Putting Engstrom in the antipsychiatry school is not really a criticism of the book, any more than calling someone a Rosicrucian would be. It is a kind of global perspective that one either agrees with or not. Engstrom is so wrapped up in academic politics, however, that he loses sight of psychiatry as a discipline and argues, for example, that the university psychiatric clinics were little involved in actual patient care and little involved in therapeutic innovation. Both statements are wrong. There was scant therapeutic novelty in psychiatry before World War I, but thereafter the main innovations in treatment—Wagner-Jauregg’s malarial therapy for neurosyphilis, Klaesi’s deep sleep therapy, Sakel’s insulin therapy, Meduna’s Metrazol, and Cerletti’s ECT—came from university clinics (none, to be sure, in the German Empire but all profoundly influenced by German academic psychiatry). As for not being directly involved in patient care, university psychiatric hospitals had large numbers of beds. The Germans became world leaders in psychopathology because they studied their patients so carefully.