REVIEWS 507 



over 40,000 persons engaged in the service of their country have suffered 

 from some form of mental breakdown during the period of the war. 



The author is a firm behever in the psycho-genetic origin of mental diseases, 

 and is a follower of Freud. He asserts that mental conflict is at the root 

 of all the psychoses : in civil life he states that this conflict centres round the 

 sexual instinct, whilst in warfare it arises out of the instinct of self-preserva- 

 tion, and his terminology is that of his master ; he refers to the human 

 '' psyche " as the equivalent to the human mind, presumably because the term 

 " psychology," usually accepted as investigating the contents of conscious- 

 ness, is not wide enough to cover the tendencies of the unconscious mind. 

 The author suggests that fear " in disguise " acts as a stimulation to some 

 persons, but we are inclined to think it is the instinct of curiosity, and not 

 fear, that is at the root of adventure, as Alpine climbers well know, and 

 that this instinct may even dominate that of self-preservation. The " herd 

 instinct " is no new discovery, and the " crowd " psychology or the " col- 

 lective will power " has always been regarded as an important factor by 

 military commanders ; indeed. Napoleon attributed much of his military 

 success to the " resultant thought wave." The author appears to suggest 

 that " patriotism" entered largely into the motive for joining up and con- 

 scription ; but the sentiment of patriotism is a complex and not a simple 

 emotion, and is a disposition or tendency roused by an idea which forms 

 a part of our conceptual system, although the panoply of war, the ritual, 

 the justice of our cause as tested by our standard of good or truth, helped 

 to kindle it. 



Coming to the record of experience, Dr. Read finds no place for " ex- 

 haustion psychosis." He states, "it is not a factor to be reckoned with in 

 the production of the psychoses," and yet (p. 143) he admits it is a " con- 

 tributory factor, and will materially aid the psychic elements at work." 

 He regards Dementia precox to be of psycho-genetic origin, and he includes 

 this in the category of the functional psychoses. He deems those who 

 difier from him to be " superficial" and " shallow," and "those whose 

 materiahstic outlook prevented them from seeing their psychic origin." 

 His views as to the alcoholic origin of the psychoses lead him to differ 

 materially from those of other observers, inasmuch as he attributes a per- 

 centage of origin of 1-5 to this cause as against 8-5 per cent, recorded by 

 Eager. He deprecates a " label "upon his cases, and uses a terminology 

 of his own in classification, with the result that his statistics cannot be 

 brought into any informing conclusion when compared with those of others 

 who employ an accepted nosology. It is also difficult to follow his tables, 

 as in the classification he shows 3,116 cases, in Table IV he refers to 3,453, 

 whereas he admittedly deals with the 3,000, the original numbers presented 

 for analysis. The author uses the term " psycho-pathic inferiority " to 

 imply what is generally accepted as congenital mental deficiency, and the 

 term " affect " to imply emotional disposition. 



He concludes an original and informing treatise by a plea for the use of 

 " restraint" in the treatment of mental diseases, in "suitable cases"; but 

 the difficulty is the one shown in the thesis — viz., that there may be a ^vide 

 divergence of opinion as to " suitability," with the result that an inevitable 

 lapse into indiscriminate mechanical control of the mentally afflicted is 

 bound to reappear, with all the intolerance of an unsympathetic treatment. 

 It is just to the author to state that he has read widely and culled from the 

 experience of others before expressing his own conclusions, which, as may 

 be inferred, deal especially with the application of Freudian psychology to 

 the origin of mental diseases. Apart from some misprints — "casual" for 

 "causal" (p. 29), and " dredging" for " deluging" (p. 162) — and the use 

 of the split infinitive, the work is an interesting contribution to the study 

 of psychiatry. Robert Armstrong-Jones, M.D. 



