Clinical vampirism. A presentation of 3 cases and a re-evaluation of Haigh, the 'acid-bath murderer'.

Clinical vampirism is named after the mythical vampire, and is a recognizable, although rare, clinical entity characterized by periodic compulsive blood-drinking, affinity with the dead and uncertain identity. It is hypothetically the expression of an inherited archaic myth, the act of taking blood being a ritual that gives temporary relief. From ancient times vampirists have given substance to belief in the existence of supernatural vampires. Four vampirists, including Haigh, the 'acid-bath murderer', are described. From childhood they cut themselves, drank their own, exogenous human or animal blood to relieve a craving, dreamed of blood-shed, associated with the dead, and had a changing identity. They were intelligent, with no family mental or social pathology. Some self-cutters are auto-vampirists; females are not likely to assault others for blood, but males are potentially dangerous. Vampirism may be a cause of unpredictable repeated assault and murder, and should be looked for in violent criminals who are self-mutilators. No specific treatment is known.

Drugs, alcohol and violence in 604 male offenders referred for inpatient psychiatric assessment.

Of 604 White and Coloured male offenders in the Cape referred for inpatient psychiatric observation, 52% habitually indulged heavily in alcohol, drugs (mostly dagga (cannabis)) or both. Indulpence in alcohol alone was frequently associated with violence and sexual assaults, alcohol and drugs together less, and drugs alone least. Those who indulged in drug-taking (i.e. dagga, LSD and hard drugs) were less frequently associated with violence, rape and other sex crimes than were those who did not; 60% of sex offenders were non-abusers. Out of 101 severely psychopathic patients in the sample, only 1 who indulged in drugs but not alcohol was charged with a crime of violence or sex. There was no evidence of a potentiating action between alcohol and dagga towards violent behaviour. Dagga appeared to diminish the action of alcohol, and may inhibit urges toward violence and rape in aggressive persons and psychopaths. Drugs did not release or set off violent reactions, and drug indulgence was associated with stealing without violence. Some implications for forensic psychiatry and arguments about drug indulgence as an extenuating factor in serius crime are discussed.

An investigation of clozapine in the treatment of acute and chronic schizophrenia and gross behaviour disorders.

Fifty-two mental hospital cases of acute and chronic schizophrenia and gross behaviour disorders were investigated and observed for 6-12 months during treatment with clozapine. Three-quarters of the acute cases recovered with full occupation capacity. Two-thirds of the chronic cases improved markedly. Antisocial behaviour was controlled in 12 out of the 13 behaviour-disordered group. The improvement in initiative and social capacity was striking and appeared to be due to improved awareness of the environment and the acquisition and handling of useful knowledge. The response to clozapine appears to be specific and relapses occurred when maintenance medication was stopped. It is of value in treating temper states in epilepsy and has the advantage of not causing extrapyramidal symptoms and side-effects are slight after the first week. Maximum improvement may not be reached before 8 weeks. Thereafter the maintenance dose can be small and fluctuations in the illness do not seem to occur. The dosage, side-effects and precautions are discussed. A rating system to display the effect of clozapine on individual parameters as well as on the over-all state was devised for this study.