The subject of the relation of recurring dreams of adult life to that almost inseparable mixture of real experience and fantasy which forms the mental life of the child was dealt with by Rudyard Kipling in The Brushswood Boy, and by George du Maurier in Peter Ibbetson, after a fashion not given to psycho-pathologists. The psycho-analytic school has of late years endeavoured to trace the genesis of the psycho neuroses to aspects of the same period generally considered less attractive. There has, I think, been less effort to establish such a connection in the major psychoses.

It became apparent soon after the introduction of chlorpromazine and reserpine that these drugs were capable both of influencing psychoses and of producing neurological disturbances closely resembling those seen in post-encephalitic Parkinsonism. In classifying drugs with these effects as “neuroleptics” Delay et al. (2) indicated that they considered the two actions to be inseparable thus implying that both resulted from common or closely related neurophysiological changes. On this basis it seemed likely that drugs which more readily produced these neurological disturbances would prove more effective in psychotic illness. It also seemed possible that there might be therapeutic value in the deliberate provocation of such disturbances, as was first advocated by Fleugel (6). The theoretical issues involved were referred to in a previous paper (MacLeod and Moffat (8)).

A systematic record of information collected during the process of diagnosis and care is essential to document understanding of the patient's mental, physical and social condition and the clinical service provided (Fig. 10.1).