Red clover silage is an important component of many organic dairy systems. The high intake and milk production potential of red clover silage has been recognised for many years (e.g. Thomas et al., 1985). Our earlier studies confirmed this potential and showed additional benefits with increased polyunsaturated fatty acid (PUFA) content of milk (Dewhurst et al., 2002). The objective of this study was to investigate further the effect of red clover silage on milk PUFA and to examine whether supplementary vitamin E, which is needed to slow oxidative deterioration of milk with enhanced PUFA content, had an effect.

In a recent review (Dewhurst, El Kabir, Harris and Mandelbrote, 1968) the evidence relating the effect of stress to thyroid function has been surveyed. In that account the comment was made that although it is impossible to assess or quantify the psychological trauma that any mentally ill patient is undergoing, it would seem reasonable to assume that if emotional stress is associated with abnormal thyroid activity, then a study of thyroid function in mentally ill patients would reveal such abnormal activity. In the present work a study has been made of the function of the pituitary–thyroid axis in control subjects and in patients suffering from schizophrenia and affective illnesses. Since there is strong evidence that emotional stress in many cases affects endocrine function through the mediation of the hypothalamus and anterior pituitary gland, measurement of the blood concentration of thyrotrophic hormone (T.S.H.) has been used in the present investigation. A further reason for assaying the blood concentration of T.S.H. is that measurement of many of the more direct parameters of thyroid function are subject to variables which are difficult to control. Studies of the blood level of T.S.H. in psychiatric patients have not, so far as we know, been carried out previously.

This paper reports a case which is noteworthy for two unrelated reasons, one genetic and the other therapeutic. The genetic interest lies in the rare instance of an identical twin with obsessive compulsive neurosis whose twin brother had a similar illness. The therapeutic interest focuses on clinical changes which occurred during unsuccessful treatment by desensitization and by aversion relief. These changes aid our understanding of compulsive behaviour and the difficulties in its treatment. At one stage in treatment independence was noted between anxiety and compulsions which suggested that compulsive behaviour need not always be maintained by its anxiety-reducing properties. The case history will first be described and discussed from the genetic point of view. The second part of this paper will focus on the unrelated aspect of treatment.

Only 16 cases of folie à trois have been reported in the English literature (Wolff, 1957). The present case seems worth recording because of the rarity with which this condition is described and the problems it raises.

In order to test whether a drug is an inhibitor of monoamine oxidase in the human subject, three main measures are available:

1. We can measure an increased excretion of the normal substrates of the enzyme, e.g. tryptamine (Sjoerdsma, et al., 1959b).

2. We can measure a decreased excretion of the metabolites resulting from the enzyme's action, e.g. 5-hydroxyindoleacetic acid (5-HIAA).

3. We can administer a loading dose of an enzyme substrate and observe how the subject deals with it before and after the drug, e.g. 5-hydroxytryptamine (Sjoerdsma et al., 1958), and epinephrine (N-methyl-C14) (Resnick et al., 1958).

The discovery that iproniazid benefits certain subjects with depression, linked with the demonstration that it inhibits the enzyme monoamine oxidase (MAO), led to the hypothesis that inhibition of MAO was the essential mechanism by which iproniazid caused relief of symptoms (Pletscher, 1959). Iproniazid, unfortunately, can produce serious toxic effects, particularly on the liver (Pare and Sandler, 1959), and this has limited its clinical application. For this reason a search has been made for MAO inhibitors with an effective anti-depressant action yet without the serious toxic effects of iproniazid. Among the newer compounds for which such claims have been made is N-isonicotinoyl (-N-N-benzylcarboxamidoethyl) hydrazine or Nialamide.