Any patient who shows a regularly recurring change of mental state will be of particular interest to the research worker, for in the recurrence, by acting as his own “control,” the patient provides the best of all comparisons.
Such a patient, a woman aged 39, provided the basis for this work. Usually sensible and well spoken, she would, about every twenty-first day, become confused and incoherent. Convulsive therapy (E.C.T.) always caused an immediate improvement, and within two or three days she was well again. (Previous experience had established that the confusion had little spontaneous tendency to recover.) As she provided this regular cycle, a systematic investigation was made over several months into those aspects more particularly relevant to the effect of E.C.T. on the adenohypophyseal-adrenocortical system, for a previous study (Ashby, 1949) had suggested that E.C.T. might owe its effectiveness to action through this system.