PSYCHIATRY IN THE FUNCTIONAL PSYCHOSES 263 



relations of functional and organic diseases. In the definition of 

 disease, as "any morbid deviation from normal health," "the im- 

 portant distinction is drawn between organic or structural diseases 

 in which there is a lesion or pathological condition of some part 

 of the body, and functional diseases in which there is an irregular 

 action of a part but without organic abnormality." But keeping 

 to this distinction it is a remarkable fact that the word "psychosis" 

 is used in opposing senses in mental physiology and mental path- 

 ology. The psychologists, having regard to the normal processes, 

 use "psychosis" as "equivalent to the mental or psychical element 

 in a psycho-physical process, just as neurosis refers to that aspect 

 of the process which belongs to the nervous system." On the other 

 hand, in psychiatry the word "psychosis" is used pathologically 

 and "designates an abnormal mental condition;" it is described 

 as a typical form of insanity ("disease-form") which can be scien- 

 tifically differentiated and correlated with a specific "disease-pro- 

 cess," and the usage implies a structural change. In neurology 

 "neurosis" is also changed from its normal functional sense in 

 psychology and used to designate a "morbid or diseased condi- 

 tion." "Functional neurosis is a morbid affection of the nervous 

 system known only by its symptoms, and without anatomical 

 basis. It is doubtless true that an anatomical lesion of some kind 

 does in each case exist, and the classification of diseases as organic 

 and functional is but a concession to our ignorance." 1 These in- 

 stances afford examples of looseness of usage in two most closely 

 interdependent lines of research showing the disharmony between 

 them that tends to confusion of understanding. It is allowable to 

 speak of the neuroses, and the meaning is plain as referring quite 

 exclusively to functional disorders; but to constitute a true psych- 

 osis, in the pathological sense, it must have a definitely differen- 

 tiated symptom-complex that can be designated as a "disease-form;" 

 this is commonly spoken of as a clinical "entity," and it implies 

 a correlated "disease-process." We may speak of acute and chronic 

 psychoses, or of organic psychoses, to distinguish the insanity due 

 to cerebral disease. But the psychoses proper being conceived as 

 real disease-entities, when in psychiatry we wish to speak of the 

 group of minor and often temporary variations of the mental func- 

 tions, parallel or corresponding to the neuroses in neurology, the 

 word functional must be added and the term functional psychoses 

 used as in the subject of this discussion. 



1 Baldwin, Diet, of Philos. and Psychol. 



