The following study was made for the Department of Psychological Medicine at Guy's Hospital in London in May, 1933. The purpose of the study was to investigate the present condition of the first hundred patients who attended the Department in 1931. Some of the findings will be compared with those from a similar study made in New York.

Examinations of the cerebro-spinal fluid, with a view to determining its starch-splitting power, have been carried out with varying success for the past thirty years, but the results which have been recorded are meagre and unsatisfying.

Caterham Mental Hospital accommodates upwards of 2,000 patients, the great majority of whom are defectives. The medical staff numbers 7, and all other staff about 500. The patients are of all ages, and are described as “unimprovable adults” and “children of school age”. The type of patient has altered very little in the past five years, but a hostel has been added which accommodates 34 high-grade boys. These are selected from the other institutions of the London County Council, and, as a certain number prove unsuitable and do not wish to return to the institutions they came from, a number of higher grade patients have accumulated in the main institution. There are also, on the female side, laundry workers of high grade who have been sent for that specific work.

Cholesterol metabolism in epilepsy has been investigated by a number of observers during recent years, but the results have been contradictory and confusing, as the following summary shows: 1920, De Crinis (1): Cholesterol increased before seizures. 1923, Pezzali (2): Cholesterol decreased before seizures; low average levels in epileptics. 1927, Robinson, Brain and Kay (3): Cholesterol decreased before seizures. 1927, Osnato and Killian (4): Results negative. 1929, Goodall (5): Results negative. 1929, Fox Gosden and Brain (6): Cholesterol decreased before seizures; general low values in epileptics and increased variability in individual patients. 1930, Duncan (7): That there is no definite evidence to show that the occurrence of an epileptic fit is associated with a fall in the level of cholesterol in the blood.

The following case appears to be sufficiently uncommon to warrant a detailed description.

Within the past few years a series of papers emanating from this laboratory has dealt with the respiration of normal subjects and psychotic patients from psychological and physiological points of view. Linking up the chain of these investigations, we have tried in this study to get some information about the respiratory type and the ventilation in different groups of mental patients, especially of schizophrenics.

The object of this investigation was to ascertain the value of the bicoloured guaiac reaction on the cerebro-spinal fluid in mental hospital practice. The reaction, which was first described by de Thurzo (i), is similar in principle to the Lange gold sol test, in that under certain conditions precipitation occurs from a colloidal system. Its originality depends on the fact that two dyes, naphthol green and brilliant fuchsin are contained in the system, one of which attaches itself to the precipitating colloid (brilliant fuchsin), whilst the other (naphthol green) remains in the supernatant fluid. It is claimed that it is not so susceptible to possible fallacies as the gold sol test (such as chemical uncleanliness), that it is possibly more selective in its action, and that it has the same practical value in the laboratory diagnosis of neuro-syphilis. Results have been reported on hospital cases (2) showing fair agreement with the Lange and Wassermann tests, but so far no records are available showing the value of this test in a series of neuro-syphilitic cases from mental hospitals, with the exception of a brief report on 10 cases (3). The present report deals with 325 fluids obtained from cases in L.C.C. mental hospitals, and these included 125 cases of general paralysis treated by malaria and other pyrexial therapies.

The study of miniature hallucinations has been, in the main, the work of French psychiatrists, notably M. Leroy, who gave them the name “Lilliputian Hallucinations” (1), (2), (3), (4). A communication from M. Leroy on this subject was read at the Spring Meeting of the S.E. Division of the Medico-Psychological Association in 1922, and a report on this was published in the Journal of Mental Science (5).

If anxiety be regarded as it is in this paper, as an energic problem, then the treatment of psychoneurotic, and to some extent of psychotic reactions, can be summarized under the following four headings:

In the literature on neurological complications of alcoholism but scant reference has been made to the occurrence of cranial nerve palsies in alcoholic peripheral neuritis. Although Russell Brain (1) states that there is no form of polyneuritis in which the cranial nerves may not suffer, he refers to the rarity with which they are affected in the alcoholic form, and mentions only the vagus and the facial nerves as being occasionally involved. Collier and Adie (2) in Price's Text-book of Medicine state that facial palsies, ptosis, nystagmus and weakness of the extra-ocular muscles have been observed, whilst Feiling (3) writes in the Oxford Medicine that with the exception of nystagmus, involvement of the cranial nerves is very rare in alcoholic neuritis.