Psychiatry, during the past fifty years, has had a phenomenal but in some respects a rather unfortunate growth. Long in what Auguste Comte called the mystical state of the evolution of a science, psychiatry rapidly entered into its taxonomic phase when, as one of the later repercussions of the romantic reaction to eighteenth century materialism, the rightful place of psychiatry among the sciences of the humanities began to be appreciated. Almost simultaneously, however, premature efforts began to be made by students in the field to achieve higher levels of scientific development, with the result that the facts of psychiatry soon became almost lost in rigid and increasingly complex systems of classification. Fortunately, in recent years there has arisen a salutary tendency among psychiatrists to review the data of their discipline, and to re-examine the pragmatic and heuristic validity of certain formulations that too readily, perhaps, had been taken for granted. Among these attempts at re-orientation may be mentioned: as to ætiology and psychopathology, the work of Freud and the psycho-analytic school; as to a valid nosology, the statistical researches of T. V. Moore and others; and as to clinical application, the objective, critical studies of the results of various methods of diagnosis and therapy appearing with increasing frequency in the recent literature. We hope that the present work will be a contribution to the movement of fundamental reorganization now evident in psychiatry and its related fields of study.

Society's attitude towards those who commit crime is undergoing a fundamental change. Interest in criminals has changed from the moral and legal to the psychological and sociological aspects, with the result that the criminal to-day has acquired a new importance. In the old days the community set out to punish the criminal and did so with considerable severity. The Law still continues to keep as its first consideration the protection of the community, and the claims of society are considered greater than those of the individual. Nevertheless, intensive study of individual offenders is essential if we hope to be able to advise society as to the best methods of dealing with those members who will not or cannot obey its rules.

In a previous paper (1) the iron, copper and manganese content of the human brain were recorded, with special reference to the G.P.I. cortex, which in certain cases contained an excess of both total and “available” (i.e., non-hæmatin) iron.

For some years following the war the number of patients admitted to mental hospitals whose illnesses were associated with alcohol definitely decreased, but recently the number again appears to be on the increase. During the past eighteen months 50 patients whose illnesses were the result of alcoholic excess were admitted to St. Ebba's Hospital. As this hospital is set aside for recoverable cases, it is possible that the number is in excess of that admitted to other mental hospitals, owing to the fact that many alcoholic psychoses such as Korsakov's disease and delirium tremens have a good prognosis. Nevertheless, in my capacity as consultant to an observation ward I have found that many patients who are suffering from delirium tremens, “pathological drunkenness “, etc., are admitted to such wards, who rapidly clear up and are discharged without being admitted to a mental hospital, and the impression gained is that the number of alcoholics is steadily increasing. It is not proposed to discuss the symptomatology of the various forms of alcoholic psychoses, which are well known, but to discuss various points of interest which arose during the investigation of these patients.

Despite the modifications introduced at Cardiff (1, 2, 3), somnifaine prolonged narcosis remains a dangerous procedure (4, 5), and we had hitherto thought that the method could only be made perfectly safe by reducing the dose below a level which is therapeutically valuable. Witt and Cheavens (6), followed by Day (7), have, however, used a medinal-luminal mixture with apparent safety and with good results, and we have followed their technique in 60 cases. A mixture containing medinal 5 gr. and luminal 1 gr. in each drachm is used. The first dose is 2 drm., which is repeated 4-hourly till sleep occurs; thereafter 1 drm. is given as required. The usual methods of nursing are adopted (3, 4), and Day claimed that narcosis could be continued for as long as 78 days with a gain in weight of from 5 to 30 lb.

Agenesis of the corpus callosum is not as rare as might be expected and over a hundred cases are on record. It is, however, remarkable for the diversity of the clinical signs that are associated with it, and no doubt these are dependent on other anomalies of the brain, some of which apparently always accompany this condition.

The history, pharmacology, physical and chemical properties of cardiazol have been recorded in many publications recently, and our knowledge has been derived from them. Our technique and method of giving the injections have been more or less on the lines laid down by Meduna and described by Kennedy in the Journal of Mental Science of November, 1937. We used a 10% solution and usually commenced with 3.5 c.c. or 4 c.c., giving bi-weekly injections. The dosage necessary to produce a convulsion varied with different individuals. When a convulsion was not induced the dosage of the next injection was increasd by .5 c.c. or 1 c.c., depending on the reaction of the previous injection. The course was terminated by weekly injections. Our highest dose was 9.5 c.c. The injections were given in 10-15 seconds, and occasionally the first stage of the convulsion came on before the needle was withdrawn. Latterly we reduced the time of the injection to 10 seconds. No definite rule can be laid down as to the number of epileptic attacks to be induced.

The experiments described in this paper were performed in an attempt to elucidate the mechanism of the convulsion following the administration of cardiazol (pentamethylenetetrazol). The paper is divided into four sections—a description of experiments, a résumé of the relevant pharmacology of cardiazol, a discussion and a summary.

(1) The “we” means the inner or subjective side of group-experience, expressed grammatically in the first person plural. For instance, the mother giving her child a bath says to it, “We are having a bath now, and then we are going to sleep “, whereas it is only the child who is going through the ceremony.

Theories have been put forward concerning children's play which relate it to phylogeny and to an impulse towards preparation for life.

Child psychotherapy must be founded on modern depth-psychology. Exact structure-analysis is the condition for therapy.

The development of psycho-analysis can be considered as a reaction against an exaggeration of the synthetic point of view in suggestive psychotherapy and moral education. If the result should be that the synthetic point of view is considered unscientific in theory and arbitrary and bad technique in practice, this would mean another exaggeration. Even in psycho-analytic circles the problem of synthesis has arisen in relation with child-analysis and with influencing the super-ego.

A sound, scientific development of psychotherapy (dealing with the entity—body, soul, mind-environment) can only be based on the position of the individual between ancestors and posterity, his own and the other sex—the environment, the whole; as well as the position of the independent, separate individual.

Patients suffering from this disorder (ulcerative colitis) more frequently than usual refer its onset and relapses to “worry”, and frequently appear mentally abnormal even to the casual observer.

The age of maturity may be regarded as having begun when the individual has finally chosen his mate, and is satisfactorily and happily married. The problems of the unmarried and the homosexual are somewhat different, but have analogous solutions.

This paper deals with the problem of neurotic anxiety, that is of anxiety which is not justified by external circumstances. Such anxiety is explained as a reaction to an internal danger situation created by emotional conflict in early life. An attempt is made to reconstruct the nature of this conflict in the light of evidence based on the psycho-analysis of patients suffering from anxiety symptoms, and the primitive defences called out by this danger are discussed. The conclusion drawn is that these defences, though temporarily successful, are in the long run ineffective, and actually set up a vicious circle which perpetuates the very danger it aims at averting.