Lectures on Schizophrenia

Review of The Biology of Schizophrenia. By R. G. Hoskins, Ph.D.. M.D. (Pp. 192. 15s.) London: Chapman and Hall. 1946.

British Medical Journal, 12 April 1947, p. 492

This book is an extended version of the Salmon lectures given last year by Dr. Hoskins. He is the Director of Research at the Worcester State Hospital, where over the past twenty years and more a large amount of work has been done on disturbances of bodily function in schizophrenia. These lectures summarize the work and forecast the trend of future research. Positive findings have not been lacking; they are practically all of the statistical type-that is, schizophrenics as a whole differ from normal persons to a significant degee in a great number of measurements. There are suggestions of deficiency in most endocrine functions-thyroid, adrenal, pituitary, and gonad. Treatment with various glandular preparations has been tried, with very disappointing results. There are differences in basal metabolic rate, in metabolism of sugar and glutathione, and also in the circulatory system, as shown in blood pressure, pulse rate, and circulation rate. But there is no qualitative difference between the schizophrenics and normal persons.

   In this respect Dr. Hoskins and his co-workers have been singularly unfortunate. It may be remembered that Gjessing, in Norway, has found in schizophrenics with circularly recurring phases remarkable disturbances of nitrogen metabolism, to a large extent controlled with thyroid; and that Hemphill and Reiss, in this country, have found specific pathological changes in the seminiferous tubules in quite early cases of schizophrenia. The work in America has led to no coherent theoretical interpretation; we are left with a jigsaw puzzle as apparently meaningless as ever. The one general finding, which repeats itself over a large number of functions, is that schizophrenics are less reactive than the normal; they can even stand much higher levels of physiological stress. One test, which involved breathing warmed moist oxygen, caused collapse in a quarter of the normal controls but was survived by the schizophrenics without notable distress.

   Dr. Hoskins alienates the reader by devoting two out of his three lectures to general considerations without much relevance or interest and by a style which is stilted, pompous, and sometimes absurd: "It is a well-known apparent paradox that preceding acrimony enhances the vividness of connubial empathy." The book's principal fault is that figures and tables are generally eschewed; for these the worker, who might otherwise have found it invaluable as a convenient source of reference, must turn to the original papers given in the bibliography. A disappointing inconclusiveness pervades this work.