Since the discovery that Bacillus coli vaccine (1) or albumose (2) were as effective as typhoid vaccine (3) in the treatment of typhoid fever, the use of non-specific protein therapy has been popular for almost any disease for which there is no other satisfactory form of treatment. T.A.B. vaccine, a mixture of typhoid and paratyphoid A and B organisms, has been found more regular and reliable in its results than typhoid vaccine (4); but milk, antitoxic sera, peptone and a variety of other substances have been used, and even malaria is considered a form of this treatment, segmentation of the parasites producing the foreign protein (5). It has been observed that Gram-negative organisms, such as the gonococcus and typhoid bacillus, produce more marked reactions when given intravenously than the Gram-positive organisms, such as staphylococci, streptococci and pneumococci (5).

All those who have worked with insulin will have been impressed by the great freeing of behaviour that the patients exhibit. It is seen in the hypoglycæmic state, before coma sets in, and as the patient returns to consciousness after interruption of the coma. The degree of this freeing varies directly with the prognosis. In this uninhibited state the anatomy, the very bones of the personality, can be studied, and the physician's observations should be able to establish the main outlines of the pathology of the total personality—the psycho-pathology.

The experiments described in this paper were performed in an attempt to elucidate the mechanism of the convulsion following the administration of cardiazol (pentamethylenetetrazol). The paper is divided into four sections—a description of experiments, a résumé of the relevant pharmacology of cardiazol, a discussion and a summary.

This paper is an attempt to record the experience gained in treating 44 schizophrenics in this hospital with cardiazol from September, 1937, when the treatment was first used, to the middle of April, 1938.

Early Work.

About twelve years ago, apart from mental work, I had occasion to use insulin to some considerable extent for the treatment of diabetes and the preparation of diabetic cases for operation, and acquaintance was thus made with hypoglycæmic shock. Most of us have had that experience. Insulin has been tried more recently in a large field, being used as a remedy in conditions of all sorts, even as a dressing for septic ulcers. But the writer's scope has been more confined, the extent being limited to mental cases.

In 1933 Sakel described the induction of epileptiform convulsions during hypoglycæmia, using camphor and cardiazol. This was not, to my knowledge, followed up systematically until Georgi's work, which started in 1934.

The occurrence of auricular fibrillation in three patients; notes regarding onset, nature and duration of manifestations.

Electro-cardiographic diagnosis, interpretation of and comparison with organic fibrillation.

The onset of heart-block immediately following a convulsion in another patient. Discussion of subsequent course and treatment.

Comment on the significance of these complications in relation to the safety of convulsive therapies.

Observations on blood-pressure in some of the above cases.