- Email: [email protected]
Handbook of eating disorders
THE LANCET
Disposal, punishment and survival in Australia.-Shurlee Swain, Renate Howe. Cambridge: Cambridge University Press. 1995.Pp 264. €30. /SEN 0-521-4 7968-1.
Pushing her pram up and down the street, a single mother is derided by her neighbours, one of whom throws a stone. The stone misses the woman and strikes the baby instead. This scene from the film A Tree Grows in Brooklyn illustrates the state of affairs in 19th century Australia, where the illegitimate child was the chief victim of sanctions designed to punish women who had sinned by having sex outside marriage. Some 20 to 30 dead babies were found every year in the lanes, drains, and riverbanks around Melbourne. Others were abandoned by their mothers in the hope that someone would take in the foundlings and care for them. And others were pushed into state orphanages, stigmatised for life by the label illegitimate. The single mother was a challenge to the norm of bourgeois marriage and family and was condemned as deviant, someone who had no place in respectable society. Because of the conflict between mothering and breadwinning, the only truly acceptable solution to her “problem” was to hand over her child for adoption. The authors of this slice of social history paint a haunting picture of
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: i
Handbook of eating disorders Edited by George Szmukler, Chris Dare, Janet Treasure. Chichester: Wiley. 1995. Pp 420.€18.99./SEN 0-471-96307@0.
: : : : : : :
times by descriptions of background The editors state that Gerald Russell, recently retired professor of psychiainformation relevant to the numerous try, National Institute and the i research projects with which Russell Maudsley and Bethlem hospitals, did has been involved; and sometimes by not want to have a Festschrift in his i speculative essays about different approaches to well-recognised probhonour, but it is difficult to imagine how better this book could be i lems. It is these latter two categories that give the book most of its interest, described. It is neither a report of recent research findings, nor a com- i but there is a wide variation in the quality of the contributions. prehensive review of current howlThe process by which authors were edge, let alone a handbook for i practitioners. Rather, it is a collection selected is difficult to discern. of articles examining various features i Although the editors write that all had of eating disorders: sometimes by worked with Russell, the nature of means of detailed reviews of the pub- i their collaboration must have been lished work (which are, unfortuvery varied. Some of the North nately, rather boring, and generally i American representatives had relaless comprehensive than equivalent tively little direct contact with reviews in recent journals); some- i Russell. On the other hand, impor-
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Vol348 * August 24, 1996
i i i i i
It also contains statistical data drawn from a sample of 150 exnuptial births drawn at 5-yearly intervals from the Index to Victorian Births matched against a control group of nuptial births. It identifies 1925 the strategies by which single moth- i mothers and 2105 children, some of ers and their children survived in i whom are followed through until age Victoria from 1850 to 1975, when i 14. And it traces the legal changes for the legal status of illegitimacy was i abortion reform, the evolution of a finally abolished. Illegal abortion, i meagre benefits system that did not hasty marriage, or cohabitation mas- i discriminate against single mothers, querading as marriage were the main i and the development of the Child escape routes from shame for a preg- i Support Scheme, whereby the nonnant single woman. When these i custodial parent made payments via failed, the woman was segregated, i the tax system. excluded forever from polite society i “The old story of sin and sorrow”, and thenceforth dependent on the i was how one unmarried mother was goodwill of parents, charitable agen- i introduced to the Victoria Neglected cies, and refuges for the reform of i Children’s Aid Society in 1895, a fallen women. The goal of these i stereotype that, despite changes in harsh institutions was to be achieved i vocabulary, remains as active as ever by prayer and endless toil. Women i in the western world today. One-parwho were accused of killing their i ent families are still disadvantaged children were sent to prison. And and marginalised. In Britain, single babyfarms sprang up, brutal i mothers have been reviled in the popestablishments in which babies died i ular press for having their children of starvation and neglect. i solely in order to jump the queue for The book is full of the voices of i council housing. And in the United women, their children, and the i States, welfare payments to teenage oppressive and unforgiving society in mothers have come under threat in which they existed-drawn from i the effort to stop moral decline. The diaries, court records, interviews, and i hostility of the moral majority is still the problem pages of women’s maga- i rampant. zines. It is the oral story of a patriarchal era when the survival of sexually active single women depended on ~ u d ySadgrove : 348 Green Lanes, London N16 9NH, UK their silence.
Single mothers and their children
i i i i
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tant British authorities, such as Fairburn, Lacey, and Crisp, who had far more direct contact with him, are not included. And the representation of European authorities is very limited-xcluding such important figures as Ploog and Steinhausen, for instance, both of whom have carried forward work initiated by Russell. Do Dare, Szmukler, and Treasure subscribe to the view that the British and Americans are somehow closer to each other than either are to other Europeans? If so, that view accords poorly with Russell’s own bilingualism (in French) and the eurocentric psychiatry to which he was directed by his mentor, Sir Aubrey Lewis. Furthermore, the editors have allocated a disproportionate number of chapters to themselves. This gives a distinct bias to subjects and views pertinent to London’s Maudsley Hospital (or more accurately, the 531
THE LANCET
I
BOOKSHELF
i i i
Bethlem, to which the anorexia neraccredited with describing bulimia i nervosa has led to the further spread nervosa, although in its original form of this illness. A similar point had vosa unit has been moved), rather than to a catholicism of interests, or ; his concept perhaps had more in i been made by Brumberg with respect to an accurate record of the progrescommon With the purging form of to Hilda Bruch and anorexia nervosa. sion of Russell's own work Over the ; anorexia nervosa than with our i Probably, we will never really know. ; current understanding of this illness. A serious scholar, Russell's erudiyears. It is worth commenting that many His genius was in understanding the ; tion is set off by his enthusiasm and of Russell's most noteworthy achieveessential similarities in psycho- ; knowledge of the visual arts. He is ments went against his original i patholow between anorexia and ; capable of great charm, and has been bulimia nervosa patients. But his much admired and loved by many of stance. He long advocated a primary role for an underlying pituitary or at ; assertion that bulimia nervosa was an ; his colleagues and students. This least hypothalamic lesion in anorexia ''Ominous variant of anorexia ner- ; handbook succeeds in illustrating the depth and range of his contribution, nervosa, but his research (and its fur- ; VOSa" has not been supported. It is clearly a less ~ r i o u illnesss ; and the great influence he has exerted ther extension by other groups, such throughout the field of eating as our own and that of Pirke, pioog, ; Russell has made the most signifiand Fichter) have clearly demon- i Cant and wide-ranging contribution of ; disorders. all his generation to the understand- ; Despite the criticisms I have made, strated h a t the endocrine features are epiphenomena. H~ was originally ing of eating disorders. Rare among ; I think that anyone who is interested dubious of the of any form of ; modem medical academics, he is not in these serious and complex disorpsychotherapy, but his work with Only an inquisitive and rigorous ders will derive great benefit from Dare and SzmuNer has been h e most ; research worker, but also a compasreading it. convincing yet of all studies evaluatsionate and skilled clinician. He pre- ; ing family therapy (albeit of a most ; serves a keen ability to criticise his ; ; P J V Beumont unusual form, directed at encouragown work. Typical of him, he has ing parents to assume h e responsibil- ; expressed considerable anxiety as to ~h","","n~::i~~~~~~~~' ity of care for their children). H~ is ; whether his description Of bulimia ; New South wales 2006. Australia
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i i i i
i
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Selected books: nursing Community Healthcare Nursing.-Sheila Twinn, Barbara Roberts, Sarah Andrews. Oxford: Butterworth-Heinemann. 1996. Pp 527. €25. ISBN 0-75061590-7. Nursing in Primary Health Care.-Fiona Ross, Ann MacKenzie. London: Routledge. 1996. Pp 202. €9.99. ISBN 0-415-106168. Nursing for Incontinence-2nd edn.Edited by Christine Naton. Beaconsfield, Bucks: Beaconsfield Publishers. 1996. Pp 401. €16.95. ISBN 0-906584-42-6.
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Key management skills in nursingManagement in the acute ward.Jane Walton, Maggie Reeves. Dinton, Nr Salisbury: Quay Books. 1996. Pp 100. €9.95. ISBN 1-85642-041-8.
Selected books: radiology Current Topics in Radiography-2.Edited by Audrey Paterson, Richard Price. London: Saunders. 1996. Pp 311. €19.95. ISBN 0-7020-2202-0.
Making Sense of Research: An lntroduction for Nurses.Gill Hek, Maggie Judd, Pam Moule. London: Cassell. 1996. Pp 150. €9.99, ISBN 0-304 33338-7.
Fundamentals of Emergency Radiology.-Philip Wiest, Paul Roth. Philadelphia: Saunders. 1996. Pp 175. €27.95. ISBN 0-7216-5182-8.
Nursing Negligence: Analyzing Malpractice in the Hospital Setting.Janet Pitts Beckmann. Thousand Oaks, California: Sage. 1996. Pp 282. $25.95. ISBN 0-7619-0226-0.
Clinical Audit in Radiology: 100+ recipes-Edited by Ray Godwin, Gerald de Lacey, Adrian Manhire. London: Royal College of Radiologists. 1996. Pp 312. €25. ISBN 1-872599.
Endpiece
Stigmata of syphllls The lesions of congenital syphilis may heal leaving stigmata, which include linear scars around the angles of the mouth and small, notched upper central incisors. Taken from ABC of Sexually Transmitted Diseases (third edition) edited by Michael W Adler. (London: BMJ PublishingGroup. 1996. Pp 71. €13.95. ISBN 0-7279-08848.)
532
Vol 348. August 24, 1996
Disposal, punishment and survival in Australia.-Shurlee Swain, Renate Howe. Cambridge: Cambridge University Press. 1995.Pp 264. €30. /SEN 0-521-4 7968-1.
Pushing her pram up and down the street, a single mother is derided by her neighbours, one of whom throws a stone. The stone misses the woman and strikes the baby instead. This scene from the film A Tree Grows in Brooklyn illustrates the state of affairs in 19th century Australia, where the illegitimate child was the chief victim of sanctions designed to punish women who had sinned by having sex outside marriage. Some 20 to 30 dead babies were found every year in the lanes, drains, and riverbanks around Melbourne. Others were abandoned by their mothers in the hope that someone would take in the foundlings and care for them. And others were pushed into state orphanages, stigmatised for life by the label illegitimate. The single mother was a challenge to the norm of bourgeois marriage and family and was condemned as deviant, someone who had no place in respectable society. Because of the conflict between mothering and breadwinning, the only truly acceptable solution to her “problem” was to hand over her child for adoption. The authors of this slice of social history paint a haunting picture of
:
: i
Handbook of eating disorders Edited by George Szmukler, Chris Dare, Janet Treasure. Chichester: Wiley. 1995. Pp 420.€18.99./SEN 0-471-96307@0.
: : : : : : :
times by descriptions of background The editors state that Gerald Russell, recently retired professor of psychiainformation relevant to the numerous try, National Institute and the i research projects with which Russell Maudsley and Bethlem hospitals, did has been involved; and sometimes by not want to have a Festschrift in his i speculative essays about different approaches to well-recognised probhonour, but it is difficult to imagine how better this book could be i lems. It is these latter two categories that give the book most of its interest, described. It is neither a report of recent research findings, nor a com- i but there is a wide variation in the quality of the contributions. prehensive review of current howlThe process by which authors were edge, let alone a handbook for i practitioners. Rather, it is a collection selected is difficult to discern. of articles examining various features i Although the editors write that all had of eating disorders: sometimes by worked with Russell, the nature of means of detailed reviews of the pub- i their collaboration must have been lished work (which are, unfortuvery varied. Some of the North nately, rather boring, and generally i American representatives had relaless comprehensive than equivalent tively little direct contact with reviews in recent journals); some- i Russell. On the other hand, impor-
i
:
Vol348 * August 24, 1996
i i i i i
It also contains statistical data drawn from a sample of 150 exnuptial births drawn at 5-yearly intervals from the Index to Victorian Births matched against a control group of nuptial births. It identifies 1925 the strategies by which single moth- i mothers and 2105 children, some of ers and their children survived in i whom are followed through until age Victoria from 1850 to 1975, when i 14. And it traces the legal changes for the legal status of illegitimacy was i abortion reform, the evolution of a finally abolished. Illegal abortion, i meagre benefits system that did not hasty marriage, or cohabitation mas- i discriminate against single mothers, querading as marriage were the main i and the development of the Child escape routes from shame for a preg- i Support Scheme, whereby the nonnant single woman. When these i custodial parent made payments via failed, the woman was segregated, i the tax system. excluded forever from polite society i “The old story of sin and sorrow”, and thenceforth dependent on the i was how one unmarried mother was goodwill of parents, charitable agen- i introduced to the Victoria Neglected cies, and refuges for the reform of i Children’s Aid Society in 1895, a fallen women. The goal of these i stereotype that, despite changes in harsh institutions was to be achieved i vocabulary, remains as active as ever by prayer and endless toil. Women i in the western world today. One-parwho were accused of killing their i ent families are still disadvantaged children were sent to prison. And and marginalised. In Britain, single babyfarms sprang up, brutal i mothers have been reviled in the popestablishments in which babies died i ular press for having their children of starvation and neglect. i solely in order to jump the queue for The book is full of the voices of i council housing. And in the United women, their children, and the i States, welfare payments to teenage oppressive and unforgiving society in mothers have come under threat in which they existed-drawn from i the effort to stop moral decline. The diaries, court records, interviews, and i hostility of the moral majority is still the problem pages of women’s maga- i rampant. zines. It is the oral story of a patriarchal era when the survival of sexually active single women depended on ~ u d ySadgrove : 348 Green Lanes, London N16 9NH, UK their silence.
Single mothers and their children
i i i i
: i : i :i :i :i i i
:i i i i i i i
tant British authorities, such as Fairburn, Lacey, and Crisp, who had far more direct contact with him, are not included. And the representation of European authorities is very limited-xcluding such important figures as Ploog and Steinhausen, for instance, both of whom have carried forward work initiated by Russell. Do Dare, Szmukler, and Treasure subscribe to the view that the British and Americans are somehow closer to each other than either are to other Europeans? If so, that view accords poorly with Russell’s own bilingualism (in French) and the eurocentric psychiatry to which he was directed by his mentor, Sir Aubrey Lewis. Furthermore, the editors have allocated a disproportionate number of chapters to themselves. This gives a distinct bias to subjects and views pertinent to London’s Maudsley Hospital (or more accurately, the 531
THE LANCET
I
BOOKSHELF
i i i
Bethlem, to which the anorexia neraccredited with describing bulimia i nervosa has led to the further spread nervosa, although in its original form of this illness. A similar point had vosa unit has been moved), rather than to a catholicism of interests, or ; his concept perhaps had more in i been made by Brumberg with respect to an accurate record of the progrescommon With the purging form of to Hilda Bruch and anorexia nervosa. sion of Russell's own work Over the ; anorexia nervosa than with our i Probably, we will never really know. ; current understanding of this illness. A serious scholar, Russell's erudiyears. It is worth commenting that many His genius was in understanding the ; tion is set off by his enthusiasm and of Russell's most noteworthy achieveessential similarities in psycho- ; knowledge of the visual arts. He is ments went against his original i patholow between anorexia and ; capable of great charm, and has been bulimia nervosa patients. But his much admired and loved by many of stance. He long advocated a primary role for an underlying pituitary or at ; assertion that bulimia nervosa was an ; his colleagues and students. This least hypothalamic lesion in anorexia ''Ominous variant of anorexia ner- ; handbook succeeds in illustrating the depth and range of his contribution, nervosa, but his research (and its fur- ; VOSa" has not been supported. It is clearly a less ~ r i o u illnesss ; and the great influence he has exerted ther extension by other groups, such throughout the field of eating as our own and that of Pirke, pioog, ; Russell has made the most signifiand Fichter) have clearly demon- i Cant and wide-ranging contribution of ; disorders. all his generation to the understand- ; Despite the criticisms I have made, strated h a t the endocrine features are epiphenomena. H~ was originally ing of eating disorders. Rare among ; I think that anyone who is interested dubious of the of any form of ; modem medical academics, he is not in these serious and complex disorpsychotherapy, but his work with Only an inquisitive and rigorous ders will derive great benefit from Dare and SzmuNer has been h e most ; research worker, but also a compasreading it. convincing yet of all studies evaluatsionate and skilled clinician. He pre- ; ing family therapy (albeit of a most ; serves a keen ability to criticise his ; ; P J V Beumont unusual form, directed at encouragown work. Typical of him, he has ing parents to assume h e responsibil- ; expressed considerable anxiety as to ~h","","n~::i~~~~~~~~' ity of care for their children). H~ is ; whether his description Of bulimia ; New South wales 2006. Australia
i
: i
i i i i
i
i
Selected books: nursing Community Healthcare Nursing.-Sheila Twinn, Barbara Roberts, Sarah Andrews. Oxford: Butterworth-Heinemann. 1996. Pp 527. €25. ISBN 0-75061590-7. Nursing in Primary Health Care.-Fiona Ross, Ann MacKenzie. London: Routledge. 1996. Pp 202. €9.99. ISBN 0-415-106168. Nursing for Incontinence-2nd edn.Edited by Christine Naton. Beaconsfield, Bucks: Beaconsfield Publishers. 1996. Pp 401. €16.95. ISBN 0-906584-42-6.
:
i i i i
: :
:
.i
Key management skills in nursingManagement in the acute ward.Jane Walton, Maggie Reeves. Dinton, Nr Salisbury: Quay Books. 1996. Pp 100. €9.95. ISBN 1-85642-041-8.
Selected books: radiology Current Topics in Radiography-2.Edited by Audrey Paterson, Richard Price. London: Saunders. 1996. Pp 311. €19.95. ISBN 0-7020-2202-0.
Making Sense of Research: An lntroduction for Nurses.Gill Hek, Maggie Judd, Pam Moule. London: Cassell. 1996. Pp 150. €9.99, ISBN 0-304 33338-7.
Fundamentals of Emergency Radiology.-Philip Wiest, Paul Roth. Philadelphia: Saunders. 1996. Pp 175. €27.95. ISBN 0-7216-5182-8.
Nursing Negligence: Analyzing Malpractice in the Hospital Setting.Janet Pitts Beckmann. Thousand Oaks, California: Sage. 1996. Pp 282. $25.95. ISBN 0-7619-0226-0.
Clinical Audit in Radiology: 100+ recipes-Edited by Ray Godwin, Gerald de Lacey, Adrian Manhire. London: Royal College of Radiologists. 1996. Pp 312. €25. ISBN 1-872599.
Endpiece
Stigmata of syphllls The lesions of congenital syphilis may heal leaving stigmata, which include linear scars around the angles of the mouth and small, notched upper central incisors. Taken from ABC of Sexually Transmitted Diseases (third edition) edited by Michael W Adler. (London: BMJ PublishingGroup. 1996. Pp 71. €13.95. ISBN 0-7279-08848.)
532
Vol 348. August 24, 1996