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Dr Thomä's book is more than a monograph on Anorexia Nervosa written from a psycho-analytic point of view. Almost one half of its 332 pages (plus 20 pages of bibliography) consists of two quite extensive psycho-analytic case histories which are of value to psycho-analysts whether or not they are specifically interested in anorexia nervosa. The author discusses critically and in considerable detail questions of nosological classification, constitutional factors, pathogenesis, various psychological approaches to the theory and treatment of this condition, differential diagnosis, somatic symptomatology, somatic therapies. He gives a succinct and thoughtful survey of the history of the anorexia nervosa syndrome, beginning with Morton's description of two cases in 1689, to the classical descriptions of Gull in England and Lasègue in France (1873) and to the confusion with Simmonds' disease (pituitary insufficiency) earlier in this century. Nowadays the syndrome is clearly differentiated from an endocrinological disorder, its psychogenic nature, recognized by Gull and Lasègue, is reestablished, although in much more sophisticated form than was possible in the days of Gull and Lasègue.
Anorexia nervosa, while not a disease-entity—however ill-defined—like schizophrenia or hysteria, is considered by Thomä as a syndrome with fairly well-marked clinical characteristics. This is in contrast to a recent American monograph on the same subject (Bliss and Branch, Anorexia Nervosa, New York (Hoeber), 1960) where a weight loss of twenty-five pounds or more, attributable to psychological causes, is considered, for purposes of their study, as the sole diagnostic criterion. According to Thomä, the following characteristics distinguish anorexia nervosa from other conditions leading to malnutrition and emaciation: (1) preferred age puberty and post-pubertal period; (2) preponderance in females; (3) psychogenic restriction of food intake; (4) spontaneous and induced vomiting, frequen