Sex hormone deficiency in schizophrenia has been suggested by the usual appearance of the psychosis in adolescence, the not infrequent somatic abnormalities, aberration of libido with often its eventual extinction, and, histologically, by the suggestive though not entirely accepted work of Mott (1919), Lewis (1923) and certain others implicating the testis. Accordingly, many workers have treated schizophrenia with sex hormone preparations empirically but without specific endocrine indications. The reported results have been inconsistent and disappointing. In this respect our experience with various hormones has been similar to that of others. The need for a physiological test to establish a diagnosis of endocrine deficiency and control appropriate therapy has been keenly felt. Values for the normal excretion of sex hormones at various stages during adolescence are not as yet established; estimations are not a practical possibility on a large scale, and with the exception of one excretion product of steroid metabolism with an androgenic action, namely, 17-keto-steroids, demand a biological technique. Testis biopsy, described by Charny (1940) and Lane Roberts (1939) is, therefore, a valuable diagnostic procedure, and possibly not without some therapeutic value. We have already described and classified a striking pathology of the testis in schizophrenia from studying biopsy material (Hemphill et al., 1940). The special features were atrophy of seminiferous epithelium, failure of spermatogenesis, thickening and hyalinization of the basement membrane and collapse or shrinkage of many tubules. We were unable to note consistent absence or marked reduction of interstitial elements in cases where secondary sexual characteristics were well developed, although the work of Mott (1919) drew particular attention to failure of internal secretion. The interpretation of the pathology is, of course, uncertain, but the atrophy of spermatogenetic structures suggested that there was a lack of normal or adequate gonadotrophic hormone necessary for the maintenance of spermatogenesis and the activity of the testis as a generative organ. For this reason we treated cases with gonadotrophic hormone of pregnant mare's serum (gestyl). This follicle-stimulating hormone is believed, in the male, to promote spermatogenesis. Treatment was dictated by the histology of the biopsy specimen. Gestyl was administered in 800 to 1,000 unit doses daily for variable periods of up to 48 days. Anti-hormones were tested for at the completion of treatment in the last series of cases, and further biopsies were made as a check-up for physiological efficacy.

Since Hippocrates and his Roman followers described the habitus apoplecticus and the habitus phthisicus, linking these antithetical physical types with certain temperamental peculiarities and with susceptibility to specific diseases, much research has been carried out in an attempt (1) to prove the existence of physical types and to discover their nature, and (2) to investigate the relation of these types to temperamental traits. This work has done much to clarify the issues at stake.

Graphology, the theory and practice of diagnosing character from handwriting, is gradually developing from its initial stage, in which it had been the mysterious art of a few people who claimed to be especially gifted, into a science which can be taught and studied. The widespread mistrust of it is partly justified by this state of development. From a scientific point of view it needs more precision of method and terminology as well as corroboration of its results by objective methods. The description of the character as a whole and assessment of the significance of single features still depend to a large extent on the graphologist's experience and knowledge of human nature as well as on his stylistic abilities, and some other subjective factors. Moreover, only part of the accepted graphological interpretations have been based on inductive methods using statistical comparison, experiment and the like; for the rest, they have regarded handwriting as the more or less unwitting expression of the subject's personality, and they have attempted to assess this either by empathy, or by an effort to understand and explain which might itself be founded on the graphologist's private philosophy or on the psychoanalytical system. The results obtained in this way called for corroboration by statistical evidence. The present writer therefore welcomed Dr. Eysenck's suggestion to submit her graphological reports to objective control in the following way: She was to answer a questionnaire on the temperamental qualities of 50 neurotic patients, a sample of whose handwriting was given her, assess their intelligence, give a short character description, and, last of all, match the specimens of handwriting against anonymous summaries of the case-records of the patients. Her results were then compared with the patients' own answers to the questionnaire, their score in the Progressive Matrices Test, and the psychiatrist's description of the patient's character. Dr. Eysenck has reported the numerical results. In the present paper the validity of the graphological opinion on personality traits confirmed by at least one of the sources of control will be examined, and the handwriting signs of these traits will be set forth.

The following paper is a description of a form of direct psycho-therapy with children undertaken in a Child Guidance Clinic, and some account of the results achieved in certain cases.

The unfailing regularity of the rhythm of his manic-depressive cycles each week renders the patient in question particularly suitable for investigation, and throws into relief changes which might be less marked if the transition between the phases was more gradual and the periodicity less certain.

This paper describes an investigation into the significance of physique in effort syndrome.

Abnormalities in the vestibular reactions in schizophrenics have been reported in the literature. Pekelsky (1921) observed transitory lack of caloric response in two cases of catatonic stupor. Rosenfeld (1926) described four cases of acute catatonia in which on calorization a slow deviation appeared instead of the physiological response. Claude, Baruk and Aubry (1927) examined four cases of catatonia, eight of hebephrenia and one of dementia paranoides. In one of the catatonic cases no caloric or galvanic response could be elicited, and in the three others the reactions were diminished. The other cases showed normal reactions. The authors stated that a diminution of the responses could sometimes be observed in hysteria. Claude, Bourguignon and Baruk (1932) found the Chronaxie of the vestibular nerves greatly increased in patients with catalepsy, but normal after the disappearance of that symptom. Joo and Meduna (1935) stated that in old-standing cases of schizophrenia a lack or a considerable diminution of the vestibular responses could nearly always be found. Sercl and Vinar (1937) examined the vestibular reactivity in twelve cases of hebephrenia and thirteen cases of paranoid schizophrenia. The responses to rotation were normal in all cases. The caloric responses were found to be diminished or lacking. Lack of caloric response was more frequent in the hebephrenic than in the paranoid cases. Löwenbach (1936), working on Gjessing's cases of periodic catatonia, carried out quantitative investigations taking into account the latency period of nystagmus, its duration and the number of oscillations. He examined thirty cases, each of them repeatedly, and attempted to correlate the results of the tests with the periodical changes in the clinical picture. He found that shortly before and during periods of stupor the vestibular reactivity dropped, and that sometimes only a slow deviation could be elicited. The lowering of the frequency was due to the prolongation of the slow phase. The abnormalities were independent of the duration of the illness, and in some old-standing cases the response was normal. Sometimes a temporarily diminished reactivity was noticed which did not coincide with a change in the clinical picture. Löwenbach noted frequent and often abrupt changes in individual cases, and in some he observed transitory complete loss of reaction. Angyal and Blackman (1940) studied vestibular reactivity to caloric and rotatory stimulation in 58 unselected male schizophrenics and in 20 normal controls. The response to caloric stimulation was found to be considerably lowered, the rotatory response only slightly reduced. There was no correlation to the duration of hospitalization or to the conventional subtypes of schizophrenia. However, in a group of five patients with extreme apathy, indifference and poverty of mental contents the reactivity was particularly low. In cases with a periodical course the vestibular reactivity was distinctly lower during the catatonic periods than during the intervals. The same authors (1941) investigated the nystagmic reactions to caloric stimulation under the influence of alcohol, hyperpnoea and CO-inhalation in schizophrenics and normal persons. While in normals alcohol intake results in an increase in the frequency of the nystagmus, in schizophrenics a decrease was observed. CO, which normally has a depressing effect on the nystagmic reaction, produced an increase in schizophrenics. Hyperpnoea, while causing an increase in normals, had the opposite effect in schizophrenics. Freeman and Rodnick (1942) studied the amount of sway induced by rotation in thirty schizophrenics and in an equal number of normal controls. The patients were found to be significantly less reactive than the normal subjects.

In view of the success of E.C.T. in depressive states of the middle-aged it seemed worth while to take the risk of extending its benefit to patients over 60, whose clinical picture often differs very little from that of the next younger age-group. Since January, 1941, when E.C.T. was first used in the Crichton Royal, an increasing number of such patients has been treated. It is proposed to give a short, retrospective survey of these cases in order to assess if the therapy has justified itself by its results, and to find out the dangers and the limits of its application. Among over 500 patients treated were 76 over 60, 62 females and 14 males, with the following age distribution:

In a previous communication to this Journal, the author described the results of three years' experience of pharmaco-electrical shock-therapy in the schizophrenic and depressive psychoses, and presented clinical and experimental evidence for an organic basis of these conditions. It was shown, firstly, that there is convincing evidence for supposing that deranged oxygen-glucose metabolism of the cerebral neurones is the essential lesion; and, secondly, that all these conditions can be classified according to their response to shock-therapy into two groups—dysoxic encephalopathy, or cerebral dysoxia, in which oxygen-metabolism is principally at fault, and which responds to anoxic shock; and dysglycolytic encephalopathy, or cerebral dysglycia, in which glucose-metabolism is at fault, and which responds to hypoglycaemic shock. The former condition is synonymous with depressive states, and the latter with schizophrenic reaction-types in the orthodox terminology.

The object of this paper is to present a brief review of nearly five years' experience of the schizophrenic group of psychoses as found in military practice, with particular reference to its treatment, and to important new facts which have recently come to light regarding the relative values of the convulsive and insulin therapies.

The growing incidence of juvenile delinquency during the past years has become a serious concern of the general public and the authorities. Following the lead taken by the Home Office, a number of local authorities, child guidance clinics and welfare agencies have instituted inquiries into the causes and conditioning factors of juvenile crime from the social, economic and medico-psychological points of view. The institutions for the mentally defective have been faced with the same problem through the increasing number of cases referred by the juvenile courts, and Dr. D. Turner, in his Annual Report on the Royal Eastern Counties Institution, Colchester, for the year 1943, called attention to the difficulties of their management within an institution of the usual type. The question calls urgently for a settled policy regarding their disposal and treatment, and it goes without saying that this can only be attained on the ground of a better insight into the psychology of the delinquent defective.

Though English is the language of the citizens of the U.S.A., it would be rash to assume that their reading vocabulary was identical in its familiarity with that of the citizens of the British Isles. Hence it is possible that a vocabulary test which is suitable for discriminating among adults in the U.S.A. may not be as suitable for that purpose among adults in this country. A critical examination of the Shipley-Hartford test seems called for, in order that the test may be used with success on this side of the Atlantic.