Mental deficiency, once regarded as a homogeneous entity, now is recognized as a pattern of defective behavior that may be induced by any one of a large number of underlying disorders. The syndromes identified are so many and their etiology as yet sufficiently obscure that the task of classification presents a major challenge. The text under review, which arranges a copious amount of clinical material in a new scheme proposed by the author, fails to meet this challenge adequately.
Dr. Kugelmass suggests a quadripartite division into "developmental, metabolic, neuromotor, and psychological amentia." These categories lack a common point of reference—etiologic, anatomic, or clinical—and consequently are neither logically exhaustive nor sufficiently inclusive. Developmental metabolic disorders, such as phenylketonuria, must therefore be arbitrarily assigned one or the other rubric. "Metabolic" is forced to suffice for diseases as different as juvenile neurosyphilis and Niemann-Pick's disease. It is difficult to fathom what use of