One criticism was that the 12-month follow-up failed to capture a true clinical picture, and that more time was necessary to demonstrate their worth. The team that carried out this original work have now published 3-year data on 330 individuals detained under section of the Mental Health Act,1 randomised on discharge to CTO or voluntary status via Section 17 leave. No improvements in readmission rates, time to first readmission, or duration of readmissions were found for those placed on CTOs. The findings are even more powerful than the original results; CTOs now exist in various forms in over 75 jurisdictions, but no solid scientific evidence has yet been produced to support them. If there are subpopulations for whom (or specific circumstances in which) they work, such characteristics have yet to be delineated. A ‘least restrictive’ principle underpins the Mental Health Act, and a strong rebuttal is needed to justify ongoing CTO use – so-called ‘revolving-door patients' should not be replaced by revolving-door policy.

The necessity of a cognizance of those Acts of Parliament affecting asylums in their capacity as large employers of labour has become more obvious of late by the operation of an Act which came into force in July last—“The Workmen's Compensation Act”—where, for the first time in British law, a responsibility has been cast upon an employer to pay damages or compensation for personal injuries which are not the result of any negligence or other unlawful act, either of himself or his servants for whose conduct he is legally responsible.

Those responsible for these lectures took their courage in both hands when they chose me to follow in the line of the eminent doctors and lawyers who preceded me. For I am in no way a Very Important Person. I held the lowest of judicial offices, though in my opinion one of the most important. But while emphasizing your courage, I want to assure you very sincerely that I am fully conscious that it is a great honour to be selected for this task. Indeed, I am somewhat overawed, but I can only try my best.

The author records two cases in support of his view that the syndrome of acute delirious mania is frequently an effect of renal disease, is, in fact, a hyperacute uræmic insanity.

It is obvious that it would be quite impossible within the short limit of time at our disposal to enter into a full and complete account of all the data collected with reference to these admissions, which commenced on January 1st, 1892, and terminated on December 31st, 1899; I will therefore confine my remarks to the more important features presented by them.

It is to Jung, of Zurich, that we are indebted for the attempted division of attitudes of mind into the introverted and the extroverted types. In his Analytical Psychology he gives us a chapter on types, and in 1924 appeared his large work on Psychological Types. According to Jung, the introverted type of individual is characterized by the fact that his libido is turned towards his own personality to a certain extent—he finds within himself the uncon ditioned value. The extroverted type has his libido to a certain extent externally—he finds the unconditioned value outside himself.

Generalized xanthoma is a cholesterol disturbance of the cells, coincident with a normal lipoid content of the blood serum.

The case described involves the skull, dura mater, brain, pleura and gallbladder.

S. B., aged 16 years, was admitted into the Clapton Asylum, May 7th, 1875, with the following history. She was born a healthy girl, having no mental defect. She enjoyed good health up to nine years of age, when she became the subject of chorea, supposed to have been caused by exposure to the sun. She was sent to Margate, in the hope that the change might prove beneficial to her, but the chorea continued. Four years ago, while bathing, epileptic fits came on, and soon afterwards the chorea ceased. Her intellect is said to have become weak after the fits were noticed. She has never since been free from them. She was sent to Caterham and afterwards to Hampstead Asylum, whence she was transferred to Clapton.

I feel that some kind of apology is due for my venturing to bring before a society which concerns itself mainly with practical questions what I fear will be regarded as a decidedly unpractical paper. Still, it may not be without advantage once in a way to step aside from the more arduous path of observational or experimental investigation in the region of psychiatry with its exacting conditions, and view things from a more general standpoint. And, while confessedly it may lead to no practical outcome, if by challenging some acknowledged views, and raising a breeze of controversy, however gentle, which may ruffle the quiescent surface of the pool of accepted opinion, it should at least suggest some grounds for a reconsideration of certain important questions connected with psychology and psychiatry, the object of the writer will be achieved.

Few problems are we called upon to solve surpassing in importance that of demonstrating the insane nature of the evil propensities and criminal deeds, which are the outcome of nocturnal epilepsy. If, during the night, a man be periodically roused from his sleep in great bewilderment and mental agony, that quickly cease; or, if in the midst of apparent sanity, he were to be found, unexpectedly, in the morning, either maniacal, or sullenly disposed to unprovoked acts of extreme violence, we may, with confidence, diagnosticate that he is an epileptic, and irresponsible for what he has perpetrated.

In connection with the malarial treatment of general paralysis of the insanein thishospital, we have endeavouredto producea secondseriesof malarialrigorsin such casesas had not shown sufficient mental or physical benefit after a first infection terminated six or more months ago.

This little volume is in great part a reprint of papers which appeared in the “Lancet.” The object of its author is to describe simply and concisely the clinical characters of certain nervous disorders which he believes to be of a syphilitic nature. It consists of four chapters—the first treating of the diagnosis of syphilitic nervous affections, the second dealing with the pathology and morbid anatomy of them, the third containing illustrative cases, and the fourth devoted to a consideration of prognosis and treatment.