Personality in Arterial Hypertension: By C. A. L. Binger, N. W. Ackerman, A. E. Cohn, H. A. Schroeder and J. M. Steele. (Psychomatic Medicine Monographs, published by the American Society for Research in Psychosomatic Problems, New York, 1945. Price, $3.00.)

The largest part of this book is devoted to a case history study of 24 patients with hypertension. The authors conclude that the composite type of personality may be described thus: 'The outstanding elements are exaggerated dependent strivings, submissions coupled with stubbornness, feelings of weakness and defencelessness, suppression of hostility, fear of injury and emotional detachment. In addition there was a tendency to develop acute emotional disorders characterized mainly by anxiety and depression and often associated with temporary failure of the usual techniques of mastery of the environment. … There was usually a restricted social life, inhibited sexual development with actual or relative impotence, a tendency to failure of heterosexual adjustment, and unconscious homoerotic orientation and a tendency to incur frustration and suffering in interpersonal relationships, and in the relationship with employers.' The onset of hypertension is often related to a traumatic emotional experience. 'The core of the traumatic experience consists in sudden loss of security resulting from a real or phantasied threat to the patient's life or to the life of a parent figure.' The authors are careful not to claim that the personality they describe plus the emotional trauma bear an ætiological relationship to hypertension. Their study is primarily nosological. For this reason, they add, the question of control study is irrelevant. We cannot quite follow the validity of this argument. If control studies on other psychosomatic disorders reveal the same or similar patterns, it seems to us that the correlation adds little or nothing to the psychosomatic aspects of hypertension. Our view is fortified by their admission that the same personality type was found in patients whose hypertension was consequent to pyreonephritis and/or hydronephrosis as in those in whom the hypertension was 'essential'.

The book is extremely limited in scope. The psychosomatic aspects of hyper