The first number of the Journal of Mental Science appeared on 15 November, 1853. It will be noted that we are still in our 99th Volume—the discrepancy is accounted for by changes in the mode of issue during the first few years.

The first duty of your President is to say thank you and this I do with great sincerity. To be elected President of this historic association is indeed an honour, and I very much appreciate it.

The Education Act of 1944 lays on the Local Education Authorities the duty of providing special educational treatment for certain categories of children distinguished as “handicapped.” Included under this heading are maladjusted pupils. These are defined (by regulations) as “pupils who show evidence of emotional instability or psychological disturbance and require special educational treatment to effect their personal, social or educational readjustment.” This definition is, in the words of The Times (1950), “broadly based,” and has indeed been a source of confusion. The first clause asserts a proposition which is very nearly circular, since “emotional instability” and “psychological disturbance” stand as much in need of definition as maladjustment. The second clause makes for even greater uncertainty. Is it intended to indicate that only some children showing evidence of psychological disturbance or emotional instability need “personal, social or educational readjustment”? The suggestion that this can be effected by special educational treatment has led to much bewilderment. Presumably what is intended is that these children have, in common with other handicapped children, a need for special educational treatment, and also a need for personal, social and educational readjustment. For no other class of handicapped pupils is it suggested that the handicap can be treated by education, however widely this term is conceived or however specialized to the particular needs of the handicapped child.

Corpora amylacea (C.A.) or amyloid bodies found in the brain and the product of amyloid degeneration in other organs derive their name from the starch-like reaction which they give with iodine (Virchow); otherwise these substances have few points in common, and while amyloid disease has become fairly rare nowadays, the presence of C.A. constitutes one of the regular changes in senile and senescent brains. This is perhaps why it has attracted much less attention than amyloid degeneration. For instance in 18 out of 25 papers, containing detailed accounts of the histo-pathological pictures, I found no references to C.A., yet one could hardly assume that amyloid bodies were overlooked. Most text-books pay scanty attention to the subject, while Buzzard and Greenfield (1921) consider it of no pathological significance. Since, however, C.A. are encountered under a variety of conditions (not merely senility), in greatly varying amounts and at different sites in the central nervous system, it may be worth while to investigate their nature, origin and occurrence in the light of recent observation.

It has often been noticed that patients in amnesic states are prone to underestimate their age. In cases of Korsakov's psychosis this under-estimation may be very gross, and its extent appears to be determined, in part at least, by the duration of retrograde amnesia (Meggendorfer, 1928). A similar, if less extreme, under-estimation of age may also occur in the early stages of recovery after head-injury. In a recent study Weinstein and Kahn (1951) refer to this phenomenon as disorientation for age and adduce some striking examples. Thus one of their patients, a woman of over 70, insisted that she was 38. These authors do not, however, attempt a systematic analysis of this facet of disorientation.

Mongolism was one of the earliest syndromes to be recognized as a specific type of mental deficiency and was first described as such by Langdon Down in 1866. The term “mongol” was applied to this type of defect by Langdon Down on account of the superficial facial resemblance he observed in its subjects to individuals of the Mongolian race.

There is a considerable body of literature concerning the diagnostic value of differences in pattern and scatter found in response to intelligence tests.

In recent years there has been renewed interest in correlating cerebral function with mental phenomena. For a time, with the advent of prefrontal leucotomy, interest in the frontal lobe reigned supreme. However, in recent years the temporal lobe has been coming to the fore, and is now beginning to rank with the frontal lobe in importance.

The case here described is of interest in that it concerns a young man of good intelligence who presented a disorder limited to visual-gnostic functions; this is noteworthy as the majority of the cases described are elderly patients and there are usually other than visual gnostic functions involved. The case has special circumstances of additional significance. The patient had lost the sight of his right eye in infancy and he was a definite right-handed man; the damage involved the right hemisphere; this exceptional coincidence raises interesting problems of hemispheric dominance.

Paintings and drawings of emotionally and mentally disturbed persons have been the subject of many psychological and psychiatric investigations. The psychological evaluation of graphic art can probably be considered as the oldest “projective” technique. Paintings and drawings have been systematically studied by psychologists and psychiatrists from three different aspects: 1, As indicators of the developmental stage reached in perceptual, motor and intellectual functions (Goodenough, 1926; Graewe, 1932; Bender, 1938; Gesell and Ames, 1946).

It may be regarded as an established fact that the incidence of mental disorder is much higher in the single than in the married. In a previous paper two possible explanations were discussed: 1. There is a selection by marriage, whereby individuals who are personally and socially handicapped tend to remain single. Among such possible marriage handicaps there are certain personality traits which correlate markedly with a predisposition towards certain forms of mental disease, in particular schizophrenia.

From October, 1947, to October, 1952, we have had the opportunity of performing prefrontal leucotomy on 339 patients at the Neurosurgical Clinic in Belgrade. As this operation is of importance in the treatment of mental disease we consider it necessary to report our experiences and our results.

The use of muscle relaxants in E.C.T. constitutes an important advance in psychiatric practice. The merits of the method are not only due to the beneficial effects of the relaxant itself; the anaesthetic, that is invariably administered at the same time, plays an essential part in the procedure. Every phase of the treatment is greatly improved. Anxiety, which so often develops during unmodified E.C.T., is greatly reduced if not abolished altogether. There is no cry or other noise that might disturb other patients awaiting treatment; the convulsion is attenuated to a reaction that may be varied at will from a mild modified convulsion to a mere flicker of facial muscles or complete absence of muscular activity. Cyanosis is absent and the colour remains good throughout, and—perhaps most important of all from the therapeutic point of view—there is no restlessness or confusion after the treatment, the patient sleeping quietly after the treatment until he wakes up without any unpleasant sensations or memories.

As modification of electro-shock is becoming a routine procedure in every patient undergoing this therapy, it is necessary to find a muscle relaxant, or as it has been commonly called a “curarizing agent,” which will be ideal for this purpose. Ideal should mean no toxicity, rapid onset, short duration and rapid termination of neuro-muscular blocking action.

In previous communications (1951, 1952) we have shown that lysergic acid diethylamide (LSD-25), a drug which has a remarkable psychological effect in minute oral doses, also has an effect on carbohydrate metabolism resulting in an increased concentration of hexosemonophosphate in the blood. This observation has been confirmed by Cornforth and Long (1952). What was less clear from the experiments in mentally healthy subjects was the relation in time and severity between the psychological symptoms and biochemical changes.

The purpose of this experiment has been, in the first place, to bring about improvement in certain patients who were responding insufficiently or not at all to psychotherapy, by the use of this drug for which claims have been made that it is of value in the therapy of some anxiety states, such as those characterized by tension; and in the second place to gain by experience an understanding of how much we are justified in expecting from its use. Within the limited series of eleven patients so far treated, results have been sufficiently encouraging to make us wish to continue.