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”.

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.

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.

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.

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.

The last five years have seen the beginning of a remarkable new development in the pharmacological approach to psychiatry. Pharmacological treatment for mental disorder is not, of course, new; drugs like hellebore, opium, camphor, bromides, paraldehyde and the barbiturates cover a large part of the history of psychiatric therapy. Since 1951 a number of new drugs with the generic title of tranquillizers have been introduced, of which the two best known are chlorpromazine and reserpine. They have the characteristic effect of producing sedation without producing sleep.

Few people would be inclined to underrate the actual, and, even more, the potential contribution which the study of the effects of drugs on personality can make to psychiatry. The large number of research papers in this field contributed both by psychiatrists and psychologists bears witness to the interest in this field, as does also the testimony of Freud, who is reported by Ernest Jones to have given it as his opinion that in due course pharmacological treatment of psychiatric disorders would oust all others.

The diagnostic criteria of descriptive psychiatry inevitably vary between the generations and even from decade to decade. New hypotheses imply new selections from the quite illimitable mass of data which may be collected from any patient. Hence new pictures may emerge whose relation to the old may be only partial, and whose inclusion under traditional rubrics may give rise to confusion, or pose problems which are verbal rather than clinical.

A statistical study of large numbers of chronic mental patients may seem to have no direct bearing on the problem of how to treat the individual patient and prevent chronicity. Yet the collection and analysis of mass data form an essential part of epidemiological studies which have made possible many notable advances in preventive medicine. Much of the statistical information at present available in various official documents such as the annual reports of the Ministry of Health and the Board of Control, the Registrar-General's Statistical Review, are so generalized and fragmentary as to be almost meaningless (Lancet, 1955). A few mental hospitals publish annual reports containing broad statistical information; but the detailed facts needed for proper assessment of the size and nature of the problem and for any rational reform are almost invariably lacking. Throughout the field of psychiatry, particularly in connection with the development and effect of chronicity, the existing vital statistics are incomplete and inconclusive.

In our clinical ward programmes we have utilized music rhythm instruments in rhythm groups to stimulate long-term schizophrenic patients and to induce their participation in social group endeavour. These clinical experiences together with various observations in this same connection, heightened our interest in the actual physiologic and motoric response of the schizophrenic patient to music rhythms. The evidence is strong that mentally “normal” persons do respond behaviourally and physiologically to music and its rhythms. Does the long-term schizophrenic patient manifest an objectively measurable response to such rhythm? If it could be demonstrated that the activity and the physiological functioning of the schizophrenic did respond to musical rhythms, then these stimuli might constitute a valid method for the modification of the behaviour of the schizophrenic patient.

Perhaps in no other applied discipline are there to be found so many differences of opinion as exist in clinical psychology today. Clinical psychologists in fact even disagree about the fundamental approach to their own subject. Let us examine briefly what appear to be the major approaches.

Experimental work on the performance of schizophrenic patients indicated that different patterns of response were to be found among patients who could be considered subjectively as withdrawn and inert on the one hand, and sociable and active on the other. This subjective classification appeared to cut across diagnosis within the schizophrenic group.

The frequency with which new drugs become available to the psychiatrist emphasizes the need for quantitative evaluation of their therapeutic effect. Comparable statements, scales of measurement and base-lines are required (Ref. 1–6).

Anthropometry has benefited in the last 20 years from two distinct advances, the use of standardized photography by Sheldon (1940) and the application of factor analysis to physical measurements as initiated by Burt (1944). Tanner in a critical review (1947) compared these two main approaches to interpretation of body type. Later (1954) he defended photoscopic somatotyping against the charge of subjectivity in ratings by stating the degree of consistency obtained by experts, although such consistency is admittedly less common among less expert somatotypists. Factor analysis can claim some theoretical advantages, and certainly greater mathematical exactness than photoscopic typing: but here the question arises as to whether the measurements so far employed for factor analysis yield the best information; statistical treatment by itself, however sophisticated, is no substitute for the best or right choice of measurements.

We preface this short communication by emphasizing that it originates as a by-product from some work that is still in progress at the Burden Institute on the balance of electrolytes in various normal psychological and neurotic conditions. This research is chiefly being conducted by McLeod, Morrison and Fosbrooke, in the Biochemical Department, and Grey Walter in the electrophysiological laboratory.

There have been many new types of sedatives and hypnotics evolved in recent years. The term “tranquillizing drug” is a recent innovation which suggests a calming effect without a hypnotic effect. Methylpentynol (“Oblivon”) is one such drug which has little hypnotic action, but is said specifically to relieve anxiety. This action was noted by the relief of apprehension observed in patients prior to dental treatment (Trotter, 1953). Methylpentynol is a higher alcohol which in high dosage has a hypnotic effect in animals (Margolin et al., 1951). No toxic effects have been reported. It is made up in rather large, blue-green capsules containing 250 mg. of methylpentynol, and also as an elixir.

In recent years electrophoretic methods for the analysis of the serum proteins have been extensively and fruitfully applied to studies of diseases of the nervous system (Volk, Saifer, Rabiner and Oreskes, 1955; Volk, Saifer, Rabiner and Hinterbuchner, 1956; Press, 1956).

The following paper describes the psychological part of a psychiatric and EEG study of psychiatric illness occurring for the first time in women of the involutional age range. The origins of the investigation and the clinical results are fully discussed elsewhere (Tait et al., 1957). They include such matters as the psychiatric observation that classical forms of melancholia seem to have become relatively infrequent. One possible explanation for this may be thought to be in the earlier recognition, hospitalization and treatment of psychiatric illness. It was decided that an appropriate study would pay attention only to women who are admitted to a mental hospital for the first time. In practice this has included all such women admitted to amenity beds in the hospital over a given period of time. This modified selection of admissions was made in order to ensure as wide a range of illness as possible, giving a higher proportion of neurotic illness without excluding psychotic material. The age range studied was that usually considered to encompass the normal range of the biological involution, 40–55. Such a study thus avoids the bias (apart from age) of any preconceived mode of selection. By including only first admissions, some assurance was given that up till then, the patients had been reasonably free from psychiatric illness.

In attacking the problem of the relationship of endocrine function to the schizophrenias and other mental diseases, we have avoided the elementary conception that certain hormones are responsible for special psychological traits and have reached the following conclusions. First, the quality of the mental disturbance depends mainly on a genetically conditioned personality pattern, various individuals reacting in different ways to the precipitating causes. Second, the hormones come into the whole picture only in so far as the hormone equilibrium of the body determines how far the individual can adjust himself to the increased demands arising out of the occurrence of various precipitating causes (Reiss, 1955). It is therefore understandable that very many, or even the majority of people suffering from severe endocrine disturbance, need not necessarily show any psychopathological changes, since their personality pattern is not so conditioned and no increased demands for adjustment are made by the occurrence of precipitating causes. On the other hand, it is equally understandable that certain disturbances in hormone production and equilibrium, even when clinically obscure, can be decisive for mental breakdown in individuals with the appropriate personality pattern, at the occurrence of precipitating causes.

For this purpose average normal values were studied in 40 normal cases, and 40 mental cases were selected from amongst those who were suffering from various mental disorders who were given electric convulsive therapy.