years psychiatrists have recognized that there is a type of emotional dissence from school. This is a deep-seated psychoneurotic disorder fairly sharply differentiated from the more frequent and common delinquent variety of school truancy. The syndrome, often referred to as "school phobia," is recognizable by the in ense terror associated with being a t school. The child may be absent for Broadwin, Isra T. A Conhidwion to the Study d Truancy. Au. J. OUTHOPSYCHIATUY, 11.3.1932.Fo" turbance in children, associated with great anxiety, that leads to serious ab-per1 -d s of weeks or months or years, unless treatment is instituted. The children,

Chiceta, IffinoisNOREXIA NERVOSA has presented a frequent topic for discussion A in the medical and psychiatric literature of many nations. I t is the intent of this paper: 1) to review this general literature with emphasis on clarification of some of the conflicting statements that have been made; 2) to study in some detail the dynamics of starvation; 3) to review more specifically the literature that concerns the anorectic male; 4) to present in detail the case histories and treatment of two prepubescent boys with this symptom complex, and to refer briefly to two others; and 5) to formulate in the discussion that concludes the paper the psychodynamic aspects of the subject. A comparison between our male and female cases, an explanation for this symptom choice, apparent reasons for the less frequent occurrence of this symptom complex in boys, and finally, practical suggestions for treatment will also be offered.REVIEW OF THE GENERAL LITERATURE OF ANOREXIA NERVOSA Although Morton (25), in a book published in 1694, was probably the first writer to refer to this symptom complex, as he does in the chapter entitled "Of a Nervous Consumption," Sir William Gull (10, 11), in 1874, described and named anorexia nervosa. While he had observed the condition in males, he described it as occurring typically in girls between the ages of 16 and 25 who showed extreme loss of weight with no demonstrable organic disease, slow starvation pulse, amenorrhea, and low respiration rate. A tendency to irritability, remarkable energy and ceaseless activity in these patients despite poor nutritive functions were also pointed out by him. He regarded the cause as a "perversion of the ego" and said the want of appetite was due to a morbid mental state. Although he had seen one fatal case, he regarded the prognosis for the most part as favorable. He advised feeding a t regular intervals and surrounding the patients with persons who had the greatest control over them. H e added significantly that the inclination of the patient should in no way be consulted.Since this early description of anorexia nervosa, many articles have appeared in the literature as adequately reviewed by Rahman and others (23)

HIS paper describes a technique for psychiatric treatment and research in T the behavior problems and psychoneurotic disorders of children in which concomitant therapeutic efforts are made by two psychiatrists, one of whom deals with the significant parent and the other directly with the child. Although the rationale of the approach has been indicated by Lowrey (I), and a t times even explicitly stated in the literature by Almena Dawley (2), Greig (3), Anna

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