The author studies the psychosomatic literature which reflects changes in psychosomatic medicine in North America during the last twenty years. During this period contributions by psychiatrists have been steadily increasing while contributions by neurologists and other specialists have been less frequent. Particularly important have been the contributions of psychoanalysts. While welcoming a trend toward experimental laboratory research, Wittkower cautions that it is of limited value in a field with so many variables; he feels that careful clinical observations are no less demonstrable than statistical work based on imprecise experimentation. Because of lack of team work between the different specialties, and hence a multidisciplinary research approach, psychosomatic medicine is in a period of crisis which threatens its existence.