Fibrosis. Ciba Foundation Symposium 114

knowledge. It was not unpleasant simply to sit and read, and should be useful to people interested in learning more about the medical beliefs and practices of this period. Mental illness, mental retardation, and substance abuse are important concerns today, but they are not recent phenomena. A consideration of mental disability in a historical context is essential to an understanding of the current situation. Don Martindale, a former professor of sociology, and Edith Martindale, a psychiatric social worker, cite legislative acts, government reports, sociological studies, and their own first-hand evidence to document this history in their most recent book, Mental Disability in America Since World War II. Their story begins with the earliest definitions of alcoholism from Persian legends, the founding of Quaker hospitals for the mentally ill in the eighteenth century, and the use of narcotics in the early 1900s. The majority of the book, however, examines the history of mental disability from 1945 to the present. The eight chapters consider the nationalization of mental disability, the opening and subsequent reform of institutions, the development of opposition to institutionalization of the mentally ill, and the process of closing the institutions in the 1970s. The authors praise the development of humane treatment, therapy, and other reforms in the care of the mentally disabled but register their dissatisfaction with the results of deinstitutionalization, to which they attribute the release and abandonment of over one million mentally incompetent people. While well-documented, the history suffers from lack of a clear focus and coherent organization. It is, nevertheless, interesting, well-indexed, and up-to-date. Mental Disability in America Since World War II provides an informative account for physicians, psychologists, and lay people with an interest in the historical background of mental disability. Given that many disease states result from host response to injury, the host processes comprising fibrosis are of interest to both basic scientist and clinician. Modulation of a fibrotic response can occur at various levels: expression of genes for extracellular matrix proteins, organization of these proteins, degradation of these proteins, and growth and activity of cells involved in synthesizing factors involved in any of the above. The Ciba Foundation Symposium Fibrosis addresses evidence for all of these possible control mechanisms. Miller et al. and Bailey and Light discuss the structure and organization of the