MODERN CLINICAL PSYCHIATRY
By A. P. Noyes, 1903. Phila.: Saunders, 1934. pp. 485.
This book is the polished form of a series of lectures given at the Rhode Island State Hospital to senior medical students who chose to spend their summers studying the mental quirks of civilized man rather than sun-tanned anatomy at the beaches. It is an understanding and critical integration of data from the various biological sciences of anatomy, physiology, chemistry, and psychology. At the same time the author attempts to give a personally evaluated recognition to psychoanalysis and its contributions. It is a strictly modern book, although it follows a classification that has only recently been changed for the better. Its modern tone lies in its stressing of psychological contributions to psychiatry as being valuable rational explanations of the genesis and dynamics of normal and abnormal behavior. Here is one more psychiatric textbook which recognizes the necessity of using even hypothetical concepts when we lack biological facts, especially when these concepts help the psychiatrist to penetrate deeper than the surface symptoms to discover the fundamental maladjustment of the personality which lies at the root of
the so-called "functional" disorders as contrasted with the recognized organic diseases.
If we check this psychobiological point of view with the pages devoted to it we should be misled. Only five chapters are devoted to the functional psychoses, one to the psychoneuroses, and one to psychopathic personality states—as against twelve which describe the organic conditions. It is a fact, however, that the number of patients in our hospitals are victims of functional or psychological (mental) disorders rather than of organic diseases. The functional disorders are infinitely less understood and hence have a poorer prognosis. It is for this reason that such weighting of a textbook in psychiatry (as opposed to abnormal psychology or mental hygiene) is extremely welcome.
By way of conclusion, the reader should not confuse the term "psychobiological" with "psychoanalytical"; the term "psychobiological" merely means the study of psychology by the methods of biology. Freud has abandoned his physiology and neurology for the clinical techniques supplemented by highly original speculation. I include this explanation because several members of the faculty and others have asked me whether it was not true that modern psychiatry is over-run by the psychoanalysts. I have answered this in the negative on two grounds. First, it does not follow that the most aggressive group is the dominant group or the most prolific writers on the subject the most profound. Further, a belief in the functional point of view does not involve psychoanalysis in the least, necessarily, or a sympathetic interest in Freudian theories indicate a dominance of psychoanalysis in phychiatry. This book is a case in point.
