1 Department of Health, New Haven, Connecticut 06511
The preceeding letters emphasize some very valid points, among them the fact that distortions of useful acts can become classifiable as symptoms, as Dr. Palmeri observes.
Regarding the comments by Dr. Leonard, Solnit, and Lourie: In the wide range of activities labelled pica, a variety of contributing or coexisting factors, such as emotional deprivation, cannot be ignored. There was certainly no intention to extend the conclusions to all deviant appetites. Dr. Gutelius emphasized the factor of ingestion in defining pica.