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The authors state that the purpose of this book is “… to attempt clarification of present concepts,” and that “It [psychosomatic medicine] is an operational approach to the theory and practice of medicine in which the structure and function of the psychic apparatus are also indicated as variables in health and disease… It specifically denies the type of thinking in which the psychological factor is considered as a separate layer or as an afterthought in the evaluation of the patient.” In order to accomplish their aim of clarification of concepts, the authors have presented reviews and reprinted papers of exciting historical interest in the development of psychosomatic medicine in the nineteenth and twentieth centuries, together with papers and introductory passages to reprinted papers by the Mount Sinai Seminar Group. The whole is a well-organized continuum, which allows the experienced as well as the inexperienced reader to experience, as was the intent, the struggle of pioneers to ferret out, to accept and to introduce into medicine the against-the-tide concepts of psychological etiology of disease, and the view of the patient as a socio-psycho-biologic entity.
Within the classical Freudian point of view there is much that is holistic and phenomenologic. The reviewer was much interested in the following from the 1873 paper by Lasègue, “On Hysterical Anorexia”: “The term anorexia might have been replaced by hysterical inanition…, but I preferred the former term without otherwise defending it, precisely because it refers to a phenomenology which is less superficial, more delicate and also more medical.” The acumen, based upon phenomenology, of early writers, such as Gull, Lasègue and Charcot, uncluttered as they were by later psychiatric and psychoanalytic theory, is refreshing.
There is presentation of the tenets of present-day psychosomatic medicine from the points of view of Freudian theory, ego psychology and homeostatic adaptation. The development of these tenets