How electro-convulsive therapy (E.C.T.) acts, what is the chain of cause and effect from the electrical application to the clinical improvement, are questions whose answers are as uncertain as ever, in spite of the importance of such knowledge to psychiatry and in spite of the researches of nearly twenty years. The experiments reported in this paper are an attempt to elucidate the links of one possible chain. What are the possibilities? I shall review them briefly, restricting the review to the physiological and biochemical aspects and omitting any reference to the psychological or psycho-analytical.

In this paper, which is a preliminary communication, I want to present and discuss phantasies of the process of birth and of life before birth, which emerged from certain patients undergoing hypnoanalysis.

Having stated the case for the atomistic approach to Rorschach validation (Keehn, 21), we must now turn to an examination of the methods and results of the application of the approach to a single Rorschach sign.

“The T.A.T. draws forth no more than twenty small samples of the subject's thought. To suppose these will invariably provide a skeleton of total personality is unduly optimistic” (6). With this warning no experienced clinical psychologist is likely to disagree. The present aim has been to provide a method of analysing and quantifying the content of the responses which minimizes dependence on hypotheses derived from outside the test situation and to relate the results to the amount produced and, more particularly, to the rate of production.

Until a few years ago there existed a sharp dichotomy of opinion between the pharmacologists, who, on the basis of their experiments, assigned to acetylcholine the role of universal synaptic transmitter, and the electrophysiologists, who denied that this substance could effect the transfer of excitation from one conducting element to another. It is, however, now generally agreed that, certainly at the neuromuscular junction, and probably also at ganglionic and some—but not all—central synapses, acetylcholine does indeed exert a primary transmitter action. It must be added that recognition of this fundamental action has been hastened as a result of recent experiments by those very electrophysiologists (such as Eccles and his colleagues) who previously supported exclusively electrical hypotheses of nervous transmission. For this reason the assumption which is implicit throughout this paper that the acetylcholine in brain is concerned in maintaining central synaptic transmission is likely to go unchallenged and requires no detailed justification here.

The association of an abnormal electroencephalogram with obsessive-compulsive states has been investigated by Pacella et al. (1944), who found in these states a higher incidence of “convulsive-type” patterns, consisting of occasional or frequent runs of serial 2–4 c/s potentials of high amplitude than in a random control group. In most of the cases this type of activity was only noted after a period of hyperventilation not exceeding two minutes.

Cook, Dax and Maclay (1952), studying the population over age 65 in the public mental hospitals in England and Wales, showed that, for the ten-year period 1938 to 1948, the percentage of patients over age 65 to the total mental hospital population rose by approximately three times as much as the per cent. increase in the general population of those over age 65 to the total population. However, in addition to the magnitude of the problem of mental ill-health in the aged, its many aspects involve extensive fields where knowledge is still lacking. In consequence, it is extremely desirable to investigate more fully the psychiatric disorders occurring in old people, and the increasing importance of these maladies—especially their social significance—has prompted the present study.

It is charactersitic of mental ill-health that the individual's capacity to make continuous co-operative relations with others is impaired. In the psychoses and psychopathic conditions this is unmistakable; in the neuroses it is sometimes less so, and there are even neurotic patients who seem to be especially kind and co-operative. But we know that they only achieve this behaviour at great cost of effort, anxiety and guilt and that, if they break down, they can be very hostile and withdrawn.

In December 1950, Salter's valuable book What is Hypnosis? (1) was published in England, and some months earlier Strauss (2) had pointed out the wide implications for medicine of Salter's observations, were they confirmed, and indicated the more resistant nature of psychogenic pain, compared with organic pain, to amelioration by hypnotic suggestion. The present article reviews three very different cases in which, at some stage in treatment, an autohypnotic approach to pain was used, and a further case in which autohypnosis, as a means of relief of pain, had been discovered accidentally by the patient. An attempt is made to relate the results and information obtained from these cases to Salter's work and views on hypnosis.

In the course of a systematic investigation of the pharmacological properties of a-substituted glycerol ethers it was found that some of these compounds produced muscular relaxation and paralysis. In small doses, administered sub-cutaneously, muscular relaxation and a sleep-like condition were produced in laboratory animals—in larger doses there was ataxia followed by paralysis. Of the various compounds studied, mephenesin was found to be the most potent and to possess the greatest margin of safety, and it is this product which is used, for oral administration, in Myanesin Elixir.

Since the introduction of curare to modify the contractions in E.C.T., the use of relaxants has become standard psychiatric practice. These substances reduce the risk of fractures and enable treatment to be given to patients who would otherwise be denied it owing to risks arising from concomitant physical disease. During recent years great efforts have been made to simplify the technique of muscle relaxation, in particular to evolve a method which is short in duration, free from undesirable side-effects and easy in use. In this short paper we give a description of our experience with three drugs recently introduced, namely, Suxamethonium Bromide or Brevidil “M” which we used in 111 treatments, Suxethonium Bromide or Brevidil “E” (70 treatments), and Suxamethonium Chloride or Scoline (653 treatments). These choline succinic ester derivatives have similar characteristics which can be considered together.

When one finds a legend associated with a disease it may be accepted as a general rule that little is known about its true cause. This is exemplified by Huntington's chorea, of which it is said that the original case was a man who imitated Christ's agony on the Cross. A great deal of work has been done on this complaint, but much of it has been to do no more than to confirm the findings of Abel Huntington, who recognized its hereditary nature in 1797.

A previous communication (Carpenter and MacLeod, 1952) described the application of a maze, together with a simple test of limb co-ordination, to the study of alcoholic intoxication in rats, as modified by acetaldehyde. As part of a scheme of work here, it was desired to observe the effect of drugs and other substances upon the degree of intoxication produced in rats by ethyl alcohol. Such studies, pursued by the methods previously given, soon led to a formidable mass of recorded material, some features of which were not adequately dealt with by the scoring technique employed. It became necessary to adopt a scoring system which would give an overall indication of the various manifestations of alcoholic intoxication, to serve for the purpose of compact tabulation of results and the drawing of conclusions.

The Industrial Neurosis Unit of Belmont Hospital has one hundred beds, two-thirds of which are occupied by males. The vast majority of the patients are chronic psycho-neurotics and psychopathic personalities, who show poor social adjustment. The material treated here is what is usually labelled as “hopeless.” Letters from Out-Patient Departments, seeking admission are prefaced, “We know this is a hopeless case …,” or “If you cannot help him then there is no hope for him …,” etc. During the four years of its existence the Industrial Unit has evolved and practised a variety of techniques of group psycho-therapy, in addition to the orthodox psychological and physical treatments available in modern psychiatric hospitals. More and more importance is being attached to the value of group methods here, to the extent that some doctors, after taking a brief history, thereafter employ group-therapy exclusively. This paper is an attempt to discuss the relative values and roles of therapy carried out at individual and group levels in the Industrial Unit.

In the course of treatment by psychotherapy progress is often hampered by the patient coming to rationalize his reaction to problems; while he attains an intellectual insight, he fails to respond at emotional levels sufficiently to enable him to gain relief from tension or to alter existing patterns of behaviour.

Symptoms of mental disorder are common in cases with cerebral tumours and malformations. Progressive dementia, clouding of consciousness and personality changes make their appearance sooner or later. They have been understood as the result of interference with cerebral functions. However, there are patients in whom the relationship between cerebral lesions and mental disorder is obscure. They present conditions not usually associated with demonstrable structural changes, and the coexistence of mental and physical symptoms appears purely accidental, both running their course independently.