“Research is largely dependent on individual enthusiasm, but can certainly be stimulated and maintained by the co-operation of the senior medical staff. There is reason to fear that such work is undertaken in some quarters without any guidance or encouragement from seniors, and laborious original investigations have received little or no recognition from those in authority.... Although there is no uniformity of practice, report is made that in many asylums junior medical officers are placed in charge of chronic cases only, and have no duties in reference to the treatment of newly-admitted cases. This appears to be most undesirable. Junior medical officers, in addition to their statutory routine duties, should be given the opportunity of co-operation with their senior colleagues in clinical work. Consultation between the various members of the medical staff in doubtful and interesting cases is very desirable....” (p. 30.) If the reader will pause for a moment, and in imagination put himself in the position of a junior medical officer, “_placed in charge of chronic cases only_,” he will not only come to understand the “stunting of ambition and the gradual loss of interest in scientific medicine” of which he has read, but may admire the self-restraint of a report which can speak in temperate language of such a state of affairs. Another difficulty that stands in the way of this urgently needed reform in medical education is the inadequacy of the text-books available for the student. In many of these text-books the introductory chapters contain some, often irrelevant,[86] morbid anatomy, and the remainder deals with “psychology.” The latter frequently consists largely of anecdotes, often “funny” and sometimes more appropriate to the “after-dinner” hour than the text-book, and enumerations of the mental _symptoms_ of the cases. In practically every available English text-book the latter are depicted only as they appear after they have become fixed, habitual, hardened and rationalised. Such “units” of terminology as “delusions,” or “delusions of persecution,” “hallucinations,” etc., are freely used. In other departments of clinical medicine the text-book writer does not describe a patient as suffering from a cough, and leave it at that; yet the phrase “suffering from delusions” is the veriest commonplace in the text-books. Yet just as a cough may be due to tuberculosis of the lung, pharyngeal irritation, hysteria, or a variety of utterly different causes, each class of case requiring a different treatment, so the causes of delusions are even more infinitely varied. But the gravest defects of these text-books is that few of them make any attempt whatever, except in the case of such forms of disease as have an organic cause, to explain the _development_ of the trouble, the precise nature of the primary cause or causes and the way in which the disturbance of the patient’s personality has been gradually effected.