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During 1957 the United Charities of Chicago celebrated its hundredth year of service to the people of Chicago. One of the primary events of that celebration was the Family Service Bureau Institute Series entitled "Focus on the Family in the Growing Community!' In her luncheon address to agency staff members and professional workers from throughout the Chicago area, Dr. Babcock paid high tribute to the United Charities for its great contributions during a century of change. She devoted herself primarily, however, to the role of the family agency in tfre face of the changes of today. This portion of her address, though prepared for a special audience, presents a challenge to family agencies every where.

In this paper we present the observations made in a follow-up study of 166 patients who had been treated in the psychiatric outpatient department of the University of Chicago Clinics between July 1, 1935, and March 30, 1937. We have attempted, by means of a review of the records and follow-up interviews, to evaluate the results of treatment, to compare the original diagnoses with the diagnoses made at the time of the follow-up interviews and to relate the present study with a previous study on inpatients. 1 METHODS AND MATERIALS The criteria for inclusion of a patient in this study were that he had been seen originally by one of us at least one year previously to the time of follow-up and that a thorough physical and psychiatric work-up had been recorded when the patient was first seen. Of the 206 cases reviewed, forty were discarded for the following reasons

The question whether the entity described by Kinnier Wilson should be expanded to include additional symptoms and signs reported by others in similar cases has been debated in the scientific literature for the past two decades. The case presented here is of interest because of the nature of the onset, the absence of tremor, the clinical methods used in an attempt to establish the presence of hepatic damage and the mental status and personality changes of the patient. REVIEW OF LITERATURE A brief review of the development of the concept of hepatolenticular disease reveals that the condition aroused interest before the time of Wilson and is probably not so rare as is generally believed. Strumpell 1 in 1878 described a case in which the disease seemed to resemble multiple sclerosis but which was a typical instance of this condition; in 1883 Westphal 2 reported 2 similar cases of a disorder