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During the twelve years that have passed since the publication of Dr. Bellak's first multiauthored volume on the schizophrenic syndrome,
there have been many similar efforts. The benefits and limitations of multiauthored books are clear since chapters will invariably range in quality, although this is compensated for by the specialized expertise of the contributors. That a number of editors have felt the need to call upon a score or more of contributors when writing about the schizophrenic syndrome is presumptive evidence that we are not dealing with a discrete disease entity.
The twenty chapters and two appendixes range from some of the senior editor's personal and highly interesting reminiscences to community psychiatric approaches. Unlike many similar efforts, this volume includes psychoanalytic and psychotherapeutic considerations. This is not only refreshing but to be lauded since some workers in the field seem to have lost sight of the fundamental fact that the patient is a person and not a schizophrenic.
It may be more useful to examine critically some of Dr. Bellak's ideas rather than to comment on specific chapters. In recent years he has spoken eloquently against the concept of schizophrenia as a disease entity. He has argued that it represents a syndrome which is the final common path of ego defects secondary to various etiologies. The etiologic and pathogenic factors that he lists are genogenic, chemogenic, psychogenic, and neurogenic. There is a danger that the reader may reify these factors which are only helpful as theoretical formulations, i.e., cognitive aids. Certainly the distinction between chemogenic and genogenic factors is of doubtful validity when considered in physiologic terms. The inclusion of psychogenic with organic factors involves the mixing of two different universes unless we are to believe that psychogenic factors operate through means other than genes, chemicals, and nerves. It is not clear whether we are dealing with a