Friedrich Nietzsche was descended from a noble Polish family which sought refuge in Germany from religious persecution. His ancestors on both sides are reported to have been healthy and long-lived. His father was a Lutheran clergyman, his mother the daughter of a clergyman. He was born on the 15th of October, 1844, in the parsonage of Röcken, in Prussian Saxony. His father laboured under a cerebral affection for eleven months, and died when Friedrich was five years of age. His sister, Frau Förster Nietzsche, tells us that this was the consequence of a fall on the head; but Friedrich stated his belief that his own nervous disorders were inherited from his father.

When Lannelongue published his accounts of his first cases of craniectomy for microcephalus, the hope was raised that microcephalic idiocy would prove a curable form of mental deficiency, and would come to be classed among the ordinary surgical diseases of children, as being mainly a bony deformity to be remedied by the use of the knife and the saw; and though Lannelongue himself did not follow Virchow's teaching and regard premature ossification of the cranial sutures as the primary cause of microcephalus, but attributed it to its actual cause, namely, arrested development of the brain, still he considered that there was undue compression and consequent dwarfing due to bony pressure, and that craniectomy would relieve this and lead to increase of brain growth.

The Oxford Clinic for Nervous Disorders first came into official being in the beginning of 1918, when the Committee of the Radcliffe Infirmary did Dr. W. McDougall and myself the honour of appointing us as Physicians-in-Charge of this department, and asked us to organise and run it. It was started with an outpatient department one afternoon a week and was entitled the Department for Nervous Disorders. This term was chosen as it was hoped that it would induce all classes of nervous cases to apply for treatment. Particularly for those cases which show mental symptoms was this title chosen, in the hope that such patients would come to the clinic without feeling they were being specially branded as “mental.” Opportunity would be given for treatment, and possibly improvement or even cure might be effected, and thus certification, which every one of these cases most dreads, could be avoided.

The subject who presented this anomaly of development of the scalp was M. B., aged 66, a peasant woman from the province of Comasca. Of medium height, regular conformation of body, dark complexion, irides dark chestnut, thick and black eyebrows, hair thick, strong, black, with only a few white ones, notwithstanding her advanced age. Her mother, a brother, and a sister have been insane. She suffered some years ago from puerperal mania, and was finally admitted to the asylum at Como labouring under simple lypemania, on 25th March, 1884. She died suddenly from syncope on the 27th of the same month. The autopsy revealed advanced fatty degeneration of the heart and liver.

In a former paper diet was referred to as a part of the management of the epileptics under care in a mental hospital, and the opinion expressed that, on a diet mainly purin-free, tendencies to serial fits, confused states and dream states appear less marked.

My choice of subject for this address has not been altogether fortunate, and what I have to say will need your indulgence. Having fixed the subject hastily when I had the honour to receive your secretary's invitation, I soon found, on taking stock of my knowledge, that I had no clear idea what the new psychology was, what it had done, and on what the claim sometimes made for it to supersede an old and effete system was grounded. A new method of study making large promises was evident enough, but of the new conquests which are to revolutionize psychology I must confess ignorance. My remarks, then, will be critically interrogative, on purpose made to elicit definite information. If that light be forthcoming it will prove how little mere theoretical criticism is worth.

Feldman (1951) published a scale for predicting the response of patients to E.C.T. and insulin coma therapy. Using only Minnesota Multiphasic Personality Inventory profiles meeting stated requirements (at least one elevated scale, moderate F scale scores, etc.) he carried out an item analysis of the M.M.P.I. responses of 42 patients who had responded well to shock therapy and 42 patients who had remained unimproved (psychiatrists' ratings). He derived a 52-item scale, scored as an additional M.M.P.I. scale and labelled Ps, high scores indicating poor prognosis. This he cross-validated on a further 100 patients (categorized as recovered, improved or unimproved) and all categories were well discriminated by Ps scale scores.

Friedrich Wilhelm Nietzsche was born at Röcken, in Saxony, in 1844. His father was a Lutheran clergyman, and his grandfather held a high official position in the Lutheran Church. His grandmother Nietzsche “came of a family of pastors,” and his mother was the “daughter of a parson”. In view of the strongly antagonistic attitude which Nietzsche afterwards adopted towards the Christian scheme of morality, the marked clerical strain in his ancestry is worthy of note. According to his sister Their ancestors, paternal and maternal, were very long-lived. “Of the four pairs of great-grandparents [one] great-grandfather…reached the age of ninety, five great-grandmothers and great-grandfathers died between seventy-five and eighty-six, two only failed to reach old age. The two grandfathers attained their seventieth year, the maternal grandmother died at eighty-two, and grandmother Nietzsche at seventy-seven.” Nietzsche's mother was also long-lived; she was born in 1826, and was married, in 1843, to Pastor Nietzsche, who was then thirty years old. She died in 1897, “after having suffered ill-health for several years”. Pastor Nietzsche is described by his daughter as being an “extraordinarily sensitive man…any sign of discord, either in the parish or in his own family, was so painful to him that he would withdraw to his study, and refuse to eat or drink, or speak with anybody”. This tendency to seek solitude is worthy of note, as it reappeared in a very marked degree in his son, Friedrich. The father was short-sighted—as was Nietzsche—and, in 1848, this resulted in an accident, the consequences of which were disastrous: he tripped over an obstacle which his defective eyesight had prevented him from observing, and he suffered as a result from concussion of the brain. This shock to the nervous system initiated a train of symptoms—chiefly cerebral—which led to his death eleven months later. The fall may have been the cause of the attack; or, as another biographer says, perhaps “only hastened its approach.” The same writer informs us that Pastor Nietzsche “might have hoped for a fine career had he not suffered from headaches and nerves”. Frau Förster-Nietzsche, however, says that her father had not suffered from headaches prior to the accident. In view of Nietzsche's history, one feels inclined to agree with Halévy, more especially as, where any history of nervous or of mental symptoms of a morbid character are concerned, relatives are usually the last to admit them. Mügge says that Pastor Nietzsche “suffered either from concussion or softening of the brain…doubtless this accident hastened his death”. The youngest of the three children born to Nietzsche's parents, a boy, died just after his second birthday “from teething convulsions”. There was apparently nervous instability in the family; and Ireland says that O. Hansson “learned from a family who knew Friedrich Nietzsche from childhood that a disposition to insanity had been inherited for several generations, both on the father's and the mother's side”. This statement is not in accord with the details of family history as given by Frau Förster-Nietzsche; at the same time, it is, perhaps, no injustice to her to surmise that she was desirous of minimising the pathological aspect of the family heredity, and of laying greater stress upon the more favourable characteristics. When Nietzsche's life-history with its morbid mental vicissitudes is considered, however, it would be surprising if the family annals were found to be clear of all traces of nervous instability.

Earlier investigations (3, 4) have shown an abnormal glutamic acid metabolism in schizophrenic patients.

These changes are, briefly, low glutamic acid level (and high glutamine level) especially in acute cases. Glutamic acid concentrations below 1.2 milli grams per 100 ml. venous blood were ascertained in most of these patients.

The treatment of congenital syphilis, in spite of the advances in the general treatment of syphilis in the last thirty years, still leaves much to be desired. Veeder, after treating some 500 cases of congenital syphilis in St. Louis between 1912 and 1920, came to the conclusion that the results of treatment were most unsatisfactory, and that very little was to be gained by the treatment of the syphilitic child. He advocated the treatment of the parents to prevent the birth of syphilitic children. Nabarro is of opinion that the criterion of cure should be the complete cessation of any symptoms of activity and a normal blood and cerebro-spinal fluid. He has not been able to fix any limit of time after which he can regard the patient as cured. He mentions a case of his which relapsed with interstitial keratitis after having had a negative Wasser mann reaction for eight years. Ambrose King doubts whether congenital syphilis is ever really cured; he states that “cases had been seen in which manifestations of congenital syphilis appeared only after the lapse of a number of years, and others in which active lesions occurred, but with a negative Wassermann”.