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As a science caught up between the mythical and the rational, psychoanalysis is subject to the pulls of two opposing currents, a creative enlightened one concerned with the investigation of the unconscious, and a conservative counter-current observable in the psychoanalytic theory of femininity. In her analysis of these warning elements the author goes back to the genesis of psychoanalysis and its creator and takes a close look at the primal myth (the legend of Breuer and Anna O.), the primal dream (Irma), and finally the primal analysis (the case of Dora).

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Idiopathic nephrotic syndrome. Puncturing the biopsy myth.

Ann Intern Med

November 1987

Department of Medicine, New England Medical Center, Boston, Massachusetts.

We used decision analysis to compare the conventional strategy of biopsy-tailored therapy with alternative strategies not using renal biopsy in treating adults with idiopathic nephrotic syndrome. We evaluated data on steroid and platelet-inhibitor therapies and a new clinical strategy, empiric sequential therapy. This sequential approach involves use of short-term alternate-day steroid agents, followed by long-term platelet inhibitors for persistent nephrotic syndrome.

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