This is a summary of the views and findings of Professor Karl Kleist and his co-workers. It is based on a series of papers published by members of the Frankfort-am-Main University Psychiatric Clinic from 1939 to 1951.

These papers are the result of follow-up studies carried out on patients who had been admitted to the Frankfort Clinic between 1920 and 1953. These patients had been diagnosed as suffering from one of Kleist's special forms of schizophrenia.

Vincent van Gogh was born at Zundert (Province of Noord Brabant) in 1853, the eldest son of a minister of the Protestant church. We know little of his childhood years; he is described as a rather headstrong boy, but not abnormally so, his sister (1) pictures him as a great nature-lover and rather an introvert. His mother, a sensible and strongminded woman, handled him with indulgence, his father, by nature a kindly man, could be stern and forbidding, yet all his children including Vincent adored him. He loved his brother, Theo, quite as much, “who had inherited his father's name and his heart's goodness”.

May I, in the first place, thank you most sincerely for the honour you have done me by electing me as your President during the coming year. Whilst the names of my distinguished predecessors enhance this honour in my eyes, at the same time I cannot help a feeling of humility and inadequacy at the thought of attempting to follow in the footsteps of those illustrious members of our profession whose names shine ever more brightly as the march of time reveals more clearly their contribution to our specialty and to the welfare of the mentally ill.

This Address tonight will mostly concern psychiatric treatment, and it must be quite exceptional, I think, for those of us, still in our late forties, to have lived through such a revolution in treatment as we have seen in the last twenty years in this country. In this revolution I believe we have seen Great Britain emerge as one of the countries now leading the world in the skilled, humane and all-round treatment of her mentally ill patients. There is obviously still very much that needs to be done, yet we must try not to underestimate what has already been achieved recently in this country.

Reports on the use of Rauwolfia alkaloids in the treatment of the mentally disturbed and on the remarkable central properties of this group of agents have encouraged a trial of the effect of both mixed Rauwolfia alkaloids, and of reserpine in the management and treatment of the chronic psychotic patient.

Previous papers from this hospital have reported clinical, neuropathological and other studies on patients subjected to temporal lobectomy for epilepsy (Falconer, Pond, Meyer and Woolf, 1953; Hill, Falconer and Pampiglione, 1953; Meyer, Falconer and Beck, 1954; Mitchell, Falconer and Hill, 1954; Falconer, Hill, Meyer, Mitchell and Pond, 1955; Meyer and Beck, 1955; Meyer and Yates, 1955; Meyer, 1956). The detailed psychiatric changes following temporal lobectomy are the subject of this paper. Apart from individual case studies and short comments, the effects on personality of temporal lobe ablation have not so far been reported.

When the Council greatly honoured me by their invitation to be the Maudsley Lecturer for 1956, my first concern was as to what subject I could choose for my remarks.

A survey of the literature on handicapped children reveals comparatively little on the subject of epilepsy.

Most of the articles dealing with cognitive functions have been concerned wholly or mainly with verbal intelligence as measured by tests of the “Binet” type. Those relating to behavioural or personality traits have been mainly impressionistic.

The purpose of this survey was to assess the intellectual and social status of 150 children of 73 certified mental defectives. It is proposed to discuss the mothers in this paper and the children in a further one. The mothers in this group were all at one time patients at the Fountain Hospital. Much of the initial work was done by Mrs. L. Mundy, the Senior Psychologist, who had already tested most of the mothers, and Miss Kerry, the social worker, who had maintained contact with many of the discharged mothers and their children. One of the main factors which have made the research easier has been the general good feeling towards the Fountain felt by our ex-patients. They want the Fountain in general and the Physician Superintendent in particular to know how they are and what they are doing. Dr. Hilliard's “somewhatunorthodox procedure with difficult cases” (1956) and his views on feeblemindedness have now become fairly generally accepted. His view that many of these women can work successfully in the community has been substantiated already. It is hoped that this survey will help to avoid the inhuman and expensive administration process whereby an allegedly feebleminded mother is permanently separated from her child.

The nomenclature of neurology is already so extensive and so chaotic that every proposed new term requires its apology and precise definition before being accepted—just as every term, new or old, should be weeded out, if it cannot be given a satisfactory definition.

This paper follows a preliminary communication to this Journal two years ago (Sandison, Spencer and Whitelaw, 1954) and gives an account of the fuller experience gained up to the present time with lysergic acid diethylamide in the treatment of mental illness.

In recent years a number of studies have been undertaken in which the “night vision” or dark-adaptation of psychiatric patients has been compared with that of normal subjects. These studies have their origin in a wartime observation that the incidence of “night-blindness” among neurotics was higher than among normal Service personnel. Evidence of functional disorders of vision is of interest from several points of view, psychiatric and ophthalmological as well as psychological and physiological. The aim of this article is to make a critical evaluation of the results so far obtained, determine what generalizations are possible and consider implications for further research.

The first distinctive account of this condition was given by George Huntington, a physician of Long Island, in 1872. Since then our knowledge regarding aetiology has not advanced greatly, though the hereditary nature of the illness and the fact that it is transmitted as a Mendelian dominant by both sexes has been established.

Although numerous instances of the surprising efficacy of placebos in a wide variety of conditions have been reported lately, little has yet been done towards providing an explanation of the occurrence of placebo reactions in terms of psychology. In what follows, the main findings concerning placebos will first be described, and then an attempt made to relate them to psychological theory. Even if this attempt is premature, it may succeed in showing the need for further work and in suggesting what directions this might take.

There seems little reason to believe that schizophrenia in the Bantu differs materially from the disease in other races, and no one thus far has produced conclusive evidence of fundamental differences between the symptoms of African and European schizophrenics. Nevertheless, certain diseases common in Europeans, are rare in Africans, others tend a different course, and the latter condition may perhaps apply to a somewhat variable disease like schizophrenia, especially considering the existence of certain factors which will be discussed.

This paper will make an attempt to examine critically the major psychological approaches to the problem of brain damage and to point out why such a vast number of psychological studies of neurological patients have on the whole proved to be disappointing. Up to the present time most of the findings are equivocal, inconsistent, and very often contradictory; no acceptable theory of brain functioning and organization has emerged from them and the diagnostic tests in this field show too high a degree of misclassification to be sensitive enough for clinical use. Finally, an attempt will be made to outline a more fruitful approach to brain damage.