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SynopsisThe clinical course and outcome of anorexia nervosa are presented in a 10-year followup study of 76 severely ill females with anorexia nervosa who met specific diagnostic criteria and had participated in a well-documented hospital treatment study. Information was obtained on 100% of the subjects. A comprehensive assessment was made in 93% of the living subjects in specific categories of weight, eating and weight control behaviours, menstrual function, anorexic attitudes, and psychological, sexual, social and vocational adjustment. Five subjects had died, which gives a crude mortality rate of 6·6%. Standardized mortality rates demonstrated an almost 13-fold increase in mortality in the anorexia nervosa subjects. Only eighteen (23·7%) were fully recovered. Sixty-four per cent developed binge-eating at some time during their illness, 57% at least weekly. Twenty-nine (41%) were still bulimic at follow-up. The high frequency and chronicity of the bulimic symptoms plus the high rate of weight relapse (42% during the first year after hospital treatment) suggest that intensive intervention is needed to help anorexics restore and maintain their weight within a normal range and to decrease abnormal eating and weight control behaviours.

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SynopsisBulimic and non-bulimic anorexics were compared on psychological variables during a hospital treatment study. Although before treatment bulimic anorexics displayed more overall psychopathology than non-bulimics, many of the differences disappeared with treatment. There was no difference in severity of depression or body size estimation in these groups both before and with treatment. There was no difference in treatment response as measured by rate of weight gain. More expression of discomfort by bulimic anorexics during the acute phase of illness may in part account for some described differences in these two groups.

SECTION 1: INTELLECTUAL MAPSProofs and Refutations is already a classic, a model of clarity and succinctness, as well as of excellence. Yet, as Mark Twain noticed, everybody praises a classic but nobody reads it. And it is a fact, regrettable, but true nonetheless, that almost nobody reads Proofs and Refutations. Mark Twain thought classics were praised but not read because people were hypocrites and classics were bunk with a high reputation. In this essay I propose a different explanation of why classics in general may be hard to read and why Proofs and Refutations in particular has had few readers. Paradoxically, Proofs and Refutations is both easy reading and incomprehensible to many readers, indeed both highly readable, crisp, and amusing, as well as not even readable beyond the first two or three pages, infuriatingly frustrating, and so on. Yet many people praise it as a classic. If it is a classic, how is it that almost nobody can read it? And if almost nobody can read it, why is it a classic? Was Twain right? I believe I can explain the paradox of the simultaneous clarity and unread ability of Proofs and Refutations and make it easily accessible to those who complain that it is not readable.My thesis (and it applies to other such paradoxical classics as well) is that Proofs and Refutations is locally very readable to almost all readers, but globally readable only to a few readers. Only a reader who can provide for Proofs and Refutations an appropriate intellectual map can read it with ease globally; once that map is provided, the reader who might otherwise struggle with the text unsuccessfully will find all of a sudden that it is highly readable, enjoyable, stimulating, and in sum, very clear. There are readers for whom Proofs and Refutations has become clear in this way. In this essay I shall discuss three possible intellectual maps for Proofs and Refutations-maps which can be used separately but which I think are best used together. I will also show how the book becomes clear once these maps are provided. To explain how I propose to render Proofs and Refutations readable by offering three appropriate maps, I must first present a brief excursion into intellectual backgrounds, intellectual maps, and classics. I shall discuss Proofs and Refutations itself in later sections.There are two types of classics (both intellectual and artistic)-those which call for new intellectual maps to provide a new order for the intellectual background, and those which do not. Let me fix my terminology: intellectual backgrounds constitute those works which we regularly see around us. Intellectual maps are the specific ways of picking out of the background what is deemed significant, both for a given definite purpose, as well as for putting the various significant things in some order or other. The appearance of any new work changes the intellectual background-although at times ever so slightly-and the appearance of even a classic work need not call for a radical change. A radical change, finally, is not so much an addition of ...