Anatomical Relationships

Professor Strecker tells us that when he took up his first post in a mental hospital he asked the medical superintendent, " What is sanity? " and was informed that it was a capacity for being dexterous enough to keep out of asylums! This saying has evidently deeply tinged his subsequent thinking. On the one hand it has made him sympathetic with his patients, whom he regards as having enough individuality to reject the demands of a preposterous world by insisting firmly on the validity of their own premises. On the other hand, it has also made him cynical as to the value of the mass reactions of those outside the walls of mental hospitals. Both groups he regards as characterized by a retreat from reality. Like many other psychiatrists he uses the florid manifestations of those admittedly insane as a key to the understanding of the curious behaviour of the mass-mind. Whatever psychiatry has gleaned from its patients has been made available for mental hygiene. In this country we are accustomed to speak of the man in the street, implying a belief that he holds an individual common-sense view; Professor Strecker prefers to speak of the crowd-man, whose reactions are mainly determined by mass psychology. Those who know the United States will appreciate his point. He then proceeds to discuss what he calls first aids to reality evasion, which are widely employed, some innocent, others harmful both personally and socially. Thereby the crowd-man becomes an easy victim of propaganda. No finesse is required; merely shopworn platitudes, slogans, symbols, and the flimsiest generalizations are needed. He uses the convenient label " stereotype" for the man whose principal aim in life seems to be to standardize all his ideas and reactions in accordance with the prevailing conventions of his group. Turning to methods directed towards combating a state of affairs which he considers modern conditions to be aggravating, he lays stress on the importance of developing " first the capacity to think, then a few quiet places in which to think, and finally some worth-while things to think about-this would constitute the prescription of mental hygiene. " He proceeds to develop his argument as follows. A strongly extroverted environment is not particularly good, even for the extrovert. It provides too many broad, brilliantly lighted, and noisy avenues along which energy may be uselessly expended, and far too few quiet shaded retreats in which meditative thought may come to a fruitful maturity. Joad reflects: " To step on foot-throttles, insert coins into metal slots, scan headlines, crowd through clicking turnstiles, turn on the radio, hurl ourselves over the surface of the earth in a mechanism propelled by petrol-these constitute the modern notion of entertainment. " As for the introvert, an extroverted society will have little or none of him. Unless he is fortunate enough to find a niche in which he may think, he is very likely to be bruised by encounters with a social stratum which, though friendly and genial on the surface, underneath is quite hard and unyielding to nonconformists. In the present state of the world it is perhaps inevitable that the author's destructive criticism is more forcible than his constructive planning for mental hygiene. Nevertheless this book, based on his Salmon Memorial Lecture, provides reading which is not only sardonically entertainingbut also salutary. STRUCTURE OF THE RETINA Re,tine Hurniaine et PhUnomnMes Enitoptiqlues. By Dr. E. P. Fortin. (Pp. 207 : 124 figures; 3 coloured plates. 250 francos.) Buenos *Aires: E. P. Fortin. Dr. E. P. Fortin's book on the human retina and entoptic phenomena summarizes many years of specialized study, the author having been particularly prominent in the investigation of entoptic appearances. The present monograph is a challenging essay, for if its conclusions are accepted it involves little less than a completely new anatomy and physiology of the retina. Fortin advances strong criticism of Cajal's methods of studying the retina and his conception of retinal structure, stressing in particular the points that Cajal's studies are based largely upon non-human eyes and that his methods are open to the possibility of-numerous artifact appearances. This criticism is supported by many untouched photomicrographs, some of them in colour. Fortin holds that the neuro-epithelium at the fovea is not hexagonal but round, the hexagonal figures seen under the microscope being artifacts due to shrinkage. The rods and cones, he holds, are equally long, and the foveal elements are neither the one nor the other, but a specific structure intermediate in character between the two. He also disputes that the external limiting membrane has the structure generally ascribed to it, and holds that it has no connexion with Muller's fibres, which indeed he regards as artifacts. Even more thoroughgoing is his view of Henle's fibre layer, which he holds to be not fibrous, but to represent fine canaliculi carrying a fluid permeating the whole retina. The attachment of the external limiting membrane to the ora is held to induce changes of form at the fovea with a consequent " accommodation " localized here. Fortin suggests that a new layer described by him as " campanules " associated with Henle's fibres are the recipient elements of the retina. He elaborates a theory of vision based upon the disproportion in size of the red blood corpuscles and the finest of capillaries, the friction induced setting up something like electrical currents. Entoptic phenomena are analysed in the light of these views on the structure and function of the retina and are held to give corroborative evidence. How far the author's views are valid is difficult to decide. His own factual evidence is not inconsiderable. It is, therefore, all the more regrettable that his criticisms of the existing teaching are in tendentious language.