While elaborating a test for cholesterol in the cerebro-spinal fluid, 0. H. Boltz (I) observed and investigated a reaction which occurred predominantly in cases of neuro-syphilis, and which he named the acetic anhydride-sulphuric test. To I c.c. of spinal fluid was added 03 c.c. of acetic anhydride, drop by drop, and after mixing the fluids by shaking, o@8c.c. of concentrated sulphuric acid was added in drops, and the mixture shaken again. The development of a blue pink or lilac colour characterized a positive reaction. The test has been studied in this country, and it has been claimed that the reaction is positive in almost every case of general paresis, and negative in almost every other type of mental disorder, except certain cases of non-paretic neuro-syphilis. As this constitutes a surprising degree of specificity of an apparently simple chemical reaction for a single disease, I have carried out the reaction in association with the routine tests in a series of cerebro-spinal fluids with a view to ascertaining its value. One hundred and sixty fluids were examined—a comparatively small number on which to base conclusions, but the results will show that the claims previously advanced for the value of the test require considerable modification.

From time to time in convict prisons examples are seen of certain morbid mental states which are described as distinct disease forms under the name of “prison psychoses.” These states may be defined as special types of mental reactions developing upon conflicts which arise as the result of imprisonment, and possibly from the shock attending the criminal act, trial and conviction. They have been the subject of much inquiry, but, on account of the variation in the material which was available and in the conditions under which the studies were pursued, some confusion of thought appears to exist as to what may or may not be regarded as belonging to this class of disorder, and whether, in fact, the classification is not redundant. The sole justification for the use of the term “true prison psychosis” lies in the ability to establish the disorder as a separate entity, lest the name should be applied to conditions which are adequately described under other titles, as has been the case with shell-shock and “barbed-wire” disease.

Epidemic encephalitis resembles many of the common infectious diseases in being caused by a virus which no one has seen, or has been able to grow in an artificial medium. Whether it has been possible even to transmit the disease to animals is still a matter of dispute, although the most recent work tends to confirm rather than to discredit the assertions of those who claim to have done so. This work is of the greatest interest, and it is of special importance in that it clarifies some of the difficult clinical problems which the disease presents. In particular, it seems to shed light on the question why the more acute forms of the disease are less often followed by progressive sequelæ than those in which it begins more insidiously.

It is to Jung, of Zurich, that we are indebted for the attempted division of attitudes of mind into the introverted and the extroverted types. In his Analytical Psychology he gives us a chapter on types, and in 1924 appeared his large work on Psychological Types. According to Jung, the introverted type of individual is characterized by the fact that his libido is turned towards his own personality to a certain extent—he finds within himself the uncon ditioned value. The extroverted type has his libido to a certain extent externally—he finds the unconditioned value outside himself.

This paper is based upon observations taken on patients at rarkside Mental Hospital, Macclesfield.

Martin's modification of a Riva-Rocci sphygmomanometer was used. The systolic pressure (S.P.) was taken at the point on the scale when the first audible click was heard through the stethoscope on decompression following obliteration of the left brachial artery, and the diastolic pressure (D.P.) at the point when the loud thuds suddenly became dull (the end of the third and beginning of the fourth phase).

There is no lack of evidence that a subconscious measurement of the lapse of time takes place. For example, domesticated animals are often strikingly punctual; some idiots manifest an accurate faculty for time measurement; many men can judge the hour correctly without looking at a clock; others can wake at a predetermined minute; and, as a rule, post-hypnotic suggestions take effect with startling and cryptic punctuality. Investigators are agreed that time-gauging is much more accurate during sleep and trance than in the waking state—in other words, is now more a subliminal than a supra-liminal faculty.

Clinical and pathological experience has shown that encephalitis lethargica, like neuro-syphilis and disseminated sclerosis, is essen tially a chronic disease. For whether it declares itself acutely or insidiously, and however complete the recovery from the initial phase may appear to be, in a large proportion of cases the infection, which has evidently lain dormant for weeks, months or years, again becomes active and gives rise to the grave disabilities with which we are familiar. The distressing result is that we never know when the patient is cured. At present we are at a prognostic impasse.

Childbirth and lactation entail a severe stress on the female sex, and, under certain circumstances, are liable to cause insanity, during the course of which attempts at infanticide and suicide are common. For this reason the insanities connected with child-bearing and lactation have a definite medico-legal aspect. In the past very little has been written on this subject, though infanticide is by no means uncommon, and cases of child murder account for a large percentage of the population of the female division of the State Criminal Lunatic Asylum at Broadmoor. Possibly a study of some of these cases may not be lacking in interest.

My view of the nature of this disease coincides with that of Dr. Mackenzie; The disease encephalitis lethargica may be defined as an infection the toxic products of which have an affinity for the grey matter of the central nervous system, and so give rise to any of the syndromes of disease of that tissue or to any combination of such syndromes, and which runs a fickle course that may end in recovery, death, or the production of characteristic sequeæ.

The ingestion of a pint of milk by a normal fasting individual is followed by certain blood changes, the most important of which are an increase in the leucocyte count and a slight rise of blood pressure. In the condition known as anaphylaxis, or protein shock, the general symptoms are accompanied by a fall in the number of blood leucocytes, a reversal of the differential count, and a lowering of the blood-pressure.

In a series of 412 cases admitted between December 20, 1923, and December 29, 1925, the blood-serum was tested, and of these, 105, or 25.48%, were found to be positive. This shows the distinctly high incidence of syphilis of I in every 4 admissions.

In March, 1925, Clark and Collip (1) published a modification of Tisdall's method for the estimation of calcium. They had made extensive use of their method, and claimed that it gave an error of not more than 2%.

Following on the momentous discovery of the causative organism of syphilis by Schaudinn and Hoffmann, some eight years later Noguchi, working under the great difficulties of his own method, demonstrated the presence of spirochætes in the brain of a general paralytic.

This work has been undertaken with the object of disclosing metabolic deviations which might aid in the ætiologyor diagnosis of the psychoses, especially in cases of dementia præcox, epilepsy, melancholia and secondary dementia.

The objects of this investigation were to find out in what respect the resistance to hæmolysis of the red blood-corpuscles differs in mental disease from the normal, and to make a contribution towards the elucidation of pathological mental states and their relationship to pathological states of organs of the body other than the brain.