Discussions on crime and punishment frequently bring into relief two fundamental facts: one that everyone is dependent upon his fellows; the other that the physico-chemical, biological and psychological or spiritual worlds are, as J. S. Haldane pointed out, only the same worlds at different planes of interpretation.

The social impact of mental illness, like that of other diseases which are covered by public health organizations, is governed by quantitative considerations. Two cases of typhoid fever are worse than one, and the same applies to schizophrenia. A principle, complementary to Bentham's doctrine of the greatest good for the greatest number, is the foundation of mental hygiene. The object is to try to reduce the total quantity of discomfort in the community due to mental illness. The effort is not expended only on people recognized to be ill enough to need hospital care. It includes those cases in the community who are less acutely ill and the members of the normal population, who have to tolerate the burden of mental illness in their relatives or associates. The basis of the whole activity is clearly quantitative. In order to comprehend the problem or to evaluate results of effort, adequate statistical data must be collected. It might be thought that to labour this point was unnecessary, and some may even consider it dangerous. Nothing is duller than the compilation of unnecessary statistics, official or unofficial, and nothing can be more misleading than numerical data collected or interpreted without proper forethought. I will therefore first draw attention to some erroneous conclusions, which have been sometimes drawn from statistical data in the psychiatric field.

This report concerns 100 patients treated by prefrontal leucotomy. The technique employed has followed that of Freeman and Watts.

In the case of the 47 manic-depressive patients treated the prognosis without operation was considered very poor. The majority (34/44) had failed to respond to electric convulsive therapy, which was contra-indicated in the remainder by reason of physical health. Seven out of these 47 cases had been in hospital under two years, but there was a history of many years' poor social adaptation or recurrent mental illness. The average duration of illness in the recovered cases of this manic-depressive group was 31 months. That of the failures 45 months.

Laughter, known to mankind as a physiological response to happy and comical events in general, is one of the most inviting guides through human life, but sometimes it may point to various morbid states of mind.

Physiological laughter has been studied by numerous psychologists and philosophers, the pathological part of the subject and compulsive laughter by many physicians, both clinicians and anatomists. Reading through the accessible part of the extensive literature on laughter one realizes that much has not yet been quite elucidated. In recent years we have had an opportunity of following a few most interesting cases of pathological laughter. This essay has been devoted to a review of the psychological, clinical and anatomical studies, and to an analysis of our five cases and their relation to epilepsy.

Sleep-walking, which is a fairly frequent symptom in children, is less common in adults, and, though fascinating, this subject has not yet received as much attention as its importance deserves. In the Text-Book of Medicine edited by Price there is no mention of this symptom. In the medical and legal literature one often comes across the same case-histories quoted by successive writers, some of whom consider somnambulism a hysterical dissociated state, while others maintain that it is an epileptic phenomenon. A correct diagnosis is essential not only for the purpose of treatment, but also for assessing criminal responsibility. Unfortunately, the features stated to be characteristic of somnambulism would seem really to be due to more than one condition.

Fractures of the dorsal vertebrae remain one of the chief complications of convulsion therapy; and the problems of their mechanism and significance have not yet been completely solved. The present investigation has been developed with the intention of throwing fresh light on these matters by a comparative study of similar lesions in 27 patients suffering from the convulsions of idiopathic epilepsy, 21 of whom have also been treated by electrical convulsion therapy. A control group of 30 patients suffering from non-convulsive psychoses has also been examined, and in all cases the spine has been examined both clinically and radiologically, attention being focused, for the sake of clarity, on the dorsal region only.

The idea of trying to replace the irregular major fits of epilepsy by convulsions, artificially induced under controlled conditions of time and place, is an eminently reasonable one; but there has so far been no systematic investigation of the therapeutic possibilities of this procedure. The present work, which has been carried out over a period of two years, is intended to clear the ground for such a study; and this report includes an account of the effect of electrical convulsion therapy not only on the frequency of the fits, but also on the psychotic symptoms which were associated with the epilepsy in many of the patients.

Since the work of Sakel, v. Meduna and Moniz, a large number of papers have been published on physical methods of treatment. Statistical studies of the results of these forms of treatment have been most commonly used and have demonstrated their usefulness.

Comparatively little attention has been devoted to schizophrenia in the extensive psychiatric literature which has accumulated during the War. While man-power was more important than Man, it could hardly be otherwise, for those who succumbed to this illness were usually invalided even in the event of full recovery. But there was perhaps another reason to be found in the belief that schizophrenia was merely an old friend of peacetime interjecting itself inconveniently into wartime medicine, but not having any special or unusual qualities save perhaps an acuter onset or a better prognosis.

After the cessation of hostilities with Japan some 60,000 Europeans were released from Prisoners of War Camps in territory under Japanese control. Of these, a high proportion were sick and were admitted to hospital. Nearly all the psychiatric cases among them were admitted to the 41 British General Hospital, Hospital Town East, Jalahalli. These cases admitted to this hospital were 60 in number, and of them 50 were considered psychotic, 6 neurotic, and in 4 no gross psychiatric disability was found. In order, adequately, to assess the significance of this incidence of mental disorder in the prison camps, a brief résumé of the conditions of imprisonment and of the state of the cases admitted to general medical wards is considered essential.

Conscious generalized immobility, in which the musculature remains in the tonic state in which it has been placed voluntarily, is known amongst naval officers, printers and nurses, amongst the last being known as “night nurses' paralysis.” Its duration is of a few seconds or minutes, and it appears to be a cataleptic phenomenon. It differs from cataplexy in that the musculature is tonic, and perhaps hypertonic, with the eyelids open, whereas in cataplexy the subject falls to the ground with muscles limp and eyelids closed, as if asleep.

The following two case-records furnish an interesting example of similar mental illness occurring in identical twins, in which, however, in the one case the illness had come on endogenously, whereas in the other there was an apparent precipitating cause. Their age when seen was 25 years.