NEW YORK ACADEMY OF MEDICINE, SECTION OF PEDIATRICS

an associate professor in the department of psychiatry. The clinic is located in the Harriet Lane Home and, though belonging to psychiatry practically speaking, it has been as much an integral part of the Harriet Lane Home as the clinic for children with heart disease or that for tuberculous infants. The department of psychiatry has only outpatients. All patients entering the psychiatric clinic to be seen by Dr. Kanner and his associates are referred from the pediatric clinic and have already been investigated completely by the pediatricians. When the investigation conducted by the psychiatric clinic is completed, a full report is written and attached to the unit history and through that medium is brought to the attention of the pediatrician who referred the case to the clinic. On receiving the report from the psychiatric clinic the pediatrician undertakes treatment with Dr. Kanner's knowledge, or Dr. Kanner undertakes the treatment with the pediatrician's knowledge, or they cooperate in the treatment. The pediatrician takes charge of the patient if he can and wishes to do so. The cases which the psychiatric clinic takes over are the more difficult ones, requiring special insight, guiding skill or much labor and time or special command of the community machinery for the care of problem children. During the three years of its existence the psychiatric clinic has taken charge of 1,400 children. It is roughly estimated that among the new patients coming to the dispensary 1 out of 10 brings some problem needing adjustment in the psychiatric clinic. Dr. Kanner has taken pains to make clear to the pediatric staff that no distur¬ bance or difficulty in behavior or, indeed, variation from normal behavior can be too slight for his interest or aid. In consequence, children are sent to him because of lack of appetite, vomiting, rumination, disturbances of sleep such as night terrors and sleep walking, disturbances in speech, bad habits such as tics and nail biting, disturbances of a sexual nature, antisocial exhibitions, emotional upheavals, hysterical conditions and mental defects. The value of the psychiatric clinic in the Harriet Lane Home lies chiefly in (1) the care of individual children, (2) the education of physicians and students and (3) the investigation of abnormal behavior in the human being. Probably