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Dr. Culpin's article does not justify its title. We should have expected to find some definite pronouncement on the present position of psychotherapy from a lecturer on psychoneuroses, but the only information in this respect may be summed up in words used by the writer, 'Taking a general view of recent development we find a great increase of interest in the mental processes underlying certain disorders'. It seems a rather unnecessary expenditure of energy to write an article of five columns to tell the readers of the Lancet this obvious fact. However, apart from this general defect in the article there are one or two points worth noting in it.
The author tells us that practically all the physical disabilities seen in cases of shell-shock had been described by Hector Gavin in his book 'Feigned and fictitious Diseases in Soldiers and Sailors' which appeared in 1843. This is interesting information for those medical men who like to look upon shell-shock as a new and never-before-known syndrome. Psycho-analysts have never been blind to the fact that practically all life long before the war, and they have constantly stated and demonstrated this fact.
Further he points out that H. W. Page and the late Furneaux Jordan in 1891 definitely established the emotional origin of 'railway spine' which was then looked upon as due to gross organic changes, just as at the present time certain observers would like to regard all cases of shell-shock. The emotional factor in shell-shock psycho-analysts have always maintained and emphasised as a fundamental cause of the symptoms.