BOOK REVIEWS 67

The Asylum us Utopia. W. A. F. Browne and the Mid- Nineteenth Century Consolidation of Psychiatry. Edited with an introduction by Andrew Scull. Tavistock Classics in the History of Psychiatry. Routledge, London, 1991. No. of pages: 240. Price: E40.

This is the seventh of a series of Tavistock Classics in the History of Psychiatry; republication in original type- face of eighteenth and nineteenth century landmark psy- chiatric books with an introduction by a medical historian. Andrew Scull sets the historical scene and reviews the career of W. A. F. Browne, a near contempor- ary of the better known John Conolly. Browne, born in Stirling in 1805, gained his LRCSE in 1826, and was quickly converted to the practice of phrenology, which was, we are told, ‘at least as influential in the first half of the nineteenth century as psychoanalysis in the first half of the twentieth’. In 1828 Browne travelled Europe in charge of a well-to-do lunatic and was able to visit and observe asylums throughout Belgium, France and Italy, thus gaining a truly international view of the asy- lum scene. On returning to Stirling in 1833, he established himself as a general practitioner before taking up the post of Superintendent of the Royal Lunatic Asylum at Montrose. Here he applied the principles of the new Moral Treatment with vigour and success, and seeking to publicize his achievements gave a series of public lec- tures. Appearing in 1837, What Asylums Were, Are, And Ought To Be was the published version of these lectures, describing in graphic detail the horrors of the old mad- house system, the shortcomings of the current reformed

asylums and the attractive attainable alternative that was his vision.

The book was a great success and secured Browne’s future as first Superintendent of the new Crichton Royal Asylum in Dumfries and in 1857 as the first Scottish Commissioner in Lunacy. The book does more than offer a Utopian vision of what the Victorian age could provide in care and treatment of the mentally ill. Browne sum- marizes what is known about the aetiology and epidemio- logy of mental disorders and reviews the classification systems in vogue. With great originality he describes the fundamental problem in schizophrenia as an ‘incapabi- lity of perceiving the relations of ideas’. Touchingly, the book ends with a footnote that is intended to demon- strate Browne’s means of providing occupational therapy for his patients, but which also reveals his level of trust in them: ‘. . . it may be mentioned that the manuscripts of these pages were transcribed, and the proofs corrected by individuals in the asylum under my charge’.

This book was a winner in 1837, and has a remarkable clarity and readability which make it a joy to read today. While Tavistock/Routledge are to be thanked for repub- lishing this volume, and making it available to all, at E40 it does not represent value for money. The beauty of these reprinted classics should surely be that every interested practising psychiatrist can own a copy, and appreciate the aspirations and labours of those who laid the foundations of our subject. Only libraries and the holders of generous merit awards will find this volume on their shelves.

ROBERT HOWARD Institute of Psychiatry, London

Geriatric Nutrition: A Comprehensive Review. J. E. Morely, Z. Glick and L. Z. Rubenstein. Raven Press, New York, 1990. No. ofPages: 503. Price: $102.

There is a definite transatlantic flavour to this review of nutrition in the elderly. It is refreshing to read a text specifically devoted to nutrition in the elderly which con- tains in many chapters a proper scientific discussion of current work in the field and most chapters are well refer- enced.

The recommended allowance in this text will be out of step with the new dietary reference values from the Department of Health contained in a recent report (HMSO 1991).

There is not available at present, to my knowledge, such a comprehensive discussion of most of the aspects of nutrition in the elderly, varying from nutritional inter-

vention of the immune response to practical matters regarding nutritional support.

I do not feel that the chapter on memory enhancement in mice with chronic menhaden oil administration, or indeed the chapter on zinc status in impotence, is really justified in an otherwise balanced and general text. There is the occasional irritating typographical error, such as in the chapter on gastrointestinal function, where ‘dys- phasia’ appears instead of ‘dysphagia’. Otherwise, the book is well presented and diagrams are clear.

I think this book is a valuable addition to the literature, though the specialist nature of the text will make it attractive to libraries and those directly concerned in research in the field.

A. J. THOMAS Plymouth General Hospital