. The burden of our work should now be 

 away from morpholgy and more in physiologic lines. 



Psychiatry and Criminology 



The relation of psychiatry to criminal anthropology is a close and 

 important one. There is on the one hand the instinctive or hereditary 

 criminal, and on the other the moral imbecile and the insane who do 

 criminal acts perhaps casually or as an accidental product of violence 

 and delusion. It is for the psychiatrist to help in solving the difficult 

 problems of the border-line cases. As a rule we can say that the crim- 



