PSYCHOLOGICAL MEDICINE 183 



surpass in psychological interest the smaller group of neurotic condi- 

 tions that do not regularly come under institutional care. 



It is not now easy to say how this latter group of cases will to any 

 extent be brought under the observation of the psychologist. Except 

 in isolated instances, the material of private practise may be systemat- 

 ically observed only by the physician who treats it. For our psycho- 

 logical understanding of these cases, we shall presumably remain de- 

 pendent upon such studies as the specially interested physician is able 

 to make in the course of his practise. These researches should improve 

 in number, if not also in quality, as medical students acquire more 

 knowledge of psychopathological problems, and of the means by which 

 to approach them. The case is more favorable with that part of this 

 material than is seen in general hospitals, or in small private institu- 

 tions, but the obvious economic difficulty of providing for the system- 

 atic psychological study of this material is one which it has not yet 

 been attempted to meet. If these conditions are thus less accessible 

 as a group, it is partly compensated for by their greater accessibility as 

 individuals, owing to the generally better preservation of the intellect 

 and cooperative faculties, so far as these enter. In the comparative 

 study of the neuroses and psychoses, these factors to some extent bal- 

 ance each other. 



The most practical means to further the accessibility of psycho- 

 pathological material for psychological research, has been through the 

 establishment of research positions in the institutions whose facilities 

 are adequate to them. The past decade has witnessed the inception of 

 a considerable amount of this work, under various state and private 

 auspices. The conspicuous success of Franz at Washington and of 

 Goddard at Vineland may be mentioned. These positions have been 

 regularly rilled by persons of the university training in psychology, who 

 are expected to devote their time to original investigation. Whatever 

 the special character of the material investigated, the main responsibil- 

 ity for psychopathological investigation will rest — and perhaps it may 

 be added that it ought to rest — with the men in these positions, re- 

 lieved of the perpetual penalty of therapeutic promise. As the suc- 

 cess of these positions depends upon the men whom they will draw, 

 and this in turn upon the opportunities they offer, it may be well to 

 briefly analyze from both standpoints the external conditions under 

 which this work is done. 



Institutions that make scientific appointments are presumably ready 

 to devote themselves in some measure to work of a purely research 

 character, the immediate practical realization of whose benefits is likely 

 to be a matter of more than ordinary good fortune. The creation of 

 such positions therefore implies in the administration a fair degree of 

 sympathy with scientific motives. Institutions inadequate to this de- 



