“Thought-disorder” in schizophrenia was initially a psychiatric concept derived from clinical observation. As crystallized in standard psychiatric authorities, say Mayer-Gross, Slater and Roth (1954) the primary features of the talk (and inferentially the thinking) of thought-disordered schizophrenic patients are:

1. (i) Inconsequential following of side issues.

2. (ii) Tendencies for the thought to be directed by alliterations, analogies, clang associations, associations with accidents of the speaker's environment, symbolic meanings, and the condensation of several (perhaps mutually contradictory) ideas into one.

3. (iii) Words used out of context, e.g. concrete meanings taken where abstract meanings would be appropriate.

4. (iv) Clinging to unimportant detail.

5. (v) The use of laconic answers, e.g. I don't know, maybe, perhaps—indicative of emptiness and vagueness of ideas.

6. (vi) Thought is generally marked by gaps, poverty, indefiniteness and vagueness.

7. (vii) Indications of thought-blocking.

8. (viii) Indications of pressure of thoughts.

Although there have been many attempts to discover in the body fluids, chemical peculiarities characteristic of schizophrenic illness, the outcome of most of these investigations has been inconclusive (see for example Altschule, 1953; Kety, 1959). Little attention has been paid, however, to purine metabolism until the recent studies of Kishimoto (1958) who reported peculiarities in the absorption spectra of body fluids in schizophrenia which he attributed to abnormalities in the conversion of adenine through hypoxanthine and xanthine to uric acid. These findings appeared to be supported by evidence which included the determination of urinary xanthine by a xanthine oxidase method based on that of Williams (1950).

The need to clarify the “confusion in neurology and allied disciplines between the body image, the body schema, the body concept and the perceived body” was emphasized by Smythies (1953). For the neuropsychiatrist it is perhaps the disorders of the body schema and perceived body which are of the greatest interest and importance, but the confusion which still exists between the body concept and the body percept make it probable that a definition and examination of the body concept would clarify thinking about all Body Image problems.

An investigation into the factors concerned in the etiology and pathogenesis of childhood schizophrenia is fraught with difficulties in numerous areas. Encountered are such problems as the diagnosis itself; doubt that psychoses exist in childhood; the existence of the duality organic or functional schools of thought, and of frequent contradictory findings reported by various groups of investigators in the field.

In these days we expect a good deal of a painter with claims to originality—a good deal more than most of them can give. We are habituated to pictorial representation as a major means of communication of ideas and we are surrounded by technically proficient work in the competitive field of advertising. Work of this kind is evocative too—at least to the variety of emotions which may determine the act of buying—and the poster that does not come off soon comes down. Except in the esoteric field of prestige-advertising, the sales-curve is the sole judge of the efficacy of this kind of appeal and the consumer—the indirect and unwilling patron—is rarely himself able to judge the effects of such hidden persuaders as the artist has built into his work.

Nearly one hundred years ago, Anstie (1864) wrote: “Among the too frequent instances which are to be found in medical nomenclature, of confusion and uncertainty in the application of descriptive terms, there is none, perhaps, more striking than is occupied by the words Narcotic and Stimulant.” Both classes of substance embrace drugs of antiquity. Thus of the depressants, alcohol dates from the time of the Thracian god, Dionysus, while the earliest use of stimulants such as caffeine and xanthine is lost in the obscurity of the past (Goodman and Gilman, 1955a). Even today, there exists no systematized codification of response to the two classes of drug, although it is implicitly assumed that stimulants and depressants are invariably and mutually antagonistic in their effect on the central nervous system. Advantage was therefore taken of phenomena arising during drug intoxications to categorize abnormal features in the central nervous system common to each of the two classes of intoxicant and to essay a comparison, the one with the other.

In a previous study H. Holland (3) had found an increase of static ataxia under a depressant drug, as compared with a “no drug” condition, and in view of the close relation between static ataxia and the body sway test of suggestibility (1), which in turn is a frequently used measure of personality, it appeared desirable to investigate the general problem of the relation between drugs and behaviour on the ataxia test.

The authors wish to describe and discuss a patient suffering from a sub-acute organic psychiatric syndrome, who appeared to have visual hallucinations. One of us (F.F.) had been interested in the attempt of K. Conrad (1953a, b) to apply Gestalt Theory to the psychiatric syndromes due to coarse brain disease. When he heard of this case, he felt that the psychological approach of Conrad would explain the patient's unusual symptoms. The case was under the immediate care of Dr. A. Forrest and psychological testing had been carried out by Mr. E. Macpherson. The three authors decided that the case merited publication in view of its considerable clinical and theoretical interest.

In a series of papers concerned with the problems of repeated psychopathic and delinquent behaviour, use has been made of a loose theory which interprets the social behaviour or habit as being a particular learned response to stress, anxiety or emotional disturbance, or to stressor stimuli not necessarily activating physiological stress (190-200). This theoretical position was adopted on account of its relative simplicity, its similarity to many clinical theories, and its ease of access for laboratory and operational studies. In a mainly adult hospital setting, the area chosen for research has been the differentiation of stable and unstable patients, the determination of methods which allow for accurate prognosis of future stability or instability and the form which future instability might take. The objective also contains the assumption that an explanation of instability should be in a form which permits therapeutic endeavour or at least indicates some basic principles for therapy to adopt, and utilizes variables which change as the patient changes.

There has been relatively little work in psychology and psychiatry in which use has been made of the pupillary reaction to light and darkness; most of the work that has been done has been connected with the relatively slow reactions found in schizophrenia. This neglect is difficult to understand in view of the fact that this reaction and the autonomic innervation determining it are relatively well understood and do not present the same experimental and theoretical difficulties as the psychogalvanic reflex which is very much more widely used (Martin, 1960). In the present study, which forms part of a larger series, an attempt was made to investigate the influence of drugs on the reactivity of the pupil to changes in light stimulation.

The history of mediaeval medicine shows clearly that the decline of a science takes place whenever the tendency to theorize overruns the desire to observe and measure. Psychiatry with its shorter medical history has suffered from this tendency until fairly recent times. Even now, it is possible to estimate the efficiency of a nation's psychiatric progress by comparing the amount of factual research with the emphasis placed on unproven theoretical concepts in clinical practice.

Culture in its anthropological sense has been described as “a configuration of learned behaviour and results of behaviour whose component elements are shared and transmitted by members of a particular society” (Linton, 1936); in other words, a way of life. It has long been understood that more than one type of culture may be found in any one society. All societies are stratified and in an industrial society people of different levels have different ways of life. These are subcultures.

There are, in the main, two principal methods of biological research into the problem of causation of schizophrenia. In the first, or direct method, studies are made of the body fluids and of the metabolism of schizophrenics in the hope of turning up some toxic factor or error of metabolism. Such studies are currently under way in a number of centres and, although many claims as to positive findings have been made, none of these has as yet been substantiated and the majority have actually been refuted by subsequent analysis. These studies have been directed by two main hypotheses of the causation of the illness described in a previous communication (14). Now it is clear that one great difficulty entailed in using this approach is that our basic knowledge of neuro-chemistry and neuropharmacology is still extremely limited. The very complexity of the neurochemical processes of the brain would seem to offer a large number of possible loci of metabolic disturbance, any of which might be responsible for the onset of schizophrenia. Thus, we can say that the probable results of all such investigations at present will be purely negative, i.e. we will discover that the given metabolism of injected adrenaline, serotonin, etc., is normal in the illness. Thus, the second, or indirect, method becomes increasingly important. This consists of two parts. The first is implied merely by the general statement that the advance of neurochemistry and neuropharmacology may disclose other areas of function in which specific hypotheses of the causation of the illness may be constructed. The second consists of a detailed study of the precise mode of action of known psychotomimetic agents. Knowledge of the mode of action of mescaline and LSD-25 in detail would pinpoint areas for research in the metabolism of schizophrenics. Unfortunately, however, very little seems to be known at present of the mode of action of these drugs. Most of the work that has been done has been carried out on LSD-25 (see e.g. the annotated bibliography put out by Sandoz Inc., Hanover, New Jersey, 1958). However, the important field of the structure-activity relationships (SAR) of mescaline seems to have been strangely neglected. The research programme here would include the synthesis of a number of analogues of mescaline according to systematic principles to determine the role the details of its molecular structure play in the mode of action. These analogues would be subjected to a number of tests—psychopharmacological, neurophysiological and neurochemical—comparison between the results of which would give important information not only of the SAR of mescaline but also of the details of its mode of action and the interrelationships between behavioural, neurophysiological and neurochemical factors involved that would help us explain the former effects in terms of the latter, which reduction is the main aim of biological science. The present paper reviews the little that is known at present about the SAR of mescaline and then reports some new studies in the psychopharmacology of this field.

The phenomena of “spirit-communication” in mediumistic trance, of “spirit-possession” and of “demonopathy” are closely related, and known to both East and West. Clinical psychiatrists, however, have taken little interest in them, with the exception of some French and a few Spanish authors. These conditions nevertheless do present themselves to the psychiatrist in many countries and it is misconceived to think that they are to be found only in outlandish cultures, the preserve of the field worker in ethnology. It is true that M. J. Herskovits (1951, 1958) has argued that certain kinds of behaviour categorized in terms of culture-bound concepts cannot be applied to other societies, so that African and Afro-American spirit possession, for example, cannot be compared with apparently similar “psychopathological seizures” in the West. No doubt such behaviour receives different cultural definitions according to their respective backgrounds, but this does not exclude the possibility of a specific psychological mechanism being common to them all.

In their evidence to the recent Royal Commission on the Law Relating to Mental Illness and Mental Deficiency the R.M.P.A. stated the problem of the psychopath in terms of delinquent or otherwise anti-social behaviour. After eliminating cases where such behaviour resulted from well-recognized forms of mental illness or defect, from psychoneurosis or organic disease or injury, their Memorandum went on to say that there remained a group of patients “whose daily behaviour shows a want of social responsibility and of consideration for others, of prudence and foresight and of ability to act in their own best interests. Their persistent anti-social mode of conduct may include inefficiency and lack of interest in any form of occupation; pathological lying, swindling and slandering; alcoholism and drug addiction, sexual offences, and violent actions with little motivation and an entire absence of self-restraint, which may go as far as homicide. Punishment, or the threat of punishment, influences their behaviour only momentarily and its more lasting effect is to intensify their vindictiveness and anti-social attitude.”

In this paper we have tried to demonstrate some of the ways in which social selection operates in the ascertainment of dull and subnormal children. In England backward children, by the terms of the Education Act of 1944, may be referred by their teachers for medical examination and “ascertained” as educationally subnormal, thereby qualifying for special educational treatment. Alternatively, they may be classed as mental defectives (or now, severely subnormal) and excluded from the schools altogether.