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This volume is one of the Everyday Practice Series planned to furnish the general practitioner with usable authoritative monographs on various subjects. Here this purpose is only partly successful. The long clinical experience of an eminent internist affords a satisfactory factual basis, but the modern interpretation of such facts is lacking. For, in the future, the physician should no longer be content when a diagnosis has been made that the heart is structurally sound but is functioning abnormally. Nor will he be able to mask his futility under complicated but vague concepts of vegetative or endocrine unbalance. It will be his major task to determine what the cardiac condition is trying to express, and that problem is not answered in terms of any mechanistic formula.
Dr. Brooks assumes the practitioner to be a working psychologist as well as a psychiatrist, but declares an intimate knowledge of either science is unessential. Mere knowledge of the human animal is entirely adequate according to his viewpoint. His attitude, which the reader is encouraged to take, can best be illustrated by the theories the author advances to explain 'true' cardiac neuroses as distinguished from such symptom complexes as paroxysmal tachycardia or anxiety angina. 'There is a considerable element of imitation in their evolution, they furnish a means for the evasion of duties, they appear to be the result of pure egotism'. One might almost suppose that nothing had been written in the past thirty years about dynamic factors which are not visible on the psychic surface. It is a pity that Dr. Brooks did not study further the implications of the report of Major Goddard which is cited in the discussion of war-time sufferers from neuro-circulatory asthenia. This observer found these men to have had no sex experience. A considerable percentage presented definite perversions or inversion, and these findings have been confirmed since the war period in women with this syndrome.
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