PRESIDENTIAL ADDRESS — SECTION F. 105 



REMARKS ON CERTAIN MENTAL DISORDERS WHICH 

 MAY BE REGAR,DED AS PREVENTABLE. 



BY 



J. Marius Moll, M.D. 



Presidential Address to Section F, delivered July 13, 1922. 



Few diseases cause more distress and unhappiness to the 

 patient and to his friends than mental diseases. No other dis- 

 orders affect to such a great extent the social and economic 

 efficiency of the sufferer. And no other class of patient, after he 

 has got better, is branded with the stigma which attaches itself — 

 tliough verjr unjustly — -to many a recovered inmate of a mental 

 hospital. Also, if a person recovers from a mental illness, this 

 recovery, unfortunately, is often not total nor lasting. There- 

 fore, in no other kind of ailment would prevention be more 

 desirable and of greater importance to the individual as well as 

 to the community. 



In this address I propose to give a short survey of certain 

 important kinds of mental disorder which are, or which we are 

 learning to regard as, preventable ; and to discuss shortly the lines 

 along which tliis prevention lies. 



The possibilities of preventing disease naturally increase 

 with our knowledge of the etiology. It is not always necessary 

 to know all the details of causation, as long as we know certain 

 factors, e.g., we are still ignorant of the micro-organism which 

 causes smallpox. Notwithstanding this, the methods of prevent- 

 ing the occuiTence of this condition have developed to such a 

 degree, that it has became a rare exception amongst civilised 

 people. Now, what do we know of the etiology of the various 

 psychoses? With regard to some we know a good deal; especi- 

 ally during the last twenty-five years our knowledge has increased 

 and deepened. But with respect to others there are still many 

 important points about which we are totally ignorant. 



Jelgersma divides the mental disorders into two main groups, 

 the " intoxication-" and the " germ "-psychoses. Those of the 

 first group are caused by an intoxicating agent, a poison in the 

 widest sense; it is either introduced from without, or can also be 

 produced inside the body itself. These psychoses, if their course 

 is not checked, lead to stinictural changes of the brain (demon- 

 strable under the microscope) and end in a terminal dementia 

 or disintegration of the personality. In the second group which 

 has also been called ." functional psychoses " there is no etio- 

 logical poison, no microscopic alteration of brain-cells and no 

 lementia. Although this system is open to criticism on some 

 points, its basic principles have much to commend themselves. 



