IN 1935 V. V. Issahyev reported very favourable results from the treatment of a number of cases of idiopathic epilepsy by diathermy to the head, stating that although the method could not be held to cure the complaint, nevertheless it produced considerable relief in the majority of cases. The object of the present investigation has been to repeat this form of treatment in a further series of cases in order to see how far these results could be confirmed.

Provision for the observation of cases of mental disturbance occurring in the administrative and the user area of the Liverpool Corporation is made in one of the city institutions, Smithdown Road Hospital. In this large general hospital are located two special divisions, containing 180 beds, one for female and one for male patients, and to the wards of these divisions are receivable all cases of attempted suicide occurring in Liverpool.

The clinician's share in a discussion on psychoses of circulatory origin must be to provide, in the first place, a description of the characteristic clinical pictures. This would mean the enumeration of a rather puzzling variety of observations, among which it has until lately been rather difficult to find any systematic order. One could scarcely add very much to the classical chapter on arteriosclerotic psychoses in Kraepelin's text-book. Since, however, Dr. Krapf has singled out the hypertensive psychoses as a special group, the task is no longer one of pure description. The application of the achievements of general medicine to the field of hyperpiesis should have opened new aspects in cerebral vascular disease. Supplementing the fundamental ideas given in Dr. Krapf's own paper, I propose to give you a more detailed survey, with some illustrations.

The case reported here concerns the suicide of a voluntary patient and a subsequent claim for damages for “negligence, breach of contract and warranty”, which, after many delays, was struck out of the Assize List on account of the non-appearance of the plaintiff.

Miss H. R. N—. Date of birth, November 11, 1889.

Dr. Prentice said that syphilis, in its incidence, diagnosis and treatment, presented, in mental hospital practice, problems which differed from those met with in dealing with the disease in general practice and in V.D. clinics. In the former its incidence was higher than in the general population, and that was largely because many of those whose nervous system had become affected by the later stages of the infection ultimately developed a psychosis. Drugs which were efficacious in somatic syphilis showed but little therapeutic effect in the treatment of the nervous system when affected by syphilis. There was a wide variation in the syphilis occurrence-rate among new admissions to mental hospitals, namely, from 5% to 31%; there was no doubt that incidence varied in different parts of the country; for instance, at Whittingham Mental Hospital, Lancashire, the male admissions in one year showed 21–9% with syphilis, and females 8–9%. At Narborough in the past two years—using the same methods of diagnosis—the positive males were only 7–7%, the females 4–6%. It was difficult to estimate reliably what proportion of the general population suffer from syphilis, but comparison of the figures of the Royal Commission on Venereal Diseases with those given by numerous workers in mental hospitals—excluding cases of general paresis and meningo-vascular syphilis—showed that the part played by syphilis in the ætiology of ordinary mental diseases must be a very small one. Bearing in mind the body-mind relationship, any toxic or infective process which could be a factor in the ætiology of mental illness should be dealt with. Even if the disease were predominantly psychogenic, all possible physiogenic factors should be eliminated or dealt with.