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This is not only a well-written book but it is also extremely well-documented. The author demonstrates a through knowledge of the literature on peptic ulcer and quotes freely and accurately, giving
due credit to those investigators who have contributed to the study of emotional factors in the development of this syndrome. Unfortunately, the subjects of his investigation were all male, which may influence some of his conclusions particularly as they relate to 'specificity'.
In the introduction the author states, 'The psychoanalytic technique and theory and their adaptation to clinical psychiatry and psychology are an especially important conquest. Through the prolonged psychoanalytic courses of treatment it has proved possible by critical means to arrive at a hitherto unknown greater insight in the development and developmental conditions of the human personality, in its conscious and unconscious emotional processes.' He follows this observation by pointing out that medicine, and also psychiatry, now think of peptic ulcer almost entirely from a somatic basis.
He refers to a paper by Cushing, published in 1932: 'Cushing postulated a parasympathetic center in the diencephalon, which could receive stimuli through secretion of the posterior lobe of the pituitary gland or by cortical, psychic route. In this way it might be thought, according to Cushing, that vagotonic individuals through emotion or repressed emotions would have a special predisposition to chronic dyspepsia with hyperacidity, possibly resulting in peptic ulcer.' He goes on to Camerer's studies relative to the incidence of peptic ulcer in twins, published in 1935: 'The only important twin study has been made by Camerer. In a great number of twins he found seven pairs of monozygotic and seven of dizygotic twins of whom one or both or each pair had peptic ulcer. Concordance was observed in only two pairs, namely one of monozygotic and one of dizygotic twins, whereas discordance was thus found in the