PSYCHIATRY IN THE FUNCTIONAL PSYCHOSES 303 



mental exaltation." During more than half a century these de- 

 signations have held their places in psychiatry; the search for 

 more satisfactory statements has not been altogether successful. 

 The difference of the emotional tone is the criterion, but it is not 

 a wholly true one. The depression in melancholia is consistent be- 

 cause the "somatic senses" retain enough of normal function to 

 report truly to consciousness the fact of ill-being of the body; but 

 in mania the exaltation is not constant, the physical correlatives 

 of the feeling-tone are more disordered by reductions and losses 

 yielding more irritating excitations and in many cases a fictitious 

 sense of well-being. But the "somatic senses" produce other 

 equally important symptom-factors in the changes of motility; 

 in melancholia with impaired inhibition there are both psycho- 

 sensory and motor excitations and retardations, - - in mania, 

 with graver changes and losses of inhibition, motility is more dis- 

 ordered. The word melancholia, by long usage and observation 

 of the facts, really stands correctly in the recognition of its mean- 

 ing all of its well-known symptom-factors other than emotional 

 depression; the word mania, meaning madness, stands equally 

 well for both its emotional variations and its motor excitement. 

 In mania there is graver derangement of the "thinking process" 

 and its "states" are at a lower level of reduction than melancholia. 

 These references though meager serve to show that the terms mel- 

 ancholia and mania are well understood as including a great variety 

 of states of varied combinations and proportions of their symp- 

 tom-factors; besides the many typical cases of each group there 

 are found to be very many "mixed cases." There are many phases, 

 and a two-phase conception to represent the original groups of 

 "states" does not hold good; for example, taking out the emo- 

 tional depression from one group, and the motor excitation from 

 the other, in order to designate the distinction of the phases and 

 to characterize the compound "disease-form," leads to the exclu- 

 sion from it of the very essential psycho-motor excitation often 

 associated with the depression in the former group, and to over- 

 looking the significance of the emotional changes in the latter. An 

 adequate study of the "somatic group of senses," as suggested here, 

 should help to clarify the whole matter. Compound designations 

 for the unified symptom-groups yet suggested do not satisfy the 

 requirements so well as their simple combination in "melancholia 

 mania." The psychoses cannot be limited to the insanities; 

 we must speak of the "non-insane psychoses," and in psychology 

 the word refers to normal function. It might be said that the first 

 step in the classification of mental diseases discovers two great 

 divisions : functional insanity and deteriorating insanity. 



This discussion of the thesis that the problem of psychiatry is 



