The following was copied from the British Medical Journal, I : 918-922, June 28, 1947.

(NOTE: 'flying bombs' were V1 and V2 rockets ; Synhexyl, Pyrahexyl or Parahexyl are Dronabinol or Marinol
in which contain synthetic THC - TetraHydraCannabinol, the active euphoriant in cannabis sativa-L, or in
common terms, Mari Juana - Mary Jane in Spanish.)

George Tayleur Stockings, M.B., B.S., D.P.M. (Dr. of Psychiatric Medicine)
Late(Former) Major, Specialist in Psychological Medicine, R.A.M.C.
Earnest Hart Memorial Scholar, British Medical Association
Study performed at the Royal Free Hospital School of Medicine, London

The Syndrome of Thalamic Dysfunction

The syndrome of thalamic dysfunction, or neurotic depression, is the most common of psychiatric conditions
encountered in general practice, and often one of the most intractable and difficult to treat effectively. The most
common forms of the condition are the chronic neurotic depressions, anxiety states, reactive and hysterical
depressions, and obsession disorders. The milder forms of depressions of later life, in which the dysphoria is
unaccompanied by hallucinosis, delusions, and other gross psychotic symptoms may also be included in this group
of conditions

The essential feature common to all of these disorders is a condition of the nervous system in which the
perception-threshold for unpleasant affects and sensory impressions is markedly lowered, while that for
pleasant affect and sensation is correspondingly raised -- the anhedonic or dysphoric syndrome. The
resulting dysphoria or mental pain may present itself in one or two forms, or a combination of both. In the
manifest type it takes the form of conscious depression or unpleasant mental tension ; in the sensorial or
conversion type it presents itself as a persistent and disagreeable bodily sensation, either localized or diffuse,
common examples of which are pressure-headache, generalized pains, hyperalgesia, gastric pains without
organic basis, vertigo, and feelings of abnormal tiredness and weakness.

Although it is generally taught at the present day that these conditions are entirely psychogenic in origin, there
would appear to be strong evidence that the basis of the condition is primarily a disturbance of the thalamic-
hypothalamic mechanisms, possibly a metabolic disorder. Suggestive facts are the absence in a large
proportion of such cases of any evidence of mental conflict, and the concomitant symptoms of disturbed
body-metabolism and autonomic imbalance, such as vasomotor disturbances, central nervous instability as
shown by muscular tremors, hyperalgesia, and other sensory disorders, vegetative disturbances, and
metabolic anomalies as demonstrated by biochemical tests.

The most common symptoms of thalamic dysfunction in order of frequency are : depression, irritability, and
emotional instability, with anxiety and sense of unpleasant mental tension, in the affective sphere ; in the
sensory sphere, pains and paraesthesias of various kinds, such as pressure-headache, various vague pains
and aches of infinite variety, which may be referred to any part of the body, gastralgia, low backache, and
dysuria or other symptoms referred to the urogenital tract ; in the sphere of thought, inability to concentrate,
obsession thoughts, phobias, and transient periods of confusion ("Blackouts") ; in the motor system, tremors,
sensations of weakness and loss of energy, with abnormal tiredness ; and in the vegetative systems, insomnia,
anorexia, gastrointestinal disturbances, vertigo, sexual dysfunctions, and vasomotor symptoms such as
flushing, palpitations, effort syndrome, and syncopal attacks without apparent organic basis.

The thalamic dysfunction state may be regarded as a response of the organism to stresses of various kinds. It
is one of the most common causes of chronic ill-health and loss of efficiency, and one of the most
unsatisfactory of conditions to treat. Its victims form a large proportion of the "chronics" who regularly attend
hospital outpatient clinics, and there is probably no patient who is more dreaded by the overworked
practitioner than the chronic neurotic-depressive.

Treatment of the thalamic dysfunction syndrome is often unsatisfactory because there is no specific drug
therapy known at present for the condition. Psychotherapeutic methods are lengthy, tedious, and often
unsatisfactory, since in a large proportion of such cases the causal factors (unsatisfactory home life, faulty
conditioning in childhood, etc.) cannot be removed, while not uncommonly it is found that the neurotic
behavior-patterns persist even when the precipitation stresses have been removed. Psychotherapeutic
methods usually require specialized training in the physician, and an effective symptomatic therapy aimed at
keeping the patient fit and in full working efficiency during the period of analytic or other treatment is at present
lacking, since the commonly employed remedies, such as cortical sedatives and stimulants, offer at best only
partial relief on account of their lack of specific effect on the thalamic centres, while endocrine preparations,
vitamins, and measures to improve the general health have, generally speaking, proved largely unsuccessful.