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Dr. White is indefatigable. This is his twenty-third book and it is well worth while, for all the great developments in psychiatry have occurred during the last forty years, and Dr. White has outlined them as he has observed them during that period. He disclaims that the book is intended in any sense to be an autobiography, although he gives some details of his early life; the first personal pronoun occurs several times on every page and no less than 22 pages are excerpts from his own writings. It is natural that he writes almost exclusively of American psychology and many American psychiatrists. He mentions several German ones, but only two Englishmen, viz.: Dr. Connolly, of Hanwell, who is really outside the specified period, and Dr. Ernest Jones, when he was resident in America.
It would appear that, forty years ago, the conditions in American and German asylums were more primitive than in our English ones, for the older forms of mechanical restraint were still in vogue, and in some States continued until quite recently—and there was no trained nursing staff. Now, however, some of their mental establishments are more in the nature of a hospital, and some of them seem to have progressed farther than most of ours.
Dr. White first mentions the humanitarian improvements, goes on to the introduction of scientific investigations and the influence of Kraepelin, and finally leads up to the recognition, owing to the writings of Freud, of the dynamic nature of mentation and the realization that mental symptoms have a deeper meaning than their superficial manifestations supply. We get the impression that the modern systematic development of graduated occupational therapy has not received so much attention in America as it has here. In this connection, however, Dr. White makes the useful suggestion that, instead of using primitive methods of manufacture in order to keep patients employed, modern methods of mass production might be installed in mental hospitals and the