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This book stares with an introduction summing up the literature and thinking on psychiatric illnesses that did not appear serious enough to be considered psychotic in nature. Particularly in the period of the 1880s to the 1920s, the concepts and observations appear quaint. To this reviewer, the symptoms presented for the most part suggest very definite psychosis, even though some individuals are cited as having recovered following a sea voyage or similar diversions. Further, some of the cases cited could well exemplify the pathology of paresis, although no such view is offered. But this introduction serves to suggest how vague and little understood were the symptoms of the times, and it was not until the appearance of Bleuler, Kraepelin, Freud and the psychoanalysts who came to this country seeking refuge, that our understanding of mental illness was enriched and a more scientific psychiatry came into being.
The first group in this collection of essays on insanity, “moral insanity,” and “borderland insanity” offer very little of interest with regard to borderline conditions, and their inclusion does not appear justified, although they suggest the editor's thoroughness. But Part II, with its introductory summation of concepts of the borderline group in the 1930s and 1940s begins to focus more directly, especially with the work of Hoch and Polatin, whose zeal in the development of the concept of “pseudoneurotic schizophrenia” this reviewer can personally testify to, as a former resident at New York State Psychiatric Institute, working under them. Their work is the last of a series of papers covering this period, and they agree with those preceeding them that it takes a constellation of symptoms to make this diagnosis—notable among them a polymorphous anxiety, extreme affective responses and concept displacements, even though no gross thinking disorders are apparent. They point out that these patients remain vaguely contradictory about their explanation of symptoms, and