A MIND DISEASED 65 



diseased has once been given a case of mental suffering in hand — one 

 whose investigations have led him as accurately as possible to differ- 

 entiate it from the truly alienated cases that can only be cared for in 

 protective institutions — he is at once often confronted with conditions 

 that tax his insight perseverance and skill, not only to an almost 

 unwonted degree, but far beyond the comprehension and consequently 

 the sympathy of his employers. Frequently, also, he has to contend 

 with varied and numerous and unexpected misleadings and coverings 

 up of facts which may be mostly owing to a previous false diagnosis ; or, 

 he finds the patient's normal ideation more or less in a state of irre- 

 coverable atrophy or decay; or, that there is perverted emotionalism 

 quite beyond understanding and of a continuously disastrous nature; 

 or that the will power has been so frequently strained and wrongly 

 directed that it can be relied upon for scarcely any good effort at all; 

 or, so frequently, all these in most perplexing combination. In fact, 

 the case is always one where the whole organism is more or less under 

 the spell of the mental distress, and consequently has a minimum of 

 recuperative forces at command. Even almost every physical function 

 is apt to be so lowered and perverted that, in turn, they may contribute 

 to the disease of mind and to the resistance to be overcome. In fact, 

 the case is one of " sickness all through " ; and the remedy and manage- 

 ment must be based upon this comprehensive vision, or failure will 

 almost inevitably result. 



Hence the wise remedialist will never neglect to at once institute 

 every sort of hygienic, sanitary and therapeutic measure, which may be 

 rationally indicated. Failure here is folly unmitigated; and no as- 

 sumed " special " or " exceptional " ability that presumes to get along 

 without due attention to the physical as well as mental functioning can 

 make it otherwise, try and promise as one may. 



Having first, then, given due consideration to the conditions and 

 needs of the entire case, the wise ministrant to the mind diseased will 

 next, and at once, seek to understand in detail the changes from the 

 normal psychology which are the immediate sources of the distress. 

 Here, again, ability to investigate with a penetration and thoroughness 

 that only the trained scientist can comprehend is the next great duty 

 which he owes both to his patient and to himself. To accomplish this, he 

 will bring all that his life, his reading, his special training and expert 

 ence have taught him; will exercise all the mental and moral qualities 

 of which he is possessed; will devote himself in every manner prac- 

 ticable, not only to relieving the present distress, but to arousing such 

 latent and stifled mental functions as will in due season contribute of 

 themselves to help to overcome that which is abnormal, and substitute 

 normal thoughts and feelings in its stead. In all this he will need and 

 should have the full confidence and intelligent help of those who are 



VOL. LXXXII. — 5. 



