Since early times interest has centred round the problem of whether special virtue or taint is attached to the first-born child. Some recent workers, like Pearson (1914), have believed the first-born child to be liable to physical and mental handicaps. Still (1927) focuses attention on certain diseases which appeared to be more frequently manifested in the first child in a family than in children born later in that family. He also realized that maternal age might be a significant factor in other conditions. A summary of a good deal of the work done on these problems was published by Thurstone and Jenkins (1931). These writers drew attention also to parallel studies in animal genetics. Wright (1926 and 1936), by his analysis of Polydactyly and coat colour in guinea-pigs, laid a foundation for genetical work on maternal age. The effects he observed were due to alterations of characters in early offspring. Unfortunately, experimental animals rarely live long enough to make possible the corresponding study of maternal age effects at the end of the reproductive period. Evidence that birth order of itself is of significance in animal genetics has been scanty. Recently, however, Goetsch (1937) reported that the first eggs of the queen ant (Pheidole pallidula) give rise to small and physically feeble workers. In the present communication the results of some of the writer's recent researches on the effects of maternal age and birth order in human genetics are discussed. A multitude of human malformations are relevant to this study. Investigations of their respective ætiologies is of interest from the point of view of elucidating the effects of natural selection in man as well as from the standpoint of preventive medicine.

The influence of the endocrines on the excretion of creatine and on the urinary creatinine level has become increasingly recognized of recent years. It has, of course, long been known that hyperthyroidism is accompanied by creatine excretion. A recent investigation by Sohval, King and Reiner (1938) found that the creatine tolerance test was positive in 90% of patients with active Graves' disease, but only in 10-18% of controls. Shelton and Tager (1937) showed that four out of five slightly hypothyroid children had an increased creatine tolerance.

In many theories concerning the development of psychological illness, stress has been laid upon the difficulties encountered during the earliest period of life. The problems of feeding in infancy and early childhood have, in particular, been believed to colour if not actually to determine certain neurotic and psychotic behaviour.

The development of the concepts underlying the terms mental deficiency and psychosis with mental deficiency, may be arbitrarily divided into four periods, which to a considerable degree, overlap. The first period is concerned with the separation of the two principal groups, mental deficiency and mental disorder. Even before the time of Hippocrates some differentiation had been made between the idiot, who was feeble-minded from birth and the dement, who had deteriorated from a previously normal status. Pinel (1), however, as late as 1806 used the term idiocy loosely, and included many cases of terminal dementia and other deteriorated states. The end of the first period is marked by the definitive separation by Esquirol (2), in 1828, of mental defect and mental disorder, but it was not till 1886, in England, that a legal differentiation was made been insanity and feeble-mindedness.

From a clinical point of view, mental deficiency and insanity are usually considered to be separate disorders. The members of each group who require institutional care are collected in separate hospitals and the methods of treatment are on different lines.

During the last century the fact that two people share a psychosis has been recognized as constituting a problem of psychiatry. Although quite a number of cases have been published, we were surprised at the relatively small number. The subject lends itself admirably to systematization, and the classification which has been accepted by most writers is the one evolved by French authors.

A search was made for statistical studies of the remission rate in cases of schizophrenia which had received no specialized treatment such as hypo-glycæmia. The search was confined to the period since 1918, as the period influenced by broader and more hopeful views of the nature and prognosis of “dementia præcox”. It was also confined to studies in which the remitted cases had been followed up for some time after discharge to avoid errors due to early relapses. The results of all these statistical follow-upstudies aie given in Table I. The various writers have classed their results in somewhat different ways, and it has been necessary, in constructing the Table, to fit all the results under standard headings.

Nicole and Fitzgerald's assumption in 1932 that the Wassermann test had at last passed to rest in the limbo of historically interesting experiments can hardly be said to be correct, and the test still remains to-day as the standard method for the sero-diagnosis of syphilis. At the same time the steadily increasing specificity of flocculation tests and their value as ancillary procedures cannot be denied, and the accepted diagnostic ideal is a parallel examination by one of these and by the Wassermann test.

Since sulphanilamide has been shown to be of value in the treatment of infections due to a variety of organisms, it was thought that it might be efficacious against bacillary dysentery.