Community Services for the Mentally Handicapped

A hundred years ago John Snow established that cholera was transmitted via polluted water, and the disease was eradicated from this country although the responsible bacillus had not been discovered. To-day a somewhat similar paradoxical situation exists in psychiatry. The fundamental causes of mental disorders are still unknown ; we are far from eradicating them, and indeed neurotic illness seems to be steadily increasing, but we do now possess drugs which, although discovered by accident, are powerful and effective. Phenothiazine derivatives have revolutionized the treatment and outlook of schizophrenia and contributed to the liberalization of our mental hospitals, and antidepressant drugs have altered the treatment of depressive illness. However, the sudden arrival on the clinical scene of so many effective drugs is somewhat bewildering. A symposium such as the one held last year at St. Bartholomew's Hospital " to review the present state of knowledge of the clinical and therapeutic effects and the mode of action of the various psychotropic drugs " is of considerable value. The proceedings of the symposium are now published in this book and provide stimulating and informative reading Phenothiazine derivatives and antidepressant drugs are discussed in detail both from the clinical point of view and in relation to their possible modes of action, and methods oi assessing the psychological effects of drugs both in animals and in men are discussed among other subjects in a stimulating fashion The book can be highly recommended although its price, even allowing for it, delightful cover design, seems somewha excessive. PETER DALLY.