In view of the success of E.C.T. in depressive states of the middle-aged it seemed worth while to take the risk of extending its benefit to patients over 60, whose clinical picture often differs very little from that of the next younger age-group. Since January, 1941, when E.C.T. was first used in the Crichton Royal, an increasing number of such patients has been treated. It is proposed to give a short, retrospective survey of these cases in order to assess if the therapy has justified itself by its results, and to find out the dangers and the limits of its application. Among over 500 patients treated were 76 over 60, 62 females and 14 males, with the following age distribution:

We wish to record a case of obsessional neurosis remarkable for its strange content and unusual form, and in doing so to draw attention to the comparative rarity of this condition as a primary diagnosis in Naval Psychiatry. Our observations on the last point may not be without interest in considering the aetiology of this condition.

This paper describes the case of a girl to whom certain mental tests were given while she was under hypnosis. The results of these tests are compared with the results obtained when she was in her normal state.

In a previous communication to this Journal, the author described the results of three years' experience of pharmaco-electrical shock-therapy in the schizophrenic and depressive psychoses, and presented clinical and experimental evidence for an organic basis of these conditions. It was shown, firstly, that there is convincing evidence for supposing that deranged oxygen-glucose metabolism of the cerebral neurones is the essential lesion; and, secondly, that all these conditions can be classified according to their response to shock-therapy into two groups—dysoxic encephalopathy, or cerebral dysoxia, in which oxygen-metabolism is principally at fault, and which responds to anoxic shock; and dysglycolytic encephalopathy, or cerebral dysglycia, in which glucose-metabolism is at fault, and which responds to hypoglycaemic shock. The former condition is synonymous with depressive states, and the latter with schizophrenic reaction-types in the orthodox terminology.

Ucko (1935) showed that the reaction time of the Takata test on serum can be reduced from 24 hours to 90 minutes by modifying the concentration and volume of the reagents. These reagents were applied with a further slight modification in the amount of the fluid tested and as a one-tube method for cerebrospinal fluid (Fleischhacker, 1938). 177 cerebrospinal fluids were examined, and the conclusion was drawn that the M.T.R. will indicate even very fine disturbances in the protein composition of cerebrospinal fluid. Later the test, together with others, was applied to another 165 C.S.Fs. from neurological and psychiatric patients and was found to give weak positive results in many psychoses of the so-called “non-organic” type (especially typical schizophrenics), while it remained negative in manic depressives and neurotic disorders (Fleischhacker, 1943).

The object of this paper is to present a brief review of nearly five years' experience of the schizophrenic group of psychoses as found in military practice, with particular reference to its treatment, and to important new facts which have recently come to light regarding the relative values of the convulsive and insulin therapies.

In view of the many problems that are bound to arise in dealing with “displaced children” in Europe, we thought it might be useful to report the following cases, which illustrate the dangers in accepting accounts, however circumstantial, from children about traumatic situations which had occurred to them. The young child's difficulty in separating fact from phantasy is normally fairly pronounced. Under the impact of traumatic situations, such as personal injury, death or separation from the parents, this tendency to confuse fact and phantasy becomes still more marked.

This is a description of a case of depression associated with post-encephalitic Parkinsonism, with signs predominating on the left side, treated by unilateral (right) prefrontal leucotomy.

The growing incidence of juvenile delinquency during the past years has become a serious concern of the general public and the authorities. Following the lead taken by the Home Office, a number of local authorities, child guidance clinics and welfare agencies have instituted inquiries into the causes and conditioning factors of juvenile crime from the social, economic and medico-psychological points of view. The institutions for the mentally defective have been faced with the same problem through the increasing number of cases referred by the juvenile courts, and Dr. D. Turner, in his Annual Report on the Royal Eastern Counties Institution, Colchester, for the year 1943, called attention to the difficulties of their management within an institution of the usual type. The question calls urgently for a settled policy regarding their disposal and treatment, and it goes without saying that this can only be attained on the ground of a better insight into the psychology of the delinquent defective.

An Insulin Clinic for treating female schizophrenics by insulin coma therapy has been working now for over two years, and although it is too short a time to draw conclusions as to the ultimate benefit to the patient, some points may be of interest.

Though English is the language of the citizens of the U.S.A., it would be rash to assume that their reading vocabulary was identical in its familiarity with that of the citizens of the British Isles. Hence it is possible that a vocabulary test which is suitable for discriminating among adults in the U.S.A. may not be as suitable for that purpose among adults in this country. A critical examination of the Shipley-Hartford test seems called for, in order that the test may be used with success on this side of the Atlantic.

From the point of view of the psychiatrist, if not from that of the general public, which still needs much education, Child Guidance Clinics have two quite distinct functions: one, diagnostic and advisory, the other, treatment by psychotherapy.

Certain disturbances of a higher order, e.g. aphasia and agnosia, follow as a rule a lesion of the left hemisphere in right-handed persons and vice versa. This dominance of one hemisphere for certain functions has been well established from abundant material. The Gerstmann Syndrome, recently studied, seems to obey the same rule of dominance; other disorders, such as the attitude toward paralysed limbs and defective functions, appear to be caused by lesions of the non-dominant hemisphere. The relations of the latter group, however, to the hemisphere cannot be regarded as firmly established, since the material presented is still limited.