It is commonly believed that heredity plays a considerable part in the determination of an individual's personality. If we accept the well-known definition of personality as “the integrated organization of all the cognitive, affective, conative and physical characteristics of an individual as it manifests itself in focal distinctness to others,” we might expect that much research endeavour would have been dedicated to the discovery of hereditary influences on the cognitive, affective, conative and physical characteristics of the individual. A certain amount of such research there has been, but its emphasis has been curiously lopsided; we have some studies into inheritance of physical characteristics, and numerous studies into the inheritance of cognitive characteristics, but there has been little worth-while research into the conative and affective sides of personality.

Holzinger set up his equations to show the combination of the factors—nature (A), nurture (B), and error(E)—which go to make up a score obtained by a particular twin on a particular test. If iX1 and iX2 are the twins in an identical pair and fX1 and fX2 are the twins in a fraternal pair then: —

Mental deficiency and its synonym “oligophrenia” are terms interpreted very differently in various countries; this has made it almost impossible to compare the statistical data of these countries. The concept the lay person in this country has of mental defect applies with few exceptions to individuals with intelligence quotients below 60 per cent., i.e., idiots, imbecile and obvious simpletons. When a person with this conception of mental defect—and we must admit that it corresponds fairly closely to the legal interpretation of the Mental Deficiency Acts in this country—is told that mental deficiency is a major social problem, the statement is received with some measure of incredulity. There is some justification for this incredulity. The statement is ambiguous and is based upon some rather muddled thinking. If we accept this legal and administrative interpretation of mental defect only about 1 per cent. of the population can be said to be mentally defective. Probably no other 1 per cent. of the population has such a high proportion of decent, docile and law-abiding citizens. If so, what meaning can we give to the statement that mental deficiency is a major social problem ?

Three is no branch of neuro-surgery in which the assessment of results is more difficult than in psycho-surgery. The main sources of uncertainty are:

1. (a) Mental impairment or improvement cannot yet be measured as precisely as neurological disorders, such as visual field or motor defects.

2. (b) Spontaneous recovery and the influence of the incidental psychotherapy and drugs involved in any form of surgical attention cannot be evaluated with certainty in many cases.

3. (c) Most of the cytoarchitectural fields of the frontal cortex cannot yet be defined during life by any physiological test or anatomical measurement.

4. (d) Finally, from a technical point of view the surgeon is liable to produce many incidental lesions which cannot be ascertained during the patient's life.

Phenylpyruvic oligophrenia is a syndrome in which mental deficiency is accompanied by the excretion of phenylpyruvic acid in the urine.

In the nineteenth century considerable attention was devoted to the art products of psychotics. The approach to these interesting phenomena was, however, unsystematized and of little value to psychopathology. Prinzhorn (1922) described the collection of psychotic art at Heidelberg. His monograph on the subject is a classic, but it has been pointed out by Elkisch (1945) that his analysis was not carried far enough to produce significant diagnostic criteria. In five recent articles Anastasi and Foley (1940, 1941) have made a comprehensive survey of work done on the whole field of the artistic behaviour of abnormal people. They have pointed out the inadequacies of research in this sphere: the lack of control groups of normal people, the generalizations made from a few selected data, and the constant danger of reciprocal projection.

In the early literature of mental defect there are allusions to behaviour, shown by defective children, which would now tend to be regarded as psychotic. This is probably one factor which has led psychiatrists into thinking of psychosis in childhood as an exceedingly rare occurrence. It now seems at least possible, if not probable, that many cases of early psychosis have been missed because the end-result has been equated with mental defect. In a sense it could be so classed since psychotic children are very often rendered ineducable by reason of their disorder, which sometimes seems to date “from birth” (Kanner, 1943), and in others certainly arises at an early age. However, the term “arrested development of mind” is less applicable, since the mind of the psychotic child appears to develop in a distorted and unbalanced way, showing some faculties to be absent and others apparently developed in a precocious manner (Bender, 1947).

More than two years have elapsed since the Szondi test material became available on the home market, but it seems that the widespread use of the test has been considerably delayed by the lack of a translation of Dr. Szondi's books (1, 2). Susan Deri's Introduction to the Szondi Test (3), which appeared last year, may, however, have enabled some who felt attracted by the test to acquaint themselves with it. The purpose of Deri's book is to give some guidance for the clinical handling of the test and for its interpretation. For the rationale she refers to Szondi's own books.

In an article under the above title (J. Ment. Sci., 1950, 96, 1060-91) S. Karagulla compared the results obtained in six groups of patients. Two groups, male and female, had been treated at the Royal Edinburgh Hospital for Mental and Nervous Disorders in the years 1900-39, before electric convulsion therapy had come into general use. The remaining four groups had been treated in the years 1940-48, two, male and female, by electric convulsion therapy, and two, male and female, by conservative measures only. The author had the advice and encouragement of Professor Sir David Henderson, and the final statistical calculations were scrutinized by Professor A. C. Aitken. This background of authoritative support is mentioned here, because some readers may have felt that it lent to the author's arguments and conclusions an added weight.

The first object of this paper is to describe the clinical and pathological features of two cases of sub-acute sclerosing leuco-encephalitis (first distinguished by van Bogaert in 1945). A second object is to compare these features with those of the Dawson inclusion type of sub-acute encephalitis (Dawson, 1933, 1934; Brain, Greenfield and Russell, 1943, 1948; Greenfield, 1950; Malamud, Haymaker and Pinkerton, 1950), and the final object is to emphasize the importance of mental change, when associated with motor symptoms, in the diagnosis of both these forms of encephalitis.

It is important, at the outset, to define the purposes which can be served by studying the subject of neurosis in animals, and they appear to be twofold. Firstly, animals display emotions in a simplified form, because their behaviour is not influenced by social conventions, and thus one can sometimes recognize vital underlying human feelings which are masked by other less important habits. A simple example of this is seen when two animals are given identical meals in separate feeding dishes; each animal is convinced that the other has a better meal, and they will not be happy till they have changed dishes: in human relationships, the feeling that the other person has something better often plays a major part in determining behaviour, but it is frequently disguised and seldom admitted by the person concerned. The second way in which animals can help in the study of human medicine is in controlled experimental work; for instance, the relative effects of heredity and environment can be studied comparatively easily in animals, and although it is important to remember that arguments based on animal behaviour cannot be applied directly to human behaviour, much can be gained by an exchange of information between workers in the two fields.

Psychotic states due mainly, but not exclusively, to unusual external circumstances are well known, and are commonly exemplified by such mental disorders as are occasionally met with in persons in prison, or those morbidly homesick, or suffering under the strain and stress of advanced deafness. In the great majority of these instances, however, the external conditions represent only an additional, precipitating aetiological factor which is operating as a trigger mechanism to a mental derangement of non-specific character already present in a latent state. It may therefore be of some theoretical and practical interest to report on a group of acute and subacute psychotic states whose history, features, course and outcome characterize them as constituting a readily recognizable clinical entity of purely psychological, situational origin.