A number of studies have been recently concerned with the clinical application of the Archimedes spiral, an illusory negative after-effect of apparent movement, which requires no description here. Freeman and Josey (3) reported a relationship between the presence or absence of this after-effect and a clinical judgment of memory function, while a cross-validation study by Standlee (11) failed to confirm this observation when an objective measure of memory impairment was used.

Spielman and his colleagues (1948) were initially responsible for demonstrating the anti-convulsant action of the acetylurea derivatives. However, it was not until several years later that comprehensive studies were carried out by Professor Frommel in Geneva (1953).

Phenytoin Sodium (Sodium diphenylhydantoinate) is established in the treatment of epilepsy. Toxic side effects, especially on the nervous system, have been well documented. Untoward reactions may follow therapeutic doses taken over a period of time, or as the result of a single massive dose taken accidentally or with suicidal intent.

The following case of toxic reaction is reported because of the unusual mode of presentation and the associated C.S.F. changes.

In the past few years many papers have appeared both in Europe and the United States of America demonstrating the value of Chlorpromazine and Reserpine in the treatment of mental illness. In the United States of America Kinross-Wright (1954) has reported on Chlorpromazine in the treatment of schizophrenia and claimed very satisfactory results; in this country Lomas (1955) and his collaborators have in several papers confirmed these results. With regard to Reserpine in the United States of America Kline (1954) has used the drug extensively with good results; in Europe, hopeful reports by Foote (1955) and McGrath et al. (1956) confirmed the value of this drug in psychiatric practice.

Depersonalization, derealization, unreality feelings, metamorphopsia and similar symptoms are not unusual in neuro-psychiatric patients. They are said to be extremely rare in children, Tramer (22) does not mention them, and Kanner (9) remarks only that “feelings of unreality are exceedingly rare in children. Things seem unreal to the patient, different from what he knows them to be. He is fully aware of the incongruity of his experience, which sometimes causes considerable distress.” He quotes the case of a slightly retarded boy of almost 14 years who combined feelings of unreality and derealization with occasional macropsia.

Eysenck (1957a) has recently cogitated the relation between personality and drug response. He quotes McDougall (1929) as stating “I have observed in a number of cases that the marked extraverted personality is very susceptible to the influence of alcohol. The introvert, on the other hand, is much more resistant to alcohol“. This is a remark capable of confirmation, for Eysenck (1953) has described at least two personality dimensions, each a continuum and each orthogonal to the other. These two dimensions were termed “Neuroticism-Normality” and “Extraversion-Introversion”. A number of tests have been elaborated by Eysenck (1955, 1956, 1957b) for measuring such personality quantities.

Since the discovery of the therapeutic value of induced epileptic convulsions in mental illness, there have been efforts to make this form of treatment available to those patients whose psychiatric state would benefit from it but whose physical condition contraindicates its use. Modifications have been sought, particularly since the introduction of electrical methods of inducing the fit. The modification of electroplexy takes three main forms—postural, electrical and chemical (Montagu, 1953) and it is with this third type, the use of anaesthetic and relaxant drugs, that this paper is concerned.

In earlier studies from this department (Robinson, 1955; McAdam and Robinson, 1956) it was shown that in senile and arteriosclerotic deterioration a correlation existed between the degree of deterioration assessed clinically and the amount of abnormal low frequency activity observed in the EEG. The relationship had for the first time been quantitatively demonstrated, but we had no precise knowledge of the EEG or clinical profiles presented by a group of “normal” old people. In our hospital patients, the amount of deterioration extended over a very wide range, from mild forgetfulness to severe dementia.

The Laurence-Moon-Biedl syndrome shows much variation in its clinical picture from case to case and the limits of this syndrome are indefinite. This clinical entity was first identified by J. Z. Laurence and R. C. Moon in 1866 and was more completely described by A. Biedl in 1922. In 1935, Cockayne, Krestin and Sorsby stated that some 30 isolated cases and 15 affected families were reported during the ten years from 1925 to 1935, and in 1939 Sorsby, Avery and Cockayne made a later review. In October, 1955, J. Todd described a case of Laurence-Moon-Biedl syndrome with paranoid psychosis in the American Journal of Mental Deficiency, and in 1950 R. A. Burn reviewed 82 cases giving the total number of reported cases as 260. Up to 1957 about 320 cases have been described in the world literature but even this number is likely to rise with the increased interest shown in this syndrome.

By 1975 Denmark should have 9 new mental hospitals, each, with one exception, closely linked to a general hospital. This is the most striking of the proposals contained in the Report∗ of a Commission set up by the Danish Ministry of Internal Affairs in 1952. This Commission was to “report on trends of development of the State Mental Hospital Service in respect of organization and buildings, with special reference to the necessary adaptation of the hospitals to present-day needs and forms of treatment. The Commission's deliberations, which should principally be concerned with the modernizing and extension of the hospitals together with their position in relation to the general hospital service, should also include the possible extension of treatment to categories of patients with mental disorders other than true insanity. The Commission's work should be so arranged that its report can constitute the immediate foundation for the practical organization of future reform work.” This Report contains much of general interest and much which might merit wider application.

Recent research has shown that constancy of perception breaks down in schizophrenics. Size constancy in these patients has been investigated by Raush (13, 14), Weckowicz (16), and Crookes (2). Raush found that paranoid schizophrenics had increased size constancy compared with normals and other schizophrenics. He predicted that in other types of schizophrenia size constancy might be poorer than in normals. However the difference he found was not statistically significant. Weckowicz found that chronic hospitalized schizophrenics had poorer size constancy than other hospitalized patients and normals. These two investigators determined size constancy by instructing the subjects to adjust the size of an object (a rod or a square) to the size of a standard object at a distance. Crookes used a direct method. His subjects were instructed to reproduce the size of the image of the standard object seen at a distance and not the size of the object itself. He came to the same conclusion as Weckowicz that size constancy in schizophrenic patients was impaired.

Electro-convulsive therapy was first introduced by Cerletti and Bini in 1938, and has now become the principal physical method of therapy in psychiatry.

Chlorpromazine (“Largactil”) was introduced to this country some five years ago, and since that time a considerable number of reports on its clinical efficacy have appeared, including Anton-Stephens (1954) and Garmany et al. (1954). There is now general agreement that it is a useful form of treatment in chronic schizophrenia, especially for the aggressive, disturbed patient (Salisbury and Hare, 1957). More recently another phenothiazine derivative, incorporating a piperazine ring in the side chain, has been produced.

The earliest case of cutis verticis gyrata reported in the literature appears to have been that of Robert (1) in 1843. The following instances were observed by Auvert (2) in 1854 and subsequent cases were noted by Poggi (3) in 1884 and Lombroso (4) in 1890. In 1893, McDowall (5) and Cowan (6) recorded the first occurrence of this abnormal scalp development in association with a microcephalic mental defective, and since that case report several other authors such as Möller (7) in 1903 and Judassohn (8) in 1906, described similar instances. In 1907, Unna (9) presented three cases and coined the name cutis verticis gyrata. It is also known under additional terms such as “corrugated skin”, “bulldog scalp” and “pachydermie occipitale vorticillée”.

Increasing use of the Rorschach Inkblots Test is being made in medical diagnosis, not only in psychiatry, but in neurology as well. Bibliography is too extensive to quote here, and the reader is referred to the standard work by Klopfer et al. (1956) which lists nearly 3,000 references specific to Rorschach literature. The inclusion of a long chapter on the clinical use of this test in the latest research monograph of the Association for Research in Nervous and Mental Diseases (1954) is evidence of the increasing esteem in which this test is held by specialists in neurology and psychiatry, supported by the growing use of the test in diagnosing intracranial organic pathology. It is interesting to note that in the latter field the Rorschach has proved superior in diagnostic accuracy to any other single neurological test, such as EEG, lumbar puncture, ventriculography, etc., and is often as good as the complete battery together.

Schizophrenia occurring in the early years is generally recognized to be a deteriorating illness and one in which therapy has little effect. Tredgold (6) recognized schizophrenia as a cause of oligophrenia and most mental deficiency hospitals have a number of these patients. Although not numerically a large problem, they are among the most difficult patients to handle.

7044 is a new phenothiazine derivative which can be regarded, pharmacologically, as resembling chlorpromazine much more closely than it does promethazine. It is said to have the characteristic central properties of chlorptomazine more highly developed, and in addition anti-adrenaline properties with anti-histamine properties comparable to those of promethazine. On a theoretical basis it might have the clinical indications of chlorpromazine.

Prochlorperazine, 1-[3-(3-chloro-10-phenothiazinyl)propyl]-4-methyl-piperazine dimaleate, a phenothiazine derivative related to chlorpromazine, was discovered in the Rhône Poulenc laboratories, and studied pharmacologically in 1956, by Ducrot and Koetschet, for its anti-emetic properties. Clinical trials, following this experimental evidence, suggested that, as well as possessing powerful anti-emetic properties, the drug was of considerable therapeutic value in migraine, Ménière's syndrome, and vertigo of other origins.