It was a somewhat curious thing that in a series of cases investigated by Dr. Thom and myself, that the more frequent the attacks of epilepsy the less there seemed to be to show for them in the autopsied brains. In certain cases with daily attacks the brains were strictly normal in gross appearances. It was the frankly organic cases with large focal lesions that had the occasional attacks. These frankly organic cases rarely had high frequency attacks. DR. TOM A. WILLIAMS, Washington, D. C.: Will Dr. Clark explain the eccentric convulsions such as when there is uraemia, on similar grounds? Also, if he will postulate in such cases as recover with metabolic treatment. I have published cases in which recurrent attacks of some years duration were removed by means which considered only the metebolesia. (See Journal of Neurology and Psychiatry, March, 1915.) DR. JOHN T. MACCURDY, New York: I have held the opinion for some years that the study of epilepsy was going to be of greater psychiatric moment than that of any other condition. I feel that this promise has been very largely fulfilled by the work Dr. Clark has been doing for the last two years. We have found, I think, from that work that we can really shell out what we may term an epileptic reaction, which is really the most primitive of all psychiatric reaction. It corresponds to a flight from reality. It is a return to the subjective phase, which, in the psychoses, is no vague but a very real thing. In epilepsy we get it in pure culture as a lapse of consciousness, expressed either in completeness as in a grand mal attack or partially when consciousness is merely clouded. Sleep probably represents an analogous condition. We go to sleep to repair the body while psychologically we are seeking that flight from reality which we all long for. The convulsion may be a secondary affair, and a physiological sequel to the loss of consciousness, which is psychologically determined.