43 



From the report of 1905 we take the following : 



"Beginning October 1, 1903, and continuing until the last of December 

 of the same year a series of lectures and demonstrations was given to the 

 assistant physicians on the anatomical relations and the physiological 

 functions of the various parts of the nervous system, on the different 

 changes produced by the different pathological conditions that were liable 

 to involve them, and upon the clinical symptoms manifested by such in- 

 volvement. 



"After the 1st of January. 1904, regular staff meetings were insti- 

 tuted and held three times weekly, namely, Monday, Wednesday and Fri- 

 day mornings from 10:30 to 12. At these meetings the assistant phy- 

 sicians alternated in presenting one or more cases. A systematic exam- 

 ination was made of the mental condition and also of the physical condi- 

 tion, where this had not been done beforehand, by the physician in charge, 

 followed by a discussion of the case by those in attendance. A synopsis 

 of the more important clinical features of each case, together with a sum- 

 mary of the clinical manifestations, was recorded. 



"The object of these meetings was to create a nucleus upon which more 

 complete clinical records could be built, and for this purpose a short re- 

 port was made and filed away of each case, pointing out the prominent 

 and characteristic feature of the individual cases presented. An endeavor 

 was also made to determine the underlying conditions that were the prob- 

 able factors in bringing about the mental disturbance. This problem was 

 found to be an extremely difficult one. Many important factors came into 

 consideration when an attempt was made to bring about a solution of this 

 problem which were most difficult to regulate and control, in many cases 

 wholly impossible, and tended to make this part of the work a source of 

 discouragement and in many respects very unsatisfactory. One of the first 

 essentials in the study of all pathological conditions, whether mental or 

 physical, is, of course, to have a correct conception of the normal, or what 

 is regarded as normal, in the individaul case. Without this one cannot ar- 

 rive at a definite conclusion as regards the degree and extent of the ab- 

 normal conditions that developed or that may do so. In the majority of 

 cases presented very little information was obtainable, apart from that of 

 the commitment record, or from the patients themselves. The former re- 

 ports, unfortunately, were very incomplete, and the latter almost invari- 

 ably were more or less distorted or modified by the trend and coloring of 

 the mental disturbance existing. Consequently, any conclusions arrived at 



