Reviews and Notices of Books

1921 The Lancet  
INTO a small volume of some 200 pages Dr. William Brown has packed as much sound psychological and psychotherapeutic doctrine as is to be found in many larger volumes of a more pretentious nature. He has given us less a mere clinical description of the familiar phenomena of the psychoneuroses than an exposition of the underlying psychological mechanisms and of the principles of a successful treatment. Accepting the method of psycho-analysis in the investigation and treatment of the
more » ... s, the author is unable to subscribe to Freud's views in their entirety, and indicates in a few closely argued sections the lines of divergence he is compelled to take. Further, he shows how vague and incomplete is Freud's theory of the emotions in contrast with those associated with the names of Ribot, Shand, and McDougall. It is gratifying to note that Dr. Brown is fully aware of the insufficiency of a solely psychological explanation of the phenomena of hysteria ; its peculiar physiological disorders cannot be ignored in any causal explanation that claims completeness; yet it is precisely these disorders which the psychologist tacitly neglects. Absence of the plantar reflex in a case of hysterical paraplegia is as integral a symptom as amnesia, but while the latter is accounted for by Freudian theory the former remains unexplained. It is only fair to observe that Freud himself is well aware of the lacunae in his hypothesis; and Dr. Brown has done useful service in directing attention again to this matter, for it is one which is too frequently passed by. In the chapters on psychotherapy the reader will find succinct recapitulations of the methods developed by Dr. Brown, and already published in various medical journals; and in a last section is a brief yet lucid and critical re-examination of the theories of the interaction of mind and brain, to no one of which, however, does the author seem to commit himself. Amid all sorts and conditions of modern psychological and psychotherapeutic monographs and text-books this unambitious volume of Dr. Brown's takes rank with the best. __ Intelligence " did for the Stanford revision of that scale; it provides definitely standardised methods of stating the problems to the subject and of scoring results. In one respect the standardisation is more complete, for it extends also to the order in which the tests are presented. This order, it must be stated, is somewhat complicated, and possibly equally accurate results might be obtained by a simpler procedure. In the first enthusiasm for intelligence tests the limitations of the Binet scale as indicative of a child's mentality were sometimes ignored. Dr. Melville definitely recognises that the scale gives no reliable criterion of a child's innate intelligence; it shows only "how much an individual has profited from gome typical forms of experience and training which the majority of children in civilised countries undergo not only in school but also in the home and on the playground." He insists, further, that the Binet findings must be " corroborated by a thorough psychobiological study of the case," laying stress on the fact that emotional attitude and factors of character, will, and even of attention are quite inadequately, if at all, measured by this scale. Complete directions are given for the carrying out of each test and for recording its results. The pictures and other diagrams required are embodied in the volume itself instead of on separate cards-an arrangement not without disadvantages. Of special value to English readers is the incorporation in an appendix of the complete set of Porteous maze tests which, testing as they do the foresight, the capacity to plan, the practical judgment, and concentration of the child, supply a marked lack of the Binet scale. In regard to one cardinal point the book provokes criticism. There is fairly general agreement that many of the Binet tests are misplaced in the scale, some by as much as two years. Many revisions have been published-Goddard's, Kussmaul's, Bobertag's, the Yerkes-Bridge scale (which discarded age-tests), and the Stanford revision-but the author of this book frankly prefers to return to the original scale, with all its faults. Admitting that it was based by Binet on the examination of the poorer children in the Paris schools, he maintains that it only requires correction tables for race and social status to make it available for general use, with the possibility of comparable results. From a scientific point of view one cannot but feel that it is desirable to adopt as a basis a scale of more universal validity, and not one based on children of one race and of one social grade. With so many psychologists of different countries at work on these problems the compilation of such a scale should be possible in the early future. 2. Professor Terman's new book is an analysis of the examination by means of the Stanford revision of the Binet scale of children in various grades of American schools, with the double purpose of demonstrating the great differences of capacity existing among children in each grade, and of indicating better methods than at present exist for the classification in schools of exceptional children. It is therefore primarily a book for teachers, but is also of considerable interest to school medical officers who are using the Stanford scale in their examinations of backward and defective children. Of more general biological significance is Professor Terman's claim that, while the social and educational environment of a child contributes to his success or failure with the tests, yet the chief factor is the original endowment, a claim to some extent supported by the fact that the intelligence quotient in children removed to a superior environment was not found to increase in value. Another investigation of medical interest showed that over a third of the cases gave a reduced intelligence quotient after the removal of tonsils and adenoids, while the increase of the others averaged only two points. Both results, however, must be received with caution, for the number of cases tested was too small to justify any general conclusion. How many surgeons watching or even performing the simple operation with practically no operative mortality that removal of an adenoma of the thyroid -has now become realise that scarcely more than a generation ago this operation was of so great a severity that it was almost considered unjustifiable. The whole history of this change has been most ably traced by Professor Halsted, who has lived and worked at the subject through the whole of this period. The modesty which characterises all his writings allows but little evidence in this monograph of the fact that he has contributed more than any living surgeon to the success which is obtained from the modern operations. So much credit is given to other surgeons 598 that it may hardly be realised that the author is 1 an active participator rather than an historian. The story has been most carefully written, and an enormous amount of trouble must have been taken in searching the earlier literature. Professor Halsted gives accounts of the first more or less experimental operations, and the inclusion of long abstracts from the original papers adds greatly to the interest of the survey, besides showing clearly what wonderful progress has been made in this and other branches of surgery. Even up to 1860-70 any operation upon the thyroid was apparently condemned by the majority of surgeons as a dangerous and unjustifiable procedure. From this time onwards progress was rapid, but in the early days great difficulty was experienced owing to the danger of haemorrhage. Hence a partial thyroidectomy was regarded as an almost fatal procedure, most frequently the whole thyroid was removed. It was not until several years had elapsed that it was gradually realised that removal of the whole gland was certain to be followed by deleterious effects. Step by step the slow increase in knowledge and the gradual improvement in the operative results is traced, long and careful accounts being given of the work of such men as Kocher, Billroth, Mikulicz, and many others. Real progress dates, however, from about 1879, when artery forceps were introduced and surgeons were thereby enabled to obtain an almost certain control of haemorrhage. It is difficult to realise that the introduction of these instruments ranks almost with
doi:10.1016/s0140-6736(00)55536-6 fatcat:cxbgg5kpfncankfkr4aolxhie4