President's Address: A Survey of Some Conditions conducive to Mental Disturbance, with Suggestions as to their Treatment

Conditions which experience has proved conducive to mental disturbance considered.-Suggestions as to their treatment.-A weakened inhibition, rather than any positive condition, is probably the most important factor in the production of the exhaustion psycho-neuroses or psychoses. This view is supported by the prophylactic value of giving for prolonged periods small doses of bromide to hypersensitive children or to highly-strung persons exposed to stress or tropical climate, etc.-Pavlov's work on the conditioned reflexes in dogs quoted in support of the author's clinical experience: Pavlov states that bromides should not be regarded as sedatives, diminishing the excitability of the central nervous system, but as simply regulating the nervous system by strengthening the intensity of internal inhibition. This agrees with the author's clinical experience, as small doses of bromide taken regularly over a period of many years do not diminish the mental powers but in fact increase them. Question of sleeplessness considered with regard to the way in which sedatives act. Most of these do not act as so-called "sleeping draughts"; research may ultimately show that their action is to strengthen a weakened inhibition and that sleep is only a secondary benefit.-Value of sedatives before and after surgical operation. Importance of toxaemia in the production of mental disorder; insomnia often precedes a toxic process and permits it to become active. The theory of weakened inhibition explains many problems; e.g., why certain brilliant children or adults break down and why at first there is no interference with their normal mental activity which only becomes involved as sleep and other bodily functions become affected; why a toxaemia may affect the nervous system of certain people; why a breakdown may follow over-stimulation or occur with advancing years; why some persons relapse when certain treatment is discontinued; why treatment should at times be continuous, and why patients may remain in good health and full mental activity for many years under treatment. Research made from this standpoint may be of much value in the prevention and treatment of functional nervous disorder.