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February 17, 1951


Author Affiliations

712 Fourth and Pike Building, Seattle 1.

JAMA. 1951;145(7):509. doi:10.1001/jama.1951.02920250061025

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To the Editor:—  As a psychiatrist I find it necessary to take issue with various statements made by Dr. Edward N. Cook (Misconceptions in Urology, J. A. M. A.144:1421 [Dec. 23] 1950) concerning functional sexual disturbances and enuresis. Under the heading "Conditions Based on Neuroses," the author confines causes of sexual disturbances to factors such as "fatigue, mental or physical... worry... apprehensive of the future... may be afflicted with mother-in-law trouble." Actually, however, none of these comprise a neurosis. A neurosis (or more accurately, psychoneurosis) is ordinarily considered to be based on a conflict between unconscious and conscious psychic elements to a degree where symptoms of one type or another are manifested.While Dr. Cook acknowledges that sometimes it may seem wiser to turn the problem over to a psychiatrist, he adds that he does not agree with such a course "mainly because many of my patients have

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