The therapeutic procedure of electrically induced convulsions provides a rare opportunity of studying experimental convulsive states in man and their accompanying reflex phenomena, many of which are of great importance in neurological diagnosis. Among the many interesting motor manifestations appearing during the post-convulsive stage is the grasping reflex, which has previously been observed only in certain structural disorders of the brain, usually of the frontal lobes.

That three brothers and their mother should be admitted to a mental hospital on the same day is sufficient cause to be put on record.

The question of invalidism from the Army appears to be inextricably bound up with the rather larger problem of the needs of the Army, with which, therefore, at the risk of seeming obvious, I shall try to deal very shortly.

If one may judge from the opinions of General de Gaulle, adopted largely in the training of Panzer divisions, this war differs from the last in the importance, firstly, of smaller bodies of picked men, and secondly of the continuance of production behind the lines. Thus it would now seem better to train as warriors a smaller number of eminently suitable men, while leaving others to fill those jobs of any essential kind to which they are best fitted.

Partial agenesis of the olfactory apparatus or arhinencephaly is usually associated with other gross manifestations of cerebral malformation. The subject has recently been discussed by Stewart (1939), who described the rare variety in which absence of the olfactory bulbs and tracts constituted the main abnormality. Intermediate between this, the mildest form of arhinencephaly, and the cyclopian brain in which the endbrain fails to divide into hemispheres and cranial nerves other than the first are also affected, comes a transitional group in which a partial separation of the hemispheres has taken place and arhinencephaly is present in varying degree. The present case is an example of this intermediate variety, and owing to the rarity of the condition we have thought it worthy of record, though a lack of reliable clinical and post-mortem information somewhat reduces its value. The brain was found amongst a number at the Hereford County and City Mental Hospital.

In 1897 Ganser (1) gave a lecture entitled “Ueber einen eigenartigen hysterischen Dämmerzustand.” This has been translated literally as on “A specific hysterical twilight state,” which we consider unfortunate, as in keeping the words it loses the sense of the original, for the notion of a twilight state remains foreign to us, and is better rendered as a “dimming of consciousness” or “clouding of consciousness.” Further, the concept of hysteria has changed considerably since then and his cases would now be regarded as psychotic.

Drs. Stern and Whiles, in an interesting and provocative article in the January issue (1), claim to have solved the problem of Hamlet on the assumption that Hamlet suffered from the Ganser state occurring during the course of another psychosis. By this theory they hope to reconcile the seemingly contradictory views that Hamlet was insane, and that he was pretending to be so. He was both, they say, and the latter because of his being in the Ganser state.

The authors claim to have examined the problem from a strictly psychiatric viewpoint; but it must be remembered that such a viewpoint is necessarily subject to many limitations, inasmuch as there exists no parallel to Hamlet in actuality. One has constantly to bear in mind that Hamlet is not an historical personage, but a character in a play, and that our task is not to explain some Hamlet of our own, but Shakespeare's Hamlet; and in consequence our theories must not only be psychologically acceptable, but must conform with the text of the play which, after all, is the final arbiter. With this in mind, a psychiatric study of Hamlet may be of great value, but it need not and perhaps cannot be expected to “explain” Hamlet.

The demonstration by Zondek (1936), subsequently confirmed by Cramer and Horning (1936), Gardner (1937), Collip (1936), Noble (1938), Deanesley (1938, 1939), Pybus and Miller (1938), that large doses of oestrone will impair and partly suppress the functions of the pituitary anterior lobe, especially the gonadotrophic and the growth hormone production and will produce partial degeneration of the acidophil cells, led Kirklin and Wilder (1936) to adopt this method of treatment for patients suffering from acromegaly. Their series consisted of eight patients, four men and four women, and their results may be briefly summarized as follows: There was a general improvement in three patients; headache which was originally present in six cases disappeared in four, but returned in one case, though this may have been due to a discontinuance of treatment; in three patients there was a decrease in size, in one a smaller hat was required and her dental plate became loose, in one the hands became smaller, and in one shoes became looser; the visual fields were originally altered only in three of the eight patients, and in one of these the fields returned to normal, in one there was no change, and in the third a progressive hemianopia accompanied by erosion of the sella turcica developed during treatment; hyperidrosis and intolerance of heat, originally present in two, disappeared in both; finally there was loss of libido in three cases.

The estimation of the amount of neutral 17-ketosteroids excreted in the urine has attracted considerable attention, since the level of excretion (usually expressed as mgm./24 hours) can be fairly well correlated with the output of androgenic substances determined biologically (Callow et al., 1939a, b). What constitutes the normal range of daily output is still somewhat uncertain; 1.7 to 12.6 mgm. for females, 3.5 to 15 mgm. for males (Callow, 1939), 40 to 15 for normal women (Friedgood and Whidden, 1939), 4.3 to 21 mgm. (Chou and Wang, 1939), 3.5 to 14.6 mgm. for females, 9.4 to 20.4 for males (Patterson, McPhee, Greenwood, 1942) have been quoted. We have conducted investigations in a large number of cases of each sex in the last two years, and have come to regard 6 to 15 mgm. daily as the range for normal adults, females as a rule being lower in the scale than males; after middle age a somewhat reduced output is to be expected. It has been suggested (Patterson et al., 1942) that among normals higher values are related to larger body size, but we are unable to confirm this.

During the past three years some clinical applications of corticotrophic hormone have been studied, and in this paper is described a form of involutional melancholia in which hypopituitarism and secondary hypoadrenalism are factors. Nine such cases were treated with corticotrophic hormone; in addition two cases of pituitary cachexia in young women were similarly treated.

G. A. Levvy in 1940 (Biochem. J., 34, 73) published from the Department of Pharmacology, University of Edinburgh, a new method for the estimation of barbiturates in blood, claiming that his technique gave results accurate to a 20 per cent. error or less for quantities of 1.0 mgm. or more in 20 c.c. of blood. After studying this method at first hand we have carried out a number of estimations in cases undergoing prolonged narcosis with somnifaine, and studied the blood levels of barbiturates in patients under medication with soluble barbitone and phenobarbitone, a total of 200 estimations having been made.