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Some years ago a physician was heard to remark, 'If only neurologists cared to invoke encephalitis lethargica to explain the psycho-neuroses, how tiresome they could be to modern psychologists!' Those were the days when shell-shock was being attributed to minute cerebral hæmorrhages. Times have changed, and now we have Dr. Jelliffe, of New York, boldly attempting by psycho-analytic technique to elucidate the mysterious phenomena following encephalitis lethargica. Formerly it would have required some courage to undertake the task. Cerebral localisation and irritating lesions were held sufficient to explain the manifestations, as long as the latter were physical. But when it was noticed that not only was thought movement slowed, but that morbid anxiety also was present during the attacks, involving a 'hypertonia of the entire bodily musculature, striped as well as unstriped', the time clearly had come for the physician to take a more comprehensive view of human activity, and see the organism striving for survival and mental equilibrium even when its higher cerebral centres were to a greater or less extent disabled. The effect of this physical decontrol seems to be worthy of close psycho-analytic study, not only because of the clearing up of dark places in psycho-pathology, but also and more especially because there is some evidence of therapeutic benefits to follow.
Whether psychical determination can be claimed for all the ocular movements in the crises which are the subject of this monograph needs much more investigation, as does also the actual emotional significance of any given type of movement. Detailed observation of the crises rules out the easy explanation of the eye spasms as being due to the rolling up of the globes in a simple desire for sleep, just as the onset of concomitant squint