book from a work called The Psychology of Insanity by Bernard Hart, an English physician who also published a case study of a multiple personality. Based on Cleckley's work, but with fundamental changes, from the 1970s the psychologist Robert D. Hare devised an influential "psychopathy checklist" to assess psychopathy primarily in the criminal justice system. Vitamins Virgil P. Sydenstricker was a professor of medicine and an internationally recognised specialist in hematology and nutrition. Articles published with Cleckley were among the first to describe an atypical form of pellagra (now known as "niacin deficiency") which was then endemic in southern states. In 1939 and 1941 they published on the use of nicotinic acid (niacin or vitamin B3) as a treatment for abnormal mental states and psychiatric disorders. The studies have been erroneously used to justify the use of megavitamin therapy in psychiatric disorders such as schizophrenia. Coma shock therapy Cleckley practiced the controversial "coma therapy", where psychiatric patients would be repeatedly put into comas over several weeks through overdoses of insulin, metrazol or other drugs. In the wake of sometimes fatal complications, Cleckley published in 1939 and 1941 advising on theoretical grounds the prophylactic administration of various vitamins, salts and hormones. In 1951, he also co-published case study research suggesting the use of electronarcosis for various conditions, a form of deep sleep therapy initiated by passing electric current through the brain, without causing seizures as in electroconvulsive therapy which he also used. Criminal responsibility In 1952 Cleckley, along with Walter Bromberg a senior psychiatrist and psychoanalyst, published an article on the insanity defense. They suggested changing the wording of it to: "In your opinion, was the defendant suffering from disease of the mind and if so, was it sufficient to render him unaccountable under the law for the crime charged?" The concept of 'accountability' was intended as an alternative to a narrow definition of 'responsibility' under the M'Naghten rules which requires an absence of moral knowledge of right and wrong, in effect only covering psychosis (delusions, hallucinations). They argued that mental illness can involve any part of the mind and that the insanity test should focus on the extent to which the accused's mind overall, due to some inner pathology 'whether obvious or masked', was unable to operate in accord with the law. However, 10 years later, a chapter by Cleckley on "Psychiatry: Science, Art, and Scientism" cautioned others against a