The electro-encephalogram (E.E.G.) is a record of the electrical potential changes of the brain as recorded by placing electrodes on the scalp without opening the skull. The technique is similar to that used in obtaining a electro-cardiogram, and in the apparatus shown three independent recorders are used, for reasons to be described later.

The stimulus behind this investigation was created by various factors which can only be enumerated briefly. In the course of routine sero-diagnosis of syphilis in psychiatric work at the Institute during the last five years, it became evident that, of the three flocculation tests employed, the Kahn (Kahn, R. L., 1928), Müller-Ballungs reaction (Müller, R., 1929), and Meinicke Klarungs reaction (Meinicke, E., 1929), the Meinicke original extract gave results superior in sensitivity. This feature was shown particularly in very early infections and treated cases. Three Wassermann tests, the standard method for psychiatry (Mann, S. A., and Partner, F., 1931), the Wyler drop technique (Wyler, E. J., 1929), and the Browning and Kennaway methods (Browning, C. H., and Kennaway, 1924), run concurrently, could not claim to be as good in this respect, and further, were liable to give non-specific results. The explanation of some of the anomalous reactions of one or another of the three hæmolytic systems seems to lie chiefly in the fact that sera from psychotic and mentally defective patients contain in larger degree elements that are prone to disturb specificity.

Attempts to find a function characteristic of schizophrenia which may be correlated with the electro-encephalogram have not been very fruitful. For example, in a group of 60 adult schizophrenics only a very slight positive correlation exists between the electrical activity of the brain and duration of illness (Rubin, unpublished observations). The same correlation obtains for duration of hospitalization. Although not systematically studied, there appears to be no correlation between the electro-encephalogram and diagnostic sub-type of schizophrenia.

This method appears first to have been used in the U.S.A. by Kunde, Hall and Gerty (1927) and then by Mackenzie (1927) in this country. Later Driver and Shaw (1933) gave divided doses of typhoid vaccine, and Schnitker (1934) gave typhoid H antigen. T.A.B. vaccine, containing one thousand million dead B. typhosus and seven hundred and fifty million each dead B. paratyphosus A and B per c.c., has been used here since July 6, 1928.

In any search for enteric carriers the patient with a positive blood-agglutination must be regarded as suspect. Earlier workers were of opinion that the converse of this was true—that a negative agglutination reaction implied that the case was not a carrier. It is true that McCowan and Mann (1925) described a series of nine carriers, of whom two showed a negative agglutination reaction during the clinical attack of typhoid fever, but the subsequent history of the agglutination reactions is not given. Ashby (1931) indicates in his series the prevailing belief that carriers show significant alterations in their agglutination reactions. Although repeatedly controverted in the medical literature by the publication of small groups of cases where the carrier state has been accompanied by negative blood-agglutination reactions, this view dies hard, and was revived during the recent discussions centring around the Croydon typhoid epidemic.

Since sulphanilamide has been shown to be of value in the treatment of infections due to a variety of organisms, it was thought that it might be efficacious against bacillary dysentery.

In round figures there are 11,000 epileptics in public mental hospitals, 3,000-4,000 in institutions for mental defectives, just under 4,000, who are neither insane nor mentally defective, in colonies and residential schools, and an unknown number, probably a considerable one, in public assistance hospitals and institutions. How many are living in the community is not known.

It is generally agreed that the occurrence of marked clinical dementia and accompanying cortical pathological lesions is rare in cases of idiopathic paralysis agitans. Cases which show this association have been described by Jakob (1923), and by Critchley and Greenfield (1937.). The name “Jakob's disease “has been assigned to this clinico-anatomical syndrome by the latter authors. Our case is clinically a typical one of this syndrome, and possesses some unusual pathological features which make it worthy of record.

Since the passing of the Mental Treatment Act, 1930, 135 patients have been admitted to St. Ebba's Hospital up to date. An analysis of the first 30 patients admitted on a temporary basis was made by Dr. Wootton and myself, and the results published in the Journal of Mental Science for July, 1937.

In this short paper I hope to present to you some of the problems attendant on the employment of the epileptic. In so doing I shall rely as far as possible on my personal experience of the problem as it has presented itself in my routine work as medical officer for the London district of the L.M.S. Railway, which covers a large area of our system, with some 44,000 workers employed on a wide variety of occupations.

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.

Anodontia is a physical anomaly which may present itself in varying degrees, and although cases of partial anodontia occur with comparative frequency, the condition of complete anodontia is rare.

Attention was drawn to the important work of Putnam and Merritt by an annotation in the Lancet last year. The results of their studies were published in two papers entitled “A New Series of Anti-convulsant Drugs Tested by Experiments on Animals” and “Sodium Diphenyl Hydantoinate in the Treatment of Convulsive Disorders”.