Modern miraculous cures

Modern miraculous cures

J Psychosomatic Res , 1960. Vol 4 pp 244tcv 250 Pergamon Press Ltd , London Prmted in Northern Ireland BOOK REVIEWS F ANTONELLI II Reumatis...

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J Psychosomatic Res

, 1960.

Vol 4 pp 244tcv 250

Pergamon

Press

Ltd , London

Prmted

in Northern

Ireland

BOOK REVIEWS

F ANTONELLI

II Reumatismo

Pslcosomatico.

Sot

Edhce

Umverso, Rome, 1957 210 pp

IN THIS handsomely produced volume, Professor ANTONELLI sets out to review m the hght of his very extensive experience many old and some new problems relatmg to the psychosomatic study of the rheumatic diseases, especially rheumatoid arthritis Begmmng with the concept that neurosis 1s a disturbance of personahty, and after dlscussmg how this accords with the many current defimtlons of neurosis and of psychosomatic disorders, Professor ANTONELLI goes on to expound the view that there exists a specific “rheumatic neurosis”, the outcome of mtrapsychlc conflict or environmental stress upon a special, well-defined personality type This typical neurosis 1s usually associated with somatic changes which approximate more and more to the character&c syndrome of rheumatoid arthritis as the illness develops Occaslonally, however, and particularly m the earlier stages of the disease, the neurotic picture does not include somatic components On the other hand, marked organic changes are always accompanied by neurotic marufestatlons, though the latter may not be evident at first sight The specific personality type found m mdividuals predisposed to rheumatic neurosis 1s given m some detail, and 1s dlstmgmshed from that associated with ankylosmg spondyhtls Such mchvlduals are thought to be particularly vulnerable to certain forms of stress, and these too are mmutely considered The transItion from mental confhct to physical change IS believed to represent firstly, a failure of psychic defence mechanisms, and secondly, the partlclpation of the autonomic system consequent upon the primary mental disturbance Hence the locahzatlon of the various lesions IS always of symbohc slgmficance These concepts lead on the view that the arthrltrc and other mamfestations of the disease act as a safety valve for psychic tension, which IS dIustrdted by dlscusslon of those cases m which exacerbations of the rheumatoid changes and psychosis have alternated On the organic side, Professor ANTONELLI describes m detad the role of metabolic, hepatlc, hormonal and autonomic factors, and discusses the anomahes which may be detected on laboratory mvestigatlon m these and other systems Finally, after considermg a system of classlficatlon based on the above aetlologlcal concepts, the author proceeds to the question of therapy He 1s emphatic m asserting that psychotherapy must constitute the first lme of treatment, though sleep therapy, tranqudhzmg and sedative drugs, analgesics and physiotherapy all receive appraisal as valued auxdrary agents The book concludes with a valuable bibliography of over two hundred references Professor ANTONELLI 1s to be congratulated on having produced a stimulatmg and thoughtful volume which will help many to clarify the numerous obscurltles m this difficult field of study.

N

F. LEURET and H

BON

Modern

Miraculous

Cures.

Peter Davies, London,

1957

KREITMAN

16s

OF ALL the alleged cures at Lourdes, an average of about one per year 1s declared miraculous by the

Medical details of some of these are given m this Church authorities after prolonged dehberatlon enthusiastic account by two Catholic doctors, both passionate believers m the miracles The medical reader will be struck first of all by the enormous gaps m the evidence as to dlagnosls One might have charitably assumed that more facts were available than could be summarized m a popular book, but havmg seen the complete dossiers at Lourdes one reahzed the scantmess of the 244

Book reviews

245

orjgmal evidence, and the thoroughness with which the authors have assembled all the facts that fit their views Some of the examples which the writers quote with reverence and wonder to the outMile Clauzel, for instance, suffered from spinal osteoslder seem nothmg out of the ordinary arthrltls She also had a plethora of symptoms suggestive of functIona disorder-myoclomc attacks, a large variety of fluctuatmg pains, an absence of neurological srgns, and a hlstory of After taking to her bed and refusing food for a long time psychological methods of treatment she got very weak and was thought likely to die At her own request she was carried to Mass In church she suddenly felt better, got up, walked home, ate heartily, and rapidly regained health and strength Though this pomt IS omltted m the book, her X-rays continued to show the same arthrltlc signs, but she remained symptom-free Another lady, Mme Rose Martm, made a sudden recovery from what was supposed to have been a secondary carcinoma It manifested by a lump felt on one occasion P R some months after a hysterectomy for adeno-carcmoma of the cervix She was severely constipated from heavy addIctIon to morphme, and there was evidence of pelvic Infection, but other explanations of the lump are brushed aslde If the book fads to satisfy a miracle hunter of moderate sceptlclsm, at least It makes some points clear, although not the ones emphasized by the authors For Instance, one now knows that the Lourdes records do not contam cases of sudden changes m X-ray appearances or m pathologlcal findings The miracles, such as they are, concern sudden recovery from chronic, deblhtatmg condotlons of questronable orlgm Consldermg the many thousands who visit Lourdes annually, and the many more who pray from a distance, some at least of these recoveries must be purely comcldental These expressions of sceptlclsm are not meant to Imply that psychosomatlc changes of extraordinary interest do not sometlmes take place at Lourdes and other healing shrmes Some examples of extremely rapid healmg of chronic abscesses are particularly Interesting But this book IS not the source to recommend for studying such matters D J WFIST

Symposia on Juvenile Delmquency, Delinquency. Orthopsychlatnc Assoclatlon B KARPMAN, Chalrman and Edltor Series Washington, D C , 1959 385 pp $lO,OO

Child and Juvenile

presented at the Amerrcan Psychodynamic Monograph

FIVEyearly symposia (1949-1953) on Juvemle delinquency are contained wlthrn this book They Include formal papers and dIscussIons by over thirty contributors, most of them psychiatrists Dr KARPMAN deserves special credit for orgamzmg these and other symposia on delmquency, for his valiant efforts m summarlzmg and contrasting the different vlewpomts presented m each symposium, pomtmg out neglected areas of mvestlgatlon, m trying to tie all the loose knots together and weaving a cover-all pattern For all his efforts the book remams a rather loose and repetitious assemblage, which m Its present form requires much unnecessary reading to find the kernels of wisdom that It undoubtedly contams Dr KARPMAN might well have employed his time m giving the reader an organized and crItIcal account of these proceedings, a task he ISwell qualified to perform However there are, no doubt, a number of speclahsts m the field and probably others also who prefer the full unabridged account The various psychlatrlc approaches to the field are well represented, with a few exceptions The vrewpomts of psychlatrlsts who have stressed factors of Inheritance, neuropathology, somatotypes and educational handicaps are represented m a sketchy way The endocrmologlc account contains two case studies m which the mjectlon of androgen hormone had markedly beneficial effects on body build and personality growth Delmquencles were also no longer m evidence Throughout the symposium stress was placed on an eclectic approach, though as usual there was a natural bias m the direction of each clmlclan’s special field of competence Most of the dlscussants were concerned with psychodynamlcs The tradItIona psychoanalytlc approach was represented by one discussant Ideas derived from psychoanalysis were apparent throughout the symposmm A particular topic that gives this symposium Its special feature was emotlonal prlvatlon, by which was meant the absence or lack of maternal love and other forms of maternal psychologlcal sustenance m early life Why various deficits, emotlonal traumata, and confhcts finally emerged m the form of delinquency, rather than neurosis, etc , involved conslderatlon of socIologIcal factors (“dlsruptlve environments”) besldes