Psychopathic personality: a most elusive category

For 150 years the diagnostic concept at first called ‘moral insanity’ has been troubling psychiatric nosologists. Initially emphasis was laid on the affective disturbance in this condition, which was unaccompanied by intellectual impairment. Then its conformity to the idea of a degenerative process became prominent. At various times its relation to epilepsy, hereditary disease, and vice and crime has held the stage. Latterly little advantage has been taken of the information provided about personality by the investigations of psychologists.

Serum enzyme levels in diagnosis of postoperative myocardial infarction

The levels of creatine kinase, hydroxybutyric dehydrogenase, and aspartate transaminase have been serially measured in the serum of patients undergoing surgery. Serum enzyme levels often rose to a range commonly found after myocardial infarction but fell to normal within 5-10 days. Raised serum enzyme levels have no diagnostic significance in a case of postoperative chest pain until after the fifth postoperative day, but may be significant thereafter.

'Psychogenic': a word and its mutations

The word ‘psychogenic’ was introduced into psychiatry in 1894 by Robert Sommer. Many attempts have been made to clarify the concept it denotes and apply it to clinical purposes. These attempts have been bedevilled by unsettled philosophical problems. It is suggested that the word should be decently buried.

Operative treatment of high gastric ulcer with special reference to Pauchet's method

A high gastric ulcer may be treated by excision, or the ulcer may be retained and healing encouraged by other means. If the ulcer is retained there is a small but definite risk of malignancy. Neither gastric drainage, nor the Kelling–Madlener operation, nor vagotomy and pyloroplasty ensures healing in a high gastric ulcer. Local wedge resection of the ulcer is attended by very poor results, and a high mortality and morbidity preclude the use of subtotal or total gastrectomy. Pauchet's procedure combines the advantages of limited gastrectomy and gastroduodenal anastomosis with complete removal of the ulcer. It is the recommended operation for high gastric ulcers.

Cystadenoma of the pancreas. A report of two cases

Two cases of cystadenoma of the pancreas are described, 1 presenting with bleeding gastric varices and the other showing tumour replacement of the entire pancreas. The cases are discussed with reference to the literature.

'Endogenous' and 'exogenous': a useful dichotomy?

Within a few years of their introduction into psychiatry in 1893 the terms ‘endogenous’ and ‘exogenous’ were widely used. The development of the two words and the semantic uncertainty which surrounded them is traced in this article.

Paranoia and paranoid: a historical perspective

The history of the words paranoia and paranoid is traced from the Greeks to the present day and their fluctuations of usage and concept are explored.

Edward Mapother and the making of the Maudsley Hospital

I am particularly grateful for the privilege of delivering the first Mapother Lecture. I believe it will be appropriate to devote it to a review of Professor Mapother's life and his work in shaping the Maudsley Hospital, with which he is inseparably connected. It is nearly thirty years since his death. The course of events since then has shown on what sure foundations he built. Those like myself who had daily contact with him during the later years of his life felt great respect and admiration, as well as warm affection, for him; but it is only in the perspective of recent history that the full measure of his achievement can be seen: perhaps not even yet. In preparing this Address I have been mindful of what Sir James Crichton-Browne said when delivering the first Maudsley Lecture in 1920—‘the last thing the donor of this Lectureship, retiring and shy of publicity as he was, would have wished would be that its inaugural discourse should be devoted to any elaborate eulogy of himself.’ It is an éloge rather than a Eulogy that I would wish to put before you this evening; Condorcet, a master of the art of obituary appraisal, said that an academic éloge should not be a panegyric but an effort to report the truth about a scholar and to do him full justice.

An evaluation of depression as a side effect of oral contraceptives

The purpose of this study was to evaluate the extent of depressive side effects in women of child-bearing age currently taking oral contraceptives. The incidence of depression has been variously reported as between 2 per cent. and 5 per cent. (Any Questions, 1965), but clinical impression has been that this is an underestimate. Rather alarmingly, also, there has been a tendency to explain away symptomatology on a “scapegoat effect” basis (Bakker and Dightman, 1966). By blaming the Pill the patient has been held to increase her own self-esteem and avoid responsibility for lethargy, irritability, etc. Nevertheless, alert physicians have consistently recommended caution (Kaye, 1963; Grant, 1965).

Project Head Start. An evaluation of the medical components in California

Half of 1,135 children medically examined as a part of Project Head Start in California had one or more conditions that warranted referral to a physician or dentist, and only one-fifth of these were under care. In the judgment of the examining physicians, one-third of the referable medical conditions were described as "major." Follow-up procedures were variable and not very successful. Increased local medical society participation in planning the health services for these children is recommended as an especially important step in securing care for the problems that are identified.