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Should the national idiosyncrasies in the medical history of anorexia nervosa be attributed to differences in its prevalence or to differences in medical thinking? French, German, and Italian literature prior to World War I demonstrates that three approaches within traditions of psychiatric or medical thinking suffice to explain the national differences in reports of anorexia nervosa: minute clinical description, attentiveness to psychological facts, and attentiveness to nutrition. Furthermore, additional contributing factors are considered: general interest in neuroses, the institutional context, and the political context. As a result, historical epidemiological inferences are not warranted on the basis of the number of publications alone.