The spongiform encephalopathies are unusual in several respects. Firstly, they are transmissible, and in some cases inheritable. Secondly, variants of these disorders occur in many species and can be transmitted by consumption of infected material; this has led to concern as to the potential risk from eating contaminated animal products. Thirdly, increasing evidence suggests that a ‘prion’ protein is central to their aetiology and pathogenesis, and that no nucleic acid is involved in the infective process. The role of the prion gene and its protein is outlined and proposed as the basis for an improved classification of the transmissible dementias.

When a group of 10 patients who had received surgery for carcinoma of the larynx were compared with 10 control patients who had received radiotherapy for carcinoma of the larynx, four of the former but none of the latter were found to be suffering from depression, a statistically significant difference. Depression was associated with poor communication skills and geographical isolation. Psychiatric intervention is recommended for patients undergoing mutilating forms of surgery.

The phenomenon of the vampire is ancient, ubiquitous, and fascinating; moreover, it can only be understood adequately within the context of more general blood reliefs and rituals. (See Prins, 1984 for a review). References to vampires and associated phenomena may be found in the world's great literature long before Bram Stoker created his notorious and evil Count (Summers, 1960, 1980). Belief in the vampire's actual physical existence was probably encouraged by the prevalent practice of premature burial during times of plague, by the large numbers of itinerants and beggars that abound at such times, and by the fact that many of them took refuge in vaults and graveyards. In addition, the myth was probably given more tangible reality by such physical explanations as Erythropoietic Protoporphyria or its variants. This disorder is said to induce the body to produce an excess of porphyria, which results not only in excess redness of the eyes, skin and teeth, but also a receding of the upper lip and cracking of the skin, which bleeds when exposed to light. It has been suggested that physicians of the day could only treat sufferers by secluding them during the day and by persuading them to drink blood to replace that lost by bleeding (Illis, 1964; Milgrom, 1984; Prins, 1984). In more modern times, there have been accounts of people seeking to protect themselves from vampiric attentions (Farson & Hall, 1978).

Appetite, weight, and preference for carbohydrate-containing food were followed in patients treated in double-blind trials of seven antidepressant regimes. Trimipramine and isocarboxazid combined had a significant effect in increasing appetite, carbohydrate preference, and weight; in patients who had lost appetite at presentation and were on this treatment, improvement in Hamilton score was linked to increase in weight–a finding not true of the other treatments.

There is growing evidence that early parent death can affect the severity of adult depressive illness. It was anticipated, therefore, that early-bereaved depressed patients might score higher on certain MMPI clinical scales than non-bereaved, depressed controls matched for age and sex. This is shown to be the case, the most affected scales being Hypochondriasis and Paranoia. Hypochondriasis is shown to be more strongly associated with early father death, while Paranoia is associated equally with mother and father death. There is some suggestion that early mother death is also associated with elevation of the F score. Early parent death is shown to have no effect upon the MMPI scores of non-depressed patients.

Sixty-eight depressed out-patients were allocated to treatment with either oral amitriptyline (75–225 mg/day) or intramuscular flupenthixol decanoate (10–30 mg every 14 days) in flexible dosage for 12 weeks under double-blind procedures. Various observer- and self-rating scales were applied before and after 2, 4, 8 and 12 weeks of treatment. Twenty-four patients completed the course of amitriptyline and 20 the course of flupenthixol. All variables improved over time, but there were no significant differences between the two drugs. The Newcastle scores pre-treatment were not related to drug response suggesting that both drugs were similarly effective across a wide spectrum of depressive disorders. Patients on amitriptyline tended to complain of dry mouth; those on flupenthixol had a higher incidence of extrapyramidal signs, the majority receiving anti-parkinsonian drugs at some time during the treatment. Flupenthixol decanoate in low dose is a useful anti-depressant, but should be restricted to short courses of treatment, to patients refractory to other treatments, and to patients suspected of poor compliance.

The first human renal homotransplantation was performed in 1936. Recently, with the introduction of improved immuno-suppressive techniques, this operation has been carried out on an increasing number of occasions. The first renal homotransplantation in South Australia was performed in February, 1965. The donor was related by marriage to the patient and was not consanguineous. The patient is still alive and at work sixteen months later (June, 1966).

In-vitro spectrometric measures were made of spin-lattice (T1) and spin-spin (T2) relaxation times of samples of grey and white matter from the brains of 15 patients with a pathological diagnosis of Alzheimer's disease, 5 with multi-infarct dementia, and 11 non-demented subjects. Relaxation times were significantly greater in the parietal white matter and temporal white matter of patients with Alzheimer's disease compared with that of the other subjects. This was associated with an increase in tissue water content. These findings confirm measures obtained in some imaging studies.

In discussions of schizophrenia, ‘thought disorder’ has a traditional place of prominence. Eugen Bleuler (2) believed ‘disturbances of association’ of ideas to be a fundamental symptom in schizophrenia, and among more recent authors Cameron (3) introduced the concept of ‘over-inclusiveness' to explain not only the thought process disorder, but many other symptoms of this condition.

Reports of significant changes in water and electrolytes during recovery from depression may provide insight into important physiological factors in depressive illnesses. Brown et al. (1963) demonstrated an increase in the extracellular fluid volume in 22 of 28 patients suffering from primary depressive disorders treated with E.C.T. or imipramine. The findings of these authors, which were discussed in relation to previous work on sodium metabolism and water balance in depressive disorders, were thought to support the idea of a shift of fluid from intracellular to extracellular spaces during the response to treatment. Coppen and Shaw (1963) found an increase in total body water, extracellular fluid and a decrease in the residual sodium space on recovery from depression.

Three aspects of the approach to philosophy advocated by the Oxford philosopher J. L. Austin are outlined: his conception of the nature of philosophical problems, essentially as a mixed bag; his method of linguistic analysis, namely, clarification of our concepts by active observation of the ways in which they are actually used rather than by passive reflection on their meanings; and his views on the organisation of philosophical research, that in some areas it should be pursued rather as a science is pursued, as a corporate rather than merely individual venture. It is suggested that Austin's approach provides the basis for a potentially fruitful two-way relationship between philosophical theory and medical practice.

The application of techniques of behaviour modification to chronic adult psychiatric in-patients has for the most part been directed towards individual patients, and to specific problems such as hoarding, eating, soiling or speech (Ayllon, 1963; Ayllon and Haughton, 1962, 1964; Ayllon and Michael, 1959; Bachrach et al., 1965; Isaacs et al., 1960; Mertens and Fuller, 1963; Kennedy, 1964; Sherman, 1965). In this country, Baker (1970, 1971) and Kassorla (1968) have reported on the use of operant conditioning in reinstating speech in mute schizophrenics. There have, however, been few British reports relating to groups of patients, for example in wards where nurses have been trained to function as ‘behavioural engineers' (Ayllon and Michael, 1959); whereas Krasner and Attowe (1968) specified no fewer than 200 institutions and individuals in the U.S.A. currently involved in token reinforcement programmes, concerned with disturbed or autistic children, delinquent adolescents and the mentally handicapped; 22 projects involved chronic adult psychiatric in-patients.

The paper examines the nature of causality and how the concept can be interpreted and used in epidemiological psychiatry. The relationship of causality to logical relations is reiterated, and it is emphasized that these relationships in their pure form cannot apply to any one cause of an effect which is the outcome of several causes. In such a case the relation of the cause to the effect is one of weak implication. The fact of weak implication opens the door to the construction of certain causal models, and the possibilities afforded by this situation are illustrated by reference to the work of Brown et al (1975). Weak implication may be an intransitive relationship, and this is shown to invalidate certain ways of testing such models and the conclusions which arise from them.