This investigation is concerned with the prevalence of dysmenorrhoea and premenstrual symptoms in the general population and with their relationship to personality.Many authors have expressed the opinion that such relationships exist, but we will confine our review here to those studies which have presented supporting data. Wittkower and Wilson (1940) studied 57 patients with primary dysmenorrhoea and found there was a history of childhood maladjustment four times as often in these patients as in a control group. They considered that patients with dysmenorrhoea could be classified into two main personality types: the first, “characterized by deep resentment of their feminine role”; the second, “obviously immature physically and either shy or shut-in or chronically anxious and complaintive”. Sainsbury (1960) observed a significantly raised neuroticism score on the Maudsley Personality Inventory for patients attending hospital for dysmenorrhoea. Such views as these are not universally held, and would certainly not be shared by many gynaecologists. Nor are they supported by the little evidence forthcoming from population studies.

chester 13. The growth of pharmaceutical products has brought about the change. In every century before our own, poisons and drugs were dissimilar. Poisons were substances which should not be taken at all, the province not of physicians but of wizards. Their properties verged upon the magical. They were, indeed, " unctions bought of mountebanks." By the second half of the nineteenth century science had displaced sorcery, and poisons were purchased from the chemist, not the alchemist. But they still differed from drugs. Drugs, with few exceptions, though recognized to produce undesirable actions if taken in excess, were not considered lethal agents, were not used to kill. The growth of self-poisoning has come about in the train of a rapid rise in number of highly dangerous preparations employed therapeutically, together with a great contemporaneous increase in prescribing.

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Programmes of suicide prevention require for their planning accurate epidemiological surveys. Doubt has been cast on the accuracy of many existing surveys because of the realization that suicide is under-reported and because of the lack of consistency in the procedure for suicide ascertainment. Two studies are described in this paper which attempt to examine the problem. The first is part of an international study supported by the World Health Organization. In it, Denmark and England are compared, and it is shown that there are striking differences in suicide ascertainment procedure between the two countries. Next, on a blind basis, coroners and their opposite numbers in Denmark examine a sample of each other's case records. It is found that the Danes consistently report more suicides than do the English coroners on the same case material; thus considerable doubt is cast on the supposed difference in suicide rates between the two countries. In the second study, deaths by poisoning are examined for certain coroners' districts in England and Wales. It is shown that there is considerable variation from one district to another in the relative proportions of these deaths which achieve an accident, an open or a suicide verdict. This suggests that in England and Wales coroners may not be consistent in their suicide ascertainment criteria. Hypotheses attempting to account for differences in suicide rate based on such epidemiological surveys should be viewed with great caution.

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