bluuebunny/crossref_metadata_2025 huggingface dataset:
The Thirteenth Maudsley Lecture: Education in Medicine
Authors: Buzzard E. Farquhar
Published: August 2008

When I accepted the great honour of giving the Maudsley Lecture this year, I was instructed that my subject should be one of popular interest. The theme of “Education in Medicine” was chosen with some trepidation, not so much on account of any lack it might have of intrinsic interest, but because its elaboration might lead me to express views not entirely in harmony with popular opinion. “Education in medicine” rather than “medical education”, because I had it in mind to discuss the kind of instruction which, if within his reach, would enable the layman to recognize and appreciate some of the principles on which the practice of medicine is based and pursued. And my choice was determined by the conviction, which must be generally shared, that the practice of medicine is much handicapped by a want of understanding, and therefore of sympathy and co-operation, on the part of the public—a want of understanding, the causes of which might be explored with advantage to both parties concerned in it.
Misidentification and Non-Recognition
Authors: Coleman Stanley M.
Published: August 2008

In 1923, under the title, “The Illusion of Doubles in a Case of Systematized Delusional Insanity” (1), J. Capgras and J. Reboul-Lachaux described for the first time an interesting syndrome of non-recognition. The case was that of a persecuted and megalomanic woman in whom there existed a condition of agnostic identification without disturbance of sensory or memory images. The patient postulated a series of “doubles” replacing the various persons of her environment, even her husband and daughter being included. During the course of a few months she complained that she had been shown one thousand doubles of her daughter. The person confronted was appreciated to resemble exactly the known individual, but on account of some subjective disorder, the ability to identify her was lost and the belief in “doubles” brought forward in order to explain this state of non-recognition.
On the Action of Barbituric Acid Compounds
Authors: Meerloo A. M.
Published: August 2008

Since 1922, when Kläsi's work on prolonged narcosis with somnifen—a mixture of barbitals—appeared, this form of treatment has become an integral part of the armamentarium of psychiatry. Patients suffering from various psychoses were subjected for a longer or shorter period to intoxication by a hypnotic, with or without the production of a prolonged sleep. Successes—sometimes very great successes—were claimed for this treatment. The number of publications on this subject is so large and the successes described therein so numerous, that the clinical worker is in duty bound to form an independent opinion regarding this method. The question is whether there is anything in this therapeutic method which psychiatry should retain, what that something is, and whether or not we can improve its system of procedure. Too great an enthusiasm is equally dangerous here, as is underrating the method because of a single unfortunate experience during or following the treatment.
Somnifaine Narcosis: Toxic Symptoms and Their Treatment by Insulin
Authors: Ström-Olsen Rolf
Published: August 2008

During the last decade prolonged narcosis has been accepted as a most valuable form of treatment in mental disorder, but many psychiatrists refuse to use it because of its dangers. The present paper presents clinical and laboratory evidence that a method has been devised whereby most of the toxic symptoms can be obviated. It is claimed that a large proportion of these symptoms are due to upset of carbohydrate metabolism of the liver and heart by the narcotic, and that in the administration of insulin and glucose as an integral part of the treatment a rational method of prevention has been evolved. No attempt is made to record the results of treatment, as it is proposed to publish this separately, the aim of the present paper being to show the elimination of toxic symptoms by the suggested modification of treatment.
Studies in Experimental Psychiatry. Iv: Deterioration of “G” in Psychotic Patients
Authors: Simmins Constance
Published: August 2008

In the earlier papers of this series Stephenson has already reported an experiment in psychiatry, in which patients at Horton Mental Hospital have been tested by psychologists of the Spearman School of Factors.∗ The p-factor has been introduced and its contact with psychiatric material developed. The present paper serves to introduce the general factor in cognition (“g”), and to indicate the significance of measures of the g-factor for psychiatric research.
Occupational Therapy from the Therapist's Standpoint
Authors: West Joan
Published: August 2008

The use of occupational therapy in mental or physical illness, as an adjunct to medical treatment, has developed rapidly during the past twelve years. As definitions often prove a snare to the uninitiated, and as no comprehensive phrase has been coined for this scientifically applied activity, it seems advisable to give a short survey—based largely on experience gained in the United States—of the manner and degree in which this therapy is contributing to the recovery of the sick to-day.
Notes on Asylums and the Insane in France and Belgium. (July and August, 1861)
Authors: McIntosh W. Carmichael
Published: August 2008

At a time when so much public interest is manifested in lunatic asylums and their inmates, it scarcely requires the memory of the illustrious Pinel, Esquirol, and Guislain, or the knowledge of what has been done by the present Morel, Baillarger, Falret, Moreau, &c., to tempt one over the Channel, more especially when a visit to the far-famed Gheel is contemplated. So in July and August last, having leave of absence from my duties to spend some weeks in rest and recreation, I resolved to find both in a visit to the French and Belgian asylums, having learned by experience that to travel without an object is neither profitable nor pleasant. Believing that what interested me, and regarding which my curiosity had sometimes been excited at home, might not be devoid of interest to others, I made “notes” regularly of what I observed, recording facts and impressions on the spot and on the day, rather in the order of observation than of coherence, and striving only to observe well, and to state the exact truth.
On the Pathological Elements of General Paresis or Paresifying Mental Disease (Paralysie générale)
Authors: Salomon E.
Published: August 2008

General paresis, paresifying mental Disease, or in Latin paresis generalis, that is, paresis of mind and body, insania paresans, are terms applied to the form of mental disease generally known under the French denomination of paralysie générale.
Excerpta from Foreign Journals
Authors: Arlidge
Published: August 2008

In our last abstract from German and French works, we noticed the appearance of two new French journals devoted to psychological medicine, and made some general observations upon the character and purpose of each as set forth by their respective editors. We have now collected the numbers for the whole of the past year, and will attempt to cull from them what appears likely to interest our readers; and as the subject matter before us is on the present occasion to a large extent of a clinical character, our excerpta must largely partake of the same, a circumstance which we trust will not render them the less interesting.
The Relative Mortality of Cancer in the General Population, and in the Mental Hospitals of England and Wales
Authors: Rudolf G. de M. , Ashby W. R.
Published: August 2008

The periods under review were selected according to the availability of suitable material. Before the year 1907 and during the years of the Great War the number of deaths divided into suitable age-groups are not readily obtainable. The years immediately following the end of the war were considered to be unsuitable owing to the occurrence of epidemics of influenza.
Prolonged Narcosis in Mental Disorder: Results of Treatment in 107 Cases
Authors: Ström-Olsen Rolf , McCowan Muriel L. M.
Published: August 2008

The value of prolonged narcosis as a form of treatment in mental disorder has been well recognized in Switzerland, Germany, Holland and the U.S.A., but, so far, there has been little tendency to adopt the method in this country. It is true that there has been considerable diversity of opinion about its efficacy, but it must be remembered that much of the literature published reveals that there has been a general lack of uniformity as to technique, duration and drug used, apart from discrepancies in the interpretation of results. Furthermore, one of the most potent arguments against the treatment has been its dangers— a fact which has deterred many psychiatrists from giving it a trial. These dangers, however, instead of stimulating research into possible methods which might eliminate toxicity of narcosis, gave rise to a search for a Utopian narcotic, which would serve therapeutically whilst being free from toxic effects. No less than forty substances (according to Palmer and Paine (1)) have been tried, with but little result except to increase the confusion. In a previous communication by one of us (2) toxic symptoms of narcosis were discussed, and a method was described whereby these could largely be eliminated with doses of narcotic sufficient to produce prolonged, continuous sleep. In the present paper it is proposed to summarize and comment on therapeutic results in 107 mixed cases of mental disorder, in which a total number of 128 treatments were carried out. In 117 of these treatments somnifaine was used, in 9 veronal, and in 2 dial.
Lumbar Puncture and the Cerebro-Spinal Fluid in 2,000 Cases of Mental Deficiency
Authors: Paddle K. C. L.
Published: August 2008

Serological tests on the blood of mental defectives have been, both here and in other countries, the subject of numerous investigations, but the cerebrospinal fluids of the entire population of a large mental defective institution have never, as far as I am aware, been systematically examined. This paper deals with the results of such an investigation in 2,000 cases of mental deficiency of both sexes, all ages and grades, patients at Caterham Mental Hospital during the last four years, and with the complications following lumbar puncture.
Perseveration
Authors: Rogers Kenneth H.
Published: August 2008

By “perseveration” is intended the lag or persistence (“inertia”) of a mental process. That is, perseveration refers to process-lag as a function of the individual. It is probably best studied in terms of the effect of its presence on another immediately subsequent process. It is indirectly manifested in the realm of mental content, and the effect is usually appreciated as “interference”, “inhibition” or “carry-over”, which are symptoms of its presence.
Perseveration and Personality: Some Experiments and a Hypothesis
Authors: Cattell Raymond B.
Published: August 2008

So far the attempts to relate measurements of perseveration empirically to types of personality, whether in the normal or the psycho-pathological field, have not given rise to such coherent results as might lead to any comprehensive general hypothesis.
The Clinical Significance of Social Maturity
Authors: Doll Edgar A.
Published: August 2008

A well-known novelist recently made the cogent statement that nothing that happens is important except as it happens to some person. Just as there is no sound without an ear to hear it, so there is no behaviour without some person to observe or experience it. We may elaborate this thought into the dogmatic statement that no behaviour is important except in terms of its social value. While this is not strictly true of those intimate experiences which take place within the self as a unique organism, nevertheless even such intimate personal behaviour is irrelevant to everyone else except in terms of its social impact.
Unfitness to Plead
Authors: Higson W. Davies
Published: August 2008

“Unfitness to plead” is a medico-legal proposition of practical importance to prison medical officers. My attention was drawn to it, shortly after I joined the Service, in a case tried at the Central Criminal Court. Since then I have frequently had to take the responsibility of forming an opinion and reporting as to prisoners' fitness or unfitness to plead, and recently my interest in this problem has been re-aroused by a case tried at the Manchester Assizes, the outcome of which I had discussed with my colleagues and also with members of the Bar.
On the Causation of Mental Symptoms: An Inquiry into the Psychiatric Application of Hughlings Jackson's Views on the Causation of Nervous Symptoms, with Particular Reference to Their Application to Delirium and Schizophrenia
Authors: Levin Max
Published: August 2008

When one compares the present state of psychiatric research with that of neurological research, one finds, in the former, an astonishing confusion of contradictory viewpoints. This confusion would, I believe, be resolved if research workers in psychiatry embodied in their creed certain of the principles which Hughlings Jackson unceasingly laboured to establish.
Sinus Sepsis and Mental Disorder
Authors: Jowett R. E.
Published: August 2008

In the consideration of sinus sepsis in mental disorder it is first necessary to define in our own minds what we understand by the terms used, and their joint significance. A short summary of work already done is therefore given.
Studies in Depression
Authors: Cameron D. Ewen
Published: August 2008

This series of investigations originated in a study of the Necker cube. It has been suggested that the fluctuation-rate of this and similar ambiguous bodies will serve to differentiate between the introvert and the extravert. While this assertion was being investigated, it was found that those patients who were depressed showed a slow fluctuation-rate. It was decided to investigate the question whether or not the fluctuation varied with the degree of depression. Since the fluctuation-rate is known to vary considerably from person to person, it was decided to study a group of depressives over a long period of time, if possible until recovery. The stability of the fluctuation-rate in the same person from day to day is considerable. Guilford and Braby report a coefficient of reliability of ·96.
Clinical Aspects
Authors: MacNiven Angus
Published: August 2008

Since October, 1934, we have treated 40 cases of psychoses by somnifaine narcosis in the Glasgow Royal Mental Hospital. The technique employed by us was that recommended by Ström-Olsen. The patients were isolated in a quiet room, in partial darkness, and a nurse was constantly in attendance by night and day. As a preliminary to the treatment, insulin and glucose were given for a few days beforehand, while the patient received daily bowel wash-outs. The amount of glucose given was 1 oz. to 1½ oz. three times a day, along with 10 units of insulin. This insulin and glucose routine was continued during the treatment, and for some days after the administration of the somnifaine was discontinued. The somnifaine was injected intra-muscularly in 2-c.c. doses. The degree of narcosis one wished to produce was that approximating as nearly as possible to natural sleep. Throughout, one tried to keep the patient in such a state that they were able to be roused from time to time for feeding. The amount of somnifaine necessary to produce this state varied with each patient, but as a rule we found that 6 c.c. of somnifaine given in 2-c.c. doses in the 24 hours was the average amount required. The treatment was continued for 10 to 14 days.
Studies on Lesions of the Basal Ganglia in Defectives: (1) a Case oféTat Dysmyélinisé(Hallervorden-Spatz Disease)
Authors: Meyer A.
Published: August 2008

In the following paper a case ofétat dysmyéliniséof the globus pallidus, or as it is often synonymously called,“Hallervorden-Spatz disease”, will be presented. Records of thoroughly studied cases of this condition are still rather scanty and there is much need for a systematic extension of experience, the more so since, as Helfand (16, 17) has recently pointed out, progress in the elucidation of the condition has not always been enhanced by generalizations from findings based on too small a case-material. We are happy in having at our disposal the vast resources of the London County Mental Hospitals. It is hoped to follow up this paper by publishing further cases of a rather different nature, though with some characteristics in common with the case described here.
Diffuse White Matter Gliosis in Mental Defectives
Authors: Meyer A. , Cook L. C.
Published: August 2008

This paper is a preliminary report of some investigations we are now making into the pathology of mental deficiency, mainly from the histological point of view. We have so far examined 22 cases, comprising 7 low-grade defectives showing gross neurological lesions, chiefly of extrapyramidal character, 6 microcephalics with spastic diplegia and severe mental defect, 2 able-bodied microcephalics without gross neurological signs, 1 simple able-bodied idiot and 6 mongols. In this short paper it is impossible to give even the slightest indication of the wealth of pathological material found in such a variety of widely differing conditions. A full description of our findings, together with a more detailed discussion, must be left to further papers dealing with individual groups of cases. The purpose of making a short note at this stage is to draw attention to one particular finding which struck us by its surprising constancy, i.e., a proliferation of the fibrous glia, particularly pronounced within the cerebral and often also the cerebellar white matter. In many of the cases the cortical changes were slight compared with the intense lesions of the white matter. In none of them was demyelinization a well-marked feature, nor did its severity approach that of the glial proliferation; in many it was negligible, and there were none of the fatty breakdown products, characteristic of the demyelinizing disease of the white matter called after Schilder. The gliosis was either diffused or patchy, and was often markedly perivascular; even stripe-like scars, as described by Hallervorden (10), were to be seen, although, contrary to this author's observation, there was, as a rule, no corresponding myelin defect.
Cerebral Ischæmia and Mental Disorder.∗
Authors: Pickworth F. A.
Published: August 2008

It has been calculated that over one-third of the total number of cases receiving sickness benefit have some form of nervous disorder (1), and 1 of 22 persons has to be placed in a mental hospital at one time or another (Carrel, 2). Social prejudice, however, still bars adequate support of psychiatric research, and much scientific work is hampered through lack of financial help.
The Circulatory Factor in the Pathogenesis of Mental Disorder.∗
Authors: Krapf E.
Published: August 2008

The circulatory factor in the pathogenesis of mental disorder can be dealt with in at least two different ways. The exposition can be narrowed down to a mere description of what we know for certain about the psychiatric significance of circulatory disturbances. On the other hand, I think it not less legitimate to look at the question as a highly fascinating problem, the full bearing of which upon psychiatry we are only just beginning to discern as a dim shape on the scientific horizon.
Psychoses Associated with Hypertension, Arteriosclerosis and Heart-Failure.∗
Authors: Mayer-Gross W.
Published: August 2008

The clinician's share in a discussion on psychoses of circulatory origin must be to provide, in the first place, a description of the characteristic clinical pictures. This would mean the enumeration of a rather puzzling variety of observations, among which it has until lately been rather difficult to find any systematic order. One could scarcely add very much to the classical chapter on arteriosclerotic psychoses in Kraepelin's text-book. Since, however, Dr. Krapf has singled out the hypertensive psychoses as a special group, the task is no longer one of pure description. The application of the achievements of general medicine to the field of hyperpiesis should have opened new aspects in cerebral vascular disease. Supplementing the fundamental ideas given in Dr. Krapf's own paper, I propose to give you a more detailed survey, with some illustrations.
Epileptic Reactions: An Attempt at Classification
Authors: Guirdham Arthur
Published: August 2008

The subject of this essay has almost the blessings of antiquity. The increase in the knowledge of the aetiology of epilepsy makes the revision of its classification very necessary. It has been well said that complexity of nomenclature implies poverty of knowledge. This is conspicuously true of one branch, in particular, of medicine, where the desire for classification has outrun the accumulation of data. It is not so with epilepsy, where increased knowledge of causation necessitates a revision of the scheme of classification.
The Treatment of Epilepsy with Psychosis by Prominal
Authors: Sands D. E.
Published: August 2008

Prominal was first favourably reported on by several German and other continental observers (1, 2, 3, 4) in 1932. More recently (6, 7, 8, 9, 10) there has been evidence of its value from workers in this country, mainly of its use in epileptics with mental defect. In the reported cases results have indicated that only 3 out of 66 cases failed to show diminution in the number of their fits. In the epileptic psychotics treated at Claybury during the past eighteen months the drug has been found useful in a less striking way.
The Ætiology of the Confusional Syndrome and the Use of T.A.B. Vaccine
Authors: Parfitt D. N.
Published: August 2008

Since the discovery that Bacillus coli vaccine (1) or albumose (2) were as effective as typhoid vaccine (3) in the treatment of typhoid fever, the use of non-specific protein therapy has been popular for almost any disease for which there is no other satisfactory form of treatment. T.A.B. vaccine, a mixture of typhoid and paratyphoid A and B organisms, has been found more regular and reliable in its results than typhoid vaccine (4); but milk, antitoxic sera, peptone and a variety of other substances have been used, and even malaria is considered a form of this treatment, segmentation of the parasites producing the foreign protein (5). It has been observed that Gram-negative organisms, such as the gonococcus and typhoid bacillus, produce more marked reactions when given intravenously than the Gram-positive organisms, such as staphylococci, streptococci and pneumococci (5).
Faulty Detoxication in Schizophrenia
Authors: Quastel J. H. , Wales W. T. H.
Published: August 2008

The hippuric acid excretion test (after benzoate administration) has been used by previous workers, with the general result that it affords a reasonably accurate and satisfactory test for determination of parenchymatous hepatic damage and of various hepatic involvements. The test is also known to be indicative of hepatic disorder, even where no clear clinical signs of hepatic or renal derangements are observable. A series of 67 cases of mental disorder has been examined by the test, 45 of which belonged to the schizophrenic group; 18 of these were classed as catatonics. The average value of hippuric acid eliminated in the non-catatonic schizophrenic group, expressed in terms of benzoic acid, in 4 hours after administration of 6 grm. of sodium benzoate, was 3.4 grm. with an average deviation from the mean of ± 0.4 grm. This value agrees well with the values obtained by previous workers for normal cases having no hepatic damage. The average value of hippuric acid eliminated under the same conditions by catatonic patients was 2.2 grm. with an average deviation from the mean of ± 0.5 grm. All the catatonic patients studied, without exception, showed a diminished ability to excrete hippuric acid at a normal rate. It is inferred that a metabolic disturbance of the liver affecting benzoic acid detoxication may be a characteristic feature of catatonic patients.

Work on benzoic acid detoxication in catatonic patients before and after various shock treatments for schizophrenia is in progress.
Diagnosis and Prognosis in Psychiatry
Authors: Masserman Jules H. , Carmichael Hugh T.
Published: August 2008

Psychiatry, during the past fifty years, has had a phenomenal but in some respects a rather unfortunate growth. Long in what Auguste Comte called the mystical state of the evolution of a science, psychiatry rapidly entered into its taxonomic phase when, as one of the later repercussions of the romantic reaction to eighteenth century materialism, the rightful place of psychiatry among the sciences of the humanities began to be appreciated. Almost simultaneously, however, premature efforts began to be made by students in the field to achieve higher levels of scientific development, with the result that the facts of psychiatry soon became almost lost in rigid and increasingly complex systems of classification. Fortunately, in recent years there has arisen a salutary tendency among psychiatrists to review the data of their discipline, and to re-examine the pragmatic and heuristic validity of certain formulations that too readily, perhaps, had been taken for granted. Among these attempts at re-orientation may be mentioned: as to ætiology and psychopathology, the work of Freud and the psycho-analytic school; as to a valid nosology, the statistical researches of T. V. Moore and others; and as to clinical application, the objective, critical studies of the results of various methods of diagnosis and therapy appearing with increasing frequency in the recent literature. We hope that the present work will be a contribution to the movement of fundamental reorganization now evident in psychiatry and its related fields of study.
Some Verbal Problems Connected with Character Nomenclature
Authors: Oldfield R. C.
Published: August 2008

The problem of devising scientific means of assessing and describing the personal characteristics of an individual has been attacked along a number of lines, of which the principal, perhaps, has been the attempt to separate independent variables by the use of tests, which, it was expected, might be the subject of progressive refinement through study of the intercorrelations of scores obtained with them. So, starting with the admittedly imprecise categories of common discourse, and the adjectives commonly used in the description of individuals, it was hoped that by degrees it would be possible to disentangle the basic variables to which personality and character are subject, and to provide the means of assessing each by the use of a particular test. It can scarcely be said that these hopes have been realized. The categories in question have eluded the refining power of test score factorization.(1)
Thrombo-Phlebitis Occurring in Patients Receiving Barbiturates
Authors: Palmer H. A.
Published: August 2008

In the extensive literature on sleep therapy some fifty complications have been recorded by the various authors. In a previous article (Journ. Ment. Sci., November, 1937) these were listed (pp. 660, 661) and divided into four main groups as follows:

1.

Common complications: Representing mainly normal by-products of the treatment.

2.

Complications involving particular tissues: Representing tissue idiosyncrasy.

3.

Accidents.

4.

True toxic complications: Representing a group which could not be regarded as either a necessary by-product of the treatment, an unavoidable expression of disproportionate sensitivity on the part of a particular tissue, or an accident which might be avoided.
The Analysis and Treatment of a Case of Neurotic Conduct Disorder in a Young Child Illustrating the Value and Use of Drawing in Child Guidance Technique
Authors: Edelston H.
Published: August 2008

In spite of Freud's great discoveries tracing back the origins of adult psycho-neurosis to the mental conflicts of early childhood, until comparatively recently little was done by psychiatrists generally to investigate and treat directly the mental problems of difficult and neurotic children. Though a few clinics had been established for a considerable time in Vienna and elsewhere as a result of the work of Adler and his pupils, the “Child Guidance “movement obtained its greatest impetus from America. Here it arose, however, out of social problems rather than medical; more particularly from Healey's studies of delinquent children. Partly on account of its origin in this way, and partly no doubt influenced by the behaviourist psychology so much in evidence in U.S.A., the tendency there from the beginning was to stress the importance of the child's environment and the remedial effect of altering harmful influences found in it. The psycho-analytic schools, on the other hand, have emphasized the endogenous nature of neurotic conflict, i.e., localized the trouble wholly in the child's mind; which has led them to concentrate on treatment of the child itself to the exclusion of the material surroundings.
Insulin Shock Therapy
Authors: Thomas John C. , Gilsenan Bernard , Hewitt E. J. C.
Published: August 2008

Insulin shock treatment of schizophrenia is to-day a recognized part of our therapeutic armamentarium in mental disease, and with selected cases is yielding results which are more encouraging than those given by other methods. At the same time the method is largely empirical, and the theories of its mode of action are only equalled in number by the hypothetical causes of the disease itself.
Blood-Pressure in Cardiazol Epilepsy
Authors: Guttmann E. , Reitmann F.
Published: August 2008

No problem in neurology has been approached from so many different angles as has the pathogenesis of the epileptic fit; yet it is far from being solved. Histological examination of the brains of epileptics, electric stimulalation of the human brain during operation, chemical analysis of the body fluids both in general and of the arterial and venous blood of the cerebral vessels in particular, measurements of the intracranial blood-flow, investigations into metabolic changes before, during, and after fits, electro-encephalographic studies, have produced an enormous wealth of data, which it has not, however, been possible to weld into a single theory. The most recent monograph on epilepsy—Kinnier Wilson's article on the subject in Bumke's Handbuch der Neurologie—speaks only of various “determinants” of the fit: the vascular, the humoral, etc.
Treatment and Accommodation for the Psycho-neuroses
Authors: Harris Noel G.
Published: August 2008

The advantage and desirability of early treatment in all forms of mental disorder are now generally accepted. The treatment of general paralysis of the insane by malaria, of schizophrenia by shock therapy and of the neuroses by psychotherapy covers a wide range of different methods, yet no one would hesitate to stress the importance of starting the treatment in each case as early as possible. Nor must the necessity of prophylaxis be forgotten, with the consequent importance of child guidance.
Report on Five Years' use of Prominal as Routine Treatment for Epileptics
Authors: Millman C. Guy
Published: August 2008

Although the subject of this contribution is somewhat narrow, it is hoped that points raised will have some bearing on matters wider than pure therapeutics.
On the Psychogenesis of Schizophrenia
Authors: Jung C. G.
Published: August 2008

It is just twenty years ago that I read a paper on the “Problem of Psychogenesis in Mental Disease” before this Society. William McDougall, whose recent death we all deplore, was in the chair. What I then said about psychogenesis could be safely repeated to-day, for it has left no visible traces, or other noticeable consequences, either in text-books or in clinics. Although I hate to repeat myself, it is almost impossible to say something wholly new and different about a subject which has not changed its face in the many years that have gone by. My experience, however, has increased and some of my views have matured, but I could not say that my standpoint has had to undergo any radical change. I am therefore in the somewhat uncomfortable situation of one who, on the one hand, believes that he has a well-founded conviction, but, on the other hand, is afraid to indulge in the habit of repeating old stories. Although psychogenesis has been discussed long ago, it is still a modern, even an ultra-modern, problem.
The Prognosis in Schizophrenia
Authors: Stalker Harry
Published: August 2008

A search was made for statistical studies of the remission rate in cases of schizophrenia which had received no specialized treatment such as hypo-glycæmia. The search was confined to the period since 1918, as the period influenced by broader and more hopeful views of the nature and prognosis of “dementia præcox”. It was also confined to studies in which the remitted cases had been followed up for some time after discharge to avoid errors due to early relapses. The results of all these statistical follow-upstudies aie given in Table I. The various writers have classed their results in somewhat different ways, and it has been necessary, in constructing the Table, to fit all the results under standard headings.
The Use of the Creatine-Creatinine Ratio
Authors: Pugh Caecilia E. M.
Published: August 2008

A survey of the creatine and creatinine excretion of large numbers of mentally defective patients in circumstances which precluded both keeping them on creatine-free diet and the obtaining of 24-hour specimens, led Penrose and Pugh (1939) to the use of the creatine creatinine ratio in early morning specimens of urine as an index of the metabolism of these substances in each patient, as compared with controls. The use of the ratio was found to yield results of qualitative significance. Patients suffering from conditions known to affect creatine-creatinine metabolism, such as muscular dystrophies, diplegias, and hyperthyroidism, were readily picked out, and the creatinuria of children was marked; conclusions could be drawn as to the creatine-creatinine metabolism in certain other conditions. In the above survey the numbers allowed of statistical treatment to a considerable extent, and this confirmed the validity of the conclusions drawn from the ratio.
The Contribution of the Rorschach Method to Wartime Psychological Problems
Authors: Harrower-Erickson M. R.
Published: August 2008

In his book, Psychology and the Soldier, which gives a critical estimate of the psychologist's contribution during the last war, Bartlett (1) makes an interesting statement which takes on new meaning at the present time. Commenting on the fact that intelligence tests may safely “rule out a man” from participation in activities which may endanger the group, he queries whether a man can as simply be “ruled in” for filling a responsible position. “For practical purposes,” Bartlett says, “temperament is a more important factor in success than intelligence, as the latter is understood in the mental test movement. Slight variations in temperament may make a bigger difference to a man's practical value in any social organization, such as an army, than large variations in intellectual processes. No doubt much can be done by psychological examination to discover a man's real temperamental qualities; no doubt a psychologically skilled or a psychologically trained observer can detect such qualities speedily and with reasonable accuracy. But the satisfactory direct temperament test has yet to be devised, and very likely never will be found.”
The Relationship Between Disturbance of Liver Function and Mental Disease
Authors: Berkenau P.
Published: August 2008

The purpose of this paper is to attempt to correlate results obtained from liver tests with the nosological demarcation of psychoses. The knowledge of the outstanding importance of the liver in general metabolism (it provides 12% of the turnover of energy of the body) and of its relation to some organic diseases of brain has been the subject of numerous investigations. Expectation of finding the starting-point of any disease in the liver, however, will at first not be placed too high if one recollects that every gland is only part of a system. Even where the symptoms of liver or other glandular impairment are characteristic for limited groups of psychoses deductions must be guarded, and the discovery of an unequivocal bodily symptom does not mean elucidation of the aetiology of a mental disease.
Prolonged Narcosis with Paraldehyde and Dial
Authors: Brody M. B.
Published: August 2008

In the course of routine clinical work with excited patients I found that a dose of 3 drm. of paraldehyde with 3 gr. of dial (2 tablets) often produced a long and sound sleep where other powerful narcotics were relatively ineffective. It therefore seemed worth while to try the combination for prolonged narcosis. At the outset it was attractive in that it was cheap, was given by mouth, and that both drugs had a good reputation for efficiency and safety. Paraldehyde has also the special advantage of not being a cardiac depressant (Edmonds and Gunn, 1936; Sollman, 1937). Both drugs have been used before for prolonged narcosis, but not in this combination, and usually in much higher doses. [For references, see reviews of Palmer (1937) and Gillespie (1939).]
Mirror Writing in Normal Adults
Authors: Batt J. C.
Published: August 2008

This subject has a moderately extensive literature and examples have been recorded by various authors for some years. Most of the cases, however, have been the subjects of some pathological lesion, either congenital or acquired. Perhaps the earliest authentic case is the one originally described by Rosinius Lentilius in 1698, and quoted by Critchley, of a female, presumably young, epileptic sinistrad. The sex is not as important as the other factors, but it is a pity that there is no reference to the intellectual capacity. It is, if nothing else, a pointer to the usual type of case studied. In the adults, hemiplegics seem to have proved the most fruitful source for those collecting examples of this phenomenon, although a full list of causes is well known.
Recent Hysterical States and Their Treatment
Authors: Kennedy Alexander
Published: August 2008

Recent hysteria is not a disease. Its manifestations represent the pathological exaggeration of a normal protective mechanism. By this mechanism otherwise well-adjusted individuals are enabled to gain time when a sudden reverse of fortune or an overwhelmingly difficult decision presents itself. Its purpose is to ease the blow and thus to prevent that paralysis of effective response which may result from the too sudden realization of the full implication of a situation.
Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy of Large Nodular Goiters Facilitates Tracheal Decompression and Improves Inspiration
Authors: Bonnema Steen J. , Nielsen Viveque E. , Boel-Jørgensen Henrik , Grupe Peter , Andersen Peter B. , Bastholt Lars , Hegedüs Laszlo
Published: July 2008

Introduction: The impact on tracheal anatomy and respiratory function of recombinant human (rh)TSH-stimulated 131I therapy in patients with goiter is not clarified.

Methods: In a double-blinded design, patients (age 37–87 yr) with a large multinodular goiter (range, 99–440 ml) were randomized to placebo (n = 15) or 0.3 mg rhTSH (n = 14) 24 h before 131I therapy. The smallest cross-sectional area of the trachea (SCAT; assessed by magnetic resonance imaging) and the pulmonary function were determined before, 1 wk, and 12 months after therapy.

Results: Data on goiter reduction have been reported previously. In the placebo group, no significant changes in the lung function or SCAT were found throughout the study. In the rhTSH group, a slight decrease was observed in the forced vital capacity 1 wk after therapy, whereas the mean individual change in SCAT was significantly increased by 10.5% (95% confidence interval = 0.9–20.0%). A further increase in SCAT to 117 ± 36 mm2 (P = 0.005 compared with 92 ± 38 mm2 at baseline) was seen at 12 months, corresponding to a mean of 31.4% (95% confidence interval = 16.0–46.8%). The expiratory parameters did not change significantly, whereas forced inspiratory flow at 50% of the vital capacity (FIF50%) increased from initially 3.34 ± 1.33 liters/sec to ultimately 4.23 ± 1.88 liters/sec (P = 0.015) in the rhTSH group, corresponding to a median increase of 24.6%. By 12 months, the relative improvements in FIF50% and in SCAT were inversely correlated to the respective baseline values (FIF50%: r = −0.47, P = 0.012; SCAT: r = −0.57, P = 0.001).

Conclusion: On average, neither compression of the trachea nor deterioration of the pulmonary function was observed in the acute phase after rhTSH-augmented 131I therapy. In the long term, tracheal compression is diminished, and the inspiratory capacity improved, compared with 131I therapy alone.
Notch Signaling Is Involved in Expression of Thyrocyte Differentiation Markers and Is Down-Regulated in Thyroid Tumors
Authors: Ferretti E. , Tosi E. , Po A. , Scipioni A. , Morisi R. , Espinola M. S. , Russo D. , Durante C. , Schlumberger M. , Screpanti I. , Filetti S. , Gulino A.
Published: July 2008

Context: Notch genes encode receptors for a signaling pathway that regulates cell growth and differentiation in various contexts, but the role of Notch signaling in thyroid follicular cells has never been fully published.

Objective: The objective of the study was to characterize the expression of Notch pathway components in thyroid follicular cells and Notch signaling activities in normal and transformed thyrocytes.

Design/Setting and Patients: Expression of Notch pathway components and key markers of thyrocyte differentiation was analyzed in murine and human thyroid tissues (normal and tumoral) by quantitative RT-PCR and immunohistochemistry. The effects of Notch overexpression in human thyroid cancer cells and FTRL-5 cells were explored with analysis of gene expression, proliferation assays, and experiments involving transfection of a luciferase reporter construct containing human NIS promoter regions.

Results: Notch receptors are expressed during the development of murine thyrocytes, and their expression levels parallel those of thyroid differentiation markers. Notch signaling characterized also normal adult thyrocytes and is regulated by TSH. Notch pathway components are variably expressed in human normal thyroid tissue and thyroid tumors, but expression levels are clearly reduced in undifferentiated tumors. Overexpression of Notch-1 in thyroid cancer cells restores differentiation, reduces cell growth rates, and stimulates NIS expression via a direct action on the NIS promoter.

Conclusion: Notch signaling is involved in the determination of thyroid cell fate and is a direct regulator of thyroid-specific gene expression. Its deregulation may contribute to the loss of differentiation associated with thyroid tumorigenesis.
Intravenous Lipid and Heparin Infusion-Induced Elevation in Free Fatty Acids and Triglycerides Modifies Circulating Androgen Levels in Women: A Randomized, Controlled Trial
Authors: Mai K. , Bobbert T. , Reinecke F. , Andres J. , Maser-Gluth C. , Wudy S. A. , Möhlig M. , Weickert M. O. , Hartmann M. F. , Schulte H. M. , Diederich S. , Pfeiffer A. F. H. , Spranger J.
Published: July 2008

Background: The polycystic ovarian syndrome (PCOS) is characterized by hyperandrogenism and associated with obesity and impaired glucose metabolism. Despite the high prevalence of PCOS and the considerable clinical impact, the precise interplay between metabolism and hyperandrogenemia is not entirely clear.

Objective: The objective of the study was to analyze the effects of iv lipid and heparin infusion on circulating androgen levels in healthy women.

Design: This was a randomized, controlled, crossover trial.

Setting: The study was conducted at an endocrinology center.

Patients: Patients included 12 healthy young women during the early follicular phase of two subsequent cycles.

Intervention: After an overnight fast, a 20% lipid/heparin or a saline/heparin infusion was administered in random order for 330 min.

Main Outcome Measures: A detailed characterization of androgen metabolism was performed.

Results: Elevations in free fatty acids and triglycerides, induced by lipid/heparin infusion, elevates the levels of androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), testosterone, 5α-dihydrotestosterone, estrone, and 17β-estradiol. Urinary excretion of DHEA, DHEAS, 5-androstene-3β,17β-diol, and the sum of urinary excreted DHEA and its 16-hydroxylated downstream metabolites, 16α-hydroxy-DHEA and 5-androstene-3β,16α,17β-triol, were reduced.

Conclusion: The mechanism of iv lipid and heparin infusion-induced elevation of circulating androgens described here might contribute to the development of hyperandrogenism in women with PCOS and suggests that lowering of hyperlipidemia might be a potential therapeutic target in patients with PCOS to treat hyperandrogenemia.
The Effect of Pregnancy on Subsequent Relapse from Graves’ Disease after a Successful Course of Antithyroid Drug Therapy
Authors: Rotondi Mario , Cappelli Carlo , Pirali Barbara , Pirola Ilenia , Magri Flavia , Fonte Rodolfo , Castellano Maurizio , Rosei Enrico Agabiti , Chiovato Luca
Published: July 2008

Objective: Pregnancy and the postpartum (PP) period are associated with profound changes of the immune system, which largely influence the clinical activity of autoimmune diseases. The aim of this study was to evaluate the effect of pregnancy and/or the PP period in driving a clinical relapse of hyperthyroidism in patients with Graves’ disease (GD) who are in remission after antithyroid drug (ATD) treatment. Data were retrospectively collected from 150 female patients with GD, who were assigned to two groups according to the occurrence of a successful pregnancy after ATD withdrawal.

Results: Relapsing Graves’ hyperthyroidism was observed in 70 of 125 patients in group I (no pregnancy after ATD withdrawal) (56.0%) and 21 of 25 patients in group II (pregnancy after ATD withdrawal) (84.0%) (P < 0.05). Logistic regression analysis (dependent variable: relapse/nonrelapse; covariates: age, positive family history for autoimmune thyroid disease, duration of treatment with ATD, number pregnancies at diagnosis, number of pregnancies after ATD withdrawal) showed a significant effect only for the number of pregnancies after ATD withdrawal [4.257 (1.315–13.782)]. The effect was ascribed to the PP period rather than to pregnancy itself because in 20 of 21 patients of group II (95.2%), the relapse of Graves’ hyperthyroidism occurred between 4 and 8 months after delivery.

Conclusions: The PP period is significantly associated with a relapse of hyperthyroidism in GD patients being in remission after ATD. We therefore recommend that patients with GD in remission after a course of ATD should have their thyroid function tested at 3 and 6 months after delivery.
The Witch from Colchis: Corneille's Médée, Chimène's Le Cid, and the Invention of Classical Genius
Authors: Braider Christopher
Published: August 2008

This essay explores the origins of the modern French paradigm of literary genius in the dramatic works of Pierre Corneille. Guided by a critical suggestion inscribed in an often-noted allusion to Corneille's first tragedy, Médée, near the end of Jean Racine's Phèdre, the essay argues that the key to the Cornelian model of literary greatness is the degree to which Corneille identifies his own poetic inspiration with his tragic protagonists, and capitally with the first of them, the eponymous heroine of Médée. When set in dialogue with the ventriloquistic absence of the poet mandated by the classical era's perfection of the specifically theatrical mode of representation, Corneille's identification with his tragic divas constitutes genius as the radical other of the classical cultural order that the canonical “grand Corneille” is wrongly taken to personify. In addition to generating revisionist readings of both Médée and the later Le Cid, the essay thus invites students of French literature to rethink the grounds of French literary culture as a whole.