POSTUREMeDIBRnm L 1491 dystonia. It is perhaps too early to draw any conclusions from this, but the facts just quoted may suggest that extrapyramidal rigidity and disturbances of posture are due to abnormal impulses descending from above the brain-stem level.

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Five years ago one of us (W. S.) developed a new method of treatment of anorexia nervosa with large doses of chlor-

SummaryNinety-six patients complaining of recurrent or persistent abdominal pain were referred consecutively to a surgical clinic and a medical clinic, respectively. They were examined psychiatrically after their initial physical investigation. The psychiatric examination included rating scales for depression and anxiety, a personality inventory, life-events schedule, scale of verbal expressivity, and family and personal patterns of pain and invalidism.Only 15 patients (15 6%) had organic disorders that could be responsible for their symptoms. In the remainder, psychiatric factors were considered primarily responsible for their abdominal pain: 31 were depressed; 21 had chronic tension; in 17 hysterical mechanisms were prominent; and 12 were found to be unrecognised alcoholics. Follow-up at three and six months and recognition by 80% of the psychogenic group that a psychological explanation was plausible, confirmed the diagnoses, and over half responded favourably to psychiatric management. Features distinguishing the organic and psychogenic groups were delineated. Psychiatric assessment has a place among the investigations of non-acute abdominal pain; certainly it should not be considered simply as "a last resort."

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