Book Reviews. Neurasthénie et Névroses, leur guérison définitive en cure libre. By PAULÉMILE LEVY. Alcan, Paris. 1909. 4 fr. This volume, by the well-known author of the interesting study entitled L'Education rationnelle de la volonté, consists of eleven articles, previously published and here reprinted, followed by a general account of psychotherapy. It is throughout concerned almost entirely with the question of treatment, and the pathogeny and nature of the maladies concerned are only referred to in the most superficial manner. The main thesis of the book, and one that is over and over again repeated from different points of view, is a denunciation of the Weir Mitchell dogma, the belief that isolation, rest and over-feeding are the sovereign remedies to be automatically applied as soon as the diagnosis of neurosis is made. It is sad to think that the unscientific attitude towards the subject represented by that dogma survives so extensively that any one should not only find it necessary to write a book to demolish it, but should even consider himself audacious in having the courage to attack such an established citadel. To any one who still takes the subject seriously this volume can be recommended for its discussion of the disadvantages and defects of the above-mentioned line of treatment. For any one to whom the author's position represents an obvious truism, on the other hand, the volume is not worth reading, for it contains no other substance of any value. Lévy devotes a great deal of the book to inveighing against Dubois, there being an evidently personal note in the tone of his attack, but it is plain that so far as psycho-therapeutic methods are concerned there is but little difference between the views of the two writers. The so-called rational re-education advocated does not mean, as might have been supposed, a re-education of mental processes along rational lines and based on an exact psychological analysis of the morbid happenings, but a system of arguing with the patient that is entitled “appealing to his reason." The psychology on which this is based is that of the populace at the time of the French Revolution, that Age of Reason," when the touching belief in the importance of reason as a driving force in the mind of man lasted until its undignified downfall under the wheels of Napoleon's cannon. It is curious how persistently the same attitude has cropped up in France from time to time ever since; we see it at present at the height of its activity in the "persuasive, rational" schools of psycho-therapy represented by Lévy, Babinski, Déjérine, Dubois, etc. ERNEST JONES (Toronto). Nervous and Mental Diseases. By ARCHIBALD CHURCH, M. D., Professor of Nervous and Mental Diseases and Medical Jurisprudence in the Northwestern University Medical School, etc., Chicago; and FREDERICK PETERSON, M.D., Ex-President of the New York State Commission in Lunacy, Professor of Psychiatry, Columbia University, etc., New York. Sixth edition, thoroughly revised. (Philadelphia and London: W. B. Saunders Company, 1908.) The sixth edition of this work presents the same general appearance as the preceding ones. Dr. Church has carefully revised his section and has incorporated many additions which bring the subject matter up to date and has increased the whole by twenty pages. The chapter on Localization in the Cerebral Cortex has been re-written so as to include the results of recent researches. The paragraph on the treatment of Cerebrospinal Meningitis evidently was written before the use of Flexner's serum achieved such brilliant results. A new chapter on Psychasthenia has been added and expresses adequately the more recent conceptions of this disease group. The illustrations, among which several new ones appear, remain as before, valuable, and a pleasing feature of the book. This section as a whole is excellently written and deserves high recommendation as a text-book. The section on Neurology occupies over two-thirds of the book, and it would be better for the whole if it occupied three-thirds, for Dr. Peterson's section is not by any means up to the same standard. It remains practically the same as in the several preceding editions, with the exception of a new article on Psychotherapy, which in reality is only an inadequate paragraph. The work is still old-fashioned psychiatry, which shows here and there the influence of the author's recent visit to the German clinics. The section can hardly be called revised, as stated in the preface, as the effort to incorporate a little up-to-date psychiatry gives the whole a patch-work and incongruous effect. The old chapter on Circular Insanity is retained; then follows one on Manic Depressive, which consists of three pages and is mainly a discussion as to the advisability of its admission as a nosographical entity. The old classification, “Primary and Secondary Dementia" and 'Acute Curable Dementia," is retained. To the latter a foot-note is added, explaining that "this group of cases has of recent years added to the Dementia Præcox group." One of the most noticeable things about Dr. Peterson's section is the poor balancing of the various chapters; for instance the one on Dementia Præcox covers only four pages, while the author devotes fifteen to excerpts from an autobiography of a paranoiac. The short chapter of twelve pages on Paresis remains unchanged, with no reference to some of the recent work done by Robertson and his followers on etiology, and by Wassermann and others on the relation of syphilis to the disease. No reference is anywhere made to the examination of the cerebrospinal fluid as obtained by lumbar puncture, which procedure is now widely considered to be of great diagnostic value in psychiatry. Elsewhere small additions have been made in the consideration of alcohol as an etiological factor, in the psychological aspect of memory and in a short notice of the value of the prolonged warm bath in excited cases. Dr. Meyer's review of the work of Kraepelin, Ziehen and Wernicke, which first appeared in the fourth edition, remains unchanged and stands out by itself in sharp contrast to the quality of the rest of the section. The lack of any consistent policy of classification on the authors' part, with the maintenance of the old and discarded terms in apparent equal importance with those of modern psychiatry, is very likely to induce an attack of confusion on the part of the student, or at least provoke the exclamation made famous by a confused member of Congress, "where am I at?" W. B. CORNELL. Diseases of the Nervous System. By H. CAMPBELL THOMSON, M.D. (Lond.), F. R. P. C. (Chicago: W. T. Keener & Co., 1908.) This book is divided into six sections, of which the first is introductory and deals with the General Structure of the Nervous System, the Reflexes, Rigidity and Contractures, Electrical Reactions and Lumbar Puncture. Each of these chapters is satisfactory and has been brought up-to-date, epicritic and protopathic sensibility being adequately treated in the first chapter, and the essential points of lumbar puncture in the last. The other sections are devoted to the Peripheral Nerves, the Myopathies (Muscular Dystrophies), Diseases of the Spinal Cord, Organic Diseases of the Brain and Diseases of Functional and General Origin. In a work of but 480 duodecimo pages it is manifestly impossible to fully cover the entire field of neurology, but the author has given us a book which in brief space treats most clearly of the essential features. To the alienist who has not an active neurological practice, this work offers an excellent opportunity to review the knowledge previously acquired, but perhaps not mentally arranged in an orderly fashion. The work is well illustrated by over one hundred plates, half-tones and line cuts, the most of which are original. Mechanically, the work leaves nothing to be desired. It must not be understood that the book is without defect, even when it is remembered that completeness has frequently been sacrificed for brevity, but most of these defects are of omission rather than commission and are, therefore, more excusable. In discussing the mental symptoms of multiple neuritis the following occurs: "Emotional tendencies, untruthfulness, indecision, mental confusion, with loss of memory for recent events and loss of ideas of space and time-symptoms which are grouped under the heading of Korsakow's psychosis-are generally met with in some degree, while in the more severe cases, hallucinations, delirium tremens or insanity may be present. Alienists generally believe that Korsakow's psychosis should be grouped among the insanities, just as are most psychoses, and when delirium tremens is found associated with multiple neuritis it is merely because they have a common cause and not because of any special relationship between them." This paragraph does not seem quite clear to the reviewer and we fear may be misleading to the student. The relationship between tabes and paresis is disposed of in the following parenthetical statement in a paragraph speaking of the work of Ford Robertson: (for the nature of the pathology of both is probably identical), and no mention of tabo-paresis is made. While lymphocytosis is mentioned under lumbar puncture as occurring in paresis, it is not mentioned at all under the section treating of that disease, although such procedure would be of value in differentiating paresis from neurasthenia, disseminated sclerosis, chronic alcoholism and frontal tumor, which with syphilitic affections of the brain are enumerated under diagnosis. Under epilepsy there is no adequate description of the various forms, neither Jacksonian nor psychic epilepsy being noted. The former, however, is mentioned under intracranial tumors, but the latter is nowhere described. The above are samples of a few of the defects, but in spite of them the book is a good one and deserves success. W. R. D. H Abstracts and Extracts. The Experimental Study of the Ocular Reactions of the Insane from This study-perhaps the most important single contribution that psychiatry has yet derived from the methods of experimental psychology-deals with a type of reaction that from a wholly analytical standpoint one would expect to possess many clinical possibilities. The eye movements unite extreme delicacy of response with close association with the highest mental functions, and peculiar inaccessibility to introspection. As the authors point out, this last consideration, combined with the involuntary character of the eye movements, is also an effective check on simulation. Moreover, since the eye movements are among the most universally developed of reactions, there is probably no accessible motor function in which practice is so nearly equal for different individuals. Altogether, if we except certain special features of the vasomotor responses, there is probably no form of reaction in which we should expect mental disorder to be more objectively revealed than in the eye movements. Their nearest competitors in this field are the speech and writing movements, and both of these have figured somewhat in the study of deranged mental reactions; but they yield to the eye movements on practically every point. Three aspects of oculomotor activity are considered: Ist, the velocity of the eye movements, i. e., the actual speed with which the eye moves from one to a second point of regard; 2d, the reaction time of the eye, i. e., the time required for the eye to begin to move in response to a given visual stimulus, and 3d, the pursuit movements, the ability to follow a fixation point on a moving pendulum. The number of subjects, which totals over fifty, would seem to be in each group sufficient for significance in the special results that are claimed for them. The essential interest of the data, however, centers in the manic-depressive conditions for the velocities and the reaction times, and in the dementia præcox cases for the pursuit movements. Adequate normal data are presented for comparison. It seems comparatively certain that the angular velocity of eye movements is in the manic state slightly greater than in the normal state, and within groups, the more marked excitements have the faster rates, though of course there is no high individual correlation. This the authors interpret, according to the usual point of view, as the result of the loss of inhibitory power by the higher centers in the manic state. On the other hand, the movements of the depressed cases, which are considerably slower |