Culture and Mental Disorders.

as suggestive evidence of a specific process. The mere existence of typical patterns, it seems to this reviewer, supports a concept of clinical entity but does not imply a common cause. There are other examples of striking thematic conformity as in the case of obsessive-compulsive states. If Kolle’s reasoning prevails here too, a specific underlying process would have to be postulated. Furthermore, the relationship between general paresis and primitive grandiose delusions appears less definitive than stated. The expansive-euphoric form is one of several dissimilar psychotic syndromes associated with this disorder. It has been observed time and again that the premorbid personality had decisive influence on the typological aspects of the early psychotic manifestations. Moreover, electroshock can abolish the psychotic disturbance before specific therapy is started. Since neither neurological, surgical or anatomical findings permit definite correlations between nature and extent of cortical lesions and mental symptoms, the case of the paralytic fails to qualify as a model in the considerations of the origin of delusions. Kolle’s inclination to reduce the complexity of potential variables to an almighty causal process appears over-rigid at a time when experimental investigations in the behavioral sciences provide growing evidence of multifactorial sets of causative forces. This is also overlooked by those whose therapeutic experiences with delusional patients have led them to construct highly imaginative genetic theories which have a peculiar way of acquiring an air of finality in the process of communicative circulation. It is a distinctive merit of Kolle’s style of presentation that the reader can profit from the liberal scope of the discussion without being asked to agree with particular conclusions. Since Kolle prefers questions to answers and maintains an attitude of cautious reserve in the establishment of his opinions, his essay can be highly recommended to all those who are still perplexed by the unsolved riddles of the nature of Wa/zn. F. A. FREYHAN, M. D., Farnhurst, Del.