Abstract
1. A double blind study of lithium carbonate treatment in manic illnesses is described. 2. The drug is found to be of value during the acute manic illness. The changes in clinical symptoms are statistically significant. 3. Some of the relevant clinical features are described and their effect upon the interpretation of the result discussed. 4. Brief mention is made of the blood lithium levels encountered. They are shown to have no relationship with the therapeutic effect of the drug. The implications of this for future biochemical investigations is discussed. 5. Toxic reactions have been encountered, and concomitant blood electrolyte studies are sometimes useful in anticipating these events. 6. If more were known of the natural history of manic illness it would make it easier to interpret the results of treatment. 7. Parenteral lithium therapy could extend the application of the drug in manic illnesses.

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