It has long been recognized that standardized tests of intelligence, when used with psychotic subjects, cease to be valid measures of native intellectual endowment. This does not mean, however, that it is useless to employ such tests in the study of the mentally ill. On the contrary, the intelligence test still provides us with the best objective measure of the present intellectual efficiency of the patient.

The case about to be described showed during the 18 months when she was under close observation certain remarkable pathological endocrine features. These, viewed together and in retrospect, throw considerable light on the relationship between pituitary function and so-called anorexia nervosa, and introduce a broader conception of the latter somewhat misleading designation.

In the development of involutional melancholia a variety of causes have from time to time been implicated, ranging from glandular upset of ovarian or pituitary origin to the stress of air-raids. In the bulk of cases the pathogenesis would appear to depend on the interaction of a constellation of predisposing and precipitating factors. In the present study a tentative attempt has been made to indicate a possible ethnic element in the aetiology of this psychosis.

In the treatment of involutional melancholia the administration of oestrogenic substances has for years been a feature. The results achieved with this form of therapy have varied, some workers claiming unqualified success, and others recording no change, or even deterioration in their patients.

As a rule, in hospital practice there’ is little urgency for a rapid diagnosis in idiopathic epilepsy to be effected, and doubtful cases can be submitted to prolonged observation until an actual seizure has resulted. There are, however, certain occasions when the necessity arises for the establishment of a definite diagnosis as early as possible. In the average hospital case, the period of observation necessary will be a matter of days or, at the most, a week or so, but in cases of irregular seizures at infrequent intervals, this period may have to be extended into months before any opinion can be offered. It is with a view to curtailing this period of observation that an attempt has been made in this investigation to determine a method whereby the condition can be diagnosed with a degree of certainty in the absence of seizures.

Since the introduction of the electrically induced convulsion by Cerletti and Bini the history of this procedure has become too well known to record again; but certain clinical data have come to light that are worth noting, of which the most important is the now recognized fact that this treatment is of more value in the affective psychoses than in schizophrenia, for which it was early introduced. Most writers, e.g., Elfield, Metcalfe and Paul, are agreed upon this, and it would therefore seem worth while to examine the results of this therapy in one hundred such cases. Depressions are so much commoner than manias that it would take a long time to collect a sufficient number of the latter for reliable conclusions to be drawn. These remarks are thus confined to the depressive states.

The Takata reaction has hitherto been mainly applied as a serum protein test and has been claimed useful in the diagnosis of liver disease.

It has been modified and applied to the cerebrospinal fluid (Takata-Ara (1)). Preliminary investigators found positive results in syphilis of the central nervous system, and it was thought to be a characteristic of this condition. Subsequent workers, however, found that organic conditions other than neuro-syphilis produced similar positive reactions, with the result that the test fell somewhat into disrepute. Now, however, it seems to be established that the test is indicative of a change in the albumin-globulin (euglobulin) ratios in the cerebrospinal fluid. This condition is mainly found in syphilis of the central nervous system, but occurs, of course, in other conditions affecting the central nervous system, especially where degenerative processes are involved.