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preven t ive medicine has made i ts grea tes t s t r ides and accomplishments in the field of ped i a t r i c s , and second, wha t may be t e rmed " c h i l d consciousness" has been an ou ts tand ing expression of social t rends and developments in recent years.

The impor tance of this s tudy cannot be overest imated. I t s value lies in the f a c t t h a t i t is an expression by physicians themselves of the i r a t t i tudes and thoughts toward medical problems. To some, a t first thought, the report may seem confusing. I t will undoubtedly be asked why no conclusions are reached and no plan formulated from this mass of material . I t lies in just this fac t : the book represents and gives expression to v iewpoints and thoughts , r a the r t han a pro and con discussion of some specific proposal, and there in i ts grea tes t value and impor tance are found.

B. S. V.

Clinical Psychology by C. M. Lout t i t , Director, I nd iana Univers i ty Psychologic Clinics, iNew York, 1936, Harpe r & Brothers .

The purpose of this book is to organize the w~despread materials in th~ field of applied psychology, called clinical, into a systematic presentation. The ma- terial presented is l imited to behav ior problems of children.

P a r t i deals wi th methods of examinat ion. In an in t roductory chapter the au thor gives a general descript ion of the field which includes the definition and aims of clinical psychology. The t e rm " c l i n i c a l " is justified since the aim Of clinical psychology is to define the behavior , capacity, and character is t ics of the individual , and then give suggestions for the proper ad jus tment of t h a t individual . This necessarily involves diagnosis and t reatment , their l imitation to the individual, t he child or the adolescent, and to pa t i en t s in whom there is no organic disease. I t f inally includes the re la t ionshi p of o ther professions, education, pediatrics, psychia t ry , menta l hygiene, and social welfare. I t is quite obvious then t h a t such ac t iv i t ies cannot be l imited to the meaning of the te rm psychology, a l though this is regarded by the author as the basic science of th is endeavor.

In Chapter 2 the au thor describes the examinat ion of the individual . He stresses the importance of inqui r ing into the chi ld ' s past history, p resent l iv ing conditions, his performance abilities, his repertoire of skills, habits, and his phys- ical condition. The author describes in detai l var ious methods of t e s t ing the child 's intelligence and mentions many other characteristics which would come under education, achievement, aptitude, personality, conduct, and environment. A ve ry adequate l ist of references is included in these chapters.

Numerous br ie f case records are given to i l lus t ra te the various points. The author emphasizes the f ac t t h a t the job of the psychologist is to evaluate the causat ive factors and suggest means of correct ing the causes of the var ious dif- ficulties. The earlier in the course of the school period t h a t this correction is made, the bet ter .

T rea tmen t of p r imary behav ior problems calls for changing the cul tura l milieu wi th the cooperation of the parents , and in the new surroundings car ry ing on re- t r a in ing to achieve more acceptable behav ior habi ts . To a l imited ex ten t this same program can be applied to indi rec t p r imary behavior problems, bu t in these an effort must be made to help the child overcome the in te rmedia te a t t i tudes or conflicts. The first of the p r imary behav ior problems discussed a t some length are those relat ing to conduct. They are divided iuto three groups: first, forms of behav io r objected to in the f ami ly group; second, problems impor t an t in connec- t ion wi th the home, bu t which have wider social significance; third, problems which are of serious social significance since they viola te legal requi rements and therefore a r e broadly antisocial. Ind iv idua l problems under these headings are discussed in detai l and the works and opinions of various inves t iga tors are given.

BOOK REVIEWS 845

In these cases t rea tment must be carried out by the parents. They must be taught tha t the importance of a symptom is dependent upon the cause--not the result. Prevent ion is more important than t reatment , so the author gives sug- gestions of methods of t ra ining the child so tha t diifieu]ties may be prevented. When the problem has arisen, however, the cause of the disorders depends largely upon the reaction of the individual child and parents or guardians, and the parents or guardians should be instructed in means of t raining the child so as to elimi- nate the cause. A number of cases are given to illustrate these questions.

Juvenile delinquency is especially considered in this book. A great deal of work has been done on this subject and the findings are quite uniform, so the author gives informat ion which he has obtained mainly from three extensive studies of large groups of delinquents. ~V[ost delinquents show a ra ther low in- telligence (from 80 to 90), are apt to be emotionally unstable, are of ten native- born children of foreign-born parents, live in homes which are economically and morally poor and in which the family relationship is psychologically bad, and in neighborhoods which are frequently socially disorganized and physically de- teriorating. While delinquency is the result of inadequate t ra ining and is the symptom of personali ty disturbances, the causative factors arc so numerous that the author gives various i l lustrat ive cases rather than a t tempt ing to discuss them in a general way.

The psychologic t rea tment of delinquency pat ients differs l i t t le f rom that in any other behavior problem, but in these cases behavior involves legal offenses and the child is seen only a f te r he has been to court where the first duty of the judge is to protect society. The author discusses in detail the legal procedures in cases of juvenile delinquency and shows tha t while the law must protect so- ciety from the acts of the offender and t h e p s y c h o l o g l s t is concerned with the child as an individual, there is no reason why the two views should conflict, t ie suggests active psychotherapy during insti tutionalization, and probat ion rather than inst i tut ional izat ion as punishment. The probat ion period can be used as a means to watch the child and to help him to reform, but if his behavior continues to be bad he can then be sent to an insti tution. The author recommends the co- operation of court and psychologic clinic.

There is a chapter on speech defects. A great deal is said about fears~ anxieties, jealousy, and daydreaming, There is also a very intel l igent comment on psychoses, part icularly dementia precox, schizophrenia, manic-depressive psychoses, and psychoses wi th organic pathology. Only juvenile paresis is discussed by the author.

I t can be seen from this brief sketch of the contents that the book repre- sents a very broadly outlined consideration of the whole subject. A vast amount of material is presented in a systematic form. The s tudent of clinical psychology, for whom it is wri t ten, can find here a complete description of his whole field of work as well as references which will enable him to make a detailed study of any subject in which he is part icularly interested. The author gives first a gen- eral survey of the subject, including examinations, and then devotes the remainder of the book to problems wi th which this branch of science deals. Throughout he emphasizes the fact that the book deals with the individual, not the problem. I-Ie also stresses the fac t tha t the problems are not dear-cut , but merge one into the other. I-Ie gives the varying theories of invest igators and often gives his own opinion as to which seems most adaptable. In no case does he quote theory as a fact . While the author seems to give more space than is necessary to con- ditions which are relat ively rare, or to those which arc the pr imary concern of others, such as disabilities in school subjects and problems correlated with phys- ical defects, the reader realizes on fur ther consideration tha t he gives the stu- dent such a clear idea of these that he will not be forced to look far ther . This

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means of presentation serves also to bring out his second important point--that

cooperation between this and the other related professions is to be most earnestly

sought.

This outline gives but a meager description of the scope and plan of this book.

It is by far the most useful book on clinical psychology that the present reviewer knows. It seems to contain all that is essential for the clinical psychologist as well as the psychiatrist or pediatrician with whom he works. The reviewer is im-

pressed with the care and conscientiousness of the author in his task, the lack of prejudice,.or any indication os a limited or narrow point of view. The point is

constantly stressed that the important thing is the consideration of the child as a whoIe~ and the problems that the child presents are to be considered from the standpoint of the total personality in relation to his total environment. This book is an extensive performance, well over 600 pages in length. I t is, therefore, in a sense, a book of reference and this the reviewer thinks is perhaps to be its most important service. The book is clearly writ ten, well arranged, and carries out the plan as presented by the author in his introductory chapter.

S. I. S.

~.L.