No abstract

This report describes a clinical trial in which pericyazine and chlorpromazine were used with 45 disturbed patients resident in a hospital for the mentally subnormal. The patients, who comprised a clinically heterogeneous sample, were randomly allocated by the hospital pharmacist to two major groups; in one, half the patients were given pericyazine for a 12-week period and an inert preparation for a further 12-week period while the remaining patients had the inert preparation during the first period and pericyazine during the second. In the other group, which was given chlorpromazine, the same procedure was followed. Prior to the trial proper, there was a six-week period during which all drugs except anti-convulsants were tapered off. All preparations were in syrup form and were indistinguishable from each other by taste or smell. Only the pharmacist was aware of what syrup a given patient received.

CORRESPONDENCE atrophic testes, a normal-sized penis, sparse body hair, XY karyotype, high oestrogen level, and low I 7-KS level; their conclusion is that a primary failure of androgen led to the desire for sex change. They describe a female who stopped menses at 28, developed acne, hirsutism, had a deep voice and an enlarged clitoris; their conclusion is that an elevated androgen level led to the desire for sex change. Unfortunately for the authors' hypothesis, both these clinical pictures are typical of the anatomically normal male and female after a period on oestrogens (for the male) and androgens (for the female)! Had the authors fully read the references they cite, they would had learned that a case to which they refer of a male transsexual with ‘¿ oestrogen-secreting testicular tumour' (Stoller et al., 1960) confessed years later to having secretly taken oestrogens since puberty (Stoller, i988).

factors enter3 will not alter its practical importance now recognized by its inclusion on every National Service board form. Furthermore, the possibility of a "rheumatic brain disease" in adults, which W. L. Bruetsch4 has pointed out in his works (with some histopathological evidence), again enhances the importance of this wide field of sequelae of rheumatic fever.5-I am, etc., Reading.