The literature on the subject of biochemical research in the psychoses is a vast one, and most of the problems met with in the study of mental diseases are still to be solved. It is evident, however, that these problems must be tackled from the physiogenic as well as from the psychogenic point of view; and it was with the object of examining the patient as thoroughly as possible from the physical standpoint that these investigations were carried out.

McCowan and Quastel (5) have shown, in recent work carried out in this hospital, that a close relationship exists between variations in the affective state of psychotic subjects and abnormalities in the glucose tolerance curves. So marked is the parallelism between these two that it has been found possible to make use of an index, known as the hyperglycæmic index (H.I.), which furnishes a valuable guide to the degree of emotional tension experienced by the subject. The method of determining the index is fully described in their paper; but it may be briefly stated that it is zero when the glucose tolerance curve is normal, and varies up to 100, depending upon the degree of sustained hyperglycæmia present. The affectivity of the patient was determined clinically, and, in order to test the validity of their thesis that the emotional tension and H.I. varied pari passu, it was considered that objective evidence of the patient's affectivity would be of value.

Pick's disease and Alzheimer's disease are well-defined, if rare, groups of cases which have been differentiated from the main bulk of the dementing psychoses occurring at and around the presenile period. Although these two sub-groups have much in common on the clinical side, their histopathological features are so strikingly different that many authorities consider them to be separate disease-entities.

In the tenth Maudsley Lecture a plan was put forward by Prof. Spearman for conducting a large-scale research in psychiatry. The proposal was that many mental hospitals might co-operate in a joint experiment. Psychiatrists would give their psychiatrical and physiological accounts of selected patients; and psychologists would apply specially prepared clinical mental tests to these same patients. The mass material from many hospitals was to be collocated in order to see, as Prof. Spearman says, “what goes with what, and what follows what.”

In view of the present situation in India, it seems advisable to place on record a short general review of the position of psychiatry there, and of the difficulties that have delayed improvement during the twenty years of my own experience. Having joined the Department in 1906, and having served in it since then, as Medical Superintendent, in succession, of the Punjab Asylum, Lahore, the Burma Asylum, Rangoon, and the Central Hospital for Mental Diseases, Yeravda, Poona (the last since 1912), I feel qualified to criticize it now. From 1912 until my retirement in 1926 I was the Senior Officer of the Department. By the term “Alienist Department of India” I refer to the system of asylums and mental hospitals “established” or “licensed” by the Provincial Governments for the treatment of mental disorders under the Indian Lunacy Act of 1912, and to the small group of specialists who have managed them, both before and since the coming of that Act into force. Only those institutions “established” by Government need be considered, because, as far as I am aware, no private “licensed” hospitals exist. This fact alone indicates the degree of interest that the more educated Indians take in the treatment of mental disease. The Parsis, however, have, in my experience, done a good deal to ameliorate the condition of the insane in Bombay, but this race is a small one, numbering only some 101,000.

A survey of the literature regarding the more obvious variations in the physical characteristics of the skin to be found in the mentally deranged, reveals a considerable divergence of opinion as to their degree and associations. Consequently the following investigation was undertaken with an open mind.

During the last few years at Rainhill Mental Hospital, an investigation has been carried out into the clinical and pathological features of dementia præcox in its so-called acute or malignant form. A description of the characteristic clinical features and of the gross morbid anatomy was presented in a previous article in this Journal (4), but it may be of advantage to re-state the conclusions arrived at in this preliminary inquiry.

The tell-tale facies of the subject of long-standing tabes is familiar to all clinical observers, and is the sum of several components. The pallor and thinness of the face are, in all probability, largely related to the impaired state of the patient's nutrition, and this in turn is often an expression of chronic infection of the urinary tract. The remaining components, namely, the ptosis, the pupillary anomalies and the equally constant changes in the appearance of the iris, are of neurogenic origin.

The Final Revision of the Classification of Mental Disorders by the Clinical Psychiatry Sub-Committee was passed at the meeting held on February 23, 1932.