In 1933 Sakel described the induction of epileptiform convulsions during hypoglycæmia, using camphor and cardiazol. This was not, to my knowledge, followed up systematically until Georgi's work, which started in 1934.

The occurrence of auricular fibrillation in three patients; notes regarding onset, nature and duration of manifestations.

Electro-cardiographic diagnosis, interpretation of and comparison with organic fibrillation.

The onset of heart-block immediately following a convulsion in another patient. Discussion of subsequent course and treatment.

Comment on the significance of these complications in relation to the safety of convulsive therapies.

Observations on blood-pressure in some of the above cases.

The insulin therapy of the psychoses as evolved by Sakel (1) was introduced to Three Counties Hospital 16 months ago. The total number of patients treated and under treatment is 74; 56 have had a full course of the treatment in addition to psychotherapy, and of these, 29 have been discharged and 4 will leave the hospital in the near future. A total number of 3,205 hypoglycæmic comas have been induced up to the present in 4,379 patient insulin days. Serious emergencies arose in only 6 comas. One patient had severe laryngeal spasm, another acute ódema of the lungs, and four delayed return to consciousness. No fatality occurred. Twenty-eight patients had 81 fits in the same number of comas. I shall outline briefly the circumstances which led up to the emergencies met with by myself and some published by other workers in this country, and give the treatment applied.

(1) The “we” means the inner or subjective side of group-experience, expressed grammatically in the first person plural. For instance, the mother giving her child a bath says to it, “We are having a bath now, and then we are going to sleep “, whereas it is only the child who is going through the ceremony.

The popular conception of mental defect is that it is a common abnormality of a kind fairly easy to understand and to study, and for whose ætiology simple rules can be laid down. Textbooks on general medicine usually dismiss the subject in a few paragraphs, and even those devoted to diseases of the mind rarely find room for more than one short chapter on mental defect.