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JUNE 19, 1948 REVIEWS

REVIEWS BRILISH
~~~~~~~~~MEDICALJOURNAL 1187

built up and up instead of downwards to the ground. Had they


Reviews pursued the latter course we might have seen real advances,
instead of increasing mysticism and dogmatism and a schism
of the churches. To take but one example: Freud's theory of
the unconscious was a notable advance for 50 years ago, but
in its presentation of anthropomorphized antagonists, "ideas "
DERMADROMES and the " censor," as if they were things rather than processes
it is out of touch with modern medicine. Nevertheless, Freud's
Skin Manifestations of internal Disorders (Dermadromes). By " unconscious " is directly translatable into neurological terms.
Kurt Wiener, M.D. (Pp. 690; 386 text illustrations and six So much cannot be said of some less fundamental concepts to
colour plates. 63s.) London: Henry Kimpton. 1947. which a central position has been given, such as the castration
This book will be a pseful work of reference to both general complex. It is frankly incredible that all mothers threaten their
physicians and dermatologists. Many writers in the past have sons with castration nowadays, that growing girls are kept in
emphasized the close connexion between internal complaints utter ignorance of their sexual functions, that the infant in
and external manifestations on the skin, but we do not the process of being born is "aware of some vast upheaval
remember anyone's undertaking the formidable task of collect- which disturbs the economy of its narcissitic libido," that all
ing and classifying them. The magnitude of the work may subsequent experience of anxiety is related to this birth trauma.
be gauged from the size of the volume and the number of However, not all psycho-analysts still embrace these views.
references, which exceed 3,000. The author considers that the Before Freudian psychology can take its place in the general
works and their authors referred to should not be hidden away structure of science it will baye to subject its theories to the
but shown on that page where their work is mentioned, test of critical experiment, to which so far no Freudian has
instead of being listed at the end of each chapter or relegated to shown much inclination.
the end of the book, and he has therefore adopted the system ELIOT SLATER.
of consecutive numbering beneath the main text. He hopes
that the reader may be encouraged to look up some of the CORRECT DIAGNOSIS
original sources himself. He has also invented a new word-
"dermadrome"-which denotes any phenomenon on the skin Methods of Diagnosis. By Logan Clendening, M.D., F.A.C.P.,
that accompanies an internal disorder. In fact it is an exact and Edward H. Hashinger, M.D., F.A.C.P. (Pp. 868; 143
synonym for the title of the book. Etymologically it is a illustrations. 63s.) London: Henry Kimpton. 1947.
better word than many medical terms. The capacity for accurate diagnosis is perhaps the outstanding
Although attempting to make his work as comprehensive as requisite for the successful practice of medicine. To a great
possible the author has wisely omitted to discuss subjects that extent it can be acquired only by apprenticeship to good
constitute entire divisions of medicine such as syphilis or the clinicians followed by practical experience, but there is always
skin manifestations of allergy or the nutritional disturbances of a use for the attempt to summarize in books the process by
infancy. Many writers have exhaustively considered these which diagnoses are correctly made, if only because the written
matters, and although they are an important part of dermatology word does not share the epblemeral fate of the spoken. In
their inclusion would necessitate nearly dovbling the size of the Logan Clendening's own words: "The patient does not say
volume. The word syphilis is not even mentioned in the index. to the physici3n, ' I have amyotrophic lateral sclerosis,' or
Among diseases in which the cutaneous features are important 'I have typhus fever,' but 'I am dizzy,' or 'I have lost weight,'
and often serious are diabetes and tuberculosis. The author or 'I have a pain.' The average textbook in medicine takes up
discusses these and their treatment fully. On the other hand the description of diseases under their proper names, and is not
many of the manifestations chronicled are of great rarity and therefore of help to the physician at the bedside of his patient
are seldom seen except at the meetings of clinical societies, until after he has determined what disease is present. This
where they effectively illustrate the thesis that dermatology is work therefore discusses the diagnostic possibilities of a given
an enormous subject to know though a comparatively small one case, starting from the symptoms or from the signs, or from
to practise, since the great majority of patients suffer from about the laboratory data or x-ray picture, or the electrocardiographic
a score of common diseases. However, this will not interfere record which the patient presents."
with the interest the specialist will feel in the present volume, The book opens with a long chapter on the principles of
and we warmly recommend it to him. The illustrations are logic and their application to the interpretation of clinical data.
clear and well reproduced and are a great help to the text. The reviewer found this an interesting and instructive approach.
H. HALDIN-DAVIS. Thereafter the authors discuss the significance of various
symptoms, signs, and special investigations in considerable
PSYCHO-ANALYSIS IN BRIEF detail. They reiterate the conviction that, although it is difficult
to say precisely what makes outstanding diagnosticians, a
Sigmund Freud. An Introduction. By Walter Hollitscher, characteristic of such clinicians is that they consider all possible
D.Phil. The International Library of Sociology and Social causes of the various symptoms and signs, if only to dismiss
Reconstruction. (Pp. 119. 8s. 6d.) London: Kegan Paul, them. The authors therefore include many lists of diseases
Trench, Trubner and Co. 1947. which may present with given symptoms or signs. These lists
Dr. Hollitscher has provided an admirably short and lucid gain in significance through being based on the practical
summary of the basic concepts and principal theories of experience of the authors or of other medical authorities. The
Freudian psychology. It will prove useful not only to socio- style is refreshing, for the book is enriched with many classical
logists, for whom Dr. Hollitscher intends it, but also to descriptions of disease, enlivened by pointed and amusing anec-
medical men and others who wish at small labour to have dotes, and spiced with American colloquialisms. The reviewer
some understanding of Freud. So far as the reviewer can judge, believes that physicians will read this book with pleasure and
it is an account of Freudian doctrine free from modern accre- profit.
tions. It is remarkable how much better balanced Freud's own SIDNEY TRUELOVE.
formulations are than those of most of his modern disciples
and adherents. Freud himself was a pattern of open-minded- A CORNISH HOSPITAL
ness, and again and again made reservations against the undue
extension of his theories and left room for the operation of A History of the West Cornwall Hospital, Penzance. By Dr.
other factors, such as those of a hereditary and constitutional E. C. Edwards. (Pp. 47. No price.) Truro: Oscar Blackford,
kind. Ltd.
The charge can be laid against his spiritual descendants that Dr. Edwards is to be congratulated on having recorded the
they have neglected the exploration of these lacunae. Freud's history of the West Cornwall Hospital, especially at this time
theory of psychopathology is an aerial structure which has few when the fruits of public charity have been deemed ripe for
points of contact with the solid basis of knowledge in physio- plucking by the State. We may well be proud of our hospitals
logical, neurological, and biological fields. His disciples have and of the men and women on whose enterprise and generosity