infant at the nipple. Children destined later to show this abnor mality are morbidly fond of sucking various objects, particularly their own toes or fingers. This simple pleasure had still persisted in the patient in question. On several occasions I witnessed her develop an obvious orgasm by vigorously sucking her thumb. When she was first seduced, at the age of sixteen, by the music teacher, he aroused her passions by warmly kissing her and at the same time moving his tongue round and round in her mouth ("like I am now turning the cup," she said, carrying out this action). On one occasion when referring to some high words she had had with a doctor, she said, "I gave him a good tongue-ing. That's a word that has two meanings, you know. I mean it here in the innocent sense.'

The patient had thus by devious routes come to the idea that fellatorism was the "true way" of obtaining sexual gratification, and that the conception of a child would follow on this act. "The seed of a man must enter into the woman-into the woo-mannot into the womb-man, but into the mouth" was a remark that amongst many others exemplified this. The form of gratification just mentioned she identified with the partaking of the holy sacrament; a vital fluid was swallowed in both cases, the name communion she used indifferently for both, and the penis she referred to as the "cup of kindness."

4

A series of consequences followed from this belief. Swallowing became for her an act of the highest significance. In a number of articles of diet, particularly in a peach, she saw resemblance to the genital organs and entered into an orgasm when sucking and swallowing them; she would frequently keep one hand on the communion service in the prayer-book during this process. Drink had always to be taken in a certain way, following a ritual resembling that of the holy sacrament. Her husband had poisoned her with his uncleanness; therefore, the food at home, i. e., belonging to him, which she had to swallow was also poisoned. On the other hand, she could not obtain enough food to "satisfy" her.

The bearing of this identification on the subject of the historical development of the communion ceremony cannot here be discussed, but will be obvious to those who have made a comparative study of the origin of Christian rites.

to shr: It was, therefore, not only injurious in quality, but also inadequate objesin quantity.

ood t

I ma

the

e had If we now make a short synthesis of the order of development s of the psychosis it will run somewhat as follows: A woman, acking of passionate temperament and strong religious training, had at teen, the age of sixteen been seduced, and at the age of nineteen had ing her married another man by whom she was already pregnant. After nd bearing one child she had a miscarriage, which she attributed to a gonorrhoea contracted from her husband, and underwent a number of gynecological operations and other treatment for the relief of subsequent pelvic complications; her ovaries were removed at the age of twenty-three. As the years went by, her desire to have more children was strong and her sexual inclinations increased in intensity; at the same time her husband's capacity to gratify these grew less, and she contrasted him unfavorably in this respect with her former lover. She thus blamed her husband twice over for her lack of children. She had illicit relations with other men, which caused her much remorse. Religious appeals to forsake her evil ways and lead a new life she interpreted as a revelation indicating the error of her past sexual life and advocating a new form of sexual life. For a number of reasons this idea of a new sexual life took the form of the fellatorism perversion. She tenderly loved her husband so that there arose in her mind an intense conflict between this feeling of love and duty, and the forces impelling her to turn from him to a new kind of life. The compromise between the two sets of forces was found in identifying, for a number of reasons, the act of fellatorism with the partaking of the holy sacrament. A number of abnormal mental processes were the direct outcome of this; such were delusions of poisoning, refusal to take food, intense excitement evidently of erotic origin, belief that various ministers were in love with her and eager to lead her into the "new way" of sexual life, etc. These abnormal processes clinically constituted recurrent attacks of mania.

It was impossible to perform a complete psycho-analysis of the case, and I have contented myself here with giving a few examples out of the rich material of observations made, together with the main conclusions to which the study led. By means of the knowledge gained by psycho-analytic methods one was able to render intelligible the abnormal mental processes in a way otherwise im

possible, and to obtain most valuable clues into the significance and origin of the symptoms of the psychosis. No generalizations as to the nature of manic-depressive insanity are offered from the observation of this case, but it is maintained that studies undertaken by means of the psycho-analytic method promise better than any others to give us in time an understanding of the mechanism, and perhaps the nature, of the malady.

BY CHARLES RICKSHER, M. D.,

Assistant Physician, Danvers State Hospital, Hathorne, Mass.

There have been many monographs and articles written on the subject of memory, considering it both from the practical and theoretical sides. The mechanism, the laws of acquisition and of conservation have been studied, and the many questions relating to these have been frequently debated. Binét, Henri, Ebbinghaus, Münsterberg and others have experimented with the memory of phrases, sentences and objects, and Stern a short time ago founded a journal devoted entirely to this work. In the abnormal cases the various amnesias have received special attention and have given rise to many articles based on organic brain lesions or on toxic processes.

In working on the subject of impressibility the methods of experimentation differ with each experimenter and the time which separates the presentation and reproduction also varies greatly. Some authors have allowed the subject to tell freely what they have seen or heard, while other have questioned the subject about it. Both sexes and various types of intellectual development have been studied, and the general conclusion drawn is that exactness of memory is the exception and not the rule. Stern in 100 cases received 91.5% of correct answers, while Wreschener, who experimented under similar conditions, found only 74% correct. Stern found that women forget less than men, but their memories are more unfaithful.

In the following work an attempt was made to study certain cases of dementia præcox and to determine how well the subject

*In this impressibility means not only the power to receive and retain stimuli but also the ability to reproduce them. The experiments are analogous to the "aussage" experiments of Stern and were undertaken in order to determine whether there was a marked deviation from the normal in this field in cases of dementia præcox.

could reproduce or recall certain visual and auditory stimuli after a short time and also the increase in ability to recall certain visual images after seeing them several times. The work does not concern itself with the question as to where memories are stored or by what mechanism they are conserved. The individual variation is very great, as Münsterberg has shown in normal subjects; and in different mental diseases, especially in the organic brain diseases, the percentage of error would increase as the emotional and intellectual deterioration increases.

In dementia præcox one of the first symptoms is a defect in voluntary attention. This is shown at any early stage, even before the other symptoms of the disease can be demonstrated. It is seen in the inability to continue steadily at one line of work and in students by the inability to attend closely to their studies. This is due partially to defect in volition and partially to some affect disturbance, but neither may be so prominent as to call forth comment by the patient's friends. Consciousness may be clear and the intellectual faculties may be apparently undisturbed. Since attention and interest are disturbed, it is reasonable to presume that the subject's ability to take in and reproduce certain visual and auditory sensations would be more or less markedly affected. In the following experiments two methods were used and the work was divided into two series according to the method. In the first series auditory stimuli were used, three words were repeated and after one minute of distraction the subject was asked to tell the words. Immediately afterwards three numbers were given and after a minute of distraction were recalled as before.

In the second series a page containing pictures of 14 objects or group of objects was exposed for 30 seconds. It was then covered and the subject told what he had seen, the time of reproduction being noted. This was repeated for three successive days, the subject being shown the same page for the same length of time on each occasion; the results were tabulated according to age, duration of disease, degree of dementia and form of disease.

FIRST SERIES.

In this series there were 43 subjects, 15 males and 28 females. Three words, such as bed, floor and table, were given; then after