The experimental reproduction of psychotic phenomena in the normal person is a subject which has attracted much attention in recent years from psychiatrists, and which has added remarkable and interesting facts to our clinical knowledge.

Since the passing of the Mental Treatment Act in 1930 it has been noticed that a number of patients who have been discharged recovered from hospital seek readmission as voluntary patients within a comparatively short time of their discharge.

During the course of research into an improved method of the Meinicke Klärungs Reaction (Ford Robertson, W. M., and Colquhoun, D. B., 1939) certain undesirable zone reactions occurred. This paper deals with some of the factors responsible for such non-specific precipitations.

In the literature the opinion is repeatedly expressed that Von Meduna's convulsion therapy, which is so frequently applied, is a comparatively harmless treatment, and that this method, provided the necessary precautions are taken, occasions more or less serious complications only in rare cases. This notion, however, is contradicted by the observations of others, as well as by our own experience. Lesions of the skeleton and affections of the lungs (putrid pulmonary abscesses and activation of latent tuberculosis) are first among the serious complications which may arise from convulsion therapy.

The investigation described below has as its object the determination of the influence of massive doses of insulin, such as are used in treatment of schizophrenia, on the concentration of the sugar and the ketone bodies of the blood with a view to analysing some of the causative factors of the symptoms of hyperinsulinism.

Much has been written about the possible somatic modifications that cardiazol, triazol and other convulsive agents bring about, and many investigations directed towards the elucidation of physical changes have been attempted. Such work in the materialist tradition of medicine is, no doubt, valuable. It would be unfortunate if it were to obscure other considerations.

A new and extremely interesting conception of schizophrenia is opened up by the observation of the sign of dys-symbole made by Skottowe. He has defined this sign as “a state of mind which manifests itself by the inability of the patient to formulate his conceptual thoughts upon personal topics or to discriminate the gradations of his emotions in language which is intelligible to others, notwithstanding that he may be in a state of clear consciousness, while he still retains word-utilizing ability at the level of perceptual thinking, and so is not aphasic in terms of sensori-motor neurology”.

In a previous paper published in the Journal for July, 1938, the vitamin C content of the urine of 50 psychotic patients was estimated. Although it was found that the urine content was on the low side, no definite conclusion could be reached as to whether there was any correlation between the form of mental disorder and the deficiency of vitamin C. Since that time the urines of another 256 patients have been examined, which, together with the original 50, make a total of 306.

Mr. W. T. O—, aged 48. Admitted to Han well (now St. Bernard's) Hospital on 15. iv. 1904.

The patient was admitted from Wormwood Scrubs prison, and there is no available information regarding his condition before his admission to hospital. At this time it was stated that he was confused and unable to give any accurate information about himself. He was garrulous and his conversation was largely incoherent. There are no details of his physical condition on admission. In 1908 he is described as being elated and garrulous. He expressed many delusions of grandeur, stating, for instance, that he was owed large sums of money and possessed his own private carriages, etc. He was rather childish and his memory was impaired. His physical condition was stated to be “much improved “and he was able to be up and about. Even so he showed definite and obvious physical signs of general paralysis (unequal pupils, reacting only sluggishly to light, tremor of lips, etc.).