Since the appearance of von Baer's work on animal development in 1828 (1), the mode of origin and development of the nerves has been continuously under discussion. A vast number of observations has been made concerning the visible evidences presented by fixed and sectioned material, and very many experiments have been performed to elucidate the nature of the processes at work. Yet no account of nerve development has so far received general assent, and for some time the advantages ensuing from the adoption of an agreed opinion appear to have been allowed to work in favour of its acceptance. These advantages have been found to be academic rather than real. While the formulation of hypotheses is not a proceeding which can be stigmatized as unscientific or unsound, in the absence of useful developments their retention discourages inquiry. This discouragement is the more likely to occur when, as in neurology, more than a century of effort by many workers has not succeeded in establishing beyond question facts which are of fundamental importance. It is a reason why the central problems of neurogenesis have come to occupy a field not wholly favourable to fruitful discussion.

I. Males.

(i) Object of the Inquiry.

This paper gives some first results of an investigation into types of physique and into the alleged relation between physique and temperament. The problem here is to try to discover a method of measuring the tendencies to a particular bodily build that may be present in certain individuals.

In this paper an account is given of the results of investigation of the use of the Columbian group test in a series of 10,000 male adolescent prisoners between the ages of sixteen and twenty-two years.

In availing myself of the invitation kindly extended to me by the Institute for the Scientific Treatment of Delinquency of speaking to you on “The Treatment of Mental Disorders and Mental Deficiency in Continental Criminal Law “, I have no intention to abuse this privilege by criticizing the corresponding English law or by making suggestions for its improvement. For the latter task I feel myself neither competent nor authorized, as I am only too well aware that every important legal change is dependent upon many considerations which the foreign observer—though possibly conversant with the external facts—can appreciate only inadequately. What I may safely do, however, is to summarize some outstanding features of modern continental law and to add a few personal experiences concerning the legal system under which I worked for nearly a quarter of a century. I intend to deal first with problems of insanity (including temporary insanity caused by drunkenness), secondly with other forms of mental disorders and with mental deficiency.

The estimation of vitamin C in the urine has recently been undertaken on a fairly large scale on patients suffering from physical disturbances. Harris (1) and his co-workers investigated 74 hospital patients at Cambridge, and found that 62 (84%) excreted less than the minimum standard, or 13 mgrm. per day. Excluding 19 on special diets, 43 excreted less than 13 mgrm. per day, and the average excretion of 55 was 10 mgrm. per day.

It is now a little over twelve months since the investigation and treatment of chronic infective disease was undertaken at this hospital, made possible by the erection of a treatment centre and the appointment of an ear, nose and throat surgeon. From what I have seen of the results obtained during the period under review I am convinced of its therapeutic value, not only in recent cases of psychosis where other forms of treatment have failed, but also in chronic cases, which my clinical experience would have pointed to as hopeless, has amelioration taken place.

Under the heading of “Injury before Mental Symptoms” it is desirable to consider first the surgical conditions of concussion, cerebral irritability and states of compression with their associated mental symptoms, for these must form a solid background for our consideration of all those cases where there is a head injury and mental disorder supervenes. It is, of course, possible to get an unrecognized fracture of the skull following a slight injury which will cause no further disturbance than, say, a headache. An example of this is supplied in a recent report, where a prospective member of Parliament sustained a fissured fracture of the skull as a result of bumping his head against the roof of a car when going over a hump-backed bridge; but nevertheless went about his business for a month afterwards, ignorant of the fact of the fracture, although experiencing a headache, which eventually sent him to a doctor who, by radiography, was able to make the diagnosis.

Since the discovery that Bacillus coli vaccine (1) or albumose (2) were as effective as typhoid vaccine (3) in the treatment of typhoid fever, the use of non-specific protein therapy has been popular for almost any disease for which there is no other satisfactory form of treatment. T.A.B. vaccine, a mixture of typhoid and paratyphoid A and B organisms, has been found more regular and reliable in its results than typhoid vaccine (4); but milk, antitoxic sera, peptone and a variety of other substances have been used, and even malaria is considered a form of this treatment, segmentation of the parasites producing the foreign protein (5). It has been observed that Gram-negative organisms, such as the gonococcus and typhoid bacillus, produce more marked reactions when given intravenously than the Gram-positive organisms, such as staphylococci, streptococci and pneumococci (5).

This paper is an attempt to record the experience gained in treating 44 schizophrenics in this hospital with cardiazol from September, 1937, when the treatment was first used, to the middle of April, 1938.

Early Work.

About twelve years ago, apart from mental work, I had occasion to use insulin to some considerable extent for the treatment of diabetes and the preparation of diabetic cases for operation, and acquaintance was thus made with hypoglycæmic shock. Most of us have had that experience. Insulin has been tried more recently in a large field, being used as a remedy in conditions of all sorts, even as a dressing for septic ulcers. But the writer's scope has been more confined, the extent being limited to mental cases.