Notes

PSYCHOSOMATIC MEDICINE has a special interest for psychoanalysts. Probably no analysis is carried to conclusion without the appearance of some somatic symptomatology. Psychoanalysis being the most precise method of psychological investigation, we know that it is unconscious not conscious processes that are the most closely related to symptomatology in the physical sphere. Some psychoanalysts are giving special attention to this problem, and there is a tendency to become less precise and less scientific in attitude than when remaining strictly within their own sphere. When a physiologist publishes an article in which he includes some psychological observations, if his physiological method is precise, we can accept his psychological observations as potential clues and forgive a lack of precision; but when a physician publishes an article as a psychoanalyst, and because of the attempt to combine physiological and psychological observations, loses precision in his own methodology, that is unfortunate. With a few noteworthy exceptions, the contributions of psychoanalysis to psychosomatic medicine are to be found in the classical psychoanalytic literature, beginning with Freud and Ferenczi, rather than in articles purporting to be psychosomatic studies; yet psychoanalysis does have a contribution to make both to problems of general management in medical practice, and to problems of organic disease itself. The contribution of psychiatry to the former is being increasingly recognized. For example, Chester Jones and his associates, who have given a detailed review of the literature of gastro-intestinal diseases of the last two years (Gastroenterology: A Review of the Literature from January 1937 to June 1938, Archives of Internal Medicine, October, 1938) write: 'It is of interest that more and more scrutiny is being directed towards the relationship between the central nervous system and the autonomic nervous system and the digestive tract. The importance of the ps