• of and  - This issue is historically significant for the following reasons:
  • It marks the  return to his violent roots. Being portrayed as a mass murderer during the early years of the , Joker was reduced to annoying prankster, and scarce appearances during the .
    With this story; many elements of the Joker's original portrayal were updated and remain intact to this day.
  • This story also makes relevant the fact that criminals like the Joker are held in an unnamed mental hospital for the criminally insane.   would make its first official appearance as the Arkham Hospital in , only seven issues after this one.
  • This issue also marks the permanent return of  after several years of absence.

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