Reasoning in Medicine. An Introduction to Clinical Inference

indeed she paints a vivid picture of the changes in European and American society and science by focusing on this particular disease. From the wealth of details throughout the book, it is clear that Brumberg, a historian, has thoroughly researched her material. While the details add color to the lengthy case histories, they also tend to become repetitive and tedious, and in some cases the author continues to present examples after she has already convincingly illustrated her point. In spite of this, the book is interesting. Brumberg admirably does not attempt to attribute a modern etiology to the self-imposed starvation/anorexia that existed in previous centuries, since doctors of those periods never fully explored the causes of the disease and merely tried to treat its symptoms. She does not try to re-interpret the past to understand modern anorexia. Instead, she describes the religious, social, and cultural mores of the times and how these affected eating habits. Only when she analyzes eating disorders in the twentieth century does she allow herself a more interpretative tone, analyzing how current culture and expectations might lead to obsessional behavior centered around food. She does, however, show how, across the ages, the limitations on women's control over their lives has left them with limited modes of self-expression, and she implies that manipulation of eating habits has always been an acceptable and powerful mode of self-expression, especially for women. The book should be of interest not only to health professionals, who will undoubtedly meet many patients with anorexia nervosa, but to the general public as well. Although it is not intended to be either a handbook giving advice on management of anorexia nervosa or a conclusive explanation of its causes, the book manages to present new perspectives of a very puzzling disease. By focusing on anorexia in the context of both its own history and of the history of medicine and society, Brumberg also presents new perspectives of the medicine and society of previous periods.