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                  <text>November n, 1966

Dr.

J.

C. Holden

M.

Missouri Institute of Psychiatry
51400 Arsenal Street
St. Louis, Missouri 63139
Dear'Mike,

It has

taken me scmetime to review the laboratory report.
subject is a most inportant one, and especially with the
recent articles which you have read. The major criticism that
I have of the paper is the lack of focus. The introduction is
dedicated to the general problen of laboratory standards, much
as our previous report. The discussion exercises some theoretical
The

aspects of the laboratory test changes, and the methods and

results are a staple statement of some of the changes observed
inourprogem. Ifthereportistobefocussedonlaboretory

data, then the discussion should follow

some

of the similar

aspectsofoxmpreviousreportandperhapsexpomdmfully
on the significance of laboratory tests in the treatment of the

mentally

ill.

Butthiswouldbetoomk. Ifthefocusweretobeon

the significance of laboratory test changes as indices of
physiological effects of these compounds, as seensto have been
the focus in some of the recent reports,,then this document is
deficient in not annotating the other reports more fully.
With

this in mind, I

would suggest

a concentrated review

ofthelitenatmeofthelasttmyear’sontheassociationof

pl'xemthiazineswithsuddendeaths, Newcardiacehanges,
effectsonthevisual systemandonthe skin. Bysumnarizing
these valuable reports, I think you will be presenting a
succinct picture of a major problem. After that introduction,

traspecificaspectsofthedatawhichmfindmmsualinum
long term study patients, can be presented within the context
that perhaps the small changes are still of significance.
My

oaments regarding the present discussion are largely

related tothefact that Idonotthinkweare inagoodposition
to discuss theoretical aspects of clinical physiology from our
vantage point of psychiatry.

I trust these consents are helpful.

My

best regards.

Sincerely yours ,
Pink, M.D.
Professor of Psychiatry

Max

Inf 19

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