The customary classification of the amaurotic family idiocies according to the time of life at which neurological signs first appear has obvious limitations when consideration is given to cases occupying an intermediate position between the well-established infantile form of Tay-Sachs' and the juvenile form first described by Batten (1903). It was to this group of atypical cases that Bielschowsky (1913–14, 1920) gave the name “late infantile”. This term is convenient clinically but when more examples of the variant had been reported it became evident that the group of cases so designated was not homogeneous. Wyburn-Mason (1943) was able to show in a large clinical material that many of these intermediate forms belonged either to families affected by Tay-Sachs' or by Batten's disease and that in an individual case the ophthalmological findings were usually of decisive importance in classification. The existence of a precocious variant of the classical “juvenile” type of amaurotic idiocy was thus clearly established. Klenk's (1939) discovery that the nerve cells in Tay-Sachs' disease contain large amounts of a glycolipid subsequently called “ganglioside” has provided a further valuable criterion in distinguishing this form of lipidosis from other members of the group. The present case, an example of the precocious juvenile type of amaurotic idiocy or, as we prefer to name it, the subacute form of Batten's disease, is presented as a further contribution to this subject.

It is clearly advantageous to the personality theorist to know which of his measures covary and to what extent. The results of factor analyses can be useful in summarizing some of the patterns of covariation and classifying response measures. An indefinitely large number of sets of factors may equally well describe the same set of data, however, and, before any choice of one particular set of factors, dimensions, principal components, etc., can be considered as revealing basic intervening variables or constructs in a personality theory, independent evidence must be provided. It is the purpose of this paper to reveal some of the pitfalls in making such a choice by showing how concentration on one set of factors obtained by analysing a multivariate scatter can lead to a serious loss of information when applied to the analysis of group differences in the same set of data and can suggest interpretations which are at odds with the full evidence.

Of all the tranquillizers, it may well be said that benactyzine has had the most chequered history. After its synthesis, a series of most careful experiments on animals demonstrated its ability to reduce or modify behaviour induced by stress. The first clinical trial gave rise to high hopes of its value in treatment but as further trials, more carefully designed, were made the results became increasingly inconclusive.

Evidence is accumulating that schizophrenia is a disease involving “immunoallergic” sensitization of the tissues of the central nervous system. Variations in its symptomatology may in part depend upon the altered ability of the sensitized nervous tissue to bind or release serotonin, and perhaps other endogenous catechol amines. Accumulation of these products; their rates of turnover; the presence of endogenous enzyme enhancers or inhibitors; specific endocrine dyscrasias; blood-brain barrier conditioners; as well as cellular changes in electrolytes, may all play a part in the process. Genetic defects; lags in maturation; autonomic imbalance and pre-psychotic personality structure may lurk in the background.

The assessment of the results of a treatment in any particular disorder is generally a very complicated one, by reason of the fact that the treatment does not usually improve all the manifestations of the disorder, and even when it does so, it does not affect them equally. The case of thyroid medication, which completely eliminates all the manifestations of thyroid deficiency, is an unusual one in medicine. Even where the pathological process may be completely stopped, as in general paresis and pulmonary tuberculosis, the patient may be left with residual loss of function due to irrevocable loss of normal tissue. In some cases the treatment itself may be of such a nature that the patient merely exchanges one disability for another. For example, the treatment of mild diabetes mellitus by a reducing diet may indeed eliminate the diabetes, but only at the cost of replacing it by chronic hunger and social restrictions, which many patients feel are worse than the original disease. In the end, they may give up their treatment. In some cases, the treatment has “complications”, which means to the patient that he merely exchanges one set of symptoms for another. For example, he may exchange the symptoms of duodenal ulcer for those of dumping syndrome.

There has grown up in the past 30 years in East Africa a school of medical psychologists which sets out to interpret African thought processes, personality traits and mental disorders in terms of a racially genetic and cultural disposition. A correlation is assumed or suggested between a specific brain structure, social behaviour, psychology and psycho-pathology. Explanations are couched in terms of a racial determinism, and involve an assertion of inferiority as compared with the White race.

When the diagnosis of epilepsy is made, the patient must first of all be investigated to make sure that the epilepsy is not symptomatic of a disease that will need some special line of treatment. For example, epilepsy starting at any age may be the first indication of a cerebral tumour, although this will obviously be more likely among the older patients. The nature and extent of these investigations will depend on such factors as the age of onset, the type of seizure and the associated positive physical signs. However, even in the cases where there is no evidence whatsoever that the epilepsy is symptomatic, an electroencephalogram may help in differentiating the type of epilepsy from which any particular patient is suffering, and so aid in deciding on the form of treatment most likely to be beneficial. When any necessary investigations have been carried out and the form that treatment is to take has been settled, the social implication of this diagnosis has then to be faced. This often resolves itself into a discussion of the patient's employment.

Psychiatrists and clinical psychologists can be classified into the Big-Endians who believe in classification and the Little-Endians who do not. Each side has its derogatory stereotype of the other. According to the Little-Endians, Big-Endians are tough-minded, cold, impersonal monsters who think about the human personality in terms which are static and rigidly structural rather than fluid and dynamic. Contrary to Swift, they love people in general and hate Tom, Dick and Harry. In the field of mental health, they believe in illnesses rather than in people and believe that these illnesses all have an as yet unknown physical cause. They are reactionaries.

At a recent court case (40), the plaintiff, who sustained bilateral acetabular fractures following unmodified electroplexy, maintained that the defendants were guilty of negligence by failing to use relaxant drugs to prevent the risks of injury.

The term “post-operative psychosis” refers to mental illnesses which follow in the wake of surgical operations. These conditions have received relatively little attention from psychiatrists. The text-books either do not mention them or, if they do so, consider them with the delirious or toxic-exhaustive states.

Tumours of the corpus callosum (C.c.) are known to be a difficult diagnostic problem. Intellectual and mental disturbances and rapid deterioration in the course of the illness have been observed in most of these cases and are considered by many authors to indicate an involvement of this body (Lévy-Valensi, 1910; Mingazzini, 1922; Ironside and Guttmacher, 1929; Alpers and Grant, 1931; Voris and Adson, 1935; Schlesinger, 1951, Bremer et al., 1956). However, a similar picture may also occur in tumours of other sites; moreover, tumours of the C.c. tend to infiltrate the hemispheres, particularly the cingulum and the frontal lobes, and this might well account for the mental picture. A sign which seems to be more specific for damage of the C.c. is dyspraxia restricted to the left limbs in right-handed persons. Although this dyspraxia has been reported only in a small minority of cases concerned, it has not been observed in lesions other than those of the C.c.

Between 1 January, 1948 and 1 July, 1956, forty-one children in the Fountain Group Hospital were accepted as educable by ten Education Authorities and they were transferred to appropriate schools. In addition three children under 5 years were found on admission to be of average intelligence. All forty-four children had been admitted to this hospital of approximately 700 beds for low-grade mentally defective children.

The present paper will deal with eye blink frequency and its relationship to scores on “personality” questionnaires and to frontalis and right forearm muscle tension measured electromyographically. This analysis forms part of a larger experiment with the main aim of investigating levels of muscle tension in four groups—(i) introverted neurotics, (ii) extraverted neurotics, (iii) extraverted normals and (iv) introverted normals—during relaxation and while responding to a series of questions about neurotic symptoms.

In a recent investigation the present author has shown that glucose tolerance (G.T.) was significantly lower in a group of middle-aged mental hospital patients suffering from severe depression, than in a non-psychiatric group of similar age distribution (Pryce, 1958). This observation is similar to many others reported earlier (see review by McFarland and Goldstein, 1939). The cause of this impairment of G.T. is unknown; it cannot be explained by defective absorption of glucose from the alimentary canal since an intravenous G.T. test was employed in the investigation mentioned. Again, defective dietary intake during the days before testing could have contributed to the decreased G.T. in only a few cases; there was also no correlation between G.T. and either general symptomatology or the patients' behaviour during testing. However, it was observed that the group of depressions weighed significantly less than the control group, though again no correlation was found between body weight and G.T. among the depressions themselves. McCowan and Quastel (1931) and others have reported a close parallel between decreased G.T. and “emotional tension”, evidence which favours an emotional cause for the phenomenon, in line with the theories of W. B. Cannon (1911).

The senile emotional disorders are now a major problem in mental hospital practice and their incidence increases with age. It is fortunate, however, that a better understanding and recognition of these affective disorders has, in most cases, led to early treatment and recovery.

The purpose of the present study was to evaluate the effects of hypophysectomy, the surgical removal of the pituitary gland, on the intellectual functioning of the individuals undergoing this particular form of surgery.

Beneficial results with procaine amide in the treatment of Huntington's Chorea were first reported by Goldman (1952). He was led to make an oral trial of the drug after having noticed a patient in the dentist's chair improve following an injection. He found improvement in six cases with the typical syndrome of Huntington's Chorea, of whom four had a positive family history of the disease. The evidence of improvement in these cases was partly based upon clinical observation and partly upon the patient's account of changes in his daily experience, for example, his first case had difficulty in eating, which had led to protests from other customers at a restaurant he had frequented, and this disability is said to have been satisfactorily reduced with the help of the drug.

The discovery of chlorpromazine in the Rhône-Poulenc-Spécia laboratories in France, and the subsequent early clinical studies which were carried out in that country, for example in 1952 by Hamon et al. (5) and in 1953 by Delay and Deniker (1), eventually resulted in the enthusiastic and widespread application of this compound in the field of clinical psychiatry. Chemists and pharmacologists, in many countries, have been actively engaged during the ensuing years in the search for new compounds which might prove to be more potent therapeutic agents than chlorpromazine in the treatment of mental illness. One of the tangible manifestations of their labours is the present crop of “tranquillizers” which are being extensively used in the treatment of neurosis and psychosis. Whereas opinion may be divided with regard to the real or specific value of any one of these new drugs, few would disagree with the contention that none of them is ideal. Despite the considerable number and variety of phenothiazine derivatives and other new substances which have been developed as a result of extensive research, chlorpromazine has retained much of its original therapeutic reputation, in open competition with its rivals, down the years, and is still probably the most widely used tranquillizer today. This would seem to imply that no outstanding advance has been made since the early days of the new biochemical era in psychiatry. Valuable knowledge may have been obtained as a result of the application of scientific theory and empirical methods in this field, but in terms of effective therapeutic agents the results have been meagre, with the accent on quantity rather than quality. Nevertheless, a continued search is justifiable, and any new compound which holds forth promise must be put to a clinical test if final success is to be assured and if valuable therapeutic potential is not to be summarily dismissed or heedlessly cast aside.

This contribution towards the subject is limited to three of its aspects—namely, the possible aetiological role of inherited predisposition and psychogenic factors (mainly environmental to which the patient is still exposed), the relationship between late endogenous depression and the symptoms of cerebrovascular changes, and prognosis. On the face of it, prognosis of course must ultimately depend on that of the cerebrovascular disorder but apparently hereditary and environmental factors play a more significant role. Inherited predisposition is here assessed in terms of constitutional and personality factors.

In a previous study (Kornetsky, Humphries and Evarts, 1957) it was found that the impairment of a variety of psychological processes caused by 200 mg. of chlorpromazine was not significantly less than the impairment produced by 200 mg. of secobarbital. It was also shown that the effects of drugs on psychological performance in man are related not only to the specific pharmacological activity of the drug, but also to the specific reactivity of the subject. It appeared that there was something unique to the individual which accounted for a significant portion of the effect of a drug. The present study was designed to extend these observations by reducing the number of drugs tested (in the previous study four drugs were used) and increasing the number of times a subject received each drug. It was hoped that this would give a better estimate of the effect of a specific dose of a specific drug and thus decrease the error of measurement and increase the reliability of the correlation between drugs.