Some of the younger group of enthusiasts who scoff at the influence of heredity, and talk learnedly about environment as the cause of the majority of misfits, pooh-pooh the occurrence of dementia precox at early age, and assert that nearly all cases of children who show the symptoms of this disease clear up eventually. I wish that such were the truth, but unfortunately I have seen during their developmental stage too many cases which eventually decline into complete dementia.

Of course, it will be pointed out that after all eugenics will do more than anything else to solve the problem, but no matter how wonderful eugenics appear in theory, as long as human nature remains as it is the application of eugenics as taught by some ultra-modern teachers will prove not only difficult but nearly impossible. Extreme methods will invariably produce violent reactions, and it is a simple matter to acquire the label "crank" if enthusiasm interferes with the sentiment tradition has woven about marriage. It is difficult to steer between the Scylla of tradition and the Charybdis of eugenistic enthusiasm. The very fact that so little satisfactory work has been done on the psychoses of children is in itself evidence that the matter has escaped the attention of most psychiatrists. The physicians in hospitals for the insane are often without practical experience in the matter, and those who are innocent of psychiatric training overlook what is obvious to the skilled observer. Careful investigation shows that in very early life the evolution of many cases of mental disease may be studied -it is to be hoped with advantage to the patient.

THE TEACHING OF PSYCHOLOGY AND PSYCHIATRY AT THE

UNIVERSITY OF TORONTO.

It appears that the time has come to revise our methods of educating psychiatrists. So strongly do we feel on the matter that in the University of Toronto we have developed an optional course covering five years in psychology and psychiatry. After much thought we have outlined a course of options and already a group has advanced to the fourth year of the six years' course. They are receiving sixty hours a year of special training in psychology and psychiatry during five years. Out of eighty who applied for the option some thirtyfive of the most brilliant were selected, and this group has been carefully weeded. During their second year in medicine

they received a training in elementary psychology. In their third year a course of sixty hours in more advanced as well as experimental psychology is being given, and the students advised to take additional training in chemistry and psychics. The fourth year has had sixty hours devoted to abnormal psychology, the exposition of the modern attitude of psychology towards mental defect and mental disease, taking in, of course, the theories of the Freudians, the psycho-analysts, etc. Practical work in the way of applying mental tests to normal and abnormal children has been given, with the idea of making the student familiar with the true value of mental tests, but showing also how they often fail to reveal the whole story. The fifth and sixth years of the course will be largely clinical, the work being carried on in the psychopathic hospital and psychiatric clinic at the Toronto General Hospital. These institutions are certain to offer no end of useful clinical material, which under our law is always available. Such a course will, we hope, equip a band of young psychiatrists with a training of the most useful kind, ready not only to undertake institutional work if necessary, but to carry on practice among mentally diseased persons who do not require treatment in institutions.

We feel that research must not be limited to institutions, but must be put on the broadest basis possible, and include persistent investigation of mental development and mental disease in child life. Such a plan as that adopted in the Toronto schools must eventually become a common one, and means intelligent co-operation between school boards and public health departments; the public health department assumes full authority for the inspection of children and lays out the programme to be followed by the educational authorities in dealing with abnormal types. A psychiatric department exists, and is proving a powerful influence for good; when its industrial and farm schools are in operation further advances will take place. Psychology only too often arrogates to itself the right to deal with the abnormal child, feeling certain that it is able to prescribe the proper treatment. Much as we are indebted to psychology for the splendid work done among children of low intelligence, there has been failure in the understanding of school pupils suffering from mental disease. To

admit otherwise would be to recognize charlatanry as justifiable and advisable.

INTELLIGENCE TESTS AND PRECOCITY.

Our experience with different intelligence tests has now been so great that we are in a position to estimate their value as well as appreciate their inadequacy. Unfortunately, their apparent simplicity and ease of application have resulted in the stimulation of the ambition of hosts of amateurs, especially teachers, whose work is harmful, being limited by lack of vision and knowledge, or a proper conception of the significance of the tests. They cannot understand the danger of accepting a standard of intelligence telling merely a portion of the story, and ignoring the part of it necessary to complete a picture of the child's mind and personality. An outburst in another direction is also under active development, and in psychological and pedagogical circles the discussion of the "supernormal" child waxes warm. The term supernormal is unfortunate and unscientific, as it gives a false impression, and by too many psychologists is loosely applied to a group including well-developed children above the average in intelligence and physique, as well as a group of physical and mental weaklings measuring high by the Binet-Simon scale. In them precocity is the outstanding feature, and their doom under ordinary circumstances easily foretold. What will happen to them under the forcing process so frequently recommended is well known to asylum physicians, who constantly see these wrecks stranded early in university and scholastic careers. Possibly there is little chance of saving them under any circumstances, but there is no argument in favor of hurrying the calamity.

EDUCATION OF THE PUBLIC.

The most important part of the work of the Canadian National Committee for Mental Hygiene is to educate people to a knowledge of the importance of having well-educated psychiatrists abroad in the community with the idea of helping to keep the importance of prevention ever in mind, and to scan school populations with a skilled eye with the hope of forestalling a thousand and one tragedies such as one sees today.

The psychiatrist of to-morrow must be able to grapple with problems concerning individuals who are social misfits, to analyze behaviour problems of all kinds, and to give advice regarding the mental hygiene of the whole community. It is obvious that outdoor departments of dispensaries should exist in connection with many institutions near urban centres, although this is more easily accomplished in general hospitals or psychopathic clinics, where facilities for thorough examination exist and laboratory findings are obtainable at a minimum cost. Possibly there is more red tape here in connection with institutional matters than is the case beyond the sea, but the persistent attempt to break down the barriers imposed by tradition and ignorance is bearing fruit with us. The clinics have robbed the institutions of much of the stigma formerly attached to them. Voluntary admissions are growing in number; so much might be said along these lines that one hesitates to open the subject. Then, again, the importance of prevention must never be forgotten. To do all this it is evident that psychiatrists must be emancipated from a great part of the administrative work which they are frequently ill-trained to do efficiently. They must be given large staffs of specially trained social workers and nurses to carry on follow-up work as well as investigations of home conditions.

The reaction against the purely psychological point of view in school adjustments of mentally handicapped pupils has already shown itself in certain centres, and if the greatest good is to follow the survey of school populations, psychiatrists must equip themselves to carry out this work in the best way possible, for after all it is distinctly a medical problem. How can a psychologist, for example, diagnose and prescribe for a developing case of a manic-depressive or a dementia precox psychosis? More than ever before we must now take stock of the assets and liabilities of psychiatry. The public must be shown its just reasons for existence, its readiness to adjust itself to the new order of things, and a constructive ability to do something more than merely provide custodial care for those who have fallen by the wayside.

Society Proceedings

CANADIAN SOCIAL HYGIENE MEDICAL REPORT APPEARS

A Report of the Medical Committee of the Canadian Social Hygiene Council on the Standardization of the Diagnosis and Treatment of Venereal Diseases, has just been put in circulation by the Department of Public Health at Ottawa, by whom many thousands of the Report have been issued.

The Report represents the work of a committee of thirtyfive prominent men and women physicians acting under the able chairmanship of Dr. Edmund E. King, of Toronto. Final editing of their findings and recommendations was done by Dr. J. J. Heagerty, Chief of the Division of Venereal Disease Control in the Dominion Department of Health, and the intention is to place a copy in the hands of every practising physician in the country.

The Report represents the work of a committee of thirtytwo pages, includes the following sections and sub-sections: Medical Research and Laboratory Questions; with sub-sections dealing with Licensing of Men doing Wassermann Tests and Standardization of the Methods of Making Wasserman Tests; Diagnostic Tests in Syphilis by Demonstration of Treponema Palladium; Significance of Wassermann Reaction; Negative Wassermann Reaction; with sub-section Precautionary Measures; Wassermann Tests in Connection with the Treatment of Syphilis Especially as an Evidence of Cure; Treatment of Syphilis and Relative Value of Arsenicals and NonArsenicals; with sub-section Eligibility of Marriage; Minimum Requirements of Treatment; Treatment of Syphilis ; with sub-sections dealing with Early Primary Cases, Dark Field; Wassermann Positive, Secondary, Tertiary and Latent Syphilis; Hereditary Syphilis; Early Preventive Treatment against Syphilis; Gonorrhea; Treatment of Acute Urethritis; Complications of Gonorrhea in the Male; Chronic Gonorrhea;