Freud as a medical student accepted the role of a man of science as defined by the medical milieu of Vienna, as well as the accompanying philosophy and methodology of clinical and scientific research. These forms became a part of his thought and into them he fitted his psychological discoveries as well as his view of himself. Without the medical Vienna in which he developed, Freud would not have been what he was.

Interest has recently focused on the possibility that the efficacy of drugs used in schizophrenia depends on their ability to alter disposition of cerebral dopamine. Thus, Phenothiazines and butyrophenones elevate dopamine turnover in the brain. (Andén, Roos, and Werdinius, 1964; Laverty and sharman, 1965; Sharman, 1966; Andén, Butcher, Corrodi, Fuxe, and Ungerstedt, 1970); Compounds which are clinically the most potent are those with greatest effect on dopamine turnover (Laverty and Sharman, 1965; O'Keeffe, Sharman, and Vogt, 1970). Augmented turnover is thought to be a consequence of the blockade of central dopamine receptors by these drugs. X-ray crystallography has revealed a similarity of the dopamine conformation to part of the chlorpromazine structure, suggesting that of the chlorpromazine structure, suggesting that phenothiazines can occupy dopamine receptors (Horn and snyder, 1971). More conclusively, in cats, dogs, and rabbits, chlorpromazine antagonized vascular effects of dopamine (Rossum, 1966; Yeh, McNay, and Goldberg, 1969; Brotzu, 1970); and haloperidol considerably diminished motor effects evoked by dopamine infused into the brain of cats and fowls (Cools and Rossum, 1970; Marley and Nistico, 1972).

When no endopathological abnormalities are available to serve as classifying criteria, symptom clusters are generally used as substitutes. They then form the core of particular functional diseases, especially in psychiatry. The selection of symptom clusters on the basis of clinical impression is the predominant procedure, but it is subjective and arbitrary. To remedy this shortcoming, cluster-searching methods of a sophisticated statistical nature have been introduced, though they have not so far been conspicuously successful. In some functional psychiatric diseases, such as phobic neurosis, depressive neurosis, war neurosis, and compensation neurosis, exopathological environmental, but normal, events form the classifying criteria. They are presumed to activate idiosyncratic endopathological predispositions. The classification of organic diseases relies on endopathological and inherited exopathological abnormalities as classifying criteria. As an illustration of the establishment of an inherited exopathological disease, the discovery of phenylketonuria as a clinical sign and the gradual elucidation of its pathogenesis are described.

A survey is provided of the various attempts which have been advanced to classify psychotropic drugs. The unsatisfactory nature of the schemata and the underlying reasons for this are discussed. The possible use of ‘facet analysis’ to develop a classificatory system is suggested.

As part of a survey of the need for rehabilitation services in Camberwell, a representative group of 56 unemployed psychiatric patients were selected from the Camberwell Register during 1968; most of these were chronic schizophrenics, and 29, or just over half of them, were living with their parents or siblings. This paper describes a special analysis made by a medical sociologist into the problems of these 29 patients as perceived by their relatives. Assessment of the patient's handicaps and the burden felt by the family showed a dependence on parents of pensionable age which is an obstacle to rehabilitation. Patients were content, but relatives were dissatisfied and experienced considerable financial burden and symptoms of reactive anxiety and depression. The need for special services is emphasized to help the patient towards a more independent existence when the relative dies.

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.

Two double-blind experiments are reported in which different doses of diphenylhydantoin were compared with placebo. Drug effects on tests, psychophysiological measures, and self-ratings of mood were studied in normal subjects and related to plasma levels of the drug and psychasthenic personality traits. Significant sedative effects were obtained in some self-rating variables. The combined effect in the objective psychological tests was significantly correlated (rank) to the plasma level in the higher dose experiment.

A feasibility study for a controlled trial of a certain type of formal psychotherapy is described. Patients referred by consultant psychiatrists in the Inner London Area were carefully selected and fully assessed before random allocation to one of three treatment procedures. The results indicate that the trial as initially envisaged is not feasible. The reasons for this conclusion are discussed.

The Leyton Obsessional Inventory, together with 46 questions taken from Sections M–R of the Cornell Medical Index and the short version of the Maudsley Personality Inventory were administered to a group of orthopaedic patients made up of Irish, English, and Irish immigrants. The results indicated that the Irish subjects had more obsessional symptoms and traits and also that they appeared to be more disturbed by the possession of such attributes than did the English. Among the various cultural factors considered, the bachelor state, in the case of the Irish males, and rural dwelling, in the case of Irish females, were associated with the highest obsessional scores. Ways in which the cultural background may be related to the development of obsessional symptoms and traits are discussed and suggestions are made as to the further epidemiological implications of these findings.

A syndrome characterized by the psychopathological features of anorexia nervosa occurs in male subjects. There have been 25 cases previously reported in the literature which appear to be fairly typical of the condition and the present paper adds the case histories of another six patients. Endocrine investigation on these patients reveals a disorder of urinary excretion levels of testosterone and of total gonadotrophic activity, which is comparable to the disturbance of sex hormones that accompanies the menstrual disturbance of female patients with anorexia nervosa. The exact nature of the endocrine disturbance in the male, however, is still less well understood than that in the female.

Material with pleasurable affective connotations has been found to be better recalled to a significant extent than material with unpleasant connotations in healthy volunteer subjects. Age, neuroticism and extraversion, but not sex, have proved to be associated with the variability which different subjects show in this regard. The implications of these results are discussed in relation to various theoretical constructs which seek to explain the interaction between personality variables and cognitive performance.

The purpose of this study was to test the hypothesis that there is a positive association between physical and psychiatric disorder. The study was designed to reduce potential sources of bias and the approach included random sampling of a general practice population; independent assessments of the physical and psychiatric states using objective methods and strict criteria for diagnosis; and the use of a control group. The results suggest that the hypothesis is confirmed and furthermore that ‘clustering’ of both types of disorder occurred in some individuals.

Eleven psychiatric patients with Klinefelter's syndrome are described and compared with nine patients in whom psychiatric illness was associated with hypogonadism due to causes other than chromosomal abnormality. The possible role of endocrine factors in the psychopathology of Klinefelter's syndrome is discussed in the light of the clinical and physical findings.

The investigation described in this paper considers the influence of social class and the infant's birth order on maternal care, and then, in the light of these findings, examines the association between quality of maternal care and infant development. The study population comprised 89% of all births during an 18-month period in a defined administrative area in Glamorganshire. Possible explanations for the findings are discussed.

Spontaneous and metacholine-stimulated salivation rates were measured in endogenous depression, symptomatic depression, mania, and healthy controls. In manic-depressive patients concentrations of salivary electrolytes were measured. Salivation rates were decreased in untreated endogenous depression and mania. After remission by ECT but not by drug treatment flow rates increased towards normal values. Estimations of electrolytes revealed no specific pattern of excretion in manic-depressive patients.

The rating behaviour of eight psychiatrists was studied while they learned to use a standardized psychiatric clinical interview schedule. Their progress was followed during live interviews, and also by their ratings of videotape interviews. Significant and consistent changes towards the standards of the teachers were demonstrated, as was a universal tendency to pass through a phase of rating at a higher level of abnormality than the standards they were trying to approach.