At various times attempts have been made to establish a specific pathological entity “acute lethal catatonia”. Stauder and Scheid (quoted by Mayer Gross et al., 1954) among the older writers have collected a number of fatal cases and more recently Locher (1941) has suspected qualitative difference in the type of illness of those mental patients who die suddenly in an acute catatonic state. However the general view nowadays seems to be that death is due to exhaustion or intercurrent illness. A fatal outcome is very unusual in current practice perhaps because of improved therapy. The symptoms of acute catatonic schizophrenia are so striking that a determined quest for a biochemical basis for the whole schizophrenic process has been sought in this, its most dramatic manifestation. Success in this direction has often been claimed (e.g. Fischer, 1953; Rieder, 1954; Gjessing, 1953, inter alia) but has also frequently been disputed (Georgi, Rieder and Weber, 1954). The following case is reported because the symptoms seemed to be clearly related to physiological change. It tends also to throw further doubt on the entity of acute lethal catatonia of Locher. Interesting EEG findings and characteristic response to amytal are also noted.

A small number of children have brains which are so malformed or damaged that they make little response to special methods of education. A survey of the forms of brain abnormality in these cases has been carried out by Crome (1954). The category of children who can properly be classed as ineducable is, however, strictly limited and should, probably, be confined to idiots. Williams (1957) has pointed out that the task carried out in occupation centres for imbeciles is that of “educating the ineducable”, whilst a number of recent studies have shown that imbeciles have much more educational capacity than is generally assumed.

The experiment to be reported in this paper stems from previous work on the block design rotation effect (Shapiro, 2, 3, 4; Yates, 9, 10; Williams, Lubin et al., 7). As is well known, the block design test in its various forms: Kohs, Wechsler and Goldstein Scheerer, requires the subject to reproduce, with one-inch multi-coloured cubes, a series of abstract designs. It has been reported by a number of observers that subjects sometimes leave their reproductions in a rotated position, although otherwise the designs have been correctly reproduced.

It has been clinically observed that psychiatric patients in general (6, 11) and schizophrenic patients in particular (1, 4) show abnormalities of mental speed, being “retarded” or slower than normals on many measures. Confirmatory evidence on this point is to be found but much of the early work on speed of schizophrenic reactivity used measures of speed of motor performance (12, 13) or of reaction time under various conditions (6), ignoring more fundamental slowness of thought processes. The present studies are concentrated on the recent finding that schizophrenics show abnormally slow mental speed measured in a problem-solving situation (4, 18, 19). The aim of the investigation was to discover the exact conditions under which this abnormality appears, and, thence, by manipulating the experimental conditions, to be able to bring speed of mental functioning under experimental control. This paper describes the attempt to bring speed under control by means of drugs. A second paper (2) deals with the effect of practice upon mental speed.

In this paper, a further examination is made of the finding that schizophrenics, given a problem-solving task to measure mental speed, showed marked improvements attributable to practice (4).

Preliminary investigation suggested the importance of the effects of both practice and drugs on speed of problem solving. The latter is reported elsewhere (4). There appears in the literature to be agreement that marked improvement is shown by schizophrenic patients after practice, but Huston and Shakow (11, 12) for example, give evidence that this improvement is even more marked for schizophrenics than it is for normals while Hunt and Cofer (9) report the contrary. Huston and Shakow also raise the question of whether or not it is possible, by very extended practice, to bring the performance of schizophrenics to the level of perfection reached by normal subjects after practice. Clarification of these points is necessary.

Psychoticism, neuroticism, and extraversion are the dimensions of personality resulting from the statistical analysis of a number of psychological tests. Those working in this field state that the “isolation of three main dimensions—neuroticism, psychoticism, extraversion—may be said to have been accomplished at a reasonably high level of confidence” (Eysenck, 1952, p. 293). It has been stated also that these dimensions are relatively independent of one another and all independent of intelligence. In developing the dimensional picture of personality, tests which discriminated between a group of neurotic patients and a group of normals were found to inter-correlate positively and to generate a factor of neuroticism. Similarly tests were developed which distinguished between psychotic patients and normals, and between extraverts and introverts. To the writers' knowledge however there is no study available which applies the tests for all four dimensions to the same group of people. The four orthogonal dimensions should be identifiable, and would confirm the dimensional theory.

During World War II considerable attention was given by the War Office to problems of delinquency in the Army and a number of psychiatric investigations were carried out with the ultimate aim of reducing the rate of military delinquency. Some of this work was specifically concerned with the relationship between mental abnormality (mental disorder and defect) and military delinquency. The purpose of this paper is to survey the unpublished reports, together with the published literature, and point to general conclusions.

The so-called experimental psychoses have been in the focus of increased interest recently, as a result of the discovery of new hallucinogenic or psychotic agents and of the fact that the problems can be approached more closely even in the borderline fields of pathopsychological research (biochemistry, electrophysiology, etc.) owing to advance in technique. Thus, it appears that Kraepelin's dream of producing so-called miniature psychoses by the administration of substances foreign to the body will come true after all.

Meprobamate is the shortened name of 2-Methyl-2-n-Propyl-1,3 propanediol dicarbamate, which is also known as Miltown or Equanil.

Another “tranquillizing” drug known as “Notensil” has recently been introduced to this country. It is a phenothiazine derivative, acetylpromazine, closely related chemically to chlorpromazine but without the chlorine atom which has been thought to cause the undesirable side effects of the promazine group.

Hyaluronidase, the “spreading factor” is widely used today to aid the distribution and absorption of fluids injected at various sites into body tissues. It is derived from the head of the male sperm cell which by its action dissolves hyaluronic acid in the “shell” surrounding the female egg cell and thereby allows spermal penetration and conception; generally speaking it dissolves the ground substance between cells. The most remarkable usage is in paediatrics where it allows for quick replacement of lost fluid and salt in gastro-enteritis, obviating the need to find veins, and thereby saving practically all cases from death by dehydration. There are many other uses.

It is interesting to reflect that it is 70 years since Charcot delivered his lectures on Hysteria at the Salpêtriére, 60 years since Freud and Breuer published their Studies in Hysteria and 50 years almost to the day that Pierre Janet was invited to lecture on the same subject at Harvard University. In that period—from Charcot to Janet—almost everything was said that could be said of this disease. So much so that we have entered into a sort of post-Galenic period in which all subsequent authors repeat—more briefly and less accurately—all that was said with such brilliance by this eminent triumvirate. What may be said that is new, really fresh? What researches of importance have been carried out in recent years that must today be reported, what up-to-date views on aetiology and treatment? It is humbling to admit that there are precious few. True there have been many contributions to other branches of psychiatry but it seems to me that the situation of the hysterical patient today is very much as it was when his grandparents and great-grandparents submitted themselves to the awesome scrutiny of a full neuro-psychiatric investigation.

A previous communication (Mittwoch, 1957) contained evidence that the leucocyte count in children with mongolism showed certain abnormalities. Although the total count was not affected, the lymphocyte count was lower and the neutrophil count seemed somewhat higher than in a comparable control group. It will be shown in the present paper that these differences between mongol and non-mongol children are dependent on age, and that the gradual drop with age of the lymphocyte count, which is found in normal children (Kato, 1935), does not occur in children with mongolism.

A role in mental illness for an aberrant metabolism of indole compounds was first advanced some sixty years ago, when their alleged toxicity to the nervous system figured prominently in the then current theory of auto-intoxication by bacterial action in the bowel (Herter, 1898, 1907). Although in a modified form it continues to receive the support of Buscaino (1958), auto-intoxication of this nature is now generally rejected as a factor in mental illness (see particularly Alvarez, 1924) and the renewed interest in indoles and brain function of recent years has come from a different standpoint. Thus, study of the central nervous system effects of indoles such as 5-hydroxytryptamine (serotonin) and bufotenin, and of compounds containing an indole group such as lysergic acid and reserpine, has inspired several new theories concerning normal and abnormal roles for indoles in the brain (Woolley and Shaw, 1957; Brodie and Shore, 1957; Hoffer, 1957).

Cerebral electrostimulation of subconvulsive intensity causes an increase in the concentration of adrenaline-like substances in the blood (Weil-Malherbe and Bone, 1952b). This increase becomes more pronounced as the pulse repetition rate is raised from 200 pulses per second (p.p.s.) to 500 p.p.s., in contrast to the motor, sensory, and respiratory effects which diminish under these conditions (Montagu, 1955). The increasing response to the higher repetition rates showed no sign of reaching a peak in these experiments, except in one case, and since it was not possible with the existing apparatus to exceed 500 p.p.s., the optimal conditions for eliciting the response remained undetermined. With the aid of a more versatile stimulator the adrenaline-frequency relationship has subsequently been studied more extensively, and the results are presented in this article.∗

Gjessing has taken a leading part in the clinical investigation of mental illness during the past twenty-five years. We believe it would be in accordance with his wishes that, in presenting a profile to mark the occasion of his seventieth birthday, we should choose to describe Gjessing's research interests and scientific achievements rather than his personal qualities.

The nitrogen retention, and especially the periodically changing excretion of urea, seems to be a characteristic symptom in periodic catatonia (1). We therefore made it our aim to investigate the amino acids in the urine, and later also in the blood and cerebro-spinal fluid (C.S.F.), throughout the lucid interval and the catatonic phase.

Two earlier studies (Venables and Tizard, 1956a, b) on the reaction time (RT) of schizophrenics have shown that as the intensity of a visual stimulus is increased beyond an optimum point, RT to the stimulus increases. This “paradoxical” increase in RT is not shown by normal subjects, whose RT decreases as the intensity of visual stimulus increases. It was also found that the paradoxical phenomenon with visual stimuli was only shown on an initial occasion of testing. When the experiment was repeated twenty-four hours later, although there was no alteration in the mean level of RT, the pattern of increase in RT with increasing intensity, previously found, was absent.

The problem of the increased number of elderly psychiatric patients universally encountered needs no stressing. The purpose of this paper is to assess the value of the electro-encephalogram (EEG) as an objective aid to diagnosis and prognosis in these persons. The great majority of the psychiatric patients seen over the age of 60 are either suffering from an affective disorder, almost invariably depressive in nature, or from an organic dementia whether senile or arteriosclerotic. The former is normally considered of good prognosis and the latter doubtful or bad according to the degree of the dementia and confusion.

Hydroxyzine hydrochloride (Atarax, UCB 4492) is a tranquillizer which has attracted much interest in the United States, where it has undergone a series of clinical trials with encouraging results. In order to test the claims of American investigators a trial of hydroxyzine was made on a group of psychotic and psychoneurotic patients in a large mental hospital. The effectiveness of hydroxyzine in controlling the tobacco habit was also tested by using volunteer nurses at the hospital. Their observations provided useful information on the subjective action and side effects of the drug. A small number of young children attending a local child guidance clinic were also included in the clinical trial.