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It is a great privilege to be allowed to participate in this fiftieth anniversary celebration of the Neurological Institute, and a great source of pride to me that my friend, Dr. Houston Merritt, should have invited me to talk to you about the present and future of neurology. No one has striven more to enhance the prestige of neurological medicine in this country than he has done. We cannot easily discuss the present and future of clinical neurology without some reference to its past; to its roots and trunk. It is, I think, fair to say that modern neurological medicine really stems from the early nineteenth century, at the time when, in 1818, Laennec, in Paris, founded clinical investigation as we know it and correlated is with pathology. Neurological medicine began as a clinicopathological discipline, and so in a sense it still essentially is, though it has now become more

SINCE the conception of the machine involves some complications which I consider to be not strictly relevant to the argument (and I want to be as brief as possible) I shall limit myself at first to the question whether the operations of a formalised deductive system might conceivably be considered equivalent to the operations of the mind. I believe that such a suggestion involves a logical fallacy. The declared purpose of formalisation is (I) to designate undefined terms, (2) specify unproved asserted sentences (axioms), and (3) strictly to prescribe the handling of asserted sentences, which leads to the writing down of new asserted sentences (formal proof). There prevails throughout a desire to eliminate elements that are called psychological.' Thus, (I) undefined terms are chosen without aiming to signify commonly understood logical relations; (2) 'unproven asserted sentences' replace 'statements believed to be self-evident'; and (3) the operations constituting 'formal proof' are intended to replace 'merely psychological' proofs. I think it is logically fallacious to speak of a complete elimination of what have been called 'psychological' but might better be called 'unformalised' elements of deductive systems; for : (I) No undefined term can be introduced unless its use is first explained by ordinary speech or demonstrated by examples. An undefined term is a sign indicating the proper use which is to be made of it. The acceptance of an undefined term implies, therefore, that we believe that we know its proper use though this is not to be formally described. This proper use is a skill of which we declare ourselves to be possessed. (2) Similarly for 'unproved asserted sentences': the fact that they are asserted is irrelevant. Asserted by whom? 'Asserted'

A notable advance in knowledge may raise as many questions as it solves, and a period of intensive and fruitful research may at first sight seem to leave us as far as ever from the solution of the problem we are in vestigating. This might plausibly be said of poliomyelitis. Few affections of the nervous system have been more closely or successfully studied within the past few years, yet fresh pathological and epid?miological factors appear for elucidation, effective therapy remains as remote as ever, and many of our earlier certitudes have gone by the board. Yet we must necessarily be nearer a grasp of the many problems presented by poliomyelitis, and the present time is appropriate for a review of some recent advances in our knowledge. A comprehensive summary of these is not possible within the limits of my present opportunity, and I propose, therefore, to confine myself to a brief consideration of the question of the specific treatment of the disease in the light of our rapidly changing conception of its nature. By way of definition we may say that poliomyelitis is one of a small group of infections of the nervous systems due to the action of ultra-microscopic viruses, the morpho logical identities of which are unknown to us. Other examples of the group are epidemic encephalitis and rabies, and in all three it is the grey matter which is the point of attack, whence these viruses are spoken of as " polioclastic." Of the characteristics they have in common perhaps the most striking are that they multiply only in contact with the living cell, within which their life and activity appear to be very brief, for after a short period they disappear. To this disappearance the name " auto-sterilization " has been applied, and in consequence of it virus diseases may be spoken of as " self-limiting."

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