Models of Madness, Models of Medicine: By Miriam Sigler and Humphrey Osmond. New York and London: Macmillan. 1974. Pp. 287.

This book sets out to examine the various models of mental illness currently obtaining in Western psychiatry. The authors' aim as stated is to rationalize some of the confusion that arises in psychiatric discussions. They divide the psychiatric models into two groups: first, those groups which do not offer global theories of the mind, which they call the 'discontinuous models', namely the medical, the moral and the impairment models, and secondly, those models which they regard as offering global theories of the mind, which they describe as the 'continuous models', namely the psychoanalytic, the psychedelic, the conspiratorial, the social and the family interaction models. In particular they argue that the continuous models of mental illness have tended to eschew the issue of sickness in the patient. They single out the social, the psychedelic and conspiratorial models on this count. There is an interesting parallel drawn between the current idealization of the schizophrenic experience as seen in the psychedelic model and the past romanticization of a medical condition, tuberculosis, before the time when this latter illness was amenable to successful treatment.

The authors' chief concern is to establish the validity and efficaciousness of the medical model within psychiatry. In examining this model, while they explore the roles and attitudes adopted by the doctor and patient in their relationship to each other, they do not pursue to any great extent the difference between this model's doctor–patient relationship and the relationship obtaining in other models. This is an issue which has been of great interest to some structural anthropologists who have tried to show the ways in which changes in this two-fold relationship have a bearing on the three-fold relationship of the doctor and patient and the concept of illness. The main focus of the authors is on the incapacity of the continuous models to explain and cope with the major psychoses. In particular they