It was in my early youth that I first read Bergson's Creative Evolution. At that time, as I recollect, it particularly captured my interest and attention because it seemed to embody certain essential principles which I had not found to be expressed quite so forcibly elsewhere. It is true that the validity of many of Bergson's speculations and ideas have since been seriously controverted and so find little or no support today, but his philosophy also propounds certain conceptions which are perhaps worthy of renewed attention. I refer more especially to Bergson's contrast of those two aspects of conscious experience which he terms intellect and intuition. Intellect, he argues, is the product of a gradual evolutionary process which enables the individual with increasing efficiency to select and abstract just those several features of surrounding objects which are directly relevant to the problem of evolutionary survival. In so far as it selects and abstracts, the intellect by itself can provide only a partial view of external reality. “To conquer matter,” Bergson says, “consciousness has had to exhaust the best part of its power”—it has had to “adapt itself to the habits of matter and concentrate all its attention on them, in fact, determine itself more especially as intellect.” But there remains “around our conceptual and logical thought a vague nebulosity, made of the very substance out of which has been formed the luminous nucleus which we call the intellect”. Therein reside certain powers that are complementary to the understanding—powers of intuitive recognition. Intellect is essentially based on a sort of derived symbolism gradually elaborated in the course of evolution, which serves its immediate purpose as a convenient, useful, and indeed essential device for gaining control over the material world; on the other hand intuition, according to Bergson, is capable of giving scintillating flashes of insight “into the very inwardness of life”.

Alcoholism is a grave social, economic and psychiatric problem which has attracted the attention of countless research workers and theorists. From a survey of the recent literature two conclusions emerge. Firstly, that there is at present no general agreement as to the aetiology, dynamics and treatment of alcoholism (1). Secondly, that the inadequacies of the majority of the experiments reported are such that the findings are often difficult to interpret and highly limited in their value (2, 3). In many cases the conclusions do not follow from the data; in others they are impossible to evaluate because insufficient procedural details are given; other studies attempt to answer a large number of questions and answer none adequately; some findings are based upon extremely small or atypical samples while others are based upon experiments open to such obvious criticisms that serious consideration is unwarranted. Many of these studies are apparently the by-product of the busy clinician's experiences and consequently lacking in rigour of any description. Remarkably few are predictive in their techniques or based upon any clearly formulated and testable theory. It is hardly surprising that so many fail to satisfy the usual criteria of acceptable scientific research (4).

A detailed scheme of classification of schizophrenia has been produced by Professor K. Kleist and elaborated by Professor K. Leonhard (Kleist, 1943, 1949; Kleist et al., 1950, 1951; Kleist and Schwab, 1951; Leonhard, 1936, 1957; Schwab, 1949). The validity of this scheme has been established by other investigators (Schneider, 1955; Schulte-von der Stein, 1955). An English summary of the Kleist-Leonhard scheme has recently been published (Fish, 1957). In 1955 an attempt to classify the chronic schizophrenics in the Female Division of St. Nicholas Hospital, Gosforth, according to the Kleist-Leonhard scheme was begun. By means of reading the case notes, enquiring from the medical and nursing staff and short clinical interviews it was provisionally concluded that there were 243 chronic schizophrenics in the female division with an illness of more than 10 years' duration. These patients were investigated clinically, but by the time the author took up his present appointment only 107 cases had been seen. An attempt was made, however, to investigate approximately the same proportion of patients from each ward of the female division with the exception of the geriatric ward. This series seemed to be a fairly representative sample of the chronic female schizophrenics.

Genetic factors have been shown to play an important role in the development of neurosis. These factors, however, determine the vulnerability of an individual, the degree of his predisposition for neurotic breakdown, while the available evidence indicates that the actual behavioural disturbance results from the imposition of some form of environmental stress on the individual concerned. The probability that any particular individual will develop a neurosis is partly determined by his genetic constitution and partly by the degree of stress to which he is subjected.

The task of preventive psychiatry—if there is such a thing—can be expressed in a positive form as the promotion of mental health; but mental health can be defined in two ways: as the absence of recognizable mental illness or, in more grandiose terms, as the realization to the fullest possible extent of one's personal potentialities. The latter concept has been denounced by some authorities as representing much too wide an extension of psychiatry: that it continues to be prominent in discussions of mental health programmes and the like is due to the insistence of laymen perhaps even more than of psychiatrists. It appears that in the Western World people are increasingly turning to psychiatrists for the answer to problems which once would have been the concern of priests or politicians. That they do so is a psychiatric problem in itself; that they will continue to do so in increasing numbers seems very likely—so we had better have our answers ready, even if they are only disclaimers of problems which do not concern us.

During recent years members of the Medical Research Council Pneumoconiosis Research Unit have carried out a number of studies of the prevalence and incidence of common diseases in two populations in South Wales and attempted to relate differences in morbidity to known differences in social and environmental factors (Cochrane and Miall, 1956). The communities studied are the Rhondda Fach, a mining valley with a population in 1951 of 19,722 (aged over 15 years) living in a contiguous series of eight small towns, and a number of parishes in the Vale of Glamorgan, approximately ten miles from the Rhondda Fach, in which the population of 4,621 (aged over 15 years) is spread over a relatively large agricultural area. These will be referred to as the Rhondda and the Vale. They were originally chosen to provide a complete mining community (in which the prevalence of diseases of the lungs in miners and ex-miners could be estimated) and a contrasting, predominantly rural, population respectively.

Pavlov's theory of hypnosis is, perhaps, the first theory of hypnosis to be essentially derived from physiological experiments. Arising out of his experiments with dogs, the theory hopes to explain the hypnotic phenomena in human beings.

The customary classification of the amaurotic family idiocies according to the time of life at which neurological signs first appear has obvious limitations when consideration is given to cases occupying an intermediate position between the well-established infantile form of Tay-Sachs' and the juvenile form first described by Batten (1903). It was to this group of atypical cases that Bielschowsky (1913–14, 1920) gave the name “late infantile”. This term is convenient clinically but when more examples of the variant had been reported it became evident that the group of cases so designated was not homogeneous. Wyburn-Mason (1943) was able to show in a large clinical material that many of these intermediate forms belonged either to families affected by Tay-Sachs' or by Batten's disease and that in an individual case the ophthalmological findings were usually of decisive importance in classification. The existence of a precocious variant of the classical “juvenile” type of amaurotic idiocy was thus clearly established. Klenk's (1939) discovery that the nerve cells in Tay-Sachs' disease contain large amounts of a glycolipid subsequently called “ganglioside” has provided a further valuable criterion in distinguishing this form of lipidosis from other members of the group. The present case, an example of the precocious juvenile type of amaurotic idiocy or, as we prefer to name it, the subacute form of Batten's disease, is presented as a further contribution to this subject.

When the diagnosis of epilepsy is made, the patient must first of all be investigated to make sure that the epilepsy is not symptomatic of a disease that will need some special line of treatment. For example, epilepsy starting at any age may be the first indication of a cerebral tumour, although this will obviously be more likely among the older patients. The nature and extent of these investigations will depend on such factors as the age of onset, the type of seizure and the associated positive physical signs. However, even in the cases where there is no evidence whatsoever that the epilepsy is symptomatic, an electroencephalogram may help in differentiating the type of epilepsy from which any particular patient is suffering, and so aid in deciding on the form of treatment most likely to be beneficial. When any necessary investigations have been carried out and the form that treatment is to take has been settled, the social implication of this diagnosis has then to be faced. This often resolves itself into a discussion of the patient's employment.

Between 1 January, 1948 and 1 July, 1956, forty-one children in the Fountain Group Hospital were accepted as educable by ten Education Authorities and they were transferred to appropriate schools. In addition three children under 5 years were found on admission to be of average intelligence. All forty-four children had been admitted to this hospital of approximately 700 beds for low-grade mentally defective children.

The present paper will deal with eye blink frequency and its relationship to scores on “personality” questionnaires and to frontalis and right forearm muscle tension measured electromyographically. This analysis forms part of a larger experiment with the main aim of investigating levels of muscle tension in four groups—(i) introverted neurotics, (ii) extraverted neurotics, (iii) extraverted normals and (iv) introverted normals—during relaxation and while responding to a series of questions about neurotic symptoms.

This contribution towards the subject is limited to three of its aspects—namely, the possible aetiological role of inherited predisposition and psychogenic factors (mainly environmental to which the patient is still exposed), the relationship between late endogenous depression and the symptoms of cerebrovascular changes, and prognosis. On the face of it, prognosis of course must ultimately depend on that of the cerebrovascular disorder but apparently hereditary and environmental factors play a more significant role. Inherited predisposition is here assessed in terms of constitutional and personality factors.

This investigation deals with relationships of sodium amytal and lysergic acid (LSD) to measures of immediate memory and expressive movement as a function of exposure time. Significant differences in learning and expressive movement had been obtained previously between neurotics and schizophrenics (3, 4). The extent of these differences posed the problem why memory disturbance, as in the test, is clinically not more obvious in schizophrenics than in neurotics. It was thought that accidentally favourable conditions had been used, either in difficulty of task or in exposure time, to produce the results. The decision was taken to vary the exposure time in a pilot experiment, using LSD in normals to represent schizophrenic-like symptoms.

“We would predict that any test which has been shown to differentiate reliably and validly between introverts and extraverts will, when applied to subjects who have been administered an excitant (or depressant) drug, show shifts in scores in the direction characteristic of greater introversion (or extraversion).” “… the effects of depressant drugs are similar to those of brain damage as far as objective psychological tests are concerned. Conversely, the effects of excitant drugs are opposite to those of brain damage.” These predictions by Eysenck (7) were tested using measures of immediate memory and expressive movement which had previously been validated against extraversion and brain damage. The measures discussed are derived from the Figure Reconstruction Test (immediate recall version).

In the present experiment measures of certainty and adequacy of certainty, derived from a test of immediate recall and recognition, were investigated in relation to d-amphetamine and amytal.

A small number of children have brains which are so malformed or damaged that they make little response to special methods of education. A survey of the forms of brain abnormality in these cases has been carried out by Crome (1954). The category of children who can properly be classed as ineducable is, however, strictly limited and should, probably, be confined to idiots. Williams (1957) has pointed out that the task carried out in occupation centres for imbeciles is that of “educating the ineducable”, whilst a number of recent studies have shown that imbeciles have much more educational capacity than is generally assumed.

During World War II considerable attention was given by the War Office to problems of delinquency in the Army and a number of psychiatric investigations were carried out with the ultimate aim of reducing the rate of military delinquency. Some of this work was specifically concerned with the relationship between mental abnormality (mental disorder and defect) and military delinquency. The purpose of this paper is to survey the unpublished reports, together with the published literature, and point to general conclusions.

Another “tranquillizing” drug known as “Notensil” has recently been introduced to this country. It is a phenothiazine derivative, acetylpromazine, closely related chemically to chlorpromazine but without the chlorine atom which has been thought to cause the undesirable side effects of the promazine group.

Cerebral electrostimulation of subconvulsive intensity causes an increase in the concentration of adrenaline-like substances in the blood (Weil-Malherbe and Bone, 1952b). This increase becomes more pronounced as the pulse repetition rate is raised from 200 pulses per second (p.p.s.) to 500 p.p.s., in contrast to the motor, sensory, and respiratory effects which diminish under these conditions (Montagu, 1955). The increasing response to the higher repetition rates showed no sign of reaching a peak in these experiments, except in one case, and since it was not possible with the existing apparatus to exceed 500 p.p.s., the optimal conditions for eliciting the response remained undetermined. With the aid of a more versatile stimulator the adrenaline-frequency relationship has subsequently been studied more extensively, and the results are presented in this article.∗

The nitrogen retention, and especially the periodically changing excretion of urea, seems to be a characteristic symptom in periodic catatonia (1). We therefore made it our aim to investigate the amino acids in the urine, and later also in the blood and cerebro-spinal fluid (C.S.F.), throughout the lucid interval and the catatonic phase.