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This book, whose publication is sponsored by the American College of Chest Physicians, consists of thirty-three lectures given by different authors to the staff of the Veterans Administration Tuberculosis Hospital, Memphis, Tennessee, as an orientation course in the psychosomatic approach to tuberculosis. The editor has purposefully avoided any attempt to bring together the different views in the several papers, whose quality varies greatly. Some will be of immediate interest to those psycho-analysts who are analyzing patients who have had or have the disease: especially those by Wittkower and by Hartz.
Wittkower finds that though no specific personality type prevails in tuberculosis patients they all show an inordinate need for affection together with conflicts over aggression. He distinguishes five ways in which the patients-to-be have defended themselves against these needs and impulses and relates each to the onset of the disease, to the patient's reaction to it, and to his tendency to relapse. He quotes with approval Rebner's suggestion that not infrequently the tuberculosis lesion is felt to be representative of and equivalent to the image of a frustrating, sadistically attacked, incorporated mother who is simultaneously craved for. Hartz expresses a similar view.
The insistent and overt demands for affection of some tuberculous patients seem to have led some psychotherapists to make their gratification a first stage in psychotherapy as distinct from general hospital care and management. Masserman seems to hold this to be a necessary prelude to gaining the patient's confidence. Yet the dangers of this approach in intensive psychotherapy are perhaps indicated in a case described by Galdston. A young woman who had earlier divorced her husband fell ill with active tuberculosis, anorexia, and schizoid symptoms after she had suggested to him that they re-marry. Galdston states that initially 'She required not to be told, but to be made to feel that … she wa