Both the number of attacks and the number of tablets needed were significantly reduced on the drug therapy as compared to the placebo. These results compare favourably with those obtained in previous clinical trials.

Rheumatoid Arthritis as a Psychological Disorder ' SIR,-In your leading article (July 23, p. 221) entitled " New Problems in Rheumatism " you state, " Some physicians have considered that rheumatoid arthritis is a psychological disorder. The results of clinical tests with cortisone, during which any possible psychological effect was carefully eliminated by giving control substances for certain periods-with relapse in each instance-has disproved this theory." Such a statement is 'surely somewhat facile and likely to be misleading, for it takes an altogether too superficial view of the psychogenesis of disease. The effectiveness of cortisone in rheumatoid arthriti! in fact goes some way in support of the work of Selye' and the evidence of others he compounded in his conception of the "general adaptation syndrome." In this work he recognizes the potentiality of emotional stress at least as one of the causes of the syndrome.-I am, etc., London, W.14.

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