A RETROSPECT OF MODERN PSYCHIATRY. 
7 
as 1936, Grey Walter was able to report four cases in which slow waves 
pointed to the site of a growth which was verified at operation or post 
mortem. 
Light has been shed on the age-old, mysterious yet very common 
condition of Epilepsy. It has been shown that the fit or seizure is but 
the outward manifestation of disorder in brain-rhythm potentials. 
Major and minor attacks show an increased voltage during its height. 
It is possible to differentiate by the wave-speed, those vague muscle 
jerkings, bouts of irritability and other minor variants which are a 
part of the Epileptic Syndrome. As a result of these discoveries, 
epilepsy is now described asa“ Paroxysmal Cerebral Dysrhythmia. 7 7 
The encephalograph is to-day being used not merely as a help in 
diagnosis and treatment but has been employed medico-legally to discover 
epilepsy in the criminal. During a recent case choice of the alternatives 
“prison or hospital” actually depended on the encephalographic 
findings. 
Quite apart from the above one must refer in this retrospect to the 
extraordinary change in outlook for the epileptic during the last 25 
years. Only those who remember the “era of the Bromide 7 7 will appre- 
ciate the dull intellects, the spotted faces and demented appearance of 
the old-time sufferer. To-day through the introduction of the 
Barbiturates and Dilantin we have at our disposal drugs which will in 
most cases control the fit without producing an excessive drowsiness. 
DISCOVERY OF NEW ENTITIES. 
Time passes. I must all too briefly refer to the well-known scientific 
process of collecting facts, analysing the material and splitting off 
entities into a new classification. Thirty years ago any of the following 
patients would have been wrongly classified and treated: 
1. A man has had only two fits in his lifetime both when surfing. 
2. (a) A fireman complains of faintness only when stoking his 
engine. He is nervous. 
(b) A woman having once been giddy in the street develops 
fear of going out of doors. 
3. A man falls to the ground when excited and falls asleep on 
the least provocation even when driving a car. 
4. A young adult, after a severe attack of “fever,” sleeps by 
day, is awake at night and becomes clumsy in his move- 
ments and sees “double. 77 
Case 1 . — The cause and treatment of Diabetes is now a common- 
place of knowledge. The use of Insulin in decreasing excess of 
blood-sugar is universal. That psychiatric states can result from a 
decrease in blood-sugar is a new discovery. The man mentioned above 
who, after heavy exercise when fasting, had fits was found to have a 
low blood-sugar/ He is not an epileptic but a hypoglycaemic who by 
regulating his food-intake can command his destiny. We now know that 
hypoglycaemia can produce a wide variety of symptoms including 
mental confusion, langour and pains. 
Case 2 ( a and b ). — Both have previously been treated as merely 
nervous invalids. Actually they belong to the “water-balance 
syndrome.” Our stoker loses much sweat in the hot task of feeding his 
engine in a tropical condition. He has merely a salt-deficiency. The 
