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This was a thesis successfully presented at London University for the degree of M.D.
As Dr. Culpin has had the advantage of studying the war neuroses in his double capacity of operating surgeon and physician, the result is a valuable contribution to the literature on this subject. He is non-committal in his attitude towards the Freudian conception of the origin of the Psychoneuroses but appears to have an open mind on the subject, and is open to conviction. For instance he appears to be rather inclined to favour Janet's theory of Dissociation and classifies some of his cases under the term of "Psychasthenia". Under this heading he includes Phobias and Obsessions and in this respect separates them from Hysteria. He states, however, that the only theory of causation is the theory of the unconscious and here he seems to discard Janet's dissociation theory in favour of the more reasonable Freudian conception.
With regard to predisposition, the author will not admit that every patient must necessarily have had a predisposition to a nervous break-down, though he adds that as his experience increased the percentage of cases showing no predisposing factors decreased. It is in this respect that he appears rather to neglect the ontogenetic factors: that the current conflict of modern warfare might in every case have something to do with hereditary influences and the repressions occurring in the first five years of life seems to have been overloked. Thus he only quotes one case in which it was considered necessary to analyse the early sexual repressions. That the current conflict bears a relationship to older ones in reviving buried memories is not seen.
In his chapters on treatment, Dr. Culpin deals skilfully and at some length with the revival of war experiences by the method of abreaction. He lays stress on the necessity of the emotion being felt as a new experience in association with the original cause. A hypnoidal state is aimed at in this abreaction and in this r