The popular conception of mental defect is that it is a common abnormality of a kind fairly easy to understand and to study, and for whose ætiology simple rules can be laid down. Textbooks on general medicine usually dismiss the subject in a few paragraphs, and even those devoted to diseases of the mind rarely find room for more than one short chapter on mental defect.

One difficulty which hinders the advance of psychiatry is that the facts of a mental disorder are not easy to describe and to record accurately. Many of the descriptive words used, such as “depression”, “confusion”, are taken from common speech and carry with them vague meanings. Out of sympathy with the sufferer, we tend to read our own emotions into the clinical picture. Moreover, because a disorder of thought and behaviour is a disorder of adaptation to living, the description of a mental disease involves not only the recording of the symptoms, but also a description of the circumstances and life-setting in which they occur. Another difficulty lies in the great variation in the clinical pictures of mental disorder. These vary so much that a diagnostic label such as affective psychosis or schizophrenia does not convey, and indeed is not intended to convey, an idea of a specific disease. These difficulties are somewhat more marked in the investigation of mental disorder in contrast to the investigation of mental defect. The statement that a patient is a Mongol or a cerebral diplegic conveys the idea of a fairly definite clinical syndrome, whereas a statement that a person suffers from schizophrenia calls up a much less clear mental picture. It seems that the only way out of this difficulty is to give a short statement of the clinical facts about each psychotic whom one discusses.

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.

Since there are several excellent accounts of the technique of insulin therapy (1, 2, 3, etc.), and since our method is based largely on the recommendations of Sakel, we do not intend to describe this in detail, but to discuss such variations and points of interest as have developed at Hatton during the completion of treatment in 59 cases.

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.

The term “schizophrenia” was first introduced by Bleuler (1) as descriptive of the dissociation and fragmentation of mental processes which he regarded as the chief characteristic of the condition. There is “a detachment from the world without, and a breaking up of normal psychological connections within. The personality is not integrated as in normal people; thinking emotion, and conduct are discrepant and morbid, yet there is no impairment of formal intelligence such as is found, for example, in organic dementia” (Mapother and Lewis (2)). To quote Bleuler (1), “even though we cannot as yet formulate a natural division within the disease, nevertheless schizophrenia does not appear to us as a disease in the narrower sense but as a disease group, about analogous with the group of the organic dementias, which are divided into paresis, senile forms, etc. One should therefore speak of schizophrenias in the plural. The disease at times runs a chronic course, at times in shifts; it may become stationary at any stage or may regress a certain distance, but probably does not permit of a complete restitutio ad integrum. It is characterized by a specific kind of alteration of thinking and feeling, and of the relations with the outer world that occur nowhere else”.

The outstanding successes claimed in the treatment of schizophrenia by two such apparently different forms of treatment as insulin and cardiazol lead to a comparison of their effects on body and mind. Amongst those who have studied the two methods individually are Angyal and Gyarfas (1937), and Georgi and Strauss (1937),

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.

This preliminary survey of a group of schizophrenics at Friern Hospital was undertaken in order to find out whether such cases presented any electroencephalographic deviation from normal. In the event of positive results being obtained it was hoped that, in addition to further lines for research being indicated, some light might be thrown on the issues raised by Hoagland, Cameron and Rubin (1), (2), (3), and Lemere (4) regarding electro-encephalograms in treated and untreated psychotics.