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)

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RADITIONALLY, the orthopsychiatric team has embraced the psy-T chiatrist, psychologist, social worker, and recreational therapist. The increasing interest in inpatient care of emotionally disturbed children, either in the pediatric hospital or in specially constructed child psychiatry units, has pointed up the importance of adding the pediatrician, the pediatric nurse and the teacher to this team. The Child Care Training Program of the Chicago Institute of Psychoanalysis has recognized this need by offering special dynamically oriented training to qualified people in all of these ancillary fields.The planning and development of a child psychiatry-pediatrics hospital liaison program to include collaborative teamwork in a well-baby clinic, child development special studies group, mother-baby rooming-in service, mutual staff case conferences, and reciprocal consultation services, resulted in a series of interesting and what we felt were enlightening experiences. This paper will be devoted primarily to those which involved the attempt of the child psychiatrist to gratify the requests of the pediatric residential staff for "rounds" and psychiatric consultations, as well as the learning opportunities that might be gained therefrom. The subject matter that we are presenting evolved as an interesting by-product of the child psychiatrist's attempt to best meet the expressed needs of the pediatricians.