-------------------------------------------

OPERATION FOR BLEPHAROSPASM. G. Scassel­ali Sforzolini. Brit. Jour. of OplItll., Vol. 48, No.3,,\farch, 1964, PI/. 165-168.

BIl'pharospasm or the involuntary spasmodic buttonic l'Ontradion of the orbicularis oculi has usuallybel'n considered to be of psychogenic diology butth(, treatment has bet'n unsalisfadory. The usualsurgical proct·dures for this t~lndition involve intt'r­ruption of the motor st·venth nerve to the orbicularisoculi. TIll' author found a unilateral tonic-clonictwitch in a psychoneurotic woman unaccompaniedby anatomical lesions of tht· globe or adnexa or hyamdropia. These spasms disappeart·d on pn'ssureov<'r the points of emergence of the supra-orbitaland terminal branchcs of the maxillary nerve. Be­cause of this and l)('cause of the r<·lief giwn by darkglasses, it was felt that the blepharospasm was of areflex nature. Intermption of the afferent fifth nervepathway was obtained by segmental neurectomy ofthe palpebral branch of the supra-orbital nerve andby neurotomy of the aseending palpebral branchesof tIll' infra-orhital nerve. Photographs demonstratethe apparent cure by this operation although thereW<,r<' small awas of anaesthesia remaining.-T. F.SCHLAEGEL, }n .. \1.0.

THE PSYCHOGENIC AMENORRHEAS. J. Renaud,lInci A. Netter, Scm. HOJl. Paris, 38:1720-1724,19(i2.

Two sds of ddl'rminants may he assumed to existin patients with psychogenic C('ssation of the mens­trual periods: (I) fragility of the mechanism ofthe m,'nstrual cycl,· and (2) psychological fragility,in which a minor trauma is expl'rienced as an excep­tional one.

One type of tIll' lattl'r group is th,· expansive,outgoing wom:1II who, however, soon reveals that thisI)('havior is nothing but a facadt·, She shows a con­spicuous lack of affects of personal origin, lack ofanxidy and t'om'('rn over her own body to the pointof denial of its ('xist(·nct·, exct'pt for one area; and herconcern over excessive weight. The same aloofnessappli(·s also to Ill'r external contacts. The history re­veals a reason for suffering, consisting of severefamily disturham'es, social failun" or perhaps obesitywith its conSl'CJU(·nn·s. Basically, the anwnorrheicwoman is hyperSl'nsitiw, and this personality traithas mused hl'r sulfl'ring in contrast with other peoplewho would 1)(' able to overcome similar traumaticexp<'riem·(·s. \Ior<' than the affectivity, it is the emo­tional life of the patient that is d('eply disturbed,leading to the dt'velopment of psychosomatic illness.The ('motional threshold is not only lowered but also

March-April, 1965

has an Uppt'f limit; tht'fe is no rt',;ponse to excessivestimuli.

Physical mdhods of treatment, among them bar­hituric s<'mi-narcosis, has its plan·. However, psycho­therapy based on dynamic psychology is most rt'­warding.-}AY H. SCHMIDT, M.D.

FIRST BORN AND LAST BORN CHILDREN INA CHILD DEVELOPMENT CLINIC. BruceCuslmw. Mitchell Greene, and Bill F. Snider. J.1ndie. PsycllOl., 20:179, Noe .• 1964.

The Adll'rian hypotllt'sis that birth rank has aninfluence on lift· style has bet'n re-emphasized withSchachter's studies of college students which d(·m­onstrated greater needs among the first born.

In the present study the first IXlrn and last IXlrnchildren from 650 multichild families, brought to achild development clinic within a three-year timespan, were compared for frequency differenn' amongcertain diagnostic categories. Significant differenceswere found in two categories. ( a) Among childrt'nwith eongenital defects tht·n· were mort· last bornsthan first horns, th(· ratio bt'ing 7 to 4; this is as­sumed to be the result of voluntary limitation offamily size after the birth of a defective child.(b) Among functional behavior disorders there weretwice as many first borns as last horns. These find­ings art· eonsideTl·d to be due in somt' way to birthrank. ( c) Furthermore, there were significant dif­ferenees within the behavior disorder category: theprohlems of first borns were mort' in the nature ofa lashing out at the world, whereas thos(' of lasthorns suggested a withdrawal from it.-EuZAIlETIITHOMA, I'h.D.

TREATMENT OF PSrCHOSO.\tAT1C DISORD­ERS. E. D. Wittkower. Canall. M.A.J., 90:1055J()60, 1964.

Ideally, the tTl'atment goal would he adjustmentof the charader disorder underlying tht' psyehoso­matic disorder, but removal of a disturbing symptommay he, and usually is, all that can be aC<-~lmplisht>t1.

The hulk of patit>nts suff,'ring from psychosomaticdisorders can be treated hy physicians, although somerequire psyehiatrists. Combined treatment hy aninternist and a psychiatrist is often indicated inpatients suffering from such disorders as hronchialasthma. peptic ulcer and ulcerative colitis; difficultiesarise, however, owing to differences in approach.when clinical exigency necessitates such a combina­tion.

In appraising the prospects of treatment, the ageof examination, intelligence, duration of illness, de-

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PSYCHOSOMATICS

gree of insight, nature of illness, environmental stressand personality structure of the patient should be<.'Onsidered. Usually, a functional psychosomatic ill­ness offers better prospects of successful psycho­therapy than a structural psychosomatic illness, butthe severity of the illness and of the structural lesiondoes not necessarily militate against reversibility.The possibility of multiple causation and the rela­tive significance of emotional factors should be bornein mind; <.'Orrespondingly, a variety of therapeuticmeasures may lead to symptomatic relief. It is ob­vious that a person under transient stress, howeversevere, stands a better chance of recovery than apcrson under prolonged, unremovable stress whichhe is unable to tolerate. If the personality disorderof a patient with a psychosomatic dysfunction orstructural lesion is close to a psychosis, the prognosisis more doubtful. Psychiatric measures which havebeen employed in the treatment of psychosomaticdisorders include: c1ectroconvulsive therapy, psycho­tropic drugs, hypnosis, dru~ abreaction, group ther­apy, supportive psychotherapy and psychoanalysis.­-JAY H. SCHMIDT, ~I.D.

OPHTHALMOLOGIC FINDINGS IN PATIENTSON LONG TERM CHLORPROMAZINE THER­APY. R. Bock, M.D., and Jean Swain, M.D. Amer.jour. of O/1"t"., Vol. 56, No.5, 808-810, NOl/.,1963.

"A photosensitizing agent, methoxsalen, has beenreported to result in cataract formation in animalexperiments; chlorpromazine has similar photosensitiz­in~ characteristics. TWl'nty-seven mentally ill pa­tients under the age of 55 years, who had been ona minimum schedule of average daily ingestion of 200mg. chlorpromazine for at least two years, were ex­amined ophthalmologically. No lens abnormalitiesattributable to the drug were detected. An incidentalfinding was the recording of an increase in intraocularpressure in two patients, judged to be borderlineglaucoma on subsequent testing. This is an incidenceof over 7 per cent compared with a glau<.'Oma inci­dence of 1.9 per cent found in this hospital on asurvey of 1,000 patients in an older age group in1955. Because of the small number of patients inthis report, statistical validity is lacking. The chroniceffects of chlorpromazine on intraocular pressureshould be investigated, however."

This report is surprising since both clinical andexperimental experience has suggested that chlor­promazine is of value in helping control glaucoma.­T. F. SCHLAEGEL, JR., M.D.

PARASAGITTAL PARIETO-OCCIPITAL MENIN­GIOMA o WITH VISUAL HALLUCINATIONS.Aum j. Mooney, D.o. (Oxon), Patrick Carey,M.C1I., Max Ryan, D.M.R.D., F.F.R., arul PatrickBofin, L.R.C.S.I., Dublin, Ireland. Amer. jour. of0/111t1l., Vol. 59, No, 2, 197-211, Feb., 1965.

This is an interestin~ case report because visual

116

hallucinations, which are rare in this affection, oc­curred in a patient of unusual visual perception, acommercial artist able to reproduce his hallucinations,not only in color but also in exact gradations of color.-T. F. SCHLAEGEL, JR., M.D.

WHIPLASH INJURY: A PSYCHOSOMATIC ILL­NESS. j. R. Hodge. 01lio M. j., 60:762-766, 1964.

In the typical accident, the unsuspecting and un­prepared victim is struck from behind in such a waythat the head is snapped backward and forward,resulting in a "sprained neck." Ac<.'Ompanying thephysical symptoms are psychologic symptoms of per­sonality changes, anxiety, recurring dreams of acci­dents, emotional instability, fear of riding in a car,increased dependency, focus of attention on physicalsymptoms, withdrawal of interest, and expression ofhostility. This is the typical description of a traumaticneurosis.

The elements of a typical neurosis are found inpatients with whiplash injury: predisposing person­ality, current <.'Onllict, precipitating event, develop­ment of anxiety, primary gain or psychologic attemptsto handle anxiety by formation of symptoms, andsl'condary gain or advantages to be gained from theillness. This syndrome does not represent a typicalconversion reaction in which there is no physicalailment, and which has gone out of style. Thewhiplash injury is in style and begins with a realphysical disability, but the physical symptoms arecaptured for psychologic purposes. It is a true psy­chosomatic illness.

Treatment should be both physical and psychologic,with rapid psychologic intervention to avoid a fixationof symptoms. Narcosynthesis has the special advan­tages of its abreactive potential, its acceptance bythe patient as something done to him for immediaterdief, as being a goal-limited form of treatment, andas overcoming the initial resistance to psychiatrictrt·atment.-JAY H. SCHMIDT, M.D.

SOMATIC EQUIVALENTS OF DEPRESSION. ].R. Ewalt. Texas]. Med., 60:654-658, 1964.

Psychologic phenomena relevant to depression arethe experience of loss, either of an external object(spouse, business, etc.) or of a sense of self-esteem,or personal invulnerability; anger, of the nature andtype of primitive rage, as a response to the loss;guilt feelings resulting from a sense of personal re­sponsibility for the loss (directed also at persons thepatient considers responsible and with whom heidentifies) .

Anger and self-destruction wishes may be ex­pressed through a belief that some organ or bodysystem is malfunctioning or dead (a partial suicide);the patient may try to persuade the surgeon to re­move it. This maneuver is self-punishing. The sur­gery does not put an end to the patient's dis<.'Omfort

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and it establishes the surgeon as a new target foranger. In cyclical fashion, initial relief is followedby return of symptoms and further demands forsurgery.

Somatic complaints are characterized by the in­tensity and persistence of the complaining patient,the use of symptoms as weapons against others, de­crease in former interests and sexual function, dis­turbance in sleep pattern, a desire to maintaindependence on the physician (manifested by fre­quent and inconvenient demands), and the produc­tion of feelings of anger and guilt in the physician.

The physician's availability, interest, and assurancethat discomfort is due to depression will be of thera­peutic help. Expression of anger must be allowed;when the patient realizes that such expressions arenot disastrous, symptoms will abate. The physicianshould respond to signs of improvement by express­ing pleasure that the patient is suffering less, andwarn the patient that brief, partial relapses may occur.-JAY H. SCHMIDT, ~I.D.

V.A. STUDY LINKS PERIODONTAL DISEASE TOMENTAL DISORDERS, Anxiety Possible Factor.Dental Times, Nocember, 1964.

A correlation between periodontal disease andmental disturhances was reported to the AmericanAcademy of Periodontology.

The study of 104 psychiatric patients, ages 20 to65, and a control group of 122 non-psychiatric pa­tients showed that the association "is due to some un­known intrinsic factor over and above the existenceof possihle poor oral hygiene habits, excessive calculusor occlusal neuroses."

The factor seemed to be linked with the degreeof anxiety manifested by the patient, and probably isunder the control of the autonomic nervous system.

Dr. Charles ~1. Belting, Chief, Dental Service, Vet­erans Administration Hospital, Sepulveda, California,stated that experimental evidence has shown thatmarginal gingivitis as well as gastrointestinal lesionscan be produced in dogs by stimulation of the hypo­thalamus. In Doctor Belting's study, severity of perio­dontal disease was found significantly greater amongthe psychiatric patients than among the controls.Among the psychiatric patients the severity of perio­dontal disease inereased Significantly as the degreeof anxiety increased.

The hahit of hruxism was not related to the severityof the diseas(> in either group, although the habitwas more common among the psychiatric subjects.

This finding suggests a possible need for revisionof prevailing concepts concerning the role of bruxismin the etiology of periodontal disease.-MELVIN LAND,M.A., D.D.S.

SUICIDE IN CHILDREN AND ADOLESCENTS.H. Bakwin. J. Am. Med. Women's Assn., 19:489­491, 1964.

The number of deaths in children from suicide isgreatly understated. It is the fifth most frequent

March-April, 1935

cause of death among adolescents aged 15 to 19;the second most frequent cause of death in collegestudents (motor accidents are first). Even in the10 to 14 age group, the death rate is not inconsid­erable, comparable to the number of deaths fromappendicitis, tuberculosis and disease due to meningo­coccal infection. Suicide in children under 10 yearsis rare; the youngest reported was a boy who beganto make suicidal attempts at the age of 3Jt Suicidein children and adolescents, as in adults, is muchmore common in boys than in girls. There is a sea­sonal variation; the rates are much higher in Marchto July than in December.

The most frequent motive in children is a reactionto a situation which seems unbearable, such as be­ing unloved, lacking attention, guilt feelinlts, anattempt to punish parents, remorse, shame, or anger.In adolescence, the most frequent motives are anxietyover school work, a psychotic situation, concern overa love affair, anxiety about sex, difficulty in socialadaptation and psychosis. Usually the factors aremultiple.

Prevention consists in careful attention to personswho have made a suicidal attempt and to personswith suicidal preoccupations. Centers similar to Alco­holics Anonymous have been set up in a number ofcommunities where persons in distress may call toreceive support and attention.-JAY H. ScmuDT,M.D.

THE ADJUSTMENT TO APHAKIA. Alan C.Woods. Brit. Jour. of Ophth., Vol. 48, No.7, July,1964, pp. 349-353.

The late Professor of Ophthalmology at JohnsHopkins University describes his personal experiencesin adjusting to new glasses after a cataract operation.Everything is seen as about 25 per cent larger. Itusually takes several weeks for the neophyte toaccustom himself to the magni/led aspect of theoutside world. In addition he is bothered by spheri­cal aberration which causes straight lines to be trans­formed into curves and a linear and upright worldis suddenly converted into one of parabolas. Onmovement of the eyes this difficulty is augmented sothat the outside world curves like writhing snakes.He learns to hold his eyes motionless and to tumhis head instead to prevent such a movement. The co­ordination of manual movements must be relearned.There are two other troubles which can never beovercome; these are the limitation of visual /leldsdue to a ring scotoma and a continual but necessaryadjustment of the glasses. There is a blind area about33 to 55 degrees in the periphery. At ordinarygroup conversation, faces pop in out of the blindarea with the annoying insolence of a jack-in-the-box.A difference of less than one millimeter in the dis­tance of the lens from the anterior surface of thecornea can make a difference of almost a diopter inthe refraction. It is continually necessary to havethe frames kept in adjustment.-T. F. SCHLAEGEL,JR., M.D.

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PSYCHOSOMATICS

POSITIVE DIAGNOSIS OF NEUROTIC ILLNESS.D. Maddison. New Zealand M. j., 63:349-355,1964.

Positive ft'atures may first be identified in thehistory. The onset, the exacerbations and the remis­sions of symptoms may be seen to have some connec­tions with curn'nt psychologie stress; furthermore, theobserver may recognize that the illness is causing awelcome, though not consciously planned, inter­ference with the activities of the patient or his rela­tives. The personal history will invariably containneurotic features if it is understood in some depth;relation with parents and siblings will Iw immaturein some ways and theft' will be a history of <:ompli­cated and unsatisfactory psychosexual developmentand function. Partieular note will be taken of thepatient's ego strength, i.t· .• his capacity to handleconflicts and frustrations, to maintain appropriatelong-term occupational and social goals and to copewith stress and crisis in a resilient manner.

In examining the patit'nt, his mann<'r of approachto the physician may bt' rewaling, as may be his at­titude towards the illness itself. There may aL~o besyndromes of low back pain, chest pain, facial pain,pruritus ani or vulval', dyspareunia, and dysphagia.­JAY H. SCHMII>T, M.D.

THE THREAT OF SUICIDE IN PSYCHOTHER­APr. Samuel Tenenbaum. Psychotherapy, 1:124,1964.

The author n·gards the threat of suicide in hispatients as a pervasive, ever-present, debilitatingproblem to the therapist. Suicidal threat is usedmainly for one of three purposes: to express hostilitytoward the therapist or soml' other person, to elicitthe therapist's sympathy, or to make excessive de­mands upon him. There is in addition another typeof patil'nt who may arouse grave concern. This isthe person who appears defeated in the major lifeadjustments-social, marital, vocational-and viewsdeath as preferable to the terror of living. His prob­lems appear so intolt'rahle that suicide seems thelogical way out.

Anxieties evoked by such patients, frequently seenby physicians as wl'll as hy psychotherapists, arc viv­dly descrilwd. The author l'Ondudes that the bestthat can be done for another human being is to givehim dignity, understanding, compassion, empathy,acceptance. The bl'st pn'ventive measure for a po­t<'ntial suicide is psychotherapy, but that does noteliminall' the possibility.-ELIZAIlETH THOMA, Ph.D.

MORNING GLORr SEED REACTION. Albert L.Illwam, M.D. l.A.M.A., Vol. 190, No. 13, Dec.28, HJ64.

The author reports a brief history of psychoto­mimetic drugs with special reference to morning gloryseeds. Ill' descriht·s a case of a 20-year-old femalewho ingestl·d 250 of such seeds. An LSD-type reac­tion occurred for about two days.-L. SECORD PAL­MEn, M.D.

118

THE MIOTIC LIFE: An anonymous woman generalpractitioner. Brit. jour. of Ophth., Vol. 48, No.7,luly, 1964, pp. 354-356.

Almost every facet of daily life was affected bythe use of miotics in this patient with glaucoma.From the cosmetic point of view there was theexpressionless l'ye with its pin-point pupil. It wasnecessary to pay attention to lighting in bathroomand bedroom and a flashlight was needed to searchfor objects in dark comers or under chairs. Descend­ing stairs presented difficulties even in good light.All these difficulties were accentuated at night.Color vision, especially for the darker shades wasaffected. She was able to notice a contrast, sinceafter seVl'n years of miotics, successful operations forglaueoma were performed and she once again had a"pair of sparkling eyes" and could walk down un­familiar stairs and see colors mort' brightly.-T. F.SCHLAEGEL, In., M.D.

PROBLEMS IN THE MANAGEMENT OF IL­LEGITIMATE PREGNANCY. C. V. Von der Ahe.Am. j. Obst. Gynec., 86:607-615, 1963.

The obstetrical and social histories of 1,797 unwedmothers, eared for at St. Anne's Maternity Hospital,Los Angeles, from 1956 to 1960, were reviewed.

The ages of the patients at the time of conceptionvaried from 12 to 42 years. The largest number beingin the 15- to 22-year-old age group. Here there waslittle difference in the number of pregnancies occur­ring per age group. The ages and social position ofthe alleged fathers compared favorably with agesof the girls, i.e., likes tended to attract likes, withfew exceptions.

Obstetrical complications encountered were equal­ly divided between toxemias, premature labors, andprolonged labors, each comprising a 2 per cent inci­dence. Post partum complications were mainly hem­orrhage, third degree extension of median episiotomy,and cystitis.

Of the 1,797 girls delivered, 1,775 infants were liveborn, One hundred and fifty-two infants were pre­mature; an incidence of 8 per cent. The perinatalmortality rate was 2.5 per cent; the cesarean sectionrate .8 per cent. There were no maternal deaths.Twenty-five per cent came from families in the lowinl'ome group and 75 per cent from moderate toexcdlent financial status. Seventy-five per cent ofthe babies born in this institution were relinquishedfor adoption. The majority of the girls studied werenormal, both physically and psychologieally. Theauthors believe that illegitimate pregnancy resultedfrom a combination of causes rather than a singleone. Two per cent of the patients experienced re­pt·ated illegitimate pregnancies. This value waslow and would be higher if the full truth wereknown. Post partum rehabilitation of these patientswas recognized as an urgent necessity; the stability ofthe home and family surroundings was consideredto he a most important factor in the prevention ofillegitimate pregnancy.-JAY SCHMIDT, M.D.

Volume VI

ABSTRACTED FROM THE MEDICAL PRESS

EFFECTS OF WIDOWS' BEREAVEMENT ONPHYSICAL AND MENTAL HEALTH. C. M.Parkes. Brit. M. ]., 2:274-279, 1964.

Thc mcdical records of 44 unselected widows be­fore and after bereavement were studied. It was foundthat the consultation rate for psychiatric symptomswas three times grpater during the first six monthsafter bereavement for women under 65. The amountof sedation preserilwd for them was seven timesgreater durin/.( the first 18 months after bereavementthan it had been before.

No such changes in the consultation rate for psy­ehiatrit' symptoms and in sedatives prescribed werefound among widows over the age of 65, but theconsultation ratl' for non-psychiatric symptoms in­creascd hy nearly 50 per cent in both a/.(e !,'J'oups.This chan/.(e in thc consultation rate was most markedin patients with previously diagnosed osteoarthritis;in this group, consultations for medical care increasedby 150 per cent from bereavement regardless of age.-JAY II. SCHMJI>T, ~I.D.

CEHEBHAL LIPIDS IN CO POISONING. M. Wen­der. Acta Neuropath. (Beri.), 2:371, 1963. (Ab­stracted in Excerpta Medica, Vol. 16, Sect. F., pg.1339, No(;., 1963.)

The author indicall's that the chemical picturenoted ill a relapsill/.( case of carbon monoxide poison­ing was similar to that noted in cases with demyelin­atin/.( fod in multiple sclerosis, Schilder's disease andleul'Oencephalitis. Study of the phospholipids showedthere was a reduction in the whitc matter; in thegrey mattN this value was normal. There was alsoa redudion in the total cholesterol content in thewhite matter. Patholo/.(ical findings indicated a dif­fuse demyelinating process.

EFFECT OF MENTAL DEPRESSION ON NUTRI­TION. H. C. Fowlie, Cyril Cohen and M. P.Anand. Geront. Clin. (Basel), 5:215, 1963.

Depression is often unrecognized in geriatric pa­tients; it is frequently mis-diagnosed as organic cere­bral deterioration. Pre-occupation with somatic dis­ease and fear of cancer are frequent syml?toms.Poor lIutrition and weight loss are often evident.

The authors l'xamined 60 patients with substand­ard nutrition who were hospitalized in a geriatricunit of a general hospital. Symptoms of depressionwere noted in 30; 18 were in a psychotic depression.

NIALAMIDE AS A PAIN RELIEVING AGENT.;\1. P. Mehrota and U. S. Malaviya. Indian Practit.,16:507, 1963.

The authors used nialamide (Niamid) in 25 pa­tients whose complaint was pain. The etiolo!,')! of thepain was varied. Best responses were noted in thosewhose pain originah'd in nerve roots; abdominal painand painful joints showed little amelioration. It wasnoted I hat relief from pain was often seen with thisdrug after all others had failed. The dosage utilizedby the authors was 150 mg. per day. There were noside dfeds.

March-April, 1965

DELINQUENCY AS A MANIFESTATION OF THEMOURNING PROCESS. M. Shoor and M. H.Speed. Psychiat. Quart., 37/3:340, 1963.

In a review of 12 cases, delinquent behavior fol­lowed the loss of a near and dear relative. The au­thors note that delinquent behavior, if it occurs inan adolescent who previously had no difficulties inconforming, may be part of the mourning process.They point up the value of this concept in effectingproper nnna/.(ement.

WERNICItE'S SYNDROME TREATED WITHCHLORDIAZEPOXIDE. ]. W. Doeff and ]. L.Pendleton. Amer. ]. Psychiat., 121:183, 1964.

A 42-year-old male, with a IS-year history of ex­ce'Sive alcohol intake, was admitted to the hospitalin a state of confusion, agitation and tremulousness.There were visual hallucinations, paranoid ideation,poor memory and confabulation. Neurological exam­ination revealed medial deviation of the left eye withinability to rotate the eye laterally; both pupils weredilated. There was a wide based gait and a positiveRomberg. Gross tremors of the hands and periorbitalmuscles were nott>d; vibration sense was absent inthe toes.

Initial treatment included the administration of 25mg. chlordiazepoxide 1M, thiamine 100 mg. 1M, nico­tinic acid 50 mg. daily, and diphenylhydantoin 100mg. hid. Chlordiazepoxide was then repeated (atotal of 800 mg. was given parenterally and orally).A fl'mission occurred within 48 hours.

TRIAL OF AMiNO-OXYACETIC ACID AS ANANTICONVULSANT. ]. A. R. Tibbles and D. A.McGreal. Canad. Med. Assn. ]., 88:881, 1963.

Amino-oxyacetic acid ( AOA) can increase thelevel of gamma aminobutyric acid (GABA) in thebrain. (GABA is a powerful neuronal inhibitor.)The drug was used in infants and children, all butone of whom were resistant to the usual anticonvul­sants. In eight with major seizures, five showed im­provement; in the same number with minor seiz­ures, three were improved.

PSYCHIATRIC STUDIES OF PATIENTS WITHHEMOPHILIA AND RELATED STATES. D. P.Agle. Arch. Int. Med., 114:76, 1964.

Sixteen adult and adolescent patients have beenstudied and the findings suggested that psychologicalfactors often influence the course of the blood dys­crasia. Repetitive risk taking of a neurotic nature,with resultant physical damage, was observed in nineof the patients; ten related episodes of spontaneousbleeding to periods of emotional stress.

W.D.

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