2. Symptoms arising in the atmosphere of dread: the memory- or mnemo-neuroses: (a) The elements of the dread are logical; readily understandable by the patient and the generality of mankind: the ordinary form of the memory-neurosis.

(b) Illogical dread, the elements of which are entirely incomprehensible to the patient: the obsessive form of the memory-neurosis.

In general Dr Core's work is much more akin to the French outlook in clinical psychology than to the analytical, but it is work of an unusually high character on which he merits our warmest congratulations.

H. CRICHTON MILLER.

The Care of the Adolescent Girl. By PHYLLIS BLANCHARD, PH.D. (Kegan Paul, Trench, Trubner & Co. Ltd, 1921. Pp. xxi + 201. Price: 7s. 6d.)

This book deals with the problem of the adolescent girl from a psychological and philosophical standpoint; the author is actuated by a high ideal of womanhood, and by the obvious need in the present day for adjustment in the education and upbringing of girls.

She leads up to the main theme of her subject by reviewing various philosophical and psychological theories as a background to Freud's conception of the unconscious; in comparing this with the idea of the 'subconscious' formulated by von Hartmann, she omits to point out the fundamental difference in the two theories, which rests on the Freudian doctrine of repression.

Dr Blanchard's attitude to Freudian psychology is inconsistent, and it is easy to show that she has not a clear insight into the theoretical principles; on the other hand, when quoting records of cases, her comments and explanations are based for the most part on Freudian conceptions.

There are a number of inaccuracies and ambiguities in the text, for example the author professes to use Freud's phraseology when stating that 'a suppressed sexual impulse' 'had become displaced from the conscious to the subconscious strata of the nervous system.' This mingling of psychical and physical terms occurs several times, and suggests a lack of appreciation of the mind as a psychic entity, in which the unconscious plays the larger part and has no defined relationship to strata of the nervous system.' Again, she states that Freud's theory of libido is the 'simple statement that the motivating principle of all human activity is the procreative instinct'; this is untrue, and it is difficult to reconcile it with an understanding of the theory of repression and mental conflict as a cause of the psychoneuroses. It is amazing that the work of the Freudian school on the ego-instincts should still be ignored.

A further confusion of mental and physical processes is revealed in the description of sublimation as a process in which the energy of the libido is transmitted into higher nervous processes, and traversing neural pathways of association, reinforces the aesthetic creative impulses' etc.: psychoanalysis has shown that the aesthetic creative impulse is a sublimation of the sexual instinct, and is not merely reinforced by it. The author appears to use 'higher' in the sense of intellectual, in distinction to physical, as later on she speaks of libido as becoming 'converted downwards' and producing physical symptoms.

In dealing with the views of Maeder on the intuitive impulses of the unconscious the author holds that the ultimate salvation of humanity rests in

its power to follow these impulses. Exactly what is the relation of these intuitive impulses to the sexual instinct, which matures at adolescence, is not clear; apparently "the adolescent girl is unduly sensitive to this strange force within her being, because to her, much more than to her brother, is given the serious mission of transmitting it intact to succeeding generations." This 'strange force' seems to be a possession of the ovum rather than of the spermatozoa, and to be associated with a greater capacity for self-sacrifice and altruism; so far it has escaped scientific observation.

Dr Blanchard adopts Benjamin Kidd's ideal of women and in her enthusiasm for the sex wanders away from the reality revealed by psycho-analytical research to an ideal feminine personality, which suggests psychologically a masochistic goddess. To accept a position for the larger section of the community, which involves a 'bitter conflict' in adolescence, and subsequently a life of self-sacrifice, is unthinkable in an age of progress and freedom. The procreative act should have pleasure for the woman as well as for the man, and the self-sacrifice of maternity is only one aspect, which in itself brings gratification. Masochistic gratification is referred to in a later chapter, but is lost sight of in the preliminary discussion.

The chapter on the sex instinct contains some interesting reports given by a number of adolescent girls in answer to questions concerning day-dreams, erotic dreams, menstruation, etc.; the reader is struck by the absence of adequate sex knowledge shown, and the feeling of inferiority accompanying menstruation. The maternal component of the sexual instinct is obviously subservient at this stage; the author suggests that the modern girl is beginning to choose for her husband the man whom she wants to see as the father of her children. This statement does not bear closer investigation.

When dealing with the adolescent conflict, the author states that 'with the onset of pubescence and the beginning of menstruation, there is first brought into the focus of consciousness the radical difference between the male and female organisms, a fact which has hitherto been little considered by the girlish mind.' This conclusion has been proved to be erroneous countless times by psycho-analysts; a radical difference in the male and female is recognised in the first few years by the average child, and the repressed and unexplained recognition is intimately concerned with the adolescent conflict under discussion. The cases reported, with their well-marked feeling of inferiority demonstrate the truth of this observation; the author, however, adopts Adler's view and considers the masculine protest against organ inferiority as the psychological explanation.

Dr Blanchard shows a clearer and less hampered view of her subject when she touches on the relation of religion and art to sublimation, and recalls the primitive forms of worship and the origin of magic.

In the following chapter she quotes several interesting records of neurotic cases with analytical annotations, showing their dependence on anomalies in sexual development. It is an error to describe the transference of affection in adolescence to one of the same sex as a passing perversion,' for a homosexual transference of libido in adolescence represents a normal stage of development. There is confusion again in a reference to ambivalent forms of the Oedipus complex, by which the author appears to mean the transference of positive feelings to one parent, and negative to the other. This suggests that the significance of the term 'ambivalent' is not clear to her. A further statement, which cannot be overlooked, is to the effect that certain extremists

among psycho-analysts 'gravely urge' that 'the adolescent girl who finds the problem of controlling and sublimating her impulses too arduous, be allowed full satisfaction of the sexual instinct on the biological level.' It would be interesting to know to what school these analysts belong, for it is an untrue assertion of those who, using Freud's technique and accepting his theories, have the actual right to be called psycho-analysts. Such recommendations recall the 'wild analysis' described and condemned by Freud.

In spite of the numerous unsound and inconsistent statements which appear in the book, there is also truth and insight, and the reader is left with the impression that the aim of the author is more convincing than the means advocated to attain her end. She says, 'the adolescent girl's rebellion against the influences which tend to cramp her development is misguided by the adoption of a false set of standards, so that instead of seeking an expression of her own peculiar nature, and making her own unique contribution to the race, she has sometimes attempted to follow the man-made path instead of blazing the trail for herself.' The truth is obvious, but the evil is not rectified by preaching a doctrine of self-sacrifice on the one hand, and on the other hinting at a higher mission of guiding a civilisation that has been too long in the hands of men.'

At present hard and fast rules cannot be formulated for the upbringing of the child and adolescent, but many pitfalls will be avoided by early sex enlightenment, the avoidance of unequal treatment of the sexes in childhood, and the encouragement of a view of sexuality which unites the ideal and the physical; these principles combined with increased opportunities for sublimation and work for the welfare of the community should help to mitigate the conflict of adolescence, which tends to warp and impoverish the developing personality.

SYLVIA M. PAYNE.

NOTES ON RECENT PERIODICALS.

Journal of Mental Science, July, 1921.

Both of the original articles in this number are from the hand of Sir Frederick Mott, the Morison Lectures on the Psycho-pathology of Puberty and Adolescence, and the second Maudsley Lecture which, apart from a short historical account of the Maudsley Hospital, is devoted to Sir Frederick Mott's recent researches on dementia praecox.

Both the Morison and the Maudsley Lectures deal almost entirely with Sir Frederick Mott's recent histological and biochemical researches in the changes in the sexual glands and central nervous system in cases of dementia praecox and congenital imbecility. In both conditions more or less regressive atrophy of the testes and ovary has been found in the great majority of cases examined, associated with arrest of spermatogenesis, on the one hand, and of maturation of the Graafian follicles on the other. In the central nervous system there is evidence of primary parenchymatous degeneration of neurones with glia cell proliferation. Researches into the bio-chemistry of the central nervous system in these diseases give evidence of diminution of neutral sulphur showing general inherent deficiency of oxidation processes, also a deficiency of organic phosphorus which may be correlated with the evidence of failure of nuclear phosphorus in the reproductive organs.

The regressive atrophy of ovaries and testes is not considered as the primary change in dementia praecox; Sir Frederick Mott considers that in this disease and in congenital imbecility there is evidence of a failure of vital energy of the cells of the whole body, manifested especially in the two most important to show symptoms, namely, the closely inter-related sexual organs and the brain. For the author mental processes are considered as subordinate to physiological processes and mental disorders are due to pathological physiogenic conditions.

Journal of Mental Science, October, 1921.

This number opens with an Obituary Notice by Dr Percy Smith of Sir George Savage, of whom there is also an excellent photograph. Dr Percy Smith has brought wide personal knowledge and heartfelt esteem to the writing of this article: it is a record of a good life well and fully lived.

Amongst the original articles the Presidential Address to the Medico-Psychological Association by Dr C. Hubert Bond is worthy of very careful study. Taking as his subject, "The Position of Psychological Medicine in Medical and Allied Services," Dr Bond sets out clearly the present legal restrictions in the treatment of mental disorders and the deficiencies and obstacles to progress. The need for the extension of the system of voluntary admission to county and borough asylums is first dealt with, followed by a short outline of the difficulties of defining certifiability, and the vagueness of uncertifiability as a guide to arrangements for treatment. The position is well summed up in the following sentence: "The truth is that against possible unauthorised detention, whether for personal profit or as is much more likely— for the sake of carrying on treatment, the real protection, apart from the ordinary Common Law remedies, is not in forms and procedures, but in supervision (facility for inquiry and visitation) and power to take such action as seems called for at the hands of those who have the requisite experience and independence." Emphasis is laid upon the urgent need for amendment of the existing Lunacy Laws, to enable cases of acute and curable forms of mental illness to be treated for a probationary period of at least six months without the necessity for certification.

The second part of the paper is devoted to a consideration of the Report of the Consultation Council on Medical and Allied Services established under the Ministry of Health Act of 1919, which, as Dr Bond suggests, "affords a reasonably secure basis

on which we can formulate suggestions to meet any special facilities demanded for preventive, curative and custodial treatment of mental and allied disorders. To those, more noisy perhaps than numerous, for whom the Board of Control stands for all that is reactionary and inhuman, the breadth and wisdom of the reforms advocated by Dr Bond may perhaps make for enlightenment.

The remainder of this number of the Journal is devoted to four short papers read at the Annual Meeting of the Medico-Psychological Association, 1921. "The Problem of the Feeble-minded in South Africa," by Dr J. T. Dunston, is mainly devoted to administrative legislation and statistical considerations. Special reference is made to the Mental Disorders Act of 1916, which embodies very definite advances and far-reaching reforms. Interesting reference is made to the incidents of feeblemindedness amongst the native populations of South Africa; referring to mental disorders the writer states that he has never seen, and, within his knowledge, no single case of true paranoia has been reported, amongst the native population.

"Mental Hygiene and Prophylaxis in France," by Dr H. Colin, deals also mainly with administrative and legislative problems. In France apparently, new legislation to place the treatment of mental disorders in line with modern requirements is still some way from the Statute Book. La Ligue d'Hygiène Mentale, founded in December, 1920, is apparently the centre for propaganda work for the initiation of much-needed reform.

"Legislative Restriction in connection with the Treatment of Incipient Insanity," by Dr Wilfrid Corden, Barcelona. This paper may be adequately summed up in one short extract. Lunacy Law in Spain "embodies all that red tape can do to hinder proper treatment of cases, and it presents therefore a problem which reaches a climax of complexity."

"The School Medical Service in Relation to Mental Defect," by Dr G. A. Auden. A presentation of the case of the school medical officer in relation to a unification of the Medical Services which deal with the various aspects of mental defects. The author emphasises the need for psycho-educational clinics for the examination of all children presenting abnormalities of educational progress or of conduct.

M. B. W.

Journal für Psychologie und Neurologie (Vol. XXVI).

Nos. 1 and 2. October, 1920.

O. L. Forel's psychological study, "Le Rhythme," should be of interest to physicians who have been struck by the great, largely subconscious, influence of rhythm on the mind. He traces through different departments of individual and social life the various ramifications of rhythm, endeavouring to relate them to one another and to arrive at a synthetic presentation of the subject. The study falls into three parts: (1) physical and psycho-physiological rhythms, (2) rhythm in work and play; rhythm in music, (3) experimental data on the phenomena of rhythm; therapeutic considerations.

Dr H. Preisig contributes a paper on "Malformations de la moëlle épinière," in which he gives a detailed account of the case of a child suffering from multiple malformations. Appended is a plate showing sections.

E. Grünewald (Freiburg Nervenklinik) writes on infantile spastic paralysis illustrated by the case of two brothers in whom this disease occurred.

Nos. 3 and 4. January, 1921.

This double number contains the following papers: "On the histopathology and pathogenesis of amaurotic idiocy with special reference to changes occurring in the cerebellum," by Max Bielschowsky, illustrated by five double plates. "Localisation in the nerve centres of the optic muscles. Two as yet unknown centres in the human mid-brain," being an account of certain laboratory experiments by Dr Casimir Frank in the neurological clinic in Rome (illustrated).