Numerous workers have experimented with thyroid treatment in mental disorder ever since this drug was first introduced into therapeutics. While some of them have reported success in a small proportion of their cases, others have remained quite unconvinced of its efficacy, except in mental disorder secondary to recognizable myxódema, and have attributed the changes observed to the known tendency of psychotic patients to periodic fluctuations or spontaneous recovery. Thyroid has been used in a variety of ways. Doses ranging from 1 gr. up to 70 gr. of the thyroideum siccum a day have been prescribed, and as a result it has been found that many schizophrenic patients have an abnormal tolerance for thyroid. For instance, Hoskins (1929) reported the administration of 48 gr. of thyroideum siccum a day for six months to a schizophrenic patient who showed apparent improvement and no toxic effects; but he has pointed out that not all schizophrenics can tolerate these enormous dosages without being intoxicated and made worse. It has, however, been the deliberate aim of some workers in the past to produce an intoxication, but this method has now largely been abandoned.

In 1927 Parsons published his Introduction to the Theory of Perception with a view to formulating a working hypothesis. This book has played a large part in moulding my outlook upon psychological matters, and I should like to take this opportunity of making a few observations, even although they may not be wholly in accord with Parsons's opinions. But before going on to consider his view-point, perhaps it would be best if we started off by considering what is stated in a standard psychiatry text-book upon the subject of perception.

Of fundamental importance in the problem of symptom-formation in schizophrenia is the question of the relationship of given symptoms to specific aspects of the personality. The present paper bears on this question in that it is concerned with the investigation of the imagery of the schizophrenic, and the relationship of certain symptoms to specific imagery characteristics. More specifically stated, interest here is in the questions of (1) whether or not the imagery of schizophrenics is different from that of normal individuals, and of (2) the relationships of the imagery of schizophrenics to such symptoms as hallucinations, delusions, and activity disturbances. It is believed that these observations may serve the psychiatrist in understanding the nature of the schizophrenic process by its indication of the importance of imagery in schizophrenic symptom-formation.

Among the mental symptoms associated with head injury the psychiatrist rarely happens to see those immediately following the trauma; he is principally concerned with those mental sequelæ that follow recovery of consciousness (E. Mapother). Neither is the neurologist much interested in “cases of simple concussion in which the concussion is usually of brief duration and there is no indication that the brain has been organically injured” (J. P. Martin). Thus they are generally only observed by surgeons, who are usually more interested in other aspects than the psychological or neurophysiological one. Yet these mental symptoms cannot be disregarded if a general view of the disintegration or re-integration of the nervous function after the traumatic impairment is to be formed.

Perhaps more than any other conditions, allergic diseases during recent years have been the subject of studies demonstrating the interplay of mind and body. In numerous papers on asthma, migraine and urticaria the psychological aspects of these disorders have been discussed. In these conditions the emotional origin of single attacks is generally admitted, but it is still a controversial subject whether, or to what extent, asthma, migraine and urticaria can be considered as part manifestations of a general psychopathological constitution. Hay-fever, since it is a purely seasonal disease, although of clean-cut allergic origin, has so far been excluded from such studies; and yet if in allergic diseases the biological over-reaction, the allergy, is in fact correlated in some way to the mental make-up of the patient, no other disease seems more appropriate than hay-fever as a crucial test of the importance of psychosomatic relationships in allergic disorders. Consequently, with the kind permission and support of Dr. Freeman, I set out to investigate the mental make-up of a number of hay-fever patients in the Inoculation Department of St. Mary's Hospital.

Whilst it is an undisputed fact that under certain clinical and experimental conditions various antibodies (antitoxins, agglutinins, bacterio- and hæmolysins, complement-fixing antibodies) can be demonstrated in the cerebrospinal fluid, there is a divergency of opinion about their origin. Whereas some authors (Dujardin and Dumont, Ramon, Descombey and Bilal, Neufeld and Szyle, Nélis) ascribe their presence in the cerebro-spinal fluid to their passage from the blood through a damaged blood-cerebro-spinal fluid barrier, other investigators (Mutermilch, liiert, Grabow and Plaut, Friedemann and Elkeles) believe that the central nervous system or its membranes are able to produce antibodies on their own upon contact with an antigen. In the case of the Wassermann antibody in the cerebro-spinal fluid the question of its origin is of particular interest, because of the occasional occurrence of cases which show a positive Wassermann reaction in the cerebro-spinal fluid and a negative or weaker reaction in the blood. This divergence between blood and cerebro-spinal fluid is often quoted as an example of the independence of the cerebro-spinal fluid antibody.

The Takata reaction (1) consists in the production of a flocculation or opacity in fluids on the addition of alkaline mercuric chloride solution. It has been modified and applied to the cerebro-spinal fluid (Takata-Ara (2)), and found to be positive mainly in cases of syphilis of the nervous system. Various modifications in the technique have been described, e.g., Jezler (3) and Ginkel (4), but in the following investigations on 177 specimens of cerebrospinal fluid Ucko's (5) modification of the reaction on serum, whereby the reaction time is reduced from 24 hours to 90 minutes, has been further modified by the author to permit of its application to the cerebro-spinal fluid.

In the public mental hospitals of England and Wales, over a hundred in number, there is a small proportion of patients who have arrived at a seemingly stationary condition, short of recovery, which, while calling for continued oversight, does not demand a lengthier residence in the hospital, provided some responsible person could undertake that oversight in an ordinary domestic environment.