The assessment of body build as an integral part of the total personality is now accepted as an important procedure in the practice of clinical psychiatry. Body build has been found to influence symptomatology, mental status, course and prognosis in neurotic and psychotic disorders (Betz, 1942; Mauz, 1930; Kisselew, 1931; Freudenberg, 1941; Rees, 1945, 1947). Whereas the delineation of physical types has now become an objective procedure by the use of anthropometric indices (Rees, 1949), it has long been recognized that the differentiation of physical types in women is much more difficult. Kretschmer (1921) pointed out that the types of physique described by him were less easily diagnosed in women, and Sheldon (1940) pays comparatively little attention to the variations of female body build.

Between 11 October, 1942 and 31 December, 1947, the operation of prefrontal leucotomy was carried out on 345 patients at the Graylingwell Hospital, Chichester. The technique was similar to that of the standard method of Freeman and Watts: in each case the operation was performed by Mr. A. G. Ross. The paper reports the results of a clinical follow-up investigation in 330 of the cases; the remaining 15 could not be traced.

There are few, I suppose, who would disagree with the view that we are passing through a period of social and cultural disintegration.

The interest in developmental abnormalities and their aetiology has considerably increased in recent years. In spite of this, there is a paucity of information about congenital anomalies of the teeth and about their association with similar lesions in other parts of the body.

The past ten years have seen a spectacular increase in the number of psychologists who have elected to take up the type of work usually referred to as “clinical,” This increase has been most marked in the U.S.A., where now some 25 per cent. of the members of the American Psychological Association are employed in this field, and where Government regulations and training schemes set up under the V.A. (Veterans' Administration) make it almost certain that within a few years clinical psychology will constitute the main field of employment for psychologists (1). In Canada, too, there has been a similar growth, leading to all the problems of registration and certification which are currently being tackled in the United States (2). In this country, while psychologists have occasionally been employed in hospitals for the mentally ill, the development of “clinical psychology” in any formal sense may be said to have started in 1947 with the foundation of the Psychological Department at the Institute of Psychiatry (Maudsley Hospital), one of whose objects was to give a course of training in clinical psychology to graduate students of psychology (7).

Before the the last war psychological tests were not much used in mental hospitals, as there were few tests suitable for adults and, for that matter, hardly any trained clinical psychologists in the country. The “Binet” test or some modification of it was most commonly used, but it is unsatisfactory for adults, and now redundant. The war produced a considerable number of reliable adult tests, standardized on large samples of service men and women, and, although the effective age-range was restricted by service requirements, the tests are a great improvement on pre-war material, and a welcome addition to the clinical psychologist's stock-in-trade.

The electrical method of inducing convulsions grew out of the use of convulsant drugs. Experience with E.C.T. has not proved that it is therapeutically superior to the chemical methods. One must, therefore, attribute the now almost universal use of E.C.T. to its technical and psychological advantages.

Methods employed in convulsion therapy have undergone many changes since the development of this treatment by Meduna in 1933, using oil of camphor as the convulsive agent. More efficient analeptics such as cardiazol and ammonium chloride soon displaced camphor, and they in their turn have gradually, although not entirely, fallen out of favour since the introduction of electrically produced fits by Cerletti and Bini in 1938. Curarization as suggested by Bennett in 1940, has certainly minimized some of the dangers but, on the other hand, often requires more staff than are available if large numbers of patients are being treated in the one session. In addition, the mental confusion, frequently prolonged, following any form of full convulsion therapy, may give rise to difficulties of an administrative nature as, for example, in out-patient E.C.T. It is in order to minimize these disadvantages that an alternative method has been sought.

Myanesin was first investigated in animal experiments by Berger and Bradley (1946) and found to have a curare-like muscle relaxing effect. This they thought was mainly due to action on the spinal cord, because strychnine convulsions were inhibited by the drug. Smaller doses were more effective for this than for the reduction of Metrazol convulsions. Hunter and Waterfall (1948) reported an immediate disappearance of epileptic seizures in man after intravenous administration of.4-1 gm. of Myanesin. Gammon and Churchill (1948) found that the spike and dome pattern of the E.E.G. in cases of petit mal disappears following Myanesin, whereas E.E.G. alterations associated with grand mal seizures were uninfluenced. Higher doses might, however, abolish these changes. Geer (1949) used the drug (in doses up to 3 1/2 gm.) in conjunction with electric convulsive therapy (E.C.T.) for mental disorders and found it of no demonstrable value because it apparently tended to make convulsions more severe, although it slightly increased the voltage time stimulus necessary to produce a convulsion. Unna and Kaplan (1949) examined the anticonvulsive properties of Myanesin in mice. Metrazol seizures of mice treated with Myanesin were seen to be at least as severe as controls and often prolonged. The tonic extensor phase was, however, eliminated. The death in Myanesin-treated animals was delayed as compared with controls. Electroshock also caused a seizure in 89 per cent. of the Myanesin treated mice, but no deaths occurred, whereas controls without Myanesin had a mortality of 33 per cent. Here, again, Myanesin appeared to abolish the tonic phase of the fit and only more violent clonic convulsions occurred. Schlau and Unna (1949) reported that the pattern and duration of seizures in E.C.T. in man were not changed following 2 gm. of Myanesin four times daily by mouth. They did, however, observe a shortening of the period of apnoea following the convulsion.

The man, B. T—, who is the subject of this short paper, is an ex-service man aged 32. On 4 October, 1949, he was charged at Quarter Sessions on 20 counts of stealing from the offertory boxes of churches. He was put on probation on condition that he entered this hospital. Previously he had committed 68 similar offences, and has been in prison for 8 months. In 1939 he suffered a head injury and since then has had attacks of headache, vomiting and visual disturbance from time to time.

The term “Group-Therapy” can have two meanings, and it is well to keep the distinctions clearly in mind. It can refer to the treatment of a number of individuals assembled for therapeutic sessions, or it can refer to a planned endeavour to discover (and so make accessible to the understanding, and thus control) the forces which operate in the participating group.

Dr. Rickman, in his address to-day, has raised the whole range of problems concerning the dynamics of groups. I think he has rightly drawn attention to the fact that “three-body” problems with which psychoanalysts are accustomed to deal form only part of the dynamics of a “multi-body,” a group, and that a fuller understanding of the dynamics of a multi-body is bound to influence our therapeutic technique.

In the study of palm prints, a human palm is generally divided into five areas: hypothenar, thenar-first-interdigital, second, third and fourth inter-digitals, in each of which various configurations can be observed. These configurations range in form from whorls, loops and vestiges to absence of patterns, i.e. plain structures, called open fields. Whorls are patterns each with two triradii, and loops each with only one triradius. Vestiges, which are local disarrangements of epidermal ridges, vary from resembling a true pattern to approaching an open field.

Electronarcosis (E.L.N.) is a state of unconsciousness brought about by the passage of an electric current through the forebrain. The current has a much lower milliamperage than that which is used in electro-convulsive therapy (E.C.T).

In this short paper I shall set out a theory of the origin of head-banging and head-rolling which I do not claim has never been advanced before (since my reading has admittedly been far from exhaustive), but which I personally have not so far encountered in the literature, and which is certainly not widely known at the present time.

Harrell (1943, 1946), working with children in an orphanage, reported that improvement during administration of aneurin continued during the year following cessation of the treatment. The improvement which continued occurred in intelligence tests, educational achievement, reaction time, and height and weight gains.

In cases where there is known to be a disturbance of metabolism it is natural to speculate upon the possible site of dysfunction in the organs and tissues of the body.

In phenylketonuria the basic biochemical error is a disordered metabolism of phenylalanine, the patient being unable to dispose of this substance at a normal rate (Jervis et al., 1940). The phenylpyruvic acid in the urine of phenylketonuric patients is derived from a deamination of phenylalanine in the kidney.