The following papers were read:

"Genesis of Hallucination, Illusion and Delusion," H. A. Tomlinson, M. D., St. Peter, Minn.; discussed by Drs. Richard Dewey and P. M. Wise, and by Dr. Tomlinson in closing.

"Operative Work among the Insane," Anne Burnet, M. D., Clarinda, Ia.; discussed by Drs. P. M. Wise, Chas. A. Drew, Geo. F. Inch, E. C. Runge, Richard Dewey, and by Dr. Burnet in closing.

"Gastrotomy for the Removal of Foreign Bodies," Geo. F. Inch, M. D., Kalamazoo, Mich.; discussed by Drs. H. A. Tomlinson and W. M. Edwards.

The following papers were read by title:

"Episodes in Gynecological Practice among the Insane," W. P. Manton, M. D., Detroit, Mich.

"Some Minor Studies Pertaining to the Etiology and Forms of Insanity in North Dakota," Dwight S. Moore, M. D., Jamestown, N. D.

"Treatment of the Insane; Therapeutic Suggestions," Chas. G. Hill, M. D., Baltimore, Md.

A memorial notice of Dr. Frank C. Hoyt was read by Dr. G. H. Hill, of Iowa.

A memorial notice of Dr. W. L. Worcester, by Dr. A. H. Harrington, was read by title.

Dr. Peter M. Wise: And now, members of the Association, the time has come when we must separate to go to our respective homes for another year. I hope that all of us may be able to meet in Montreal. It gives me great pleasure to introduce. to you your President, Dr. Preston. (Applause.)

Dr. Preston: Members of the Association, I thank you most heartily for the honor you have conferred upon me, especially since there are so many more worthy of the honor. I feel, too, that the honor comes not so much to myself as to my section and to my state; a state that, as was said by a distinguished speaker yesterday, claims the honor to have had the first asylum for the insane on this continent. It is said also that she claims the honor of having built the first asylum for the colored insane on this continent. On behalf of that state I bear you cordial greeting. This old mother of states was among the first to in

augurate this benevolence and charity and looks with pride now on the great advances put forth by other states here in the west and in other parts of the Union, and by you gentlemen, representing these states at these annual meetings and in your hospitals, and she bids you God-speed in your good work. I again thank you most heartily and with your forbearance and help I promise a faithful performance of the duties as far as I am able. I wish you all a pleasant homeward journey and hope to meet you all next year. (Applause.)

Adjourned.

C. B. BURR,

Secretary.

PRESIDENTIAL ADDRESS.

By P. M. Wise, M. D.,
New York.

The responsibility which devolves upon me, as the one chosen from so many brilliant workers in the field of psychiatry to preside over your deliberations, is duly felt and appreciated. No endeavor of mine, I know, will equal the demand upon me; but, if depreciation of my abilities for this high office could be a requirement, I would meet it in full measure. I ask your kind indulgence for my shortcomings. My greatest satisfaction is in occupying a place held by predecessors whose names represent the highest and the best in our department of medicine, and in great degree in the large field of medical science. It was difficult to determine upon what subject I should address you, when in the consideration of every desirable one I found it had been better used by the more able men who have preceded me. Besides, I have long believed this annual opportunity might be more fruitfully applied to a review of progress in the recent past and the indications and hopes for the future, than by the treatment of any definite subject; and with this in mind I will attempt to outline in a general way the perspective as it appears

to me.

We are on the threshold of a great epoch, and standing at the entrance to a century which promises so much, after our farewell to the greatest century of the world's history, we feel the burden of the obligations which the new cycle of years has in store for us and our children. Shall we meet the expectation? Have we after all not reached the apex of human cognition, and has the time not come when in the vibration of human endeavor our strength shall wane; and has not the virgin soil of speculative philosophy become exhausted? There are no more elements

to discover and it seems as if of those which are known speculation as to their future application to the arts and sciences has reached the limit of human comprehension.

It might be appropriate at this time to review what the past century has accomplished in our special field of medicine, but this has been done by much abler hands, and we will leave it with a reference. We have left the old and are started on the new. We should cease looking backward to grasp the results hoped for. If we have taken ourselves to account for what has not been accomplished, we should now put forth our united efforts to heal the defect. That much has been accomplished, cannot be denied. We might truthfully say that all that has been done to place alienated reason in its proper place, as manifestations of bodily disease, and its removal from the domain of the priest, the penologist, and the charlatan, belongs to the nineteenth century. "Who can minister to the mind diseased?" If this deathless query was answered before the days of Pinel and Tuke, it would have been in the prison, in the damp, foul cells of monastic structures, or by the crack of the whip, the rattle of chains, or the diabolical sneer of inhuman jailers. But the civilization that opened the century agone had no limit to its bounding endeavor. With Excelsior on its banner, and science as its goal, regulated by Christ-like impulses, it cleared away the fogs of superstition, heresy, and religious dogmatism, to build upon more stable foundations. That this impulse was slow in accomplishing results cannot be denied. The results we know; how the insane emerged from darkness into light, from demonism to human beings afflicted with bodily disease, from the accursed of God to the weak and suffering calling for our deepest pity and above all for the benefits of science.

If, therefore, we leave history, leave the past with its dead, and look ahead into the now dim perspective and attempt to interpret the veiled outlines by the aid of the defined foreground, it will not mean a prophetic effort as much as a search for those paths which offer the least resistance to progress. There is no straight path in science, neither is it broad. Sometimes the trail is lost and the pilgrim becomes confounded in the mazes of a strange country. Too often, alas, after intricacies which discourage, and perplexities from diverging roads, the wanderer is finally brought up against a wall without an outlet, or a cul de

sac in which he struggles until translation solves all his problems for him.

It is chiefly the younger members of the Association to whom the roseate hues of ambition and promise retain their brilliancy -who look forward, as those of declining vigor love to dwell on the memorable victories of their former active life, who hold the keys of progress and enlightenment, and upon whom depends the determination of the problems of to-day. If they emulate the examples to be found in the semi-centennial history of this body, in respect to loyalty to a defined purpose, stability and energy, and the sacrifice of personal ease and gain for the uplifting of the stricken of their race, the result is not doubtful. The virgin soil has been broken and tilled. This opportunity may not be theirs; but they have instead a great unfinished work that demands no less skill, labor, and persistence. They have also, what their fathers did not have, a public recognition and encouragement, a lifting of the hands.

One of the saddest and most discouraging experiences, to my mind, is contact with a medical staff refraining from investigation on the plea that the ground had already been well covered. The time-server has no part in the bright promises of the future; neither has the superintendent who values housekeeping duties over clinical experience; and in this connection it may be stated that a most desirable change in hospital management is a relief to the medical chief from those practical but material duties alien to his chosen profession.

One of the great questions awaiting analysis by patient workers is the affinity of certain physical deviations and morbid mental phenomena. These are too great in number for mention here, but notably there are syphilis and general paralysis; genius and insanity; crime and epilepsy; phenomenal creations and amnesia, or subconsciousness; spontaneity of original thought and epileptic attacks; a hyperacute moral conception and melancholia; the morphological and genetic relationship of heredity and atavism with alternately neurotic constitutions, certain bodily diseases, and nervous or mind disorders.

Data are constantly accumulating, and methods for their derivation and classification are being progressively perfected while public sentiment is being moulded into a conception of of their importance and desirability. Thus the stumbling blocks