PRESIDENTIAL ADDRESS — SECTION F. 109 



charged, only a part recover altogether and can fight the battle 

 of life unsupported. Apart from the official and statistical 

 numbers there are undoubtedly not a few cases where the disease 

 never develops far enough or violently enough to warrant their 

 admission to an institution, but who, nevertheless, have to go 

 through the rest of their lives with impaired mental and economic 

 efficiency. 



It goes without saying that an entire, or even partial preven- 

 tion of this condition would be a tremendous boon to humanity. 

 But we have not attained this ideal yet, although our anatomical 

 and clinical knowledge has made great strides during the last 

 thirty years. There is evidence to show that a disturbance of 

 the function of one or more glands with internal secretion plays 

 some sort of role ; Mott has shown that far-reaching organic and 

 microscopic changes of the reproductive glands occur. Sub- 

 stances have been found circulating in the blood which suggest 

 that a demolishing process is at work in various organs and 

 tissues of the body (Fauser). The exciting agents, however, 

 which cause these organic changes we do not know. 



Again, in many cases it is evident that strong psychical 

 powers are in action, that fundamental conflicts have arisen with 

 which the individual is unable to cope and which cause the 

 psychotic upheaval. Some schools of psychopathology (Freud, 

 Jung) regard this disturbing action of certain conflicts and com- 

 plexes as the primary cause in most cases, and are of opinion that 

 the organic changes are only secondary and caused by the pro- 

 foundly disturbed function of the mind. To further dilate on 

 these different views would carry me too far afield. It is sad to 

 relate that cures. are few and that with regard to preventing this 

 condition we are also still groping in the dark. We can ill 

 afford to rest contented with this state of affairs. All over the 

 world numerous investigators are endeavouring to find at least 

 the beginnings of the solutions of the problems that are waiting 

 for elucidation. In our country very little has been done so far 

 in this particular direction. There is no reason to believe that 

 the field here would be less fruitful than in other countries. On 

 the contrary, it is not at all unlikely that the study of psychoses 

 as they occur in our primitive races (W. Eussell found roughly 

 oiie-third of the inmates of the native mental hospital at Pretoria 

 to be suffering from dementia prsecox) would yield valuable keys 

 to the solution of the more complicated problems as they present 

 themselves in white people. 



I now come to the " functional " mental disorders, or. as 

 they also have been called, the " germ-psychoses." As I have 

 already said, with these we do not find microscopic changes of 

 the brain cells : neither do they lead to a terminal dementia (un- 

 less some other process occurs which has nothing actually to do 

 with the psychosis itself). Also, there is a pronounced tendency 

 towards recovery of individual attacks, but these attacks are 

 liable to recur. Then there is this feature : many symptoms 

 which are observed in this group are much more plausible and 

 understandable to the untrained onlooker than so many of the 



